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Example research essay topic: Values And Beliefs Transformational Leadership - 1,725 words

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... task as a member of a multi-disciplinary team rather than as a member of an inter-disciplinary one. Typically, the traditional hospital has resisted the paradigm shift that CQI represents (Lyons & Callahan, 1996, p. 136). Hospital managers refer to the traditional hospital as functional in nature. The functional structure reflects the traditional paradigm that emphasizes specialized departments and internal processes designed to support the medical staff. However, alternative structures, such as program management (Temple, Tyler, Nelson, Winstanley, & Chicota, 2004, p. 178) and patient-focused care (Mang, 1995, p. 433), are more client-centered and teamwork oriented.

Here, decision-making takes place at the program level where a relatively homogeneous group of patients is serviced by inter-disciplinary teams. A program-based structure diminishes the discipline-based constraints that are characteristic of the traditional hospital structure. Since QI is more compatible with a program-based structure, its implementation has a more favorable prognosis in hospitals that already have introduced such a structure (Mahmoud & Rice, 1998, p. 9). Successful implementation of strategy depends upon the organizational alignment or fit that is created and sustained over time.

Thompson and Strickland (1996, p. 243 cited in Lewis, 2000, p. 129) identified eight critical components in need of alignment, including leadership, structure, culture, and continuous improvement or best practice. Leadership is the process by which actions and steps are taken over time to bring the other organizational components gradually into alignment, thereby meeting the goals of the stakeholders. A significant change in strategy, such as the best-cost provider and compliance with CoP may provoke resistance among organizational members unless senior management initiates a broad cultural change. To foster a fit between strategy and culture, the interdependence of values, strategies, practices, and behaviors inside an organization must form the basis of the change efforts (Fleming & Steen 2003, p. 48). The exercise of leadership ensures that an organizational-wide QI effort takes place and maintains its momentum. QI implementation requires that the CEO engage in a more assertive leadership style.

In our hospital I propose a process for the implementation of QI that gives prominence to the role of senior management leadership and vision. The process initially builds awareness of senior managers and clinical staff, and links QI to the hospital's overall strategy. Similarly, Fleming & Steen (2003, p. 52) argued that top management could develop and champion a vision for the organization that facilitates QI transition and maintains its momentum afterwards. The creating and sharing of this vision is a key implementation challenge, and it calls for transformational leadership.

Through effective communication and persuasion, and confidence building, the transformational leader encourages the adoption of new values and beliefs, endorses the goal of organizational effectiveness, and sustains the effort to realize QI. Stated simply, the hospital CEO leads the change effort instead of merely affirming it. In addition to strong and committed leadership, the success of top-down QI implementation depends on a receptive environment, strategy, structure, and culture. If any of these contextual factors is not receptive to QI, a failed QI implementation becomes foreseeable. Fortunately, as indicated by Pawar and Eastman (1997 cited in Lewis, 2000, p. 130), transformational leadership can modify the inner context of the organization as well as be constrained by it.

Similarly, Kotter (1990 cited in Lewis, 2000, p. 131) links transformational leadership with changing the organization's strategy and culture for a better fit with the surrounding environment. According to Nadler and Tushman (1990 cited in Fleming & Steen, 2003, p. 51), the effective leader exhibits charisma (envisioning, energizing, and enabling) and creates instrumentality (structuring, controlling, and rewarding) to ensure organizational re-orientation. It's understandable that QI implementation requires organizational learning to establish a systematic problem-solving approach to meet new goals. Under the transformational leadership of the CEO, an intentional collective effort emerges to change the assumptions, values and beliefs about the organization, its goals, and methods of operating. In QI, tension exists between conflicting goals of physicians and management.

There is the adherence to the goal of quality treatment and care by the medical professionals on the one hand, and the goal of cost savings by the managerial and administrative staff on the other. These goals are reflected in the culture, structure, and work practices of the hospital. Under the leadership of the CEO, QI is linked to the best-cost provider strategy where the goals are harmonized. CQI, in mm, provides genuine teamwork using standardized tools to track progress and to find new ways in which to improve services. In order to persuade both the management team and the hospital staff of the critical importance of QI, the CEO creates strong links between the hospital vision, strategy, and CQI.

The CEO, and in time the other senior managers, interpret the environment for other organizational members and explain how CQI fits into a strategy (Fleming & Steen, 2003, p. 11). The making of this strategic linkage should persuade organizational members that senior management is committed to QI, and that the changes associated with it merit attention and involvement. Without such a linkage, QI implementation might not achieve sufficient momentum to reach a stage for the creation and diffusion of team skills and teamwork. A consensus on organizational goals and methods forms the groundwork for the development of team skills and teamwork. Values and expectations about the importance of teamwork need to precede the QI pilot projects to establish a wider legitimacy for change.

Initial projects may be non-clinical in nature (e. g. an admissions process), however subsequent projects should include a clinical content to demonstrate program merit to the medical professionals, especially the physicians. Without the clinical focus, the projects could be viewed as ventures in mercantile management undertaken simply to achieve cost savings for the hospital. The early objectives of QI teams concern the building of acceptance of QI initiatives, building team rapport, learning and recognizing small group dynamics, developing innovative problem-solving techniques, and applying them to easy projects such as pondering. After this initial phase, management should focus on shaping highly successful CQI teams with a strong clinical orientation, established lines of communication and integration with support staff, and inclusion of external partners such as suppliers into the teams.

The development of these teams depends on a change in leadership style by the senior management: more supportive, attentive, and encouraging rather than persuasive and forceful. The CEO acts as a strategic supporter and facilitator of new and effective practices. If a program-based structure replaces the traditional hospital structure, these CQI teams would be co-extensive with some of the program teams and demonstrate the characteristics of advanced QI teams: greater autonomy for program direction, a greater sense of shared duties and willingness to undertake routine tasks, increased sense of 'ownership' of functions performed, greater local budgetary control and a capacity for self-evaluation (Fleming & Steen, 2003, p. 17). The resistance to QI implementation from the physician group remains a challenge for the transformational leader.

Physicians are not easily swayed given that they are socialized and obtain their standardized skills through medical schools, and exercise considerable autonomy thereafter. Consequently, physicians may be influenced primarily in their formative period; it might be advantageous for hospital CEOs to focus more on the outer context of the hospital to encourage physician support for QI. They should lobby the medical schools for changes in values, expectations, and curriculum that are sympathetic to QI, teamwork, and organizational effectiveness. Also, senior management should build coordinating mechanisms between the discipline-based 'QI' initiatives of the medical professions and the organization-wide QI program of the hospital. However, the conceptual framework of transformational leadership (Mang, 1995, p. 429) does not provide guidance on undertaking extra-organizational change. Senior management must create instrumental levers (Fleming & Steen, 2003, p. 22) to make CQI more attractive to physicians by, for example, creating high profile roles for them in the decision-making process (e.

g. agenda setting) that are not time consuming. Management may further promote CQI projects with a strong medical component and use measures that are meaningful to physicians. In return, physicians might be encouraged to provide more input into the training programs and the communication of the new expectations of CQI.

It's out of question that certain aspects professional, physician as well as