There is still no single assessment of Genghis Khans personality. Under his unlimited power, he gathered all the Mongol tribes living to this day from Altai to Argun and from the Siberian taiga to the Great Wall of China. However, being a pedantically strict adherent to the rule of law, he wanted this power to be officially recognized. In the 52nd year of the rulers life, his long-standing dream came true: at a general tribal meeting, kurultai, he proclaimed the Divine Genghis Khan (Rossabi, 2011). Having firmly established himself on the throne, Genghis Khan created a hierarchy based on the traditional tribal life of the then-Mongolian society, distinguished by solidarity and religiosity. As a ruler, Genghis Khan was fair and wise: he founded writing and cultures origins, respected womens rights and restored the Great Silk Road.
However, asserting his dominance, the Great Conqueror sowed death everywhere: in the steppes of his native Mongolia, in the war with Northern China, and on a campaign in Central Asia. Khan adhered to his main principle: not to leave enemies behind him. There is much evidence that the Mongols walled up the townspeople alive in the city walls and built towers from them, shifting the bodies with layers of clay (Rossabi, 2011). This cruelty of Genghis Khan, apparently, came from the psychology of a warrior for whom strength was always in the foreground and, consequently, military affairs. At the same time, he did not practice cruelty for the sake of cruelty. In his orders, he often forbade the aimless beating of civilians. As a rule, the population of cities that voluntarily surrendered was spared and subjected to a moderate tribute.
Genghis Khans disagreements with his co-workers and family are mentioned only concerning his son Jochi. As a result, his third son Ogedei became the heir, but conflicts on this basis began only after his death. The Secret History of the Mongols has a more negative connotation in the description of the conquests and reign of Genghis Khan since, according to the version of detailed history, the battle of Dalan-Baljiut was won, and in secret, it was lost by the army of Genghis Khan (Rossabi, 2011). However, the reliability of both sources is still doubtful due to the high degree of propaganda from each side of that time: both the authorities of Genghis Khan and their opponents.
References
Rossabi, M. (2011). The Mongols and global history. WW Norton.
Many people often confuse the concepts of leadership and management (Stanley, 2006). While some believe they are the same, others think they are unrelated (Lopez, 2014). This debate/confusion traverses across different disciplines, including economics, public service, governance, and social sciences. In the nursing field, it has emerged through the blurred lines between nursing management roles and senior management roles, which have led to a loss of clear nursing leadership in the field (Stanley, 2006).
This confusion has further led to the failure of many nursing professionals to understand the roles of nursing managers and nursing leaders. Stanley (2006) weighs in on this argument by saying that complexity, loss of focus, and role overlaps between managers and leaders in the nursing field have exacerbated this problem. The same reasons have led some nursing managers to say that they feel disempowered and less satisfied with their jobs and roles (Stanley, 2006). Similarly, the same problem has created issues of low employee retention numbers. This paper explains the differences between leadership and management and highlights how both concepts relate to the APRN field. From this background, we demonstrate that good leaders need both excellent leadership and management skills.
What is the Difference between the Two Concepts?
The Manager is the Action Character, while the Leader is the Action Creator
Generally, leaders formulate a vision for an organization, while managers implement the same vision. Stated differently, a leader would set a direction for other people to follow, while the manager would develop a plan to stick to this direction. Here, a leader could say, Get everybody together because I want to share some great news about the direction we would follow, while a manager could probably send a memo to employees indicating when they should meet and what they would discuss in the meeting. Based on this difference, the manager is the action character, while the leader is the action creator.
Leaders have people who follow them, while Managers have People who Work for them
Leaders have people who follow them because their followers buy into their vision, while managers have followers who choose to work for them to get a pay, or reward, at the end of the month, or a contractual period (Lopez, 2014).
Leaders Encourage employees, while managers instruct employees
The main role of leaders is to motivate or empower, their followers to work on their vision. Comparatively, managers instruct employees to do the same. The latter often uses punishment, or reward, to accomplish their goals, while leaders often use persuasion to achieve the same goals (Anderson, 2012).
Leaders chart new Growth, while Managers meet Expectations
One primary responsibility of a leader is to chart new directions for employees to follow because they are visionaries. They usually take risks in doing so (Stanley, 2006). Comparatively, managers meet specific goals because they are stuck on one objective. Once they meet such an objective, their work ends (Anderson, 2012).
Application to Nursing
Generally, nursing is a social discipline. Since people are involved and interpersonal relationships are a central focus of concern in this discipline, the concepts of leadership and management are relevant. The differences between leadership and management (described in this paper) apply to nursing because, although nurses could be great leaders, they could be bad managers as well. The inverse is also true because great managers are not necessarily great leaders. From this analogy, it is easy to understand the role of nurse leaders because they do not necessarily enjoy designated authority as nurse managers do.
Instead, they get a following because they inspire, motivate, and influence others to do what they want. Relative to this understanding, many nursing literatures point out that great nursing leaders have good communication and interpersonal skills (Stanley, 2006; Anderson, 2012). Comparatively, nursing managers get their following through an authority designated to them by a person of higher standing. Therefore, they usually enjoy designated positions in an organization and are required to carry out specific duties or tasks by their superiors. Some key responsibilities include process control and decision-making. This group of professionals is also good at coordinating activities in an organization.
Although it is difficult to ignore the above-mentioned differences between leadership and management, it is pertinent to understand that leadership and management roles may overlap. The ideal situation for APRN practitioners is to nurture both qualities. This is why I believe that the best nursing professionals are both leaders and managers. Since there is a need to strike a balance between doing the right thing and doing things right, there is also a strong need to have both leadership and management skills in nursing.
Relative to this assertion, Anderson (2012) says, Critical thinking skills, active listening skills, and good coping skills are essential at all levels in todays nursing workforce (p. 3). Therefore, both leaders and managers need to envision the future. A person does not have to fit one category to do so. Comprehensively, although this paper points out that there could be a tug-of-war between leadership and management in the nursing field; this need not be the case as there is room for the two.
Lopez, R. (2014). The Relationship between Leadership and Management: Instructional Approaches and its Connections to Organizational Growth. Journal of Business Studies Quarterly, 6(1), 98-112.
Stanley, D. (2006). Role Conflict: Leaders and Managers. Nursing Management, 13(5), 31-37.
James Madison is an excellent choice for this study because he is one of the founding fathers of the United States of America. Madisons biography can provide a wealth of information about leadership because he is not only one of the founding fathers, he is also considered as the father of the US constitution.
If that is not enough, another major accomplishment of James Madison is the presidency of the United States. It is an amazing achievement because in more than 200 years of American history, there were only a few people that were voted into the White House.
It was through exemplary leadership traits that enabled Madison to rise from mediocrity to become one of the most important leaders in US history. For the purpose of this study, the life story of James Madison will be used to develop a leadership framework for leadership training.
Leadership Qualities
James Madison was only 5-foot-4 inches (Connelly 12). He was described as pale and at the same time handicapped by a weak and reedy voice (Connelly 12). On March 4, 1809 he gave his inaugural speech as the fourth president of the United States and a historian made the comment that he was extremely pale and trembled when he speak (Mattern 70).
It is important to point out his weakness because the current generation is obsessed with physical appearance. It was a challenge for Madison to succeed especially when compared to political leaders that were known as great orators. However, his weakness can be used to prove that it was through his leadership ability that enabled him to overcome the odds.
