Discussion: Leadership for Change

Health care organizations should be continuously involved in quality improvement projects to enhance health outcomes. Regardless of their commitment to change, outcomes vary depending on the leadership approaches and how change leaders manage the entire process. Transformational leadership and project management approaches enable health care organizations to implement change successfully. This discussion examines the connection between transformational leadership for change, project management approaches, and quality improvement.Transformational Leadership and the Need for Quality Improvement

Transformational leadership for change focuses on transforming the workplace cultures and routine practices to meet organizational demands. According to Khattak et al. (2020), transformational leaders encourage innovation and creativity in the challenging work environment. Since the objective is to create a vibrant work environment to achieve better performance milestones, transformational leadership for change encourages working on performance gaps through quality improvement. As a result, transformational leadership for change informs practice change by showing the need for quality improvement (Seljemo et al., 2020). In any case, health care leaders cannot achieve the transformation objective without quality improvement. I have experienced transformational leadership occasionally. A suitable example is working towards patient satisfaction, where nurse leaders collaboratively set the goals with the nursing staff while inspiring the staff to work for higher targets. The staff also contributed to the strategies necessary to achieve the set goals as everybody works towards a shared vision.

Recommending the Application of Project Management Approaches

Project management approaches can be used to support transformational leadership practices to promote a quality improvement

initiative. I would recommend applying project management approaches by engaging change leaders and showing them the relevance of such approaches in quality improvement. Alternatively, I can provide a policy brief and serve as a role model in applying project management approaches. For instance, project management recommends using a phased approach in public health transformation (Santos et al., 2020). A similar approach can be used for a quality improvement initiative, such as reducing readmission rates. The phased approach recommends planning, implementation, monitoring, and control in sequence. Planning involves goal setting and developing a timeline. A suitable short-term goal for reducing readmissions can be reducing patient readmissions by 50% in three months. A long-term goal can be improving a hospital’s rating by ten points in one year.

In conclusion, transformational leadership for change encourages creativity and innovation. Since the objective is enabling an organization to achieve higher milestones, transformation examines areas that need changes in the challenging health care environment. The urge for better performance milestones encourages positive change, which health care organizations achieve through quality improvement practices.

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References

Khattak, M. N., Zolin, R., & Muhammad, N. (2020). Linking transformational leadership and continuous improvement: The mediating role of trust. Management Research Review. DOI: 10.1108/MRR-06-2019-0268

Santos, C., Santos, V., Tavares, A., & Varajão, J. (2020). Project management in public health: a systematic literature review on success criteria and factors. Portuguese Journal of Public Health, 38(1), 37-48. https://doi.org/10.1159/000509531

Seljemo, C., Viksveen, P., & Ree, E. (2020). The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: A cross-sectional study. BMC Health Services Research, 20(1), 1-8. https://doi.org/10.1186/s12913-020-05671-y

Leadership for Change

A transformational leader is a leader who strives to promote and transform the workplace by inspiring and motivating others (Marshall & Broome, 2020). Transformational leaders are able and willing to go beyond the day-to-day operations at their workplaces, ensuring that they motivate their staff members and set SMART goals. The dynamism in the nursing field leads to unique changes that align with the introduction of new policies, laws, and technology (Nagy et al., 2014). Therefore, transformational leaders aim to adopt a management style that aligns with the changes to improve the quality of service rendered in any facility.

Nursing students must engage in practice in real-world situations to succeed in the future (Nagy et al., 2014). I once volunteered in a healthcare facility as a nurse, where I had experiences with various transformational leaders. Occasionally, our supervisor set the goal of increasing patient satisfaction in the facility. The specific goals included developing and initiating programs collaboratively and improving customer service. To establish the goals, the supervisor held meetings with the staff members, where she identified the problems and initiated all-inclusive solutions. At the meeting, she engaged us to brainstorm ideas that would help address several issues. This is not common in the nursing field since most leaders tend to be bureaucratic and use transactional management styles.

In nursing, it is possible to apply project management approaches to transformational leadership to improve service quality. One of the approaches that can apply in this context is the program evaluation and review technique (PERT) (Nagy et al., 2014). The approach allows users to establish detailed plans and check their progress and milestones in a chart. In transformational leadership, improving quality can be approached through setting the quality goals, objectives, and benchmarks to be achieved, engaging all staff members involved, and identifying the milestones achieved (Nandan, 2017) (Nagy et al.). Specific milestones include using performance data to enhance patient care, ensuring effective and safe transitions inpatient care, and determining system errors to improve patient care.

