Clinical Leadership And Management Assignment Papers.
In general terms; management is the process of planning that ensures smooth operation of the organization whereas leadership is the quality or act of leading herd of people in order to meet the organizational objectives. In case of science, Clinical Management and leadership programs aim to prepare individual for managers and leaders for systematic and better functioning of the clinical system.Clinical Leadership And Management Assignment Papers.
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The terms leadership and management are used interchangeably but have some important differences. Leadership means to generate the passion to reach at the certain level or motive a group of people to achieve success whereas management aims to provide steps or process to reach that certain level.Clinical Leadership And Management Assignment Papers.
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Doctors or health care professionals are no more involved only as a clinical expert rather clinical management and leadership skills have become one of the integral elements of practice and learning for medical students. This chapter in medical professionals is important in theoretical or practical points for delivering high quality health care service to individuals. Just like in any other field, there are certain domains important for developing leadership skills in a medical professional. Some of them are: demonstrating individual qualities, working as a team, managing health services, bringing improvement in health services and establishing a correct direction.Clinical Leadership And Management Assignment Papers.
Clinical leadership and management assignment help
In most part of the world, most of the health centers lack proper manpower, clinical equipments, increasing demand for care, and other issues related to health and safety. Therefore the demand of quality health service is increasing day after day. From inspections and certain researches; it has been found out that proper leadership and management process in clinical health is critical for integrity and proper functioning of the clinical system. Developing the skill of clinical leadership in doctors and other medical representative is of utmost important.Clinical Leadership And Management Assignment Papers.
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With extensive study the course and curriculum will slowly get rigid. It is therefore important to set up a good foundation for medical students to grab the extensive knowledge on this topic. If students are facing any problem with this recently introduced topic; they can easily get in touch with online tutors for required help. Help on Clinical management and leadership assignment, project, thesis, dissertation and more is provided to students at a very affordable price by the online tutor of this company. This online company is reachable 24/7 of the day, so students can contact the online helper anytime.Clinical Leadership And Management Assignment Papers.
The UK Clinical Leadership and Management Bachelor of Health Sciences degree lays the groundwork for graduates to pursue graduate education and careers as competent, evidence-informed, effective leaders and life-long learners prepared to engage in ethical and interprofessional healthcare management practice. Graduates develop fundamental knowledge, values, and skills to lead with cultural humility and promote compassionate, efficient, responsive services to improve healthcare outcomes, the patient experience, access to healthcare, and quality of life for people in the Commonwealth of Kentucky and beyond.Clinical Leadership And Management Assignment Papers.
Undergraduate Certificate in Clinical Healthcare Management
This undergraduate certificate is open to any currently enrolled UK student. The certificate is a good fit for those interested in obtaining the clinical management and leadership skills necessary for a health care management position, as well as practicing professionals, such as nurses, physicians, dentists, and others, who want to advance their careers and leadership potential.
The major goal of this program is to provide a baccalaureate degree program of study in Clinical Leadership and Management that will enable associate degree trained health care professionals with work experience (Track A) and freshman entry level students (Track B) to assume leadership and managerial positions in various health care settings.
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There are currently 4,130 jobs for healthcare managers in Kentucky and this is projected to grow by 20% to about 4,970 jobs by 2016. This is better than the national trend for healthcare managers, which sees this job pool growing by about 16.0% over the next eight years. In general, healthcare managers plan, direct, or coordinate medicine and health services in hospitals, clinics, managed care organizations, public health agencies, or similar organizations.
Students who graduate from the Clinical Leadership and Management Program are marketable in management positions of healthcare enterprises, able to assume greater responsibilities at their current jobs, more qualified for job promotions within their facility and may continue their studies at a graduate level. The CLM program provides for a more educated allied health care professional workforce for Kentucky communities (and beyond) and their patients, in turn, will be better served.Clinical Leadership And Management Assignment Papers.
The curriculum for the Clinical leadership and Management Program has been reviewed by the Kentucky Board of Licensure for Nursing Home Administrators and designated as meeting the academic requirements needed to sit for this examination. Those students, who have had the proper experience, need not complete an Administrator in Training (AIT) experience as a requirement. For those students that need to complete an AIT, the CLM program offers a practicum course with course credit awarded.
I knew before that these professionals were involved with planning in the healthcare facilities, but I had no idea of how intense the planning processes were. Healthcare administrators may spend years on the same quality improvement project before finalizing the change they hope to make.Clinical Leadership And Management Assignment Papers.