His apparent weakness and his less than ideal physical attributes make him an ideal candidate when it comes to the discussion about leadership. The rationale for this decision is based on the need to prove that leadership is not about charisma or the physical characteristics that enable a person to impose his will upon others.
Leadership is the ability to persuade others to follow a certain path. Leadership as a concept was demonstrated in the life of James Madison through intellect, fairness, hard work, and pursuit of excellence in everything that he did.
The starting point towards greatness begins with doing ordinary things in the most extraordinary manner. In the case of James Madison, industriousness was a trademark seen early in his life, especially when it comes to his studies (Rutland 15). He understood the value of hard work.
Although his family was part of the landed gentry in Virginia, the young James Madison knew that it is only through perseverance that a person can become a respected member of the community and contributor to society.
Another important leadership trait was humility, based on his desire to learn from others. There are those who call this trait as a teachable spirit, an attitude towards learning. This attribute was made evident when Madison became an apprentice to Thomas Jefferson (Roberts 17).
The former president Jefferson served as a mentor to his secretary of state James Madison (Rutland 169). Thomas Jefferson was a two-term president and during those years that he was in the White House, Madison was is student.
A humble and teachable spirit is important because a leader is a follower first. A leader cannot lead people if he does not understand the attitude of a good follower. It is only through humble submission as evidenced by the willingness to listen to the admonition and suggestions of a superior that the qualities of a good leader can be established in the persons heart and mind.
There are many who avoided this process and that is the primary reason why many have positions in government and business but are ineffective when it comes to leading people.
James Madison was not only a good follower he also understood the value of teamwork. Without a doubt Madison was an intellectually gifted man and for his brilliance he was credited as the Father of the Constitution. His major contributions to the creation of the said document entitled him to this distinction.
But Madison knew very well that without the contribution of other people he could not achieve what he had accomplished. Thus, he was quoted to have said, This was not, like the fabled Goddess of Wisdom, the offspring of a single brain. It ought to be regarded as the work of many heads and many hands (Kaminski 7). He knew the value of collaboration.
Another important leadership quality evident in his life was his ability to use words to greater effect. He speaks in such a manner that he wins the approval of his colleagues (Ketcham 112). A good leader must know how to speak not only with authority but with persuasion.
A leader may have the authority to force a follower to accomplish a particular task but this is not the most effective way to deal with problems and to accomplish goals. It is through persuasion that a leader can hope to accomplish objectives that require collective effort. He also speaks with fairness (Ketcham 112). It is an attribute that enabled him to garner the support of other people.
It must be pointed out that another enviable leadership quality that Madison possessed was his ability to come up with a solution to a complex problem. His leadership skill in this department was tested during the American Revolution and the time when the United States government was still in its infancy.
As a testament to his capability in making wise decisions, Madison was regarded as a man of sound judgment (Ketcham 112). It is through sound judgment that a leader can develop the correct decision-making protocol and provide solution to a particular problem.
Another leadership attribute exemplified in the life of Madison was his belief in the power of preparation (Connelly 14). Preparation is the key to success in most endeavors. It is foolish to deal with a difficult issue without the necessary preparations made beforehand. The diminutive size and sometimes weak voice of Madison was compensated with his ability to harness the power of preparation.
Another significant leadership quality of Madison was his skills in organization (Connelly 14). This leadership trait was in full display in the aftermath of the war. In the American Revolution it was easy to understand why Madison was preoccupied with war.
The requirements of the battlefield forced him to think only of strategies and logistics. But after the conflict with Imperial forces of the British Crown, Madison turned his focus on the structure of government, finance, and foreign relations (Ketcham 112). It requires a great sense of organization to see how different departments must work together as one.
Biographers of Madison also asserted that His object was not to win a particular battle or defeat a specific enemy but to champion liberty and justice whenever endangered (Kaminski 7). It demonstrated his aversion towards conflict.
Historians also highlighted another enviable trait and that is the commitment to avoid disagreements. In his long and illustrious career as a politician and statesman, Madison knew that there are times when he needed to confront a person and to sharply disagree with others.
However, Madison was wise enough to understand that it is better to resolve conflict rather than to expend a great deal of time and effort to win an argument.
Madison said that Fortunately, such disagreements may be mitigated by applying a proper method. If you see one side of a house, you can form but a partial and imperfect idea of the house, whereas if you attentively visit it on every side and examine every chamber, your idea is adequate and complete (Vile, Pederson & Williams 7).
He was also known to pursue diplomatic solutions (Broadwater 36).A great leader knows how to resolve conflict.
Another important trait was Madisons ability to consider the impact of a particular action on all the stakeholders. The proof for this assertion was the event in 1789 when Madison proposed the bill of rights as a weapon to be used by federal courts to defend liberty and justice (Kaminski 9). A good leader is mindful of the effect of his decisions on his staff, the organization, and the community.
There are other less known characteristics that may seem inconsequential but in a greater scheme of things these are important. According to one historian Madison endorsed frugality in government (Broadwater 35). It is the sign of maturity that a person knows how to conserve resources. A person who is not a good steward must not be chosen to lead.
Overview of the Hospitality Industry
The hospitality industry requires leadership in two major areas. First of all, it requires leadership in the construction and maintenance of facilities. Secondly, it requires leadership in terms of human resources. It must be made clear that leadership is needed before the construction of the appropriate facilities.
Without a clear directive from a leader a hotel cannot be built. The participation of a leader makes possible the availability of funds as well as its proper use towards the construction of a hotel, motel, and other facilities related to the hospitality industry.
The hospitality industry requires facilities. However, without human resources the hotels, motels, bars and restaurants are useless structures. It can be argued that people are the heart and soul of the hospitality industry because it sells a particular service.
In the context of leadership there are two key components when it comes to human resources and these are training and motivation.
Leadership Qualities in the Hospitality Industry
It was made clear that James Madison is an excellent example of an effective leader. His leadership qualities were discussed in detail. These leadership traits must be used to help develop a framework for teaching aspiring leaders how to train and motivate their subordinates.
James Madison was able to exemplify these leadership traits when he succeeded as one of the founding fathers of the United States and when he became the fourth president of America.
As mentioned earlier an admirable leadership attribute of Madison is industriousness. It must be the first requirement for leadership because a lazy leader will not be able to accomplish anything of significance. The hospitality industry can be characterized as a labor-intensive industry.
Thus, the leader must set the pace and must lead by example. The leader must not be late in meetings and must always demonstrate that he is ready to tackle the issues of the day.
Madison exemplified a humble and teachable spirit. A good leader must know how to learn from the experience of others. A good leader understands that he or she need not start from scratch.
A good leader seeks the advice of those who have more experience. A good leader is teachable so that there is the capacity to absorb information and insights that can help improve the business operation.
James Madison understands the power of teamwork. He demonstrated that is only through collaboration that the leader can effectively deal with a complex problem. A leader who does not rely on teamwork will soon experience burnout.
More importantly the absence of teamwork prevents the leader to have a clear overview of the whole operation. At the same time the lack of teamwork can lead to overlapping responsibilities and misuse of human resources.
Madison knew how to use the power of verbal communication. There are many leaders who are not mindful of the impact of their speech.
A leader may have the authority within a particular organization and this may give him a false sense of power so that he may tend to force people to do something rather than to persuade them to accomplish a particular task. It is better to persuade than to coerce.
A coercive action can only be effective in the short-term. The moment that the leader turns his back, the employee automatically reverts to the old practice.