References

Marshall, E. S., & Broome, M. E. (2020). Frameworks for becoming a transformational leader. Transformational Leadership in Nursing. https://doi.org/10.1891/9780826135056.0001

Nagy, C. J., Zernzach, R. C., Jones, W. S., Bowe, S. N., & Rodriguez, R. G. (2014). Quality improvement and patient safety milestones for the continuum of physician development. Journal of Graduate Medical Education, 6(4), 793-794. https://doi.org/10.4300/jgme-06-04-46

Nandan, S. (2017). Leadership and change management. Leadership and Change Management, 61-66. https://doi.org/10.4324/9781315591766-8

Hassanat I enjoyed reading your post on the transformational leadership. Nash, K., & Garratt, A. (2021) reported the focus on time and workforce availability are significant to improve the quality of health services. Perception of change may cause burden felt by a team such fatigue or staff feeling overwhelmed because they perceive lack of control over the change. Creating opportunities for innovative ideas are imperative when faced with staff shortages and chronic excessive workload. Involving those affected by the change with a clear purpose supported by evidence-based rationale are needed for the quality improvement initiatives to be successful. Long-term change is more likely to happen in an environment where staff can reflect on how things are currently done to plan how they could be improved.  Brainstorming is highly effective quality improvement tool can be used with stakeholders to help ensure engagement at worker’s level. Engagement from stakeholders provides different perspectives, innovative ideas as alternatives, provides momentum, and collaboration among the team.  For brainstorming to be an effective exercise, there should be no criticism, aim for quantity, encourage thinking outside the box and wild ideas which can provide breakthrough insights, build upon the ideas of others, one conversation at a time. The conclusion of the study was to improve quality of health services, effective and meaningful input from stakeholders (Nash, K., & Garratt, A., 2021).

I agree with you that brainstorming is an effective tool to teambuilding and improving the quality of health services.

Reference

Nash, K., & Garratt, A. (2021). Quality improvement in action. British Journal of Midwifery, 29(10), 546–548. https://doi-org.ezp.waldenulibrary.org/10.12968/bjom.2021.29.10.546

Transformational leadership is a leadership style that focuses on creating change in an organization. When a leader has a transformational leadership style the correlation to change, meaning adopting new changes or techniques, is positive (Peng, Wang, and Lin, 2021). This knowledge shows us why it is important to strive to have transformational leadership in place in an organization that needs change.

I have had many great leaders throughout my nursing career. One leader used transformational leadership style in her leadership practices. Everyone on the unit loved working for her and with her. She was often seen on the floor helping where she could and promoting teamwork and unity. If there was a change that she wanted to pilot we were more than willing to go along with her because we knew that she would have our backs and that she would support us and help us. She was a wonderful leader. When she switched to a different unit many of the nurses followed her because they liked her so much and felt so supported.

The project management approach to support transformational leadership practices is a great option for the advanced practice nurse. Project management comes naturally to many nurse leaders because many of the same concepts are used in project management and the nursing process (Sipes, 2020). I could use the project management approach in my organization through the use of outlining the project to improve quality and showing the steps that could be required for the improvement of quality. For example, at my long term care facility there has been an increase in pressure ulcers acquired at the facility. The first step in the project management process is to create a quality improvement team, from there decisions will be made about what interventions need to be implemented. The decision is made to set up big clocks outside the residents rooms who need to be turned. These clocks show what side the resident should be on during every two hour interval. This intervention is put into place. After that the results of the quality improvement project would be monitored and reported to the director of nursing to see if the visual clocks were helpful in reducing the amount of pressure ulcers. The short term goals would be to have 75% of residents be on the appropriate side during any two hour time span. The long term goals would be to decrease the number of pressure ulcers in the facility.

References

Peng, J., Li, M., Wang, Z., & Lin, Y. (2021). Transformational leadership and employees’ reactions to organizational change: Evidence from a meta-analysis. Journal of Applied Behavioral Science, 57(3), 369–397. https://doi-org.ezp.waldenulibrary.org/10.1177/0021886320920366

Sipes, C. (2020). Project management for the advanced practice nurse (2nd ed.). Springer Publishing Company.