Transformational leadership in health care today

Management in nursing is in a state of revolution based on positive transformational changes. Effective leadership on individual nursing units directly affects nursing staff satisfaction. Employees are interested in managers who can lead in a positive and encouraging manner. Nurses who are content in their positions correlate to a reduction in staff turnover and improve retention. When the nursing staff are satisfied with their employment, patient satisfaction rises. Health care organizations can see this trickle-down effect through increases in patient satisfaction scores over time. The promotion of effective communication and positive attitudes enhances a healthy environment for all employees and staff. Health care organizations should evaluate individual nurse managers on units to promote transformational leadership qualities; this will directly result in staff satisfaction, staff retention, and patient satisfaction.     

Occupational therapy practitioners' perceptions of rehabilitation managers' leadership styles and the outcomes of leadership

The purpose of this research was to serve as a pilot study to investigate the association between occupational therapy practitioners' perceptions of rehabilitation managers' leadership styles and the outcomes of leadership. Data for this study were collected using the Multifactor Leadership Questionnaire Form 5X and a self-designed demographic questionnaire. The study working sample included 73 occupational therapy practitioners. Major findings from the study indicate that overall, transformational, and transactional leadership styles are associated with leadership outcomes. Transformational leadership had a significant (p < 0.01) positive association with the leadership outcomes, whereas transactional leadership had a significant (p < 0.01) negative association with the leadership outcomes. The contingent reward leadership attribute (although belonging to the transactional leadership construct) was found to be positively associated with leadership outcomes, similar to the transformational leadership constructs. The results of this research suggest that transformational leadership styles have a positive association with leadership outcomes, whereas transactional leadership styles have a negative association, excluding the positive transactional contingent reward attribute. A larger, random sample is recommended as a follow-up study.     

The applicability of Bass's model of transformational, transactional, and laissez-faire leadership in the hospital administrative environment

The purpose of this study is to evaluate empirically in the hospital administrative environment the relationship of leadership behaviors to subordinate manager's perceived outcomes, through examination of B. M. Bass's (1985) model of transformational, transactional, and laissez-faire leadership. The author measured leadership orientation and outcome factors through subordinate managers' ratings of hospital CEOs using a questionnaire, which asked: Is there a relationship between the leadership styles of hospital CEOs and subordinate managers' self-reported willingness to exert extra effort, perception of leader effectiveness and satisfaction with their leader? Findings revealed that the relationship between transformational leadership and the outcome factors were stronger and more positive than were the transactional and laissez-faire styles. These findings are consistent with the hierarchal patterns reported and support the universality of the model.     

Specialists on Call: Part I. Teletype

The purpose of this study is to evaluate empirically in the hospital administrative environment the relationship of leadership behaviors to subordinate manager's perceived outcomes, through examination of B. M. Bass's (1985) model of transformational, transactional, and laissez-faire leadership. The author measured leadership orientation and outcome factors through subordinate managers' ratings of hospital CEOs using a questionnaire, which asked: Is there a relationship between the leadership styles of hospital CEOs and subordinate managers' self-reported willingness to exert extra effort, perception of leader effectiveness and satisfaction with their leader? Findings revealed that the relationship between transformational leadership and the outcome factors were stronger and more positive than were the transactional and laissez-faire styles. These findings are consistent with the hierarchal patterns reported and support the universality of the model.     

公立医院高质量发展背景下平台型领导对护士创新行为影响研究

目的: 为提高公立医院护士队伍创新绩效,提升护理服务质量,推动公立医院高质量发展,本文基于实地调研,系统探索公立医院护士长平台型领导风格促进下属护士创新行为的作用机制。方法: 采用方便抽样,对J省与N省三家公立医院428名护士进行问卷调查,并通过相关分析和回归分析对护士长平台型领导风格水平与护士工作繁荣、任务相关信息处理能力和创新行为间关系进行检验。结果: 护士长平台型领导风格可以通过提升下属护士任务相关信息处理能力和工作繁荣两重机制共同促进他们的创新行为。结论和建议:公立医院应通过加强各科室护士长平台型领导风格水平,鼓励其通过这一领导风格的发挥着力提升下属护士任务相关信息处理能力和工作繁荣水平,促进下属护士展现更多创新行为,最终实现公立医院护理服务质量提升和高质量发展。     

Management of health system reform: a view of changes within New Zealand.