Madison demonstrated his problem solving skills. Leaders in the hospitality industry must not only be adept at following the instructions incorporated in the training manual. They must also possess the ability to read the situation and formulate the appropriate solution to deal with the issue.
There are so many unpredictable things that can occur in a single day and each instance cannot be anticipated by the company manual.
Madison demonstrated that he believes in the importance of preparation. Take for instance the requirements of a five star restaurant. The ingredients must be fresh. The food that will be served must be hot and tasty. All these things require preparation starting from suppliers to the coordinated efforts of the workers.
A good leader prepares the ingredients, equipment, wine, and other things needed for the daily business operation of the restaurant. It will be a disaster if the cooking equipment does not work in the middle of a busy day. The reputation of the restaurant will be severely affected if there are not enough waiters to serve the patrons. Preparation is a major ingredient to success.
Madison possesses organizational skills. This capability is exemplified through an understanding of how different components of an enterprise can be made to work together as one unit.
The application of this skill will enable the leader to subdivide the workload and yet at the end of the day the team realizes how the contribution of all the workers resulted in a resounding success. Without organization skills a leader will not be able to properly utilize all the available resources of a particular business organization.
Madison abhorred conflict and disagreements. He treasured his ability to provide a diplomatic solution to a tenuous problem. The resolution of conflict within the organization does not only result in a positive work environment but it also fosters teamwork. Conflicts and disagreements are inevitable in the hospitality industry but a good leader will not allow the problem to fester.
Madison considered the impact of his actions in the lives of all stakeholders. This trait is an important requirement especially for leaders who are also owners of the establishment.
Sensitivity to the impact of a particular executive decision can mitigate conflicts with influential members of the community. It will also help determine the prudent course of action in order to avoid costly legal entanglements.
Madison believes in the important of frugality. It may not seem an important leadership trait but in view of the recent global financial crisis and the rising cost of doing business, it is imperative that leaders know how to teach their subordinates about the importance of resource management.
The leader must lead by example in this issue. The money saved from a conscientious use of resources can lead to increase revenue for the business organization.
If one will combine the leadership traits exemplified by Madison, then, the result can be utilized to develop leadership skills. A leader can use this framework to train and motivate his or her subordinates. The employees and staff of a hotel, motel, bar and restaurant requires extensive and continuous training.
Thus an effective leader must know how to communicate and persuade the workers to adhere to a particular standard. A leader who does not know how to communicate will not be able to transform an inexperience worker into someone that is effective and efficient in his job.
The second most important job of a leader in the hospitality industry is the ability to motivate workers. As mentioned earlier the hospitality industry can be characterized as a labor-intensive industry and therefore it is easy for workers to feel tired from doing the same thing over and over again. It is through motivation that a leader can inspire workers to sustain a certain level of quality in their work.
In order to understand the importance of motivation, consider the following statement, people are motivated to perform an action that directly results in satisfying their personal needs (Tucker, McCarthy, & Benton, 15). It is therefore important to have a leader that knows how to interact with workers in order to understand the problems that they face within their respective work environment.
However, workers will only confide with their leader if they know that he or she can be trusted. This is why it is also imperative to demonstrate fairness in dealing with workers.
According to a commentary made on motivated workers, employees will work hard and will not ask for too much in return with only one condition: &the elimination of a small but disproportionately powerful amount of office inanity (Kreitner & Kinicki, 25).
There are certain issues that annoy employees and it is the responsibility of the leader to know these things. In the case of hotel maids it is possible that there are certain things that prevent them from performing a good job. These issues must be dealt with. But these things can only be achieved if a leader understands teamwork and possess the requisite organizational skills.
Conclusion
James Madison is an example of an effective leader. He possessed the necessary skills that catapulted him to success. The leaders in the hospitality industry can learn much from him.
A careful analysis of his life story will reveal that certain leadership traits related to communication, organization, problem solving, and conflict resolution can be adapted for the training and motivation of workers. Workers in the hospitality require continuous training and motivation in order to sustain a high quality of service.
Works Cited
Broadwater, Jeff. James Madison: A Son of Virginia and a Founder of the Nation. NC: University of North Carolina Press, 2012. Print.
Connelly, William. James Madison. MD: Rowman & Littlefield, 2010. Print.
Kaminski, John. James Madison: Champion of Liberty and Justice. WI: University of Wisconsin Press, 2006. Print.
Ketcham, Ralph. James Madison: A Biography. VA: The University Press of Virginia, 1990. Print.
Kreitner, Robert and Angelo Kinicki. Organizational Behavior. New York: McGraw-Hill, 2009. Print.
Mattern, David. James Madison: Patriot, Politician, and President. New York: Rosen Publishing, 2005. Print.
Roberts, Jeremy. James Madison. MN: Lerner Publishing, 2004. Print.
Rutland, Robert. James Madison: Founding Father. MO: University of Missouri Press, 1997. Print.
Vile, John, William Pederson and Frank Williams. James Madison: Philosopher, Founder and Statesman. OH: Ohio University Press, 2008. Print.
Tucker, Mary, Anne McCarthy and Douglas Benton. The Human Challenge. NJ: Prentice Hall, 2003. Print.
A state of crisis normally results in unprecedented consequences on people and formal structures of institutions and infrastructures. Leadership for public health crises and emergencies must respond to these crises emergencies, execute crisis management plans, and demonstrate leadership strategies. Therefore, formal leadership during public health crises and emergencies is critical for effective responses. However, in some situations, formal leadership may fail during public health crises and emergencies. This could lead to unprecedented effects on humans and properties.
The word leadership has broad usages. In this context, it would refer to decision-makers, managers, and directors, or simply persons responsible for managing public health crises and emergencies. In health care emergency and crisis management, leadership is critical for an effective response system. Hence, scrutiny of the leadership on managing the response system starts immediately. The provision of leadership may start at the local levels among the community affected by the disaster.
At this point, the media can severely criticize any apparent weaknesses and failures of the leadership system in their responses. Thus, the role of leadership in managing public health disaster is essential for the victims, as well as other people that the disaster could have affected in different ways.
One major imperative aspect of disaster and crisis management is people. People include those who respond to crises and emergencies in order to help disaster victims. Such actions would result in ineffective use of available resources in order to reach the greatest number of people who need help.
One must recognize that understanding leadership in public health crises and emergencies is a complex affair under the unique prevailing circumstances, which require effective mitigation, adequate preparation, response, and recovery. There are different leadership behaviors under such circumstances. Others may be effective and imperative, whereas other leadership behaviors could face significant challenges.
Key challenges in providing leadership during public health emergencies and crises
The main source of challenge in providing leadership during public health emergencies and crises is communication. In most cases, the bureaucratic officials may take over control of the situation and hamper effective communication. As witnessed in the previous public health emergencies, political leaders and local leaders normally assume control of the situations. They want to reassure the affected people and the public that the emergency is under control even when it is impossible to manage. On the other hand, leaders can communicate information, which can aggravate the publics panic, particularly when they exaggerate the emergency situation.
Some leaders may not be effective in providing reliable information to the public as the crises develop. They can break the public confidence by their declarations. In this regard, communication should be reliable, accurate, and effective, and it must come from an authority that has the power to communicate such updates to the public. Unfortunately, in most cases, public health and medical leaders may also lack effective communication strategies, particularly to the public.