Junior, Clinical Leadership & Management
Classes & Requirements
What You’ll Study
A sample of some courses you would take:
CLM 241 Health and Med Care Delivery Systems3CLM 350 Health Policy And Politics3CLM 405 Epidemiology And Biostatistics3CLM 351 Health Services Administration3CLM 354 Health Law3CLM 355 Financial Management Of Healthcare Institutions3CLM 452 Community & Institutional Planning For Health Services3CLM 444 Leadership & Human Resource Management3CLM 445 Quality & Productivity Improvement &Evaluation3CLM 353 Ethics In Healthcare2
UK Core Requirements
Graduation Composition and Communication Requirement
CIS/WRD 110 Composition and Communication 1
CIS/WRD 111 Composition and Communication 2
PSY 100 General Psychology
HHS 101 Survey of Health Professions
HHS 102 Survey of Health Professions-Shadowing Experience
CLA 131 Medical Terminology
CLM 241 Health and Medical Care Delivery Systems
WRD 205 Intermediate Composition
Historical Major Sheets
Health Sciences Undecided/Exploratory Studies Option
Many university students will change their major or career goals at least once during their college years. To assist students in finding a health profession that meets personal interests and professional ambitions, College of Health Sciences has developed an Undecided/Exploratory Studies option for students who have yet to decide the specific program of study that most closely aligns both their interests and goals for becoming a professional in health care. The Health Sciences Undecided/Exploratory Studies option provides students with an educational environment that includes coursework and co-curricular programs to introduce students to a variety of health professionals, health care settings, and the unique opportunity to explore multiple working areas found on the medical campus during their first year in college. For more information or to inquire further, please contact firstname.lastname@example.org.
Effective clinical leadership is needed at every level and should not be left to one person. As noted by Taylor et al. (2013), ‘clinical leadership can sit within a range of roles across the interprofessional team and primary care nurses can be at the forefront of policy implementation and local innovation.’
Examples of leadership roles that sit at different levels within an organisation are sponsors (senior management) and clinical champions (primary care team). Having strong leadership from both a sponsor and a clinical champion ensures the project is being driven from multiple parts within an organisation and is not reliant on one person.
A sponsor is a senior leader within an organisation (such as a practice owner or business partner for a general practice team) who can provide the authority and decision-making influence necessary for successful change.
Year-on-year research by the Prosci team has identified active and visible executive sponsorship as the most critical contributor to successful change initiatives. (Prosci Change Management)
The following three roles are critical for a sponsor to fulfill:
Participate visibly throughout the project. Their sustained presence is necessary to build and maintain momentum for a change.
Communicate support and promote the change. Who delivers key messages is important within a team. Studies have shown senior leaders are the preferred senders of messages about the business reasons for change, as well as the risks or costs of not changing.
Build a coalition of sponsorship. Participants stated the need “for the primary sponsor to take a lead role in building and maintaining a healthy coalition of leaders who support the change.’
Read more about sponsors from the Prosci Change Management website
A clinical champion is someone within the primary care team who is enthusiastic and driven to get a project or change implemented. It may have been their idea or something they are passionate to support and they are often willing to go the extra mile to ensure the project’s success.
This person could be a GP or nurse who is passionate about a particular project and is able to be the key driver for the project on a day to day basis.Clinical Leadership And Management Assignment Papers.
To function well as a clinical champion they will; however, need the active support of the project sponsor described above.
Having an effective clinical champion ensures the project is integrated into everyday work for everybody. Without engaged leaders throughout the primary care team, it can be very difficult to change daily practice and achieve success.
A key to ensuring engaged leaders is taking the time to determine a common goal or vision. When determining a vision or goal it is also important to consider how you would measure success. The following questions may be helpful:Clinical Leadership And Management Assignment Papers.
“For our team to know this project has been successful, we will be doing ……. by …….”
“Our patients will be…..”
“We will have improved our results for …… by ………”
To receive a Baccalaureate Degree from the University of Kentucky in Clinical Leadership and Management, students are required to complete a minimum of 120 course credits which includes the major core curriculum, completion of the UK Core General Education coursework, and Graduation Composition and Communication requirement. It is advisable that prospective students for consideration in Track A, discuss transfer credits from their associate degree program with the CLM Academic Advisor in the College of Health Sciences Office of Student Affairs.Clinical Leadership And Management Assignment Papers.
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Visit the programme website for more information
There are currently 4,130 jobs for healthcare managers in Kentucky and this is projected to grow by 20% to about 4,970 jobs. This is better than the national trend for healthcare managers, which sees this job pool growing by about 16.0% over the next eight years. In general, healthcare managers plan, direct, or coordinate medicine and health services in hospitals, clinics, managed care organizations, public health agencies, or similar organizations.Clinical Leadership And Management Assignment Papers.
Students who graduate from the Clinical Leadership and Management program are marketable in management positions of healthcare enterprises, able to assume greater responsibilities at their current jobs, more qualified for job promotions within their facility and may continue their studies at a graduate level. The CLM program provides for a more educated allied health care professional workforce for Kentucky communities (and beyond) and their patients, in turn, will be better served.Clinical Leadership And Management Assignment Papers.
The curriculum for the Clinical leadership and Management program has been reviewed by the Kentucky Board of Licensure for Nursing Home Administrators and designated as meeting the academic requirements needed to sit for this examination. Those students, who have had the proper experience, do not need to complete an Administrator in Training (AIT) experience as a requirement. For those students that need to complete an AIT, the CLM program offers a practicum course with course credit awarded.Clinical Leadership And Management Assignment Papers.
