Quality improvement.
The discussion essay outlines the effective leadership approach that health care professionals can use to implement a successful quality improvement project that improves the services provided to the patients within the clinical facility. It outlines the role of quality improvement projects in changing systems within the clinical areas. In health care, practice quality improvement(QI) is the framework that guides the systematic improvement of ways through which care is provided to the patients(AHRQ,2013). It is mainly defined by processes that are analysed, measured, and controlled with constant efforts to achieve consistent results and outcomes. Quality improvement is beneficial to the patients and the health organisation since by providing quality healthcare, mortality cases are reduced. Quality improvement is an organisational effort whereby every health practitioner is involved due to commitment and directions from the top management. Therefore, quality improvement is systems-focused, peer-review valued associated with teamwork where errors are considered opportunities for learning and improvement. Quality improvement interventions are guided by the organisation’s leadership, who must cooperate with the workers and give initiatives and evaluate these initiatives to achieve the objective.
Leadership in Quality Improvement.
Leadership is an essential factor in quality improvement projects. According to (The King’s Fund, 2015), leadership ensures alignment commitment and gives directions within the teams. The direction provides the agreement and pride between the workers in achieving what the organisation is targeting regarding vision and strategy. They align the workers to ensure coordination and integration in work productivity. The leader also motivates the health care workers to take responsibility for their actions to achieve the overall goal rather than focusing on individual success.
Importance of Leadership.
Quality improvement projects require effective leadership who consistently assures that compassionate, high-quality health care is the top priority. The leaders ensure that the patients’ experience, concerns, and feedback, whether good or bad, are attended to. Suitable leaders for change interventions in health care offer supportive, compassionate, fair, and respectful leadership, which develops all nurses’ participation and involvement (The King’s Fund, 2015)t. The leaders motivate their workers, encourage them and provide practical support to guide innovations within the clinical area (The King’s Fund, 2015). Leaders motivated towards quality improvement ensure every worker is aware of their responsibility. They promote transparency where workers can explain their errors and mistakes since they consider errors as learning opportunities. Suitable leaders for quality improvement develop their employees’ skills and knowledge and consistently reward employees who develop new and improved ways for quality health care (The King’s Fund, 2015). Leaders form the backbone of every improvement initiative by providing unity of purpose and a sense of direction in the workplace. Several changes in leadership and leadership management structures are significant to ensure that quality improvement desired by everyone is achieved in the hospital industry (Vaughn et al., 2006). The paper focuses on the following QI project and leadership approach.
Quality Improvement Project.
Improving health care quality and systems has been the recent focus in the nursing field. Through quality improvement, the health care facilities can reduce healthcare costs and improve efficiency to have better patient outcomes. The quality improvement consists of safety and risk management measures. Over the years, quality efforts have been considered the individual responsibility of nurses. Nowadays, hospitals have acknowledged that human is to err and that these mistakes are learning opportunities and processes for improvement (Gagnon, 2021). Human error is inevitable even to the most conscientious nurses and doctors hence the need to develop systems that analyse the medical process guided by advanced technologies that influence data-driven decision making (Gagnon, 2021). The paper considers the quality improvement project of innovating the care system and the microunits to come up with flexible ways to administer patient care can be administered through the analytical process of reviewing the patient’s historical records and medication processes. One of the most common factors affecting patient outcomes is medical errors. Therefore, providers should be provided with education on quality improvement methods. The management should participate in giving them skills, knowledge, time, resources, and permission to professional making the mistakes.
Relation between leadership and quality improvement.
Scholars (Vaughn et al., 2006) engaged in an investigative study to determine effective leadership involvement in quality care improvement. The study aimed to collect data using short surveys in 8 hospitals to identify the characteristics of effective leadership in QI. This study showed that the hospital spent a quarter of its time on quality cases, showcasing a high standard of interaction with the medical team on a quality strategy involving receiving quality reports daily. Results further indicated that the chief executive has a high effect on quality improvement (Vaughn et al., 2006). In another survey to determine the extent to which the board interacts with practitioners for higher quality improvement, 84% of the respondents said that there was a greater amount of interaction from the hospital board (Vaughn et al., 2006). Leadership in quality improvement is defined as the relationship between the person who leads and those who take the action of following the directives given. Management and leadership are important in strengthening the quality of health care. Doctors and nurses have a positive experience in quality improvement are managed and coordinated under an effective leadership approach. For quality improvement interventions to become successful, effective management practice is required. According to (Drew and Pandit, 2020), working on the QI project is challenged by needing the necessary time and permission to make the changes individually. Therefore the traditional hierarchical structures in healthcare leaders need to be reconsidered. Most senior organisation leaders have the challenge of shifting their responsibility of being accountable for every action ot one that is inclusive, collaborative, and compassionate (Drew and Pandit, 2020). The leadership approach accepts employees’ errors and motivates them to perform better. Through the relationship, transformational and transactional leadership approaches were outlined as suitable for the quality improvement project. The next section discusses the leadership approaches and implementation strategies for the project.