They may use medical terminologies, which are beyond laymans comprehension. While political leaders may be willing to communicate to the public, they may lack reliable information that the people want. On the other hand, public health leaders and professionals may not be willing to address the public. Therefore, effective coordination of communication channels between these groups is critical for reliable and accurate information during emergencies and unfolding crises (Kahn, 2009).
The decision-making process is another significant challenge during emergencies. A number of factors, including legal aspects, influence decisions during emergencies. Severe health emergencies and crises, which overwhelm the local or national capacity, may require authorities to declare a state of emergency. However, public health leaders might not be the right people to make such decisions. Such situations require political leadership to do so because of the responsibilities they owe the nation. For instance, a bioterrorism attack may require the countrys leadership to protect its citizens. On the other hand, this is also a public health emergency and crisis.
Therefore, it becomes the responsibility of the state. This situation can lead to confusion, complex affairs, and lack of communication. Therefore, it is important for public health officials and the state to declare who should take charge of public health crises and emergencies. Delaying responses due to such complexities and duality may not serve the best interest of an anxious public.
Lack of coordination among different stakeholders can negatively influence leadership during a public health crisis. Parties who recognize and understand their roles can facilitate recovery efforts and delivery of services to the affected groups. However, when there is a miscommunication among stakeholders, leadership challenges may emerge and derail all efforts. Leaders must develop a working relationship in order to coordinate public health issues.
In fact, a lack of a working relationship among leaders can affect decision-making processes. These challenges will eventually affect victims. In some cases, public health officials may show a lack of involvement in the process. Media and other stakeholders can criticize them due to their poor coordination and poor leadership. Leaders must have a clear knowledge of the crisis before making public utterances. They must also be able to coordinate all forms of activities, which go on during recovery processes.
Some public health leadership may lack a framework for strategies, methodologies, norms, and standards for responses after an emergency. In addition, they may not know how to respond to the impending humanitarian crises. Such frameworks are essential in guiding public health leaders to manage situations. However, they must recognize that no two emergencies are similar. Hence, such frameworks should only act as guidelines on general areas, which are common to all emergencies and crises. Public health leaders should have such frameworks to assist them in the coordination of various post-crisis activities. Moreover, they are also useful for the implementation of various interventions in order to curb further damages, restore normalcy, and enhance the lives of communities affected (Wright, Rowitz, and Merkle, 2001).
Lack of data to act upon can derail leadership actions. Emergencies and crises create new situations with a sense of insecurity, confusion, and anxiety. This could result from a lack of adequate information. It becomes difficult to allocate scarce resources when key facts of the events are not known. This suggests that assistance may not reach the victims in a timely manner. Moreover, it may also be difficult to request help since the magnitude of the disaster or the number of resources required may not be known immediately. Still, there are no adequate infrastructures to allow leaders to mobilize resources for effective responses.
Differences in challenges between expected or ongoing public health crisis or emergency and sudden or an emerging crisis or emergency
An ongoing emergency or a crisis differs in many from a sudden crisis. Hence, leadership challenges in these scenarios may be different, but some may have close relations.
Crisis communication is a constant process that public health leaders must maintain throughout the period of the emergency or crisis. Ineffective communication results in poor management of a crisis. In poor communication systems, public health leaders may commit some fundamental mistakes. First, a lack of a formal organization among stakeholders and leaders can hamper communication (Yilmaz, 2011). Some stakeholders can decide to withhold information from other stakeholders and the public. After a few days into the crisis, stakeholders can be able to coordinate and assemble a team to manage communication processes and information dissemination to the public. Public health leaders and other government officials should not make opposing statements.
Second, during crisis management, the message should be clear and accurate. Public health officials should ensure transparency and provide available data. They should not hide any information from the public due to a lack of adequate information. Third, communication processes require synchronization (Yilmaz, 2011). It is important to consider all details of the disaster before any public announcement.
The usages of new strategies as the crisis unfolds may not present challenges. Leaders may be familiar with the new requirements because of information they may aid in the allocation of resources. Moreover, there would be aid from different sources. These contributions normally lessen the pressure on leaders and reduce the vulnerability of the victims and the community.
Leadership challenges in an ongoing crisis may rely on available information to mitigate health challenges, reduce the loss of lives, properties, and other health risks to the public and communities affected. Ongoing projects have robust systems of assessment and decision-making processes. Moreover, leaders can monitor the progress of the situation.
It could be easier to coordinate activities in an ongoing process rather than in a sudden emergency. Leaders may find it easier to work with other interested bodies and other health partners. They may adopt an inclusive model to facilitate the inclusion of all stakeholders in the process. This could result in a coordinated process rather than in a sudden state of emergency.
Challenges in an ongoing crisis could have low-levels of impacts because leaders may have logistics support hubs, infrastructure, experts available, and frameworks for the system. In this manner, they can manage supplies, water and sanitation, nutrition for victims, and effectively manage funds and other key areas during emergencies.
While leadership challenges in both cases may be similar, they differ based on the intensity and impacts on the emergency. A sudden state of an emergency or a crisis presents significant leadership challenges than an ongoing one. Crisis communication remains the single constant factor that is necessary throughout the process.
Potential solutions to the challenges
The most important aspect of managing a crisis or an emergency is to have a plan and implement it effectively. Most disasters result in severe damages and humanitarian crises because public health officials and leaders may fail to plan and implement their plans. Normally, effective preparation begins with the identification of a crisis or emergency. A country should have a communication guideline for managing crisis communication.
It is also necessary to have a response team with working knowledge in their roles. A readily available framework can provide guidelines on how leaders can organize their roles and communicate the same to other members as soon as the emergency or crisis starts. An effective plan should borrow from the best practices in crisis communication management. Such a crisis communication plan normally stipulates communication procedures, teams, and provides a centralized way of communication and exchange of information. A crisis communication plan allows public health leadership to overcome systemic challenges and actively assess information presented by all parties before making public announcements. This can prevent cover-ups and possible communications of inaccurate information.
Moreover, no public health official would have the opportunity of relaying unverified information to the public. Slow communication from public health leaders can make the situation worse than anticipated. In such cases, the media may seek news or information from untrustworthy sources that could do further damages to a crisis management process. Such sources can only cause confusion and heighten the publics anxiety about a crisis.
At the same time, trained public health leaders would have known how to react quickly, tell the truth, explain technical data to laymen, and harmonize crisis management and crisis communication (Yilmaz, 2011). The aim of communication from public health leaders is to develop trust with the public. Proper preparation remains the most important aspect of managing all crises and emergencies.
Recognition: local authorities and leaders must recognize a hazardous event that results in an emergency or a crisis. For instance, a bomb explosion may trigger leaders to recognize an event as a health hazard. The response effort then commences in earnest in order to save lives.
Allocation of scarce resources: emergencies raise issues concerning scarcity of resources. Both sudden and ongoing cases are no exception. Therefore, public health leaders must allocate scarce resources using ethical and clinical guidelines. Critical supplies that may be in short supply include medication for the survivors, surgical supplies, and rescue team personal protective gear. Public health leaders must ensure that these resources have controlled distribution to serve the majority.
Disaster assessments: public health leaders must assess the extent and impacts of an emergency situation. They must begin collecting data for information needed to facilitate the response processes. Public health leaders must be able to know at any given moment what is taking place, where it is taking place, what the survivors need, and what resources are available. The nature of any emergency or a crisis may increase in complexity due to its size and scope.