Abstract: In many areas of the developed world, contemporary hospital care is confronted by workforce challenges, changing consumer expectations and demands, fiscal constraints, increasing demands for access to care, a mandate to improve patient centered care, and issues concerned with levels of quality and safety of health care. Effective governance is crucial to efforts to maximize effective management of care in the hospital setting. Emerging from this complex literature is the role of leadership in the clinical setting. The importance of effective clinical leadership in ensuring a high quality health care system that consistently provides safe and efficient care has been reiterated in the scholarly literature and in various government reports.Clinical Leadership And Management Assignment Papers. Recent inquiries, commissions, and reports have promoted clinician engagement and clinical leadership as critical to achieving and sustaining improvements to care quality and patient safety. In this discursive paper, we discuss clinical leadership in health care, consider published definitions of clinical leadership, synthesize the literature to describe the characteristics, qualities, or attributes required to be an effective clinical leader, consider clinical leadership in relation to hospital care, and discuss the facilitators and barriers to effective clinical leadership in the hospital sector. Despite the widespread recognition of the importance of effective clinical leadership to patient outcomes, there are some quite considerable barriers to participation in clinical leadership. Future strategies should aim to address these barriers so as to enhance the quality of clinical leadership in hospital care.Clinical Leadership And Management Assignment Papers.
Keywords: management, hospital care, barriers, leadership, clinical leadership, discursive paper
Globally, health care systems in the developed world continue to struggle with escalating demands for services and escalating costs. Service design inefficiencies, including outmoded models of care contribute to unsustainable funding demands.1 An example is the continuing practice in many settings to look to hospital emergency departments to provide what are essentially, primary health care services. Clinical Leadership And Management Assignment Papers. While some progress and reforms have been achieved, numerous experts point to the need for further system change if services are to be affordable and appropriate in the future.2 They note that
[…] further change is still needed, despite years of progress in the quality of health care around the world. This transformation will require leadership – and that leadership must come substantially from doctors and other clinicians, whether or not they play formal management roles. Clinicians not only make frontline decisions that determine the quality and efficiency of care but also have the technical knowledge to help make sound strategic choices about longer-term patterns of service delivery.2
Effective clinical leadership has been linked to a wide range of functions. It is a requirement of hospital care, including system performance, achievement of health reform objectives, timely care delivery, system integrity and efficiency, and is an integral component of the health care system.2–4 Though most people are provided with health care within the community setting, hospital care continues to garner the bulk of funding and attract considerable attention in relation to care quality and related concerns.Clinical Leadership And Management Assignment Papers. Indeed, hospitals are very costly and diverse environments that vary in size and complexity, determined in part by their overall role and function within the larger health care system. The services provided by individual hospitals are determined and driven by a number of mechanisms, including government policy, population demographics, and the politics and power of service providers.5
However, regardless of the differences, the clinical areas of the hospital are critical to all health care organizations, given that it is at this level where consumers principally engage with the hospital system.Clinical Leadership And Management Assignment Papers. It is at this point where consumers are recipients of hospital care and where they witness and experience how the system functions, observing the strengths and inefficiencies of the health care system and conflict and collegiality between and among groups of health professionals. It is also at this point that clinicians, defined as any frontline health care professionals, have opportunities to fulfill leadership roles. For consumers of health care to achieve optimal health outcomes and experience optimal hospital care, many believe effective clinical leadership is essential.Clinical Leadership And Management Assignment Papers.
In this paper, we discuss clinical leadership in contemporary health care, definitional issues in clinical leadership, roles of hospitals in contemporary health care, preparation for clinical leadership roles, and the facilitators and barriers to effective clinical leadership in the hospital sector.Clinical Leadership And Management Assignment Papers.
