A Report on Appropriate Leadership


Style in a Hospital Setting


 


Introduction


Leadership can refer both to the process of leading, and to those entities that do the leading. Leadership has been a central, and sometimes controversial, topic in the study of organizations. In spite of claims to the contrary, there is substantial evidence that leadership is positively related to a variety of individual and organizational outcomes. Leaders, by their very roles, are responsible for making decisions that help their organizations adapt and succeed in competitive environments. Leaders do not merely impose goals on followers, but work with others to create a shared sense of purpose and direction (Kotter, 1996).


Leaders primarily work through and with other people. They also help to establish the conditions that enable others to be effective. Leadership is a function more than a role. Although leadership is often invested in – or expected of – persons in positions of formal authority, leadership encompasses a set of functions that may be performed by any different persons in different roles throughout a community. Primarily, the main goal of this report is to determine the most appropriate leadership styles to be used in a hospital setting. The discussion of this report will be based on the case studies provided.


 



  • What do you consider to be the key leadership traits required for the Bermuda Hospitals Board CEO?


Based on the given the Bermuda Hospitals is known as a challenging and vibrant organisation which offers a distinctive working experience. Accordingly, the hospital is in need of a new CEO that would be able to improve the current health care delivery system of the hospitals in coping with future challenges and meeting and satisfying the needs and expectations of their clients or patients. Based on the given case study, the leader that should qualify for the position in Bermuda Hospitals Board CEO is the one with transformational skills, open-minded, competent, and creative as well as discerning when it comes to analyzing and assessing the resources of the company. Since the hospitals is in need of a leader that be would provide strategic leadership to the hospitals that will be respected by both staffs and patients, they are in need of a leader who has the ability to do their obligations morally (Chemers, 1997).


            The hospital is also in need of a leader that has the ability to transform the hospital in becoming an excellent healthcare provider and the leader that have the ability to initiate changes and improvement to provide better healthcare services. Hence, the traits of a leader appropriate for the hospital are a transformational leader. Transformational leaders motivate others to do more than they originally intended and often even more than they thought possible. Such leaders set more challenging expectations and typically achieve higher performances (Tesone, 2000). Transformational leadership is an expansion of transactional leadership. Transactional leadership emphasizes the transaction or exchange that takes place among leaders, colleagues, and followers (Leithwood, 1992). This exchange is based on the leader discussing with others what is required and specifying the conditions and rewards these others will receive if they fulfil the requirements.


True transformational leaders raise the level of moral maturity of those whom they lead. They convert their followers into leaders. They broaden and enlarge the interests of those whom they lead. They motivate their associates, colleagues, followers, clients, to go beyond their individual self-interests for the good of the group, organization, or society (Einstein & Humphreys, 2001). Transformational leaders address each follower’s sense of self-worth in order to engage the follower in true commitment and involvement in the effort at hand. This is one of the things that transformational leadership adds to the transactional exchange (Shamir, 1991).


            Transformational leader can be directive or participative, as well as democratic or authoritarian, elitist or levelling.  In gaining the respect of the patients and staffs, the leader or CEO for Bermuda should also have the characteristic of transforming and empowering subordinates so that they are motivated to act beyond their self-interest in the service of a larger community.


 



  • Are these Bermuda leadership traits different to what might be required at the Royal Melbourne or the National University Hospital? Why?


It can be said that the Bermuda leaderships traits is somewhat different to the leadership traits needed in running or leading the Royal Melbourne or the National University Hospital. This is because, these three hospitals has different leadership requirements suitable for their hospital operations. Although, they belong to a common industry (hospital industry) and have commonness in terms of their objective of providing quality healthcare services, these three hospitals is operating in different management and leadership approach, hence, the leadership traits needed is different from one another.


As mentioned, the traits of the leader needed in Bermuda Hospitals is a leader who has the ability to initiate changes and transformation and a leader who has the ability to gain respect from staff and patient and provide learning opportunity to the staff through mentoring and coaching.  Basically, transformational leaders who are needed in Bermuda are leaders that create positive relations with subordinates or team members in order to strengthen employee and organizational performance. Within an organization, managers who apply transformational leadership motivate employees to look beyond their own needs and concentrate on the general interest of the group. This type of leadership involves charisma, individualized consideration, inspirational motivation, and intellectual stimulation (Levine, 1995).