LEADERSHIP APPROACHES.
Transformational leadership.
According to (Sfantou et al., 2017), leadership is the style of coordinating and directing activities of a team towards achieving a common objective. The scholar identifies six leadership styles associated with quality improvement: transformational leadership, transactional leadership, laissez-faire leadership, and task-oriented leadership. An effective leadership style fosters a positive work environment that can guarantee improved patient outcomes. Failure in leadership leads to deteriorated patient care services which likely end up in mortality or losses to the health organisation. According to (Sfantou et al., 2017), transformational leadership is defined by creating worker relationships and motivating nurses. They can inspire confidence within the workplace through a shared vision that encourages the staff, increasing their morale, productivity, and job satisfaction. Job satisfaction is highly associated with an increase in productivity.
A transformational leader is a hands-on leader who participates in working together with the team. He allows the team members to contribute to crucial workplace developments and listen to their concerns. A transformational leader motivates employees to perform at their best by providing the workers with the resources and skills to achieve a particular objective (Morales, 2020). In a work situation, transformational leaders allow decision-making by the whole team to improve one’s performance (Morales, 2020). They have idealized influence over their employees’ performance (Collins et al., 2019). They believe that a worker will get the motivation to perform better if they are allowed to actively participate and design initiatives within the organisation. A transformational leader listens to every group member’s concerns and provides emotional support since they believe that the welfare of their employees matters a lot when it comes to delivering quality work (Collins et al., 2019). Transformational leaders are suitable leaders to guide interventions and change programs within health care facilities. They can reform practices within institutions to attain a predefined objective (Sherman, 2018). They are critical initiators of change within the institutions they manage. There are many reasons why quality improvement programs fail: the reluctance of medical staff to adapt to change and the lack of engagement between the workers and the leaders. However, clinicians who assume leadership responsibilities that promote quality try to overcome these barriers. One way is to adopt a leadership style that is inclusive and attends to the needs of care providers (Kumar, 2013). According to an evidence review done by (Weberg, 2010), the results showed the impact of transformational leadership in improving health care systems is related to increased job satisfaction, increased well-being of the staff, and decreased stress of the medical staff. Increased job satisfaction, well-being, and reduced stress are essential contributions to the effectiveness of the quality improvement programs since most human error is caused by stress, anxiety, and cooperation. Poor communication among workers is also a high factor for human error in healthcare (Carrie, 2018). Therefore by fostering communication and collaboration between the team members, these errors can be significantly reduced. According to (Drew and Pandit, 2020), Quality improvement depends on motivating and inspiring care teams and providing them with the knowledge and techniques they need to enhance care pathways. It entails supporting health providers’ knowledge and judgment about what patients require and empowering them to make judgments, including resource allocation, with relevant accountability. These dependencies are related to transformational leadership, providing conceptual evidence that the leadership approach is a guiding factor for quality improvement projects.
Implementation of the transformational leadership style in the QI project.
The quality improvement project is reducing medical errors by practitioners. One way to reduce medical errors is by determining the factors that cause these errors. Minimizing the mistakes requires innovation and improved methods combined with technology to retrieve medical and patient records. Therefore the transformational leader needs to analyse these causes and reform them. As a quality supervisor in my organisation, I have identified the transformational approach as one way to implement reforms targeted at quality improvement.
I work closely with a team of five nurses as my junior quality supervisors, where we have formed groups among the nurses and doctors that coordinate and provide quality reports. Being a senior leader in the organisation, I understand that I need to be a role model in the organisation since my behavior amplifies to the workers since staff will judge important actions by observing what leaders do and not what they say (Drew and Pandit, 2020). The implementation strategy of the leadership approach will rely on the Deming 14 point philosophy for total quality improvement. The total quality improvement characteristics align with the goal of a transformational leader. Some of its characteristics are linkage to critical elements of the organisation strategic plan, quality council with members from senior positions of leadership, training schedules for the medical staff, staff support for process analysis, and policies that encourage the medical staff (McLaughlin and Kaluzny, 2004). Deming’s point applies to any type of the business since even service industries need to improve quality, just like manufacturing industries (Neave, 1987). The philosophy applies to all department divisions (Neave, 1987).
Implementation strategy.
Creating a constant purpose toward improvement.
The strategy will involve considering long-term planning within the team members. As a transformational leader, I will work to create long-term goals for the team and encourage them to do better. The approach will help reform systems and microunits within the clinical area to improve patient outcomes.
Adoption of the new strategies.