Clinical leadership in contemporary health care
The importance of effective clinical leadership in ensuring a high quality health care system that consistently provides safe and efficient care has been reiterated in the scholarly literature and various government reports.6–8 Recent inquiries, commissions, and reports have promoted clinician engagement and clinical leadership as critical to improving quality and safety.9 As one Australian example, a key priority nursing recommendation of the Garling Report was that Nurse Unit Manager (NUM) positions be reviewed and significantly redesigned “to enable the NUM to undertake clinical leadership in the supervision of patients […] to ensure that for at least 70% of the NUM’s time is applied to clinical duties.”8 The remaining time could be spent on administrative and management tasks. Clinical Leadership And Management Assignment Papers. In the more recent Francis report7 from the UK, a recommendation was made for similarly positioned ward nurse managers to be more involved in clinical leadership in their ward areas. In the United States, clinical leadership has also been identified as a key driver of health service performance, with the Committee on Quality of Healthcare suggesting considerable improvements in quality can only be achieved by actively engaging clinicians and patients in the reform process.Clinical Leadership And Management Assignment Papers. 10
However, leadership in health care is often very complex, and some authors claim it faces unique contextual challenges. For example, Schyve5 claims aspects of governance are sui generis in health care, noting
healthcare organizations also have a rather unique characteristic. That is, the chief executive is not the only part of the organization’s leadership that is directly accountable to the governing body. In healthcare, because of the unique professional and legal role of licensed independent practitioners within the organization, the organized licensed independent practitioners – in hospitals, the medical staff – are also directly accountable to the governing body for the care provided.Clinical Leadership And Management Assignment Papers. So the governing body has the overall responsibility for the quality and safety of care, and has an oversight role in integrating the responsibilities and work of its medical staff, chief executive, and other senior managers into a system that that achieves the goals of safe, high-quality care, financial sustainability, community service, and ethical behaviour. This is also the reason that all three leadership groups – the governing body, chief executive and senior managers, and leaders of medical staff – must collaborate if these goals are to be achieved (Schyve 2009:35).5
While nursing is not specifically named in the above quote, we believe nursing to be implicit and integral to leadership in hospitals. There is recognition of the challenges associated with health care governance, evidenced by significant investment internationally in building systems for leadership development in health care.5,11 For example, the UK advanced leadership programs have been instituted and run for clinical leaders since 2001 by the National Health System Leadership Centre,12 and there are some similar innovations in other countries (see, for example, Ferguson et al13).Clinical Leadership And Management Assignment Papers. This points to the realization that the cost and consequences of poor clinical leadership greatly outweigh the costs and potential benefits of provision of formal programs to enhance clinical leadership capacity ideally in a multidisciplinary health care team context.12
Indeed, across the health care sector, evidence exists of the need for clinical leadership to optimize care delivery. In addition to challenges associated with resources and demand, episodes of poor patient outcomes, cultures of poor care, and a range of workplace difficulties have been associated with poor clinical leadership,8,9,14 and these concerns have provided the impetus to examine clinical leadership more closely.Clinical Leadership And Management Assignment Papers.
Definitional issues in clinical leadership
Within the health care system, it has been acknowledged that clinical leadership is not the exclusive domain of any particular professional group.15 Rather, all members of the health care team are identified as potential leaders.16 Like “leadership,” the concept of clinical leadership can be defined in a range of ways; and while a standard definition of clinical leadership providing absolute agreement on meaning is not crucial to progress and is likely to prove difficult,17 it is useful to consider the various ways clinical leadership is conceptualized and presented in the literature.Clinical Leadership And Management Assignment Papers. While effective clinical leadership has been offered up as a way of ensuring optimal care and overcoming the problems of the clinical workplace, a standard definition of what defines effective clinical leadership remains elusive.15,18 Indeed, in some ways it is easier to consider what constitutes poor or ineffective clinical leadership.Clinical Leadership And Management Assignment Papers.
A secondary analysis of studies exploring organizational wrongdoing in hospitals highlighted the nature of ineffectual leadership in the clinical environment. The focus of the analysis was on clinical nurse leader responses to nurses raising concerns. Three forms of avoidant leadership were identified:Clinical Leadership And Management Assignment Papers.
placating avoidance, where leaders affirmed concerns but abstained from action; equivocal avoidance, where leaders were ambivalent in their response; and hostile avoidance, where the failure of leaders to address concerns escalated hostility towards the complainant.14
These forms of leadership failure were all associated with negative organizational outcomes. Similarly, McKee et al employed interviews, surveys, and ethnographic case studies to assess the state of quality practice in the National Health Service (NHS); they report that one of the most important insurances against failures such as those seen in the Mid-Staffordshire NHS Trust Foundation is active and engaged leaders at all levels in the system.14,19
Despite the definitional uncertainty, a number of writers have sought to describe the characteristics, qualities, or attributes required to be an effective clinical leader. Synthesis of the literature suggests clinical leadership may be framed variously – as situational, as skill driven, as value driven, as vision driven, as collective, co-produced, involving exchange relationships, and as boundary spanning (see Table 1).Clinical Leadership And Management Assignment Papers. Effective clinical leaders have been characterized as having advocacy skills and the ability to affect change.20,21 As well, effective clinical leaders have been linked to facilitating and maintaining healthier workplaces,22,23 by driving cultural change among all health professionals in the workplace.24 To achieve these positive outcomes, clinical leaders need to be seen as credible – that is, be recognized by colleagues as having clinical competence18,25–27 and have the skills and capacity to effectively support and communicate with members of multidisciplinary clinical teams.18,25 Taking an individual perspective, effective clinical leaders require personal qualities that reflect positive attitudes toward their own profession, have the courage and capacity to challenge the status quo, effectively address care quality issues, and engage in reflective practice.18,14 Pepin et al found that clinical competence, the capacity to lead a team, and being prepared to challenge the status quo were necessary skills for clinical leaders in one Canadian study.28 In an Australian study, findings indicated that student nurses want clinical leadership attributes from their clinical preceptors to include being supportive, approachable, and motivating, while being effective communicators.29 Table 1 summarizes the characteristics of clinical leadership and the attributes of clinical leaders distilled from the literature.Clinical Leadership And Management Assignment Papers.