On one hand, the leader of the Royale Melbourne, as based on the case study provided, is a type of leader that leads people under the principle of treating others the way he want to be treated. In this way, the traits of the CEO of the Royale Melbourne could be characterized as a leader following the principle of parallelism when it comes to dealing with the staff in the hospital. Despite the authority that the CEO hold in Royale Hospital, being compassionate and considerate of the situations and conditions that my people are in made more effective in making them respond to the needs of the hospital in providing better care. It can be analysed that the CEO of Royale Melbourne believed that the most effective way to gain the support, trust, and respect of the people is to empathize to their concerns.  In addition, communication ability also plays an important role on the leadership traits of Swinden (Royale CEO), and this allows him to practice good listening behavior. Being confident is also considered as one of the traits of the leader in Royale.


With regards to the leadership traits of the leader in National University Hospital, it can be said that Chua Song Khim possesses a trait of being credible, honest, competence, aspiring and motivational (Kousez and Posner, 2002). It can be said that the leadership trait of Khim has been able effectively meet job-related demands, create higher-performing teams, foster renewed loyalty and commitment through retention and reward strategy, increase motivational level and in reduced turnover of employees. Hence, based on the give information, the leadership traits needed in the three hospitals has a different context from each other.


 



  • Chua Song Khim refers to his faith in God as a driving force in his achievement. Do you think religious conviction is related to leadership passion? How?


The case of Chua Song Khim as a leader of the National University Hospital shows that he is a leader with a strong faith in God and he believed that this strong faith has led him to be a successful leader of the hospital. Through this real life example, it can be said that a person’s religious conviction and spiritual being has been able to have a good effect in achieving his goals in life. One of the good characteristic of a good leader is to have a strong belief of something that he or she holds dearly. It is said that beliefs may include the belief in death, God, religion, life, what is human nature, what is bad, and others. 


It can be noted that to be a successful leader one must be able to spend time and extra efforts with the subordinates in order for them to respect and trust the leader. A successful leader is the one which make the right decisions and implement the decisions effectively, the one who choose the correct priorities, relating to people and always performing with excellence to achieve the organisational objective, and these usually happen or achieved more consistently when the leader have an active and growing relationship with God and their convictions.


Religious convictions can be a leadership passion in a way that it enables the leader to have correct attitudes and behaviours as an automatic response in every challenges and problems they encounter. Those who put God in the centre are known to be inevitable and instinctive and they are empowered to do things in line with what their organisation is needed.


It is also said that when a leader do not have a strong conviction and faith in God, their leadership seems to be arduous and becomes a burden for them rather than a blessing since it contravene what is intrinsic for the leader and to the work environment where the leader belongs.


 




  • Consider the cultural environments in the three hospitals.




Royal Melbourne Hospital- a western philosophy with semi-autonomous professionals and as strong union process


Singapore University hospital- a more conservative approach with less individualistic employees


King Edward Memorial Hospital (Bermuda)- a mix of British and island cultures in a small community.


How would these cultures impact on the choice or leader or the leader’s behaviour styles?


The success of the organisation largely depends on the people who will effectively lead the organisation, in this case the hospital industries. One of the most important things to consider in choosing a leader for a hospital industry is the cultural background of the organisation or the hospital.  The management of the hospitals like Singapore University Hospital, Kind Edward Memorial Hospital and Royale Melbourne Hospital, must be able to choose a leader which has the ability to lead an organisation with a unique and distinctive culture. For instance, Singapore University Hospital must choose a more conservative leader that will be able to handle less individualist employees and the Bermuda Hospital should choose leader who has the ability to manage a mix of British and Island cultures and Royal Melbourne should choose a leader who has the ability and competencies in leading a hospital guided with western philosophy with semi-autonomous staff.


The cultural background of these hospitals has strong impact on choosing their leaders so as to ensure that their organisational goals and standards are being met. According to Hofstede (2001), the notions and context about organizational leadership and management are frequently exported to different nations regardless of the values that these ideas have been developed.  Some authors agreed that while the emergence of leadership approaches is widely acceptable to be a common in different cultures, the manner that these styles have been operationalise are commonly observed as culturally specified.  There are some arguments that exist regarding the context of leadership styles across different cultures, especially in Western and Eastern setting; hence, it is important that the hospitals must choose a leader that would be able to meet their expectation as well as their organisational culture. In addition, since the culture of the hospital is also innovative, Chua being an open-minded leader compared to Swinden would be able to give better performance in HKSH than Swinden.


It can be said that leaders face formidable challenges in building a multicultural organization that truly values diversity. To be successful, leaders need to unlearn practices which are rooted in a conventional mind set, transform, change the operation of the industry, shifting organisational culture, reforming policies, generating new structures, and redesigning  human resource systems (Jamieson and O’Mara, 1991). This is a tall order and indeed may be so difficult and complicated that it requires a new paradigm to guide hospital industries to consider culture as part of their leader selection process. The three hospitals must be able to find leaders that would be able to meet and satisfy their organisational cultures.