In order to ease the task, public health leaders must categorize the assessment into two groups. Situation or damage assessment to determine what has happened as a result of the emergency or crisis. This will allow public health leaders to determine the geographical scope of the disaster, how it has affected people and structures. Therefore, they must seek data related to the area affected, number of people affected, number of injured (morbidity) and killed (mortality), types of injuries and illnesses, conditions, and characteristics of the victims. At the same time, data on medical, health, nutritional, water, and sanitation conditions of the victims are also necessary.
The need assessments also involve a collection of data on ongoing or emerging hazards because of the spread of health concerns and humanitarian crises. They must also assess damage to infrastructures and critical facilities, residential and commercial structures affected, the vulnerability of the affected population to ongoing or expected related and unrelated hazards, and current response effort in progress. The need assessment involves collecting data on services, resources, and assist public health leaders will require in addressing the emergency.
The consequences of an emergency or a crisis may persist for a long duration because of emerging concerns that result from damages caused. Hence, treating the hazard is critical for the process. However, public health leaders must ensure that people who respond to the emergency must limit or eliminate danger to survivors. Public health leaders must call in specialists with special equipment and training on the emergency.
Coordination: public health leaders must develop an action plan for disaster coordination. Coordination is a vital and immediate component of disaster response because of the number of responding agencies that come to rescue the victims. In order to save many lives, property and alleviate suffering, public health leaders must ensure successful coordination and cooperation in safe and efficient use of response resources. The coordination process ensures that there are limited wastage, infighting, nonparticipation, confusions, and inefficient use of resources during emergency situations.
In order to ensure the most effective coordination, public health leaders should ensure that the local government administration, emergency manager, fire officer, and police department should maintain leadership at all times. This happens because the local response leaders may be familiar with the case, the area, affected people, infrastructure, geography, and other issues necessary for a successful response. In case the local leadership is unable to take leadership coordination, then public health leaders should ensure that the national government takes charge.
Declaration of disaster: crises and emergencies usually cause a public scare. Public health leaders must arrange for a disaster declaration plan. The government must acknowledge that response resources are limited, and more support is necessary, particularly to manage emerging cases. Public health leaders must also put in legal requirements depending on the laws of the land as established in emergency operations and planning.
Planning: public health leaders must ensure that the planning section provides support through gathering, evaluating, disseminating, and using available and accurate information about the progress of the incident and the functional status of all the available responders and resources. Public health leaders must create an Action Plan (SAP) to provide overall guidance and management for response operations. They must focus on collecting, evaluating, and displaying incident information and intelligence. This part also looks into preparation and documentation of APs, doing long-range contingency plans, creating plans for demobilization, and tracking incident resources.
Public health leaders must allow the local government, who has the primary responsibility, to respond to the emergency. The approach must be step-by-step as it goes high to the national government. This should happen when the local authority cannot handle the disaster at the local level. The local authority must communicate this information to the local executives, who then decide to declare the emergency or crisis as a disaster and appeal to the next level of authority for assistance.
Logistics: the response to an emergency or a crisis depends on all the support and logistical provisions, which start as soon as the resources are deployed. Response tools include rescue team, equipment, facilities, and vehicles. The Logistics section looks into acquisition, transport, and distribution of resources, provision of water, food, and medical attention. The Logistics section also ensures that there is personnel to operate equipment and perform other logistics tasks.
All these aspects of crisis and emergency management require effective planning and communication among all stakeholders. This would eliminate several leadership challenges.
References
Kahn, L. (2009). Leadership in a public health crisis. Web.
Wright, K., Rowitz, L., and Merkle. A. (2001). A Conceptual Model for Leadership Development. J Pub Health Man Prac., 3(5), 72-79.
Yilmaz, S. (2011). Fukushima Nuclear Disaster: A Study in Poor Crisis Communication. RSIS Commentaries, (93), 1-3.
A leader I am acquainted with is a nurse leader in a medical surgical unit. Her leadership style is both democratic and autocratic. For example, she directs other nurses using guidance and suggestions instead of orders. She includes others in decision-making and is attentive to our opinions; she evaluates each of them and points out which of the options is more suitable for the current situation.
However, this nurse leader can also utilize traits common for the authoritarian style of leadership. Marquis and Huston (2017) point out that strong control over the work group, coercion as a motivation tool, and communication that flows downward are standard for this type of leadership. During emergencies or situations that require our full attention, this nurse leader maintains firm and strict control over our group and usually does not allow us to counter her decisions.
However, this is done to ensure that no time is wasted on unnecessary discussions. Her ability to balance between the democratic and democratic styles of leadership is inspiring because neither of those leadership styles is entirely suitable for emergencies and events that frequently occur in medical surgical units. Without control, performance rates can drop and affect patient outcomes. At the same time, if nurses would not take part in decision making, they would be less motivated to ensure their performance is quality.
My leadership style is democratic. Therefore, many our approaches toward followers and the workflow are similar: we put emphasis on the team rather than on ourselves, we use constructive criticism, and appreciate the input from others.
However, I would be happy to maintain more control over my followers. Benoliela and Somecha (2014) point out that high-agreeableness is a good trait for a leader because such leaders can be altruistic, cooperative, trusting, and forgiving. I am an agreeable person, but a constant pursuit of cooperation and forgiveness often results in less control that I would like to have. It would be good to maintain as much control as the mentioned nurse leader has over followers because it is crucial in complex decision making and with patients who are in a critical condition.
A characteristic I would not like to integrate into my leadership style is the decision to prohibit any suggestions during an emergency situation. Although this nurse leader usually involves us in decision-making, she does not allow us to dispute her orders during a more serious event, e.g., when we are handling a critically ill patient. The problem with such approach is that the nurse leader can miss out a valuable suggestion that could potentially help the patient (Graham & Melnyk, 2014). Therefore, undisputable control is not always practical, even during emergencies.
Still, I would describe this nursing leader as a democratic one. Democratic leadership can improve the perception of healthcare facilities by patients, as it emphasizes patient-centered care. Those patients that support the involvement of their families in decision-making will support the democratic style of leadership.
Ahmad, Adi, Noor, Rahman, and Yushuang (2013) point out that the democratic style of leadership can positively influence job satisfaction among nurses. With the increase in job satisfaction, motivation and commitment will also rise. Such changes can lead to a decreased number of medical errors, reduced workplace stress and burnout, thus improving the quality of healthcare. With the reduced number of medical errors, patient outcomes will also improve (e.g., common issues such as hospital-acquired infections might become less frequent).
References
Ahmad, A. R., Adi, M. N. M., Noor, H. M., Rahman, A. G. A., & Yushuang, T. (2013). The influence of leadership style on job satisfaction among nurses. Asian Social Science, 9(9), 172-178.
Benoliela, P. & Somecha, A. (2014). The health and performance effects of participative leadership: Exploring the moderating role of the Big Five personality dimensions. European Journal of Work and Organizational Psychology, 23(2), 277294.
Graham, S., & Melnyk, B. M. (2014). The birth of a healthcare leadership academy: Lessons learned from the Ohio State University. Nurse Leader, 12(2), 5574.
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
This essay answers questions from two scenarios about Mrs. Zwick and Mr. Davis who are both sick and need medical insurance cover. Medicare part A will fully cover the inpatient care within the hospital for the five days Mrs. Zwick spends there. It will also cover meals and semi-private room and general nursing. She will pay $ 1156 deductible and no co-pay at the hospital. After being transferred to the skilled nursing home, the costs that will be covered include meals and the semi-private room, rehabilitation services, skilled nursing and other supplies and services. She will pay $ 144.50 (Carmen, 2010).