Table 1 The characteristics of clinical leadership and the attributes of clinical leaders
Notes: Table distilled from: Clark 2012;31 De Casterle et al 2008;47 Edmonton 2009;11 McKeon et al 2009;73 Stanley 2012;32 Patrick et al 2011;34 McKee et al 2013.19
Despite acknowledging the lack of a standard definition of clinical leadership, the authors in one literature review identified common themes:Clinical Leadership And Management Assignment Papers.
[…] the ability to influence peers to act and enable clinical performance; provide peers with support and motivation; play a role in enacting organizational strategic direction; challenge processes; and to possess the ability to drive and implement the vision of delivering safety in healthcare.30
Many articles assert that clinical leadership is leadership provided by clinicians often recognized as clinical leaders. Indeed, an important driver of the move toward models of clinical leadership is the notion that clinical leaders “are the custodians of the processes and micro-systems of health care.”31 Stanley has contributed a summary of seven clinical leadership characteristics which includes factors such as expertise, direct involvement in patient care, high level interpersonal and motivational skills, commitment to high quality practice, and empowerment of others.32 In contrast to managerial leadership, which operates through hierarchical superior–subordinate organizational relationships, clinical leadership has a collegiate orientation and a focus upon the patient or service interface.Clinical Leadership And Management Assignment Papers. 11 While some clinical leaders may hold positions of positional authority, primarily the influence of clinical leaders stems from characteristics such as clinical credibility and the capacity for collaboration. While transformational leadership positions the leader as a charismatic shaper of followers,33 clinical leadership is more patient centered and emphasizes collective and collaborative behaviors.19,32,34
It is apparent that the “theory” of clinical leadership is in an early stage of development, and like leadership in general, in health there is very limited empirical support for specific approaches to enacting effective models. Edmonstone notes following the implementation of numerous clinical leadership programs in the UK the little research undertaken has largely focused on program evaluation, rather than the nature or outcomes of clinical leadership.35 As the body of evidence continues to develop, some definitional clarity may be achieved.Clinical Leadership And Management Assignment Papers.
Role of hospitals in contemporary health care
Globally, hospitals are under increased strain and scrutiny. Increased demands and fiscal pressures have increased the pressures on all health professionals as well as clinical and non-clinical staff. Hospitals, once seen as representing “health care,” are now recognized as dangerous places, particularly where the most vulnerable, such as children and older people, are exposed to the risk and actual adverse clinical events. A number of nationally and internationally influential reports6–8 have resulted in changes in visibility, scrutiny, and accountability in relation to hospital care.Clinical Leadership And Management Assignment Papers. This scrutiny has increased the emphasis on the role of health professionals, including nurses, in monitoring standards, developing and evaluating better ways of working as well as advocating for patients and their families; and led to a substantial momentum in the quality and safety agenda, including the promotion of various strategies such as promoting evidence-based practice.Clinical Leadership And Management Assignment Papers.
In the hospital sector, the demands placed upon leaders have become more complex, and the need for different forms of leadership is increasingly evident. To derive cost efficiency and improve productivity, there has been intense reorganization. Coupled with these reforms has been increasing attention upon improving safety and quality, with programs instituted to move attention beyond singular patient–clinician interpretations of safety toward addressing organizational systems and issues of culture.Clinical Leadership And Management Assignment Papers. 36 Arising from these reforms has been growing recognition that many assumptions of common leadership models are not well suited to delivering change at the point-of-care delivery or to assuring increased clinician and patient engagement in decision making.3 Accordingly, there have been calls for a transition to a new phase of hospital leadership, one that places the clinical frontline and clinicians as crucial to leadership within organizations.13,37 This transformational shift in the conceptualization of leadership has seen debate move from managerial, senior leader, or singular leader interpretations of leadership to a focus upon clinical leaders and clinical leadership.Clinical Leadership And Management Assignment Papers. In part, this shift has been in response to growing recognition that while designated leaders in positions of formal authority within hospitals play a key role in administration and espousing values and mission, such leaders are limited in their capacity to reshape fundamental features of clinical practice or ensure change at the frontline.11
There is considerable evidence to suggest nurses may experience dissatisfaction with the working environment in hospitals,38 with poor work environments impacting negatively on the delivery of clinical care and patient outcomes.Clinical Leadership And Management Assignment Papers. 39 In seeking to understand this dissatisfaction, work engagement among nurses and other health professionals has been explored from the perspective of burnout and emotional exhaustion40–42 with work engagement conceptualized as a positive emotional state in which employees are emotionally connected to the work roles.43 While such studies have examined engagement with work from an emotional perspective, engagement can also be understood as a broader concept that includes an employee’s relationship with their professional role and the broader organization.44 This broader view on employee engagement ties in with the concept of organizational citizenship behavior, which captures discretionary behaviors that are not formally rewarded within the organization that help others, or are displays of organizational loyalty or civic virtue.Clinical Leadership And Management Assignment Papers. 45
The thrust of much recent attention upon attaining reform in hospitals through clinical leadership has positioned clinical leadership as a vehicle for improving clinician engagement in not only their own work, but also the care delivery microsystems in which they operate. This type of work engagement requires forms of citizenship behaviors that are focused upon improving clinical systems and practices.Clinical Leadership And Management Assignment Papers. For individual clinicians, broader engagement within the organization with systems and processes requires the capacity for citizenship behaviors that are clinically focused and motivated, both at the level of one’s own work and also the broader network of relationships and systems. These forms of “clinical citizenship behaviors” require a fair and just work culture in which individuals can openly identify issues and work together toward solutions.Clinical Leadership And Management Assignment Papers. 45
Importantly, given that clinicians may not necessarily be employees of the hospital in which they work but self-regulated and independent professionals who operate with a level of independence from typical employer–employee relationships, and who may have lower levels of commitment to the institution, understanding clinician engagement beyond the level of engagement with one’s own work, toward engagement with the broader clinical quality and safety agenda within the organization has important implications for the success of clinical leadership agendas.46 A small sample study of head nurses in a large academic hospital47 reported the development of clinical leaders improved the quality of the nursing work environment through enhanced communication, increased responsibility and empowerment, improved patient-centered communication, improved clarity and structure, and improved interdisciplinary collaboration.Clinical Leadership And Management Assignment Papers.