Since an organization’s culture is about how much members trust each other, about attitudes and emotions and their impact on team performance, organizations are defined best in these terms and in ideas like change, trust, cohesion, conformity, and adaptability. It is the leader’s responsibility to create a culture that integrates their team so that individual actions will strengthen the results of a particular healthcare endeavour.


 



  • Which of the Two CEOs (Swinden or Chua) do you think would be more appropriate/successful in leading a large Hong Kong Hospital? Why?


 


One of the leading Hong Kong Hospitals is the HK Sanatorium & Hospital.  The hospital is considered as one of the famous in HK because of its high quality hospital services as well as the comfortable accommodation for their patients. The hospital is also well known for their expensive service charge with more than 400 beds and different room types and facilities. The mission and vision of the hospital is to provide quality in service and excellence in patient care. The company has always trying to find ways on treating diseases better and provide new services that would meet the needs of the patients. In addition, the company also invites highly-qualified and experienced healthcare providers such as nurses, doctors and paramedical staff to join the hospital in providing quality and integrity to meet the expectations of their clients (HKSH, 2008). The company has a strong culture with loyal employees (Quick, 2006) and gives emphasis on providing quality healthcare services.


Based on the case given, both leaders (Swinden and Chua) can be qualified as a leader in a large Hong Kong Hospital, however, it can be said that Chua can be more qualified in becoming the most appropriate and successful leader in a large HK Hospital. As mentioned in the previous reflection, cultural background is an important factor in choosing a leader and Chua has been able to lead a hospital which is based in Singapore and have a more common cultural background (Oriental) in a Hong Kong Setting. Swinden is a leader from an organisation in the Western Country which is Australia. In this regard, cultural conflict (Weider-Hatfield & Hatfield, 1995) may arise if Swinden would lead a Hong Kong Hospital like the HKSH. However, in the case of Chua, he has been able to lead an organisation in an Asian country in which Hong Kong also belongs. In addition, if Chua would lead a large Hong Kong Hospital, he would be able to easily adjust to the organisational culture of the hospital than Swinden.


Furthermore, since communication skill is also an important factor to consider in choosing a leader. Although, Swinden has a good communication skill by being a good listener to his subordinate, i can be said that Chua would have better ability to easily communicate with the people in Hong Kong Hospital than Swinden, since, both Hong Kong and Singapore has Chinese language as one of their official languages (Eckhouse, 1994).


Hence, with these factors along with the good and effective leadership traits of Chua, it can be said that Chua is the most appropriate leader for a large Hong Kong Hospital. The application of organizational culture makes them understand the needs of these people.



  • The contingency theory of leadership suggests that the leader (and his/her skill set) should be selected for a given situation. (For example Chua Song Khim briefly refers to the SARS outbreak and its impact on his hospital.) Should a hospital select a leader/CEO according to the specific problems and issues it faces today or is leadership quality above current concerns?


Ensuring a quality and excellent healthcare services is one of the most important aspects, if not the most important aspects to be considered by a hospital industry. In this regard, it can be said that the management of the hospitals must be able to select a leader/CEO according to the specific problems and issues faced by the hospital so as to ensure that current and present needs will be met and other issues concerning the current problems should be given priority. Leaders who have been to similar situation in a hospital setting has the ability to know what style of leadership to be used in order to make the flow of the organization towards the goal or the objective set by the organization (Bass, 1996). 


Furthermore, the connection shared by the members of the organization and the new leader who has been in a similar situation faced by the hospital industry, through their collective goals and objectives, makes them recognize their role not only within the organization but also to their people they have to serve.


Although the quality of a good leader is also an issue to be considered, the experience of a leader in a similar situation is mostly needed to ensure success in solving the issue or the problem. Hence, the contingency theory of leadership is appropriate in a hospital setting to ensure quality healthcare services among people.


 


Conclusion


            Accordingly, leadership is a multifaceted behavioural responsibility which takes place in a self-motivated social context. Effective leadership includes the context of using social influence procedures to facilitate, direct, motivate, or inspire the actions of other people or the subordinated (Yukl, 1998). In doing so, being a leader needs constant task-directed effort, efficient task strategies, as well as the artful implementation of different technical, conceptual, interpersonal, and intrapersonal skills. The main objective of being a leader is to organise common goal achievement by generating and maintaining positive and constructive group performance setting.


All in all, it can be concluded that leadership styles and leadership traits in hospital settings vary, because not all hospitals experiences similar problems as the other. In this regard, that leader who leads a western hospital may not be able to effectively lead a hospital in an eastern culture, since issues and problems faced by these hospitals may be difference.


Reference


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