Since Mrs. Zwick qualified for Medicare part A, she automatically qualifies for Medicare part B. Mrs. Zwicks costs that will be covered by Medicare part B include the charges made by physicians, X-rays and other charges out of the hospital (Carmen, 2010). Medicare part B will cover all the costs incurred at the skilled nursing home.
It will cover any other costs such as those of medication, any visits by the doctors, medical equipment such as the walker she was given, health services out of the hospital and laboratory tests. Medicare part B has a deductible of $140. It has co-pay because she will pay 20% of her costs. The insurance will cover the remaining 80 percent of these costs. Mrs. Zwick pays a premium every month that is subject to adjustments every year. In the year 2012, the premium has been set at $99.90 every month.
These premiums will cater for 25 percent of the actual costs that Mrs. Zwick will incur after leaving the hospital. The remaining 75 percent will be taken care of by the federal government from revenue obtained through general taxation (Carmen, 2010). Certain services may have no costs for Mrs. Zwick to pay. Since there is a deductible of $140 for Medicare part B she will have to pay all the costs up to the time she meets the early deductible for part B before the share belonging to Medicare is paid. After the deductible has been paid she will just pay 20 percent of the amount approved for Medicare.
Medicare part D allows Mrs. Zwick to get her drug prescription at a lower cost from her own pocket. Mrs. Zwick has automatic enrolment because she has Medicare part A and Medicare part B (Carmen, 2010). All her costs will not be covered though. She will not pay anything to be covered under Medicare part D.
The policies of Medicare require that insurance does not cover costs for mistakes, infections and preventable conditions that patients get while staying in hospital. Therefore, the insurance program does not allow her to be reimbursed for the additional care she received (Carmen, 2010).
Based on the law, the hospital should carter for the costs of hospital-acquired infection. Since she was in hospital when she acquired the infection, it was the hospital that was allowed by law to pay for the costs of treatment for the infection. It is therefore unethical for Mrs. Zwick to have incurred the costs because ethical requirements do not allow her to be fleeced of her money unfairly. She can seek legal action against the hospital for failing in its ethical obligations (Carmen, 2010).
Mr. Davis has group health insurance from his former employer. Therefore, he has the right to continue with his insurance coverage via the group plan even when he is not at work. Mr. Davis will therefore remain on his former employers insurance coverage list since he was terminated for absenteeism due to his illness (Carmen, 2010). Coverage will continue for a period of up to18 months or more depending on the circumstances. Mr. Davis will have to pay for insurance coverage.
When Mr. Davis was still in employment, his employer may have taken care of all or a certain portion of his group health premiums. After leaving employment, he ceased getting any benefits. COBRA requires that he pays the full amount of the premiums. This comprises the amount of premium that he used to pay while still an employee and the contribution amount that his former employer made. He will also be required to pay an administrative fee of 2 percent (Carmen, 2010). Mr. Davis will be expected to pay group premium rates.
This is an advantage to him because these rates are lower when compared to individual rates. Because there is a possibility that some time may have passed between the time of losing his job and the time of making the COBRA election, he may be required to pay premiums in a retroactive manner from the time he left the job. The very first premium will be used to cover the period since his last day at his former employers factory (Alyssa, 2008).
One major challenge is that the number of those without insurance is on the increase. As people get older, the rate of chronic disease goes up and the changing lifestyle also contributes to the same. Another challenge is the increasing costs of medication. Those without insurance incur very high expenses some of which may have to be compensated.
In this, the state or local government spends a lot of money. To address the challenge of rising expenses the state should make it compulsory for everyone in the U.S to have health insurance. This will ensure that the number of uninsured people drops considerably (Alyssa, 2008).
Retired persons, children and the unemployed have medical cover in Germany, Great Britain, Japan and Switzerland. For medical coverage, it would not be better for Mr. Davis because in Germany, Great Britain and Switzerland he would be expected to pay part of the costs for his treatment from his pocket. In Japan, he would be better off because he can get medical cover (Alyssa, 2008). When in Japan he would not be required to pay for his treatment with his own money.
In Germany, patients have reduced cost-sharing if they want a referral to go and see a specialist. Great Britain and Switzerland require patients to register with General Practitioners for them to get referrals to a specialist. Japan has no restrictions on seeing a specialist. Coverage for pre-existing conditions is available in Great Britain but not in Germany.
Within Switzerland and Japan, Mr. Davis wont get insurance cover (Alyssa, 2008). Japan is the most suitable place for him to go. The recommendation in this paper is that all people should strive to get medical insurance cover. This reduces the burden that the government has to bear.
References
Alyssa, K.S. for insure the uninsured project (2008). Health care systems around the world, 36. Web.
Carmen, D. (2010). Income, poverty and health insurance coverage in the United States (2005). Darby: Diane Publishing.
The dramatic shifts being experienced in the scope and mode of delivering oral health care and the myriad challenges facing dental practitioners demand new and sustained approaches to develop leaders with the skills and competencies required to guide oral health practice into the future (Kalenderian, Taichman, R, Skoulas, Nadershahi, & Victoroff, 2013). As such, students in dentistry and related oral health disciplines need to be prepared on how to address these changes and challenges using appropriate leadership styles and approaches. In light of this observation, the present paper compares the three approaches to leadership with the view to identifying the most appropriate approach in dental public health contexts.
Available literature groups most of the existing leadership styles into three broad leadership approaches (trait, behavior, and situational), each with its own distinct characteristics and application mechanisms (Longest, 2011). The most traditional of the three is the trait leadership approach, which uses personality, social, physical, social, physical, or intellectual traits to differentiate leaders from non-leaders (Derue, Nahrgong, Wellman, & Humphrey, 2011, p. 8). This approach advances the perspective that leaders are born with special traits such as extraversion, conscientiousness, openness and emotional intelligence, which in turn assist them to influence subordinates or followers toward the attainment of set goals and objectives. The behavioral approach to leadership, on the contrary, denies that leaders are born and instead reinforces the perspective that specific behavioral orientations (e.g., task-oriented behaviors and people-oriented behaviors) come into play to differentiate leaders from non-leaders (Derue et al., 2011). Lastly, the situational leadership approach is different from the other two as it is embedded in situational or environmental contexts of leadership. Most situational leadership theories consider the influence of followers and other environmental variables in developing the capacity for individuals to become effective leaders (Longest, 2011).
In my view, the situational leadership approach is the most sensible in dental public health contexts by virtue of its realization that environmental contexts and followers are important components in any leadership activity. Research is consistent that dental public health programs and projects must have the capacity to not only address the needs of communities but also to gain acceptance from community members (followers) and to include them in decision-making processes (Kalenderian et al., 2013). Consequently, leaders of such programs and projects must develop the capacity to lead in different situations and contexts by changing their style of leadership to fit the followers (community members) demands, needs and expectations as demonstrated in the cognitive resource theory.
Additionally, the situational leadership approach is the most appropriate in dental public health contexts is it provides leaders with the capacity to assess the willingness and readiness of community members to implement a particular program or project. It is no secret that some dental health programs and projects may experience resistance from community members due to a multiplicity of reasons. In such a situation, leaders can shift their style to fit the community members level of readiness to the program and then address their concerns and needs from that perspective. It is also possible for leaders faced with such a situation to use Houses path-goal theory to coach and guide community members to select the best trajectories for realizing their objectives, as opposed to leading from a trait or behavioral perspective (Kalenderian et al., 2013).
