Leadership styles and effectiveness in healthcare organizations

Innovations in technology and telecommunications in recent years have provided the healthcare industry with the ability to deliver high quality services that have improved the quality of life for Americans of all ages. Despite these advances in technology, though, the nation's healthcare organizations are faced with a critical shortage of nursing staff and everyone is feeling the effects of a recessionary economic period. Compounding the problem for healthcare organizations of all types and sizes is the increasing use of managed care which is focused on profitability rather than the quality of healthcare services being provided. Moreover, the United States is becoming increasingly multicultural in composition in ways that demand culture-sensitive healthcare services. In addition, the elderly segment of the nation's demographic is growing larger and age-related healthcare issues will consume an inordinately large share of the nation's healthcare services for the foreseeable future. In this dynamic environment, identifying opportunities to improve healthcare management through informed and effective leadership represents a timely and relevant enterprise, which is the focus of the study proposed herein. The proposed study will seek to determine what leadership styles and development programs have been shown to be most effective in improving the performance of healthcare organizations in terms of the level of patient and staff satisfaction experienced as well as their profitability. To achieve this goal, the proposed study will use a critical review of the relevant peer-reviewed and scholarly literature concerning organizational leadership in general and what types of leadership are deemed most effective in healthcare settings in particular. A summary of the research, salient findings and recommendations will be presented in the concluding chapter of the proposed study.

Identifying Opportunities for Improving Healthcare Management

Problem/Issue/Improvement Project

The healthcare industry stands at a crossroads today and the direction it takes will depend on what type of leadership is available to model the way. In this regard, Froeschle and Donahue (1999) emphasize that, "Health care today is between paradigms. This state of fluctuation places extraordinary challenges on leaders of health care facilities. New leadership skills are needed to overcome this dilemma" (p. 60). Indeed, an increasing emphasis on market-driven cost-containment strategies in recent years has resulted in some fundamental changes in the provision of health care services as well as the management techniques required in this dynamic environment. For instance, according to Mizrahi and Berger (2005), "Most hospitals have restructured to achieve flatter organizational frameworks by eliminating professionally defined departments such as social work, nursing, and physical therapy. Many have moved to a more service line approach or to more integrative structures" (p. 155). As a result, healthcare management today is focused on fiscal accountability rather than on potentially more important clinical indicators of care or on quality improvement initiatives (Mizrahi & Berger, 2005). Not surprisingly, the professional cadre of healthcare providers who have been affected by these changes has become alarmed at the changes. In response, a growing number of practitioners in healthcare organizations that have experienced fundamental organizational and managerial changes in recent years have started to demand empirical evidence concerning the efficiency and effectiveness of the different organizational models being introduced (Mcgoldrick, Stewart & Watson, 2002).

Proposed Solution and Anticipated Outcomes

Although there is a growing body of evidence that confirms the impact that effective leadership can have on organizational performance and profitability, there remains a paucity of timely research concerning how organizational development can improve the performance of healthcare organizations. In this regard, Mclagan (2002) notes that, "Change is inherent in life and nature. Yet, we have only recently begun to study change in our institutions with the intent of influencing its impact. Organization development, the discipline of focusing on organizational change, is still an emerging science despite how long the term has been around" (p. 26). Indeed, leaders of many types of organizations appear to lurch from one management fad to the next in an effort to improve organizational performance. In this regard, Mclagan adds that, "Fads and trial-and-error seem to dominate our efforts to deal with the important and pervasive phenomenon of organizational development" (p. 27).

Not surprisingly, then, there remains a need to determine how healthcare organizations can provide leadership development initiatives that can provide real results in terms of delivering quality medical services while keeping an eye on the bottom line. Therefore, by identifying opportunities to improve leadership development practices in healthcare settings, it may be possible to harness existing resources more efficiently. For example, Michalisin and Karau point out that, "Leadership could serve to activate resources and core processes crucial to organizational functioning that could, in turn, have a potent effect on firm performance" (p. 2). Taken together, the research indicates that it is possible to identify better ways of helping leaders become more adept at guiding complex organizations in ways that will help them achieve their goals. The anticipated outcomes of the study proposed herein, then, relates to the identification of such improved methods, an objective which represents a valuable addition to the current body of knowledge concerning effective leadership in healthcare settings.