Hospitals are complex socio-political entities, and the ability for engagement and leadership among clinicians can be hampered by power dynamics, disciplinary boundaries, and competing discourses within the organization. The tension inherent between clinical and administrative discourses is evidenced in the findings from the evaluation of clinical directorate structures in Australian hospitals, with close to two thirds of medical and nursing staff surveyed reporting the primary outcome of such structures was increased organizational politics.48 At the same time as there have been growing calls for clinical leadership, there is evidence from Australia that reform and restructure within hospitals has resulted in a loss of nursing management roles and functions.49 Despite a policy agenda to foster clinical leadership, there are reports that managerial imperatives can instead primarily focus upon fiscal efficiency or organizational political imperatives, with various factors colluding to silence concerns of clinicians.Clinical Leadership And Management Assignment Papers.
Edmonstone11 cautions that without structural and cultural change within institutions, the move toward clinical leadership can result in devolution of responsibility to clinicians who are unprepared and under resourced for these roles. Evidence emerging from the NHS suggests particular value in leadership coalitions between managers and clinicians.19 Further, strong clinician representation at Board level has been reported to make a difference to clinical engagement.35
Preparation for clinical leadership roles
There is also a concern that many health professionals may not be well prepared to understand the nature of leadership, or take on leadership roles because of the lack of content on leadership in undergraduate course curricula.50 These deficiencies have been recognized by professional organizations and health service providers, especially in light of wide-ranging inquiries into the quality of health services in a number of countries.6,7,8 As a result, there have been efforts made to overcome these deficiencies in the preparation of health professionals. As Gagliano et al comment, there is some evidence that health service provider groups are attempting to address issues pertaining to leadership issues through design and implementation of leadership development programs.51
In the UK, a Medical Leadership Competency Framework (MLCF) has been developed and embraced by professional medical bodies, regulatory authorities, and educational providers.31 Similarly, a Clinical Leadership Competency Framework has been developed from the MLCF for use across all regulated nonmedical clinical professions, with the aim to include competencies into undergraduate, postgraduate, and continuing professional education.52 Ellis et al note that even with the establishment of these frameworks and an acceptance of them as the “gold standard for developmental activities”53 for clinical leadership, other programs in the UK in the literature report an apprentice-style program targeting doctors in training and providing them with experiential learning opportunities with senior medical officers.54 Also,Leeson and Millar describe a leadership program for allied health professionals and nurses working in community and hospital settings in the UK that aims to build individual leadership capacity.55 Such programs running alongside a national approach in some ways epitomizes the complexity of clinical leadership in health care.Clinical Leadership And Management Assignment Papers.