Overall, from the comparison of the three leadership approaches, it is evident that situational leadership theories are more applicable in dental public health contexts as they provide leaders with the opportunity to consider environmental contexts and followers.
References
Derue, D.S., Nahrgong, J.D., Wellman, N., & Humphrey, S.E. (2011). Trait and behavioral theories of leadership: An integration and meta-analytic test of their relative validity. Personnel Psychology, 64(2), 7-52.
Kalenderian, E., Taichman, R.S., Skoulas, A., Nadershahi, N., & Victoroff, K.Z. (2013). Developing the next generation of leaders in oral health. Journal of Dental Education, 77(11), 1508-1514.
Longest, B.B. (2011). Managing health programs and projects. San Francisco, CA: Jossey-Bass.
Buse, C, Martin, D and Nettleton, S (2018) Conceptualising materialities of care : Making visible mundane material culture in health and social care contexts, Sociology of Health & Illness, 40(2), pp. 243255.
This article introduces the concept of materialities of care, which may be helpful in the field of health and social care. Buse, Martin, and Nettleton (2018) explore three dimensions of the newly introduced concept: spatialities, temporalities, and practices of care, each of which is used to describe and specify social care work. Spacialities describe places actual for social care patients, such as hospitals or museums, temporalities describe processes and feelings of patients, and practices are actual actions, such as exercises, necessary to maintain health. After reading the paper, I concluded that the concept of care materialities helps me in planning my work more efficiently. For example, temporalities of care are suitable for planning patient day schedules, making them more consistent and understandable. Thus, I will use the concept in my career to complete my work quicker and more efficiently.
Kinsella, E. A. et al. (2018) Mindfulness in allied health and social care professional education: A scoping review, Disability and Rehabilitation, 42(2), pp. 283295.
This study explores the concept of mindfulness, how it helps social care workers to cope with their work stress, and how to implement it in practice. Kinsella et al. (2018) analyzed 50 studies related to mindfulness in social care and elucidated its five fundamental aspects: attention, self-awareness, compassion, non-judgment, and acceptance. For me, those findings are essential to understand how I can reduce my stress level and enhance my social and cognitive abilities, which are necessary for my career in social healthcare.
Moudatsou, M. et al. (2020) The role of empathy in health and social care professionals, Healthcare, 8(1), p. 26.
In this paper, the concept of empathy and its role for social care workers are reviewed. Moudatsou et al. (2020) evaluated and discussed 78 studies to elucidate three dimensions of empathy: emotional, cognitive, and behavioral. All of them are important for social care workers, who should be able to feel and understand the emotions of their clients and, in addition, cope with their own. For me, this model provides a robust tool for enhancing my empathy: emotional dimension for feeling others emotions, cognitive for proceeding with them, and behavioral for coping with my own emotions. I will remember it and use it to become a better social care worker during my career.
Papadopoulos, I, Koulouglioti, C and Ali, S (2018) Views of nurses and other health and social care workers on the use of assistive humanoid and animal-like robots in health and social care: a scoping review, Contemporary Nurse, 54(4-5), pp. 425442.
This article explores the usage of assistive robots in the social healthcare field. The main topics are the attitudes toward robot usage among social care workers and patients, in which activities robots may be the most valuable, and where their use causes the most concerns. Papadopoulos, Koulouglioti, and Ali (2018) analyzed nineteen studies connected with robot usage in healthcare. High cost, privacy concerns, and patient safety are the main obstacles that discourage social health workers from using robots. Still, they are especially useful as information providers for patients. For me, the importance of the article is that the implementation of new technologies, such as robots, is inevitable and may drastically increase the efficiency of social work. Thus, it is crucial to know how robots may be effectively used during my future career and understand all risks of working with them.
Smith, T. et al. (2018) Leadership in interprofessional health and social care teams: A literature review, Leadership in Health Services, 31(4), pp. 452467.
This critical literature review presents the interprofessional health leadership framework: a set of necessary skills and qualities that are helpful for interprofessional leadership. Smith et al. (2018) analyzed twenty-eight papers and elucidated twelve patterns that were included in the framework: examples of them are personal leadership qualities, communication and creativity skills, and a high level of expertise. The framework is good for analyzing which skills are necessary for healthcare leaders and help them develop those skills. I will use this model as a backbone for developing my leadership qualities and skill, which are necessary for my social healthcare career.
References
Buse, C, Martin, D and Nettleton, S (2018) Conceptualising materialities of care : Making visible mundane material culture in health and social care contexts, Sociology of Health & Illness, 40(2), pp. 243255.
Kinsella, E.A. et al. (2018) Mindfulness in allied health and social care professional education: A scoping review, Disability and Rehabilitation, 42(2), pp. 283295.
Moudatsou, M. et al. (2020) The role of empathy in health and social care professionals, Healthcare, 8(1), p. 26.
Papadopoulos, I, Koulouglioti, C and Ali, S (2018) Views of nurses and other health and social care workers on the use of assistive humanoid and animal-like robots in health and social care: a scoping review, Contemporary Nurse, 54(4-5), pp. 425442.
Smith, T. et al. (2018) Leadership in interprofessional health and social care teams: A literature review, Leadership in Health Services, 31(4), pp. 452467.
Leadership is one of the most significant aspects of advanced nursing, included in most educational programs curriculum and inevitably occurred in practice. Indeed, solving a problem identified in a healthcare organization enables a practitioner to develop convincing arguments to encourage others to take actionEast Orange General Hospital, create plans and execute them, and evaluate the efficiency of interventions (Hickey & Giardino, 2021). In my practicum site, East Orange General Hospital, the problem of the impoverished populations refusal to attend the follow-up visits with their doctor has been recently identified. Consequently, my practice hours completion is focused on creating interventions and solutions to the issue, and creating a plan with proper strategies is vital for success. This paper aims to explore the project management design and leadership styles appropriate for the efficient addressing of the issue of the impoverished population skipping the follow-up appointments.
The problem of the impoverished beneficiaries who do not attend their follow-up visits is critical for the East Orange General Hospital because most patients represent that population, and their behavior negatively influences the services quality. Skipped appointments are severe for the organizations because they reduce efficiency, increase costs, and waste the previous treatment results (Dantas et al., 2018). The issue must be addressed on the healthcare organizations end with the practitioners, physicians, and administrators involved. The initiatives implementation requires an execution design that includes diverse leadership approaches and project management techniques where multiple activities can be performed and evaluated simultaneously. The SMART objectives and evidence-based practice implementation are the design approaches for creating a project to address the problem of impoverished patients skipping their follow-up visits (Sipes, 2020). For instance, the objectives must be formulated based on the recent evidence, with the related actions necessary to achieve them.
The strategys focus is the population that needs an intervention to change their behavior towards attending the doctor. As the beneficiaries interact with their physicians, nurses, and administrators, a change in their practice is required to decrease the number of missed follow-up visits. The Statement of Work (SOW) must include separate action plans for each stakeholder; thus, the leadership styles to address them can vary (Sipes, 2020). In interaction with the administrators, autocratic execution is appropriate as they must follow the action plan to achieve results (Spiva et al., 2021). In contrast, physicians aware of aspects of their patients life and health conditions can use different influence tactics; therefore, the leadership style suitable for them is transformational. Nursing practitioners role in the project is to communicate with the impoverished population and encourage them to change behavior towards attending the follow-up visit. Consequently, they would benefit from the visionary leadership style through which the person in charge would support their willingness to impact patient outcomes.
