Innovations in Technology and Telecommunications

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).

Analysis of Problem/Issue/Improvement Data

Given its potential impact on a company's bottom line, the relationship between organizational performance and leadership has been the focus of a growing amount of research in recent years and the connection has been well documented. According to Michalisin, Karau and Tangpong (2007), "Organizational researchers have revealed that the relationship between leadership behavior and specific performance outcomes is complex, and that the specific behaviors that are effective often depends on a variety of variables, including situational factors and follower characteristics" (p. 2). The complexity of the situation is more pronounced in some settings than others, of course, and it is reasonable to posit that healthcare organizations represent some of the most complex organizational settings because of the wide range of professions and services that are involved. A number of researchers have confirmed effective organizational change requires progressive leaders who are not afraid of "rocking the boat" and overcoming administrative inertia and the reluctance to change that is characteristic of any type of organization (Mclagan, 2002). For example, while it may be possible to improve the quality and efficiency of healthcare services by implementing technology-based solutions, professional healthcare providers may be reluctant to embrace drastic changes to their routine unless they can discern a "what's in it for me?" quality to the initiative. Indeed, leading other people to a common organizational goal may well represent one of the most difficult endeavors in the human experience and it requires leaders who can successfully overcome the obstacles and constraints that stakeholders and limited resources will inevitably throw their way.

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).