Other countries have developed education and professional development programs in clinical leadership for doctors, nurses, and allied health professionals working in their respective health systems. Some of these programs have similar features to UK NHS leadership frameworks and associated strategies. For example, in New Zealand medical schools are working to provide leadership training in their undergraduate medical curriculum.56 In Australia, training programs are available to hospital medical registrars in teaching hospitals.57 Opportunities for allied health professionals to engage in clinical leadership development programs offer similar opportunities for capacity building in leadership, especially in postgraduate training.58,59
Globally, the International Council of Nurses identifies leadership as one of the major considerations underpinning their activities and has established a Global Nursing Leadership Institute as a vehicle for these activities.60 In addition to this global approach, local initiatives to enhance clinical leadership have been developed and implemented in a number of countries.Clinical Leadership And Management Assignment Papers. Interestingly, while many countries have taken a relatively widespread approach to clinical leadership development, in Australia, New South Wales Health’s response to the Garling report has been the “Take the Lead,” a program developed specifically for NUMs to enhance their clinical leadership skills through professional development activities.61 However, it must be noted that while effective clinical leadership is identified as a key issue to be addressed, and despite a number of strategies designed to enhance clinical leadership, to date there are a lack of studies that show improvements in patient outcomes or outcomes for the health workforce as a result of these strategies. And, as Moscrop comments, “questions persist about what leadership means in medicine”.62
Facilitators and barriers to achieving effective hospital-based clinical leadership
Clinical leadership, if it is to be evident and successful, requires broader clinician engagement and forms of citizenship behaviors within the clinical context that mediate the realization of this form of leadership. Much has been written in the organizational and health care literature about employee work engagement and the benefits derived through promoting work engagement.5,19 Similarly, organizational citizenship behavior is well rehearsed in the literature.Clinical Leadership And Management Assignment Papers. Considerable evidence confirms positive associations between constructs such as job satisfaction, work performance, improved productivity, and engaged employees.5 Organizational citizenship behavior has been defined as work-related behaviors that are discretionary, not related to the formal reward systems, and which promote the effective functioning of the organization. The types of behaviors commonly seen to form organizational citizenship behavior include altruism, courtesy, conscientiousness, and civic virtue,63 including acts such as helping those with a heavier workload, giving of one’s time to help others, not taking long lunch breaks, and completing tasks on time.Clinical Leadership And Management Assignment Papers. 64 The focus of attention on work engagement and citizenship behaviors, both within and outside of the health care literature, has largely been upon the general construct of work engagement or disengagement with attention to work roles and tasks.46 The turn toward clinical leadership requires attention to different facets of work engagement and citizenship behaviors, in particular the nature of clinical citizenship behavior as opposed to generic forms of these behaviors.Clinical Leadership And Management Assignment Papers.
Despite the widespread recognition of the importance of effective clinical leadership to patient outcomes, there are some quite considerable barriers to participation in clinical leadership. Such barriers are noted extensively in the literature and can include lack of incentives, lack of confidence, clinician cynicism, poor communication, poor preparation for leadership roles, curriculum deficiencies at undergraduate level in medicine and health professional courses, experience as participants in poorly constructed clinical leadership programs, inadequate resourcing of development programs, poor leadership, lack of vision and commitment at the higher levels, perceptions of leadership as “other” and not core to a clinical practice role, poor interdisciplinary relationships, role conflict, and at times rejection of the “leader” role as unacceptable impost, resistance to change, and poor team work.2,12,50,65–67,69–71
Edmonstone35 cautions that the emphasis upon competency-based leader development has done little to foster effective clinical leadership in the UK, despite its potential usefulness, and informative and summative evaluation of leader development. Although considerable discussion has occurred on the need for clinical leadership, and large scale pubic inquiries evidence the considerable patient harm that has occurred in the absence of such leadership,7,8 there continues to be a major disconnect between clinicians and managers, and clinical and bureaucratic imperatives. The debate over who is best positioned to lead service delivery and the place of clinicians in governance continues.Clinical Leadership And Management Assignment Papers.
Effective clinical leadership is associated with optimal hospital performance. It is allied to a wide range of hospital functions and is an integral component of the health care system. Developing clinical leadership skills among hospital nurses and other health professionals is of critical importance. However, despite the widespread recognition of the importance of effective clinical leadership to patient outcomes, there are some quite considerable barriers to participation in clinical leadership. Future strategies should aim to address these barriers so as to enhance the quality of clinical leadership in hospital care. As the focus on hospital performance intensifies, leadership to increase efficiencies and improve quality will be of increasing importance.Clinical Leadership And Management Assignment Papers.
Abstract: The National Health Service (NHS) is one of the UKs most cherished but political public institutions, providing healthcare, free at the point of delivery. The English NHS must make £20bn efficiency savings in the next 3 years whilst in the midst of fundamental structural change outlined in the government’s Health and Social Care Bill. This paper will explore the history of leadership and management in the NHS; the evolution of clinical leadership; national strategies to improve NHS clinical and managerial leadership and Lord Darzi’s pivotal NHS review. It defines the kind of leadership and management required for today’s NHS, looking to overcome some of the main challenges such as improving healthcare quality whilst making efficiency savings and engaging grass roots workers to deliver sustainable, long term improvements. Finally this manuscript makes suggestions as to where future investment is required to improve clinical leadership and management in the NHS.Clinical Leadership And Management Assignment Papers.
