Leadership Culture and Continuous Improvement in Healthcare

Introduction to Leadership Culture

Culture delineates the behavioral customs, mutual practices, common outlooks, and beliefs that govern any organization. The leadership culture of an organization is a distinctive and potent aspect of its overall organizational culture. Leaders can be considered the cultural designers and planners of any organization — in the end, an entity embraces and espouses the individualities and priorities of its leaders. Forming a culture of leadership is a fundamental constituent of an organization's capacity to grow and progress year over year. This is not something that can be executed all at once. Instead, a culture of leadership advances gradually by undertaking the essential steps and investing the time and resources needed to develop leaders not just at the highest levels of the organization, but throughout it at every level (Schein, 2006).

Leadership culture can be defined as the system of often unspoken customs, standards, and assumptions that act as guiding principles, directing the manner in which managers exercise leadership within a given organization. The behavior of leaders accounts for approximately forty to sixty percent of organizational culture, making it the fundamental factor in shaping leadership culture (Read, 2015).

Organizational Conditions Necessary to Develop a Leadership Culture

There are various conditions and components within an organization that are essential to developing a leadership culture. One key condition is having a clearly articulated mission, vision, and set of values. Adaptation of the organizational mission, values, and core strategies is an imperative objective for leadership development. In particular, leaders and their cultural influences model, support, and promote alignment with the organization, making managers, teams, and employees ready to develop commitment and act in accordance with organizational direction (Read, 2015).

A second element involves building the leadership culture into the hiring process. It is imperative for leaders to not only dedicate themselves to new leadership responsibilities, but also to ensure this dedication is reflected in recruitment and hiring. This means enlisting individuals who fit within the organization's culture of leadership capability. Third, accountability must be built into leadership development. For a culture of leadership to exist, it is imperative that leaders treat leadership development and improvement as a vital element of organizational progression. This encompasses properly delineating goals and objectives to be attained at every level and department of the organization (Schein, 2006).

How Leadership Culture Shapes Healthcare Quality and Safety

Leadership culture significantly influences the organizational climate, which encompasses shared perspectives on organizational aspects such as decision-making, customs, and norms regarding work activities. Leaders, through the culture they establish, can generate a setting of continuous improvement in quality and safety (Tsai, 2011). Leadership supports and nurtures a culture of safety and continual learning — a setting that ensures patients are always at the heart of healthcare planning and delivery. Personnel are supported in rendering healthcare with the purpose of providing safe, efficacious, and compassionate care. Leaders achieve this in part by fashioning culture, generating the right conditions, and modeling the behavior essential for quality to flourish (Health Service Executive, 2016).

Top leaders have a considerable impact on the culture of safety and continuous improvement in a healthcare organization through strategic initiatives. One key approach is direct interaction with frontline employees — for example, leadership walk-arounds. This involves regular visits by managers to the various clinical units or departments within the healthcare organization to engage with personnel in candid discussion regarding safety and improvement. Such engagement can constructively impact culture. When leaders take time to identify mistakes or inaccuracies, dedicate resources to follow-through, and address specific safety issues, they perceptibly exemplify the significance of patient safety as an organizational priority (Frankel et al., 2008).

Leadership culture can also influence healthcare safety and improvement through the management of disorderly and unethical behavior by healthcare staff. Because executives have oversight over medical personnel, they have the capacity to ensure that unprincipled, unethical, and incompetent personnel do not put patients at risk. This also encompasses ensuring that prompt feedback is provided when particular behaviors are not appropriate and pose a threat to the quality of care rendered.

References

Agency for Healthcare Research and Quality. (2012). Adapting organizations for change. Retrieved from https://archive.ahrq.gov/hcqual/meetings/mar12/chap12.html

Barnsteiner, J. (2011). Teaching the culture of safety. The Online Journal of Issues in Nursing, 16(3).

Frankel, A., Grillo, S. P., Pittman, M., Thomas, E. J., Horowitz, L., Page, M., & Sexton, B. (2008). Revealing and resolving patient safety defects: The impact of leadership WalkRounds on frontline caregiver assessments of patient safety. Health Services Research, 43(6), 2050–2066.

Garvin, D. A. (1993). Building a learning organization. Harvard Business Review.

Health Service Executive. (2016). Framework for improving quality in our health service. Retrieved from http://www.hse.ie/eng/about/Who/qualityandpatientsafety/qpsfocuson/Framework-for-Improving-Quality-2016.pdf

Read, J. M. (2015). Leadership culture and why it is important. LinkedIn. Retrieved from

Schein, E. H. (2006). Organizational culture and leadership (Vol. 356). Hoboken: John Wiley & Sons.

Tsai, Y. (2011). Relationship between organizational culture, leadership behavior and job satisfaction. BMC Health Services Research, 11(1), 98.