Transformational leaders are associated with implementing new strategies and philosophies within the organisation. I will encourage the employees to learn new skills that fit in with the new change model. It involves providing them with the necessary resources and new information. Rather than working under competitive pressure, the process will involve cooperating with the medical staff to prioritise their clients’ needs and design services to satisfy those requirements. They should be prepared for how the operations are shifting and allow for new changes.
Reduction of inspections.
Inspections of quality in the clinical facility are costly and time-wasting; therefore, we will implement the use of service-user feedback and observation. Reducing inspection will reduce variation in medical processes, minimising errors (Hughes, 2018). Instead of using a physical process for inspection, the approach will integrate a statistical process that reviews records of treatment and patient’s illness (Hughes, 2018). Being a transformational leader, I will not focus on who did wrong; instead, the focus will be on how to eliminate the error as a team. Through this, the medical staff will realise errors as learning opportunities; therefore, they will be motivated to be transparent and responsible.
Institute training at the job.
A transformative leader initiates reforms by building new and improved ways in the organisation. Therefore, I will create training programs that give the medical team skills in analysing patient records using electrical medical records systems to store patient information data. The training will also involve providing new information regarding reforms and how to implement them at a personal level. Through training, the medical staff will gain consistency that helps minimise errors. It emphasises learning and improvement of skills so that everyone can perform better. Through training, the medical staff will be challenged to learn from one another and provide a positive environment for teamwork.
Implementing leadership.
Transformational leaders are collaborative and inclusive. I will improve in collaborating with the team members on delivering quality (Hart et al., 2015). The strategy involves providing the support and resources for the medical staff to build on their skills. It will include coaching the medical staff to reach their full potential (Hart et al., 2015). I will interact with the teams during work to determine the strengths and weaknesses of each staff and learn how to develop them into conscientious professionals.
Eliminating fear.
Many healthcare professionals fear making mistakes. Fear impacts quality improvement negatively (Bugdol, 2020). The strategy will help drive out fear so that the medical staff can be transparent after making mistakes. The approach will involve leadership that aims to develop professionals and not blame them for mistakes. Instead, they will be coached to perform better. The staff will be briefed on preventive measures for mistakes through group discussions. The strategy will allow communication between higher levels of leadership management to junior staff. It will allow the staff to express their ideas and concerns without fear and maintain an approachable leadership style (Bugdol, 2020). Encouraging workers to express their ideas motivates innovation throughout the team since every member will take pride in initiating interventions.
Barriers and enablers to change in the leadership approach.
Quality improvement projects are enabled and challenged by some factors in the organisation. The health care facilities involve a broad management structure with different values and opinions. Some leaders within the organisation may feel inferior working with the medical staff (Page, 2011). Autocratic leaders who prefer ruling to leadership may overrule the idea of collaborating with the junior medical staff. The hospital board may have wrong perceptions about the change system and collaborative leadership. They may feel like enforcing these changes may cost the hospital more funds, reducing profitability. Health care providers who admit their errors and mistakes risk firing and terminating their medical licenses. Therefore they will fear admitting to their mistakes. However, good leaders need to convince the leadership of the leadership style. There should be ways to convince the management board to be on board with the reforms by stating the interventions’ long-term goals and future value (Page, 2011). Transformational leaders have to develop interventions that are budgeted and cost-effective. The interventions need to be driven by value for money addition. The initiative of collaborating with the workers needs to be a personal initiative by the leader before implementing it as an organisational policy and culture (Page, 2011). The implementation strategies need to be fact-checked and tested before full implementation to reduce the risks.
Researchers conducted a study to investigate transformational leadership style and the barriers of application in the medical practice provided by first-line nurses. The study identified fourteen barriers to the leadership approach, the major being a weak awareness of the approach in healthcare organisations (Abdulsalam, Rajab, and El Seesy, 2018). The first challenge identified was a lack of awareness of transformational leadership in medical practice. The second barrier to the approach was the staff’s poor training and lack of self-development goals in implementing the approach practices. The study highlighted another barrier associated with work stress and multiple job burdens. The leader is concerned with many managerial roles that affect collaboration with the team. Fear of loss of power was pointed out as a barrier where most managers fear that respect accorded by the staff will reduce. The barrier is associated with the preference for traditional administrative styles among health workers. The nursing career is complex where they need to attend to the patients full-time; therefore, the time to offer training and coaching is unavailable. The barrier limits the efficiency of the leadership approach.
Conclusions.
Quality improvement initiatives are essential factors for the improvement of health care facilities. Leaders are required to take the initiative step and align the staff towards quality improvement by giving directives and collaborating with the rest f the staff. The approach will involve using transformational leadership styles to manage the reforms. Minimizing medical errors can be achieved through the approach of transformational leadership; however, leaders need to consider the barriers associated with the strategies. The systems change needs to implement service user involvement and co-production where patients participate in offering services. The approach will mainly depend on the patients’ feedback to implement these changes.
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