I share the editor’s confusion1 about ‘clinical leadership’ and ‘management’ of the NHS. Leadership and management have overlapping attributes, both are professional, but they are not synonymous and it obfuscates discussion of the issues to use them interchangeably.Clinical Leadership And Management Assignment Papers. There is no harm in calling ‘dustbin men’ ‘waste management operators’ if it raises their morale and self-esteem. However it is sad when honest to goodness management of a magnificent national organization find it necessary to indulge in such self-aggrandizing terminology. Clinical leadership qualities are needed in a wide variety of roles in the NHS but management is only one of them. Clinicians who wish to take on senior management roles (either in commissioning or in hospitals) are vitally important, there should be more of them and the training programmes which have been developed are absolutely necessary. When we wish to discuss the optimal qualifications and training of management skills, let us say so and keep the terminology clear.Clinical Leadership And Management Assignment Papers.
Notwithstanding all this, ‘clinical leadership’ training initiatives have become a euphemistic flavour of the month. Courses, diplomas and masterships abound. Even the notion of a Faculty is gaining ground and for good reasons – but the name should be accurate. These training opportunities have been set up largely (but not exclusively) to encourage clinical professionals particularly doctors and some nurses to acquire management skills, on the premise that professionals in frontline clinical practice are better placed to improve the operation of the NHS. Of course their input is vitally important but the question is, how can they be used to best advantage? Indeed searching for the holy grail of optimal management of the NHS has a substantial history.Clinical Leadership And Management Assignment Papers.
Before the NHS, medical superintendents in charge of small hospital organizations were common and often successful. In the early years of the NHS, doctors treated patients and there was no expectation for them to take heed of the costs. They were supported by small numbers of relatively poorly paid non-clinical administrators, some of whom had received some training at a Staff College and others who learnt on the job. Some were very good. However as the potentials for treatment expanded and the cost of the NHS got increasingly out of hand, government accepted the Griffiths report in the early 1980s in which he proposed that the NHS required high quality captains of industry with business and financial experience in order to improve the efficiency and productivity of this increasingly complex and expensive national business. They became the Chief Executives of the NHS, rightly commanding substantial salaries. Over time policymakers were keen to increase the authority of these managers and that of the clinical professionals with responsibility for patients diminished, to one more akin to that of ‘hired artisans’. This created an increasing professional/management divide; clinicians’ morale fell, patients unmet expectations caused concern to politicians and the costs continued to rise. Not surprisingly as the NHS was moved once again into an open market environment, the model promoted by Lord Darzi of getting frontline doctors to manage the costs as well as the service to patients was welcomed by policymakers and governments alike. Cynics might suggest that its attractiveness was in part based on the fact that if and when it failed, the professions alone would take the blame. There is still considerable doubt, as discussed by Ham and colleagues2 as to whether such a model run by self-styled ‘keen amateurs’, even after attending a ‘clinical leadership’ course, is the best way to run the vast and complex NHS operation. Many doubt whether it can work at all.Clinical Leadership And Management Assignment Papers.
It is inevitable that the costs of the NHS will always outstrip resources. The challenge is to use those available (whatever they are) in an optimal way. While it should take advantage of good business-like principles and practice, the NHS is not a business and patients with their life and death, common and uncommon problems, cannot be handled or discarded like unprofitable commodities. Thus conventional market practices will always fail.
The knowledge and experience of the clinicians are crucial but are quite distinct from the skills brought to the table by those from the financial and business world, regarding efficiency, productivity, value for money and financial solvency. The underlying principles and operation of the NHS are unique and it requires a unique management system.Clinical Leadership And Management Assignment Papers.
Logic therefore dictates that a new model should be explored where there is an equal partnership between the clinical profession and those with business and financial experience who each can bring their own skills and can learn enough of each others profession, not only to gain insight but also to gain mutual trust and respect. It is common experience among those who have worked in the NHS for a long time that those Hospital Trusts or Foundations which have been run successfully (and there have been quite a number of them in spite of the inevitable financial constraints) have succeeded because the non-clinical managers have understood and respected the clinical needs and views of patients and the professional doctors and nurses caring for them, and the leaders of the clinical profession who have taken on managerial roles, have reciprocated by understanding and respecting their non-clinical managerial colleagues. Notably where this partnership has been successful, morale throughout the organizations has risen and even difficult financial decisions have been accepted and supported.Clinical Leadership And Management Assignment Papers.
All this indicates that the current enthusiasm for the training of some clinicians in management principles is essential and should be applauded, but it is only half the story. It is equally crucial for both senior and junior non-clinical managers to receive complementary training in understanding the principles and limitations of medicine. Such proposals have received considerable support from individuals and have been explored in some depth at Green Templeton College in Oxford, by the Royal Society of Medicine and by Surrey University.3 Sadly they have so far failed to advance, not least due to a singular lack of enthusiasm and financial support from either the Department of Health or the NHS executive.Clinical Leadership And Management Assignment Papers.
In summary, it is not so much a Faculty of ‘Clinical Leaders’ which is needed but a Faculty of ‘Management of Health Services’ where management is dependent on an equal partnership between clinical and non-clinical professionals and where complementary and appropriate training programmes can be trialled and promoted. Such a Faculty might allow the exploration of a new model of management which has a real chance of successfully tackling the singular problems of the NHS, which have eluded policymakers for so long.Clinical Leadership And Management Assignment Papers.
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