Several practice changes must be implemented to address the issue of the East Orange General Hospitals impoverished patients misattending their follow-up visits. Patient education performed by a physician should explain the importance of the additional appointment and the consequences of skipping it (White et al., 2021). Nursing practitioners can influence patients decision-making by discussing the priorities of the impoverished population representatives and sharing information about the costs of treatment that a timely follow-up visit could prevent. From the administrators perspective, practice change includes new protocols of notification, such as the increased number of SMS and phone calls.
The barriers to successful project management and realization are uncertain hospital attendance policies frequently updated in the East Orange General Hospital due to the COVID-19 pandemic. Furthermore, the patients reaction to practice change is unknown and might result in adjusting all execution strategies and the projects activities (Sloane et al., 2018). A plan facilitator with various actions and participants must be the one with access to all units and authority among the stakeholders (White et al., 2021). My preceptor was willing to develop and execute the agenda; thus, they took the role.
The projects success depends on how the entire team will deal with the barriers, the facilitators ability to notice and address the issue timely, and the executions efficiency. Indeed, in the case of the COVID-19 lockdowns or other side reasons for the impoverished populations inability to visit the hospital, physicians, practitioners, and administrators would be forced to change their activities. The autocratic leadership style would be beneficial for the latter to change their follow-up notifications or switch by following the new instructions (Sipes, 2020). Transformational relationships between the executors and physicians would allow the doctors to create individualized tactics to reach patients, such as telemedicine recently adopted in several East Orange General Hospital units. Lastly, the visionary leadership style applied to nursing practitioners will help them keep trying to impact their beneficiaries.
The leaders skills, such as listening, delegation, and evidence-based decision-making, match the identified facilitators and barriers. Indeed, the practice gap achieved through multiple actions performed by diverse employees is proven successful when an executive person hears and addresses the feedback (Sloane et al., 2018). Furthermore, a leader who prioritizes delegation over multitasking is more efficient as they make all team members feel needed and free up time for additional research or strategy improvement.
Addressing the problem of the impoverished population refusing to attend their follow-up visits is crucial for the East Orange General Hospital. The project management strategies must comply with the roles of all stakeholders and include SMART objectives based on the evidence about the population and their behaviors consequences. Diverse leadership styles, such as autocratic, transformational, and visionary, are necessary to achieve sustainable results effectively.
References
Hickey, J. V., & Giardino, E. R. (Eds.). (2021). Evaluation of quality in health care for DNPs (3rd ed.). Springer Publishing.
Sipes, C. (2020). Project management for the advanced practice nurse (2nd ed.). Springer Publishing Company.
Sloane, D. M., Smith, H. L., McHugh, M. D., & Aiken, L. H. (2018). Effect of changes in hospital nursing resources on improvements in patient safety and quality of care: A panel study. Medical Care, 56(12), 1001. Web.
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.
The interview was undertaken with an emergency ward nurse whose role was to assist healthcare specialists in dealing with the reception of patients in the casualty area to receive patients in need of immediate care. The main issue experienced in the past few months was the ambiguity in leadership, especially in cases where the roles of different specialists coincided or overlapped. In such cases, there has been experienced the confusion of roles, making it take time before the patients would be taken to the wards for stabilization before extensive treatment would be taken based on the tests run on the patients. The issue had been experienced on several occasions and required quick intervention before such a case would lead to a crisis resulting in the death of a patient. The interviewee has worked in the emergency department for over two years and stated that the issue has persisted for a long time and needed intervention. After learning about the situation, the management has tried to assign one medical practitioner at a time, but some situations require a team to ensure the safety of the patients.
Issue Identification
According to the interview, the main interdisciplinary issue identified was the role and leadership ambiguity in nursing practice. Role and leadership ambiguity is critical in nursing practice, especially when the nurses are confronted with complex conditions requiring immediate attention. Still, the healthcare team does not know where to handle the case. Such cases are experienced, especially when an unconscious patient is brought to a hospital emergency department and requires immediate medical attention. In such conditions, an interdisciplinary team must undertake all the necessary measures to identify the problem with the patient and take the necessary measures to ensure that the patient is stabilized before the actual care is provided. In addition, an interdisciplinary team is required to enhance the quality of care provided where specialists in different health care issues are involved in ensuring that all the procedures are executed in time to save the patients life.
We examined the healthcare records maintained in the facility and identified that the time taken from when the individual was admitted to the time the individual was attended to was high. Cases of medical errors were also slightly higher, indicating the challenges in role ambiguity. In addition, we also got some notes from the facility suggestion box with complaints about poor emergency services from the casualty department. Among the aspects outlined in the notes were delays in attending to patients and a low admission process.
Change Theories That Could Lead to an Interdisciplinary Solution
According to the identified problem, different change theories can be used to solve the situation. Among the most efficient theories that can be used in the situation are the Lippitt, Watson, and Westley planned change theory, which focuses on the nurses role and responsibilities as change agents (Wagner, 2018). The theory is effective in diagnosing the healthcare problem, assessing the motivation and capacity for change, assessing resources and motivations, establishing strategies and objectives, and determining the role of change (Wagner, 2018). The theory provides mechanisms for maintaining the change and development of an organizational culture based on the realized impacts of change. Such steps can effectively solve the role and leadership ambiguity in the hospital.
The other theory applicable in the facility is the innovation diffusion theory which explains how available knowledge can be used to develop a solution that can be adopted for a clinical issue. The theory gives room for the adoption or rejection of an idea if the change agent is based on the success of the change agent in dealing with the identified problem (Wagner, 2018). The theory is essential as it involves other stakeholders like policymakers responsible for developing policies in the healthcare facility.
The chaos theory can be used significantly where linear change development method delays change development. The theory is based on the best intentions and focuses on providing quick fixes that improve organizational functions (Wagner, 2018). It can be used to improve the quality of healthcare services and enhance patient care safety.
Leadership Strategies That Could Lead to an Interdisciplinary Solution
Interdisciplinary teams require leaders with unique qualities to enhance the groups success in executing a specific task. Such leaders should apply different strategies to ensure that all parties involved are equally engaged in providing the desired solution (White et al., 2019). These leaders apply strategies like self-regulation, where the leader does not dominate all the decisions made in the team and gives other professionals their opinions. In addition, communication strategies are also critical in interdisciplinary teams to enhance the level of understanding among the professionals (White et al., 2019). A supportive team climate is also necessary for developing an effective interdisciplinary solution as all the participants feel a sense of belonging (Zajac et al., 2021). Leaders can also ensure that appropriate tools and resources are provided for the adequate performance of the team.
Collaboration Approaches for Interdisciplinary Teams
Teamwork is one of the best collaborative approaches used in an interdisciplinary team. This approach ensures that all the members from different disciplines work together for a common purpose and to attain similar set goals (Zajac et al., 2021). In addition, teams also make decisions together and share resources and responsibilities to provide successful solutions. In addition, interdisciplinary teams do not compete against each other as they have different knowledge backgrounds. Therefore, all the members should be given time to execute their services to the best of their knowledge without interference from other members (Zajac et al., 2021). Respect for professionalism is also a critical aspect of an interdisciplinary team and makes all the members feel the worth of being part of the team.
References
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2019). Translation of evidence into nursing and healthcare. Springer Publishing Company.
Wagner, J. (2018). Leadership and influencing change in nursing. University of Regina Press.