This paper reports on the context and process of health system reform in New Zealand. The study is based on interviews conducted with 31 managers from three Crown Health Enterprises (publicly funded hospital-based health care organizations). A number of countries with publicly funded health services (e.g., UK, Australia and New Zealand) have sought to shift from the traditional 'passive' health management style (using transactional management skills to balance historically-based expenditure budgets) to 'active' transformational leadership styles that reflect a stronger 'private sector' orientation (requiring active management of resources--including a return on 'capital' investment, identification of costs and returns on 'product lines', 'marketing' a 'product mix', reducing non-core activities and overhead costs, and a closer relationship with 'shareholders', suppliers and customers/clients). Evidence of activities and processes associated with transformational leadership are identified. Success of the New Zealand health reforms will be determined by the approach the new managers adopt to improve their organization's performance. Transformational leadership has been frequently linked to the successful implementation of significant organizational change in other settings (Kurz et al., 1988; Dunphy and Stace, 1990) but it is too early to assess whether this is applicable in a health care context.     

The aging nursing workforce: How to retain experienced nurses

In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce.     

Management development: a study of nurse managerial activities and skills

This study discusses an activity competency model that may be used to investigate the perceived importance of managerial activities and skills required by three levels of nurse managers (top, middle, and supervisory management). Our findings indicate that the importance of nurse managerial activities differs significantly according to the level of nurse management. A set of critical managerial activities and skills/knowledge needs for each level of nurse managers was identified in the study. These findings provide guidelines for nursing-management development programs, training, and career planning. They also can serve as a guideline for recruiting and selecting an effective nurse manager.     

Case management: managing the nurse case manager

Nurse executives and nurse managers have become proactive in response to the health care crisis by creating and implementing innovative health care delivery models such as nursing case management. Nursing case management utilizes a nurse as case manager and the unit-based system of managed care to achieve financial and clinical outcomes for target patient groups. Nurse managers can support the nursing case management model best by practicing good managerial skills, developing a participative style of leadership, and empowering the nurse case manager.     

The seven S's for successful management

Becoming a successful manager in a health care agency is, for most new managers, an awesome goal. Successful management is more than knowledge of leadership roles and management functions that can be learned in school or educational workshops. Successful management involves effective use of both the manager's affective and cognitive domains. Mentoring and apprenticeship with a successful nurse leader is for many novice managers a highly valuable way to learn management skills since this allows for techniques with a successful nurse manager to be visualized and then modeled. "Seven S's" that provide a framework for managerial success are discussed.     

Leadership in the formation of new health care environments

The capacity for managers to be effective leaders is clearly being challenged by rapid changes in the health care environment. In this climate, transformational leadership is considered superior to hierarchy-dependent, transactional leadership. This approach may also be very effective in motivating staff and fostering organizational transformation. The article describes six processes that are critical for those who seek to be dynamic leaders: visioning, communicating for meaning, creating possibilities, developing stakeholders, building spirit and will, and sustaining focus.     

Quality circles: the nurse executive as mentor

Changes within and around the health care environment are forcing health care executives to reexamine their managerial and leadership styles to confront the resulting turbulence. The nurse executive is charged with the profound responsibility of directing the delivery of nursing care throughout the organization. Care delivered today must be of high quality. Declining financial resources as well as personnel shortages cause the executive to be an effective innovator in meeting the increasing demands. Quality circles offer the nurse executive an avenue of recourse. Circles have been effectively implemented in the health care setting, as has been consistently documented over time. By way of a participative management approach, quality circles may lead to increased employee morale and productivity, cost savings, and decreased employee turnover rates, as well as realization of socialization and self-actualization needs. A most effective approach to their introduction would be implementation at the first-line manager level. This promotes an acceptance of the concept at the management level as well as a training course for managers to implement the process at the unit level. The nurse executive facilitates the process at the first-line manager level. This facilitation will cause a positive outcome to diffuse throughout the entire organization. Quality circles offer the nurse executive the opportunity to challenge the existing environmental turmoil and effect a positive and lasting change.     

Co-dependency in the workplace

Co-dependency has become a familiar term in recent years. No only do mental health professionals encounter the phenomenon, but with the bestseller status of Co-Dependent No More (Beattie 1987), more and more laypersons have begun to identify co-dependent individuals among family members and friends. Community health nurse managers may encounter this problem in clients as well as in other nurses. Of particular concern to the community health nurse manager is co-dependency among nurses on the staff. Co-dependency exhibited by nurses can have a negative effect on group morale and team spirit in a community health setting. This article defines co-dependency and presents guidelines for responding to it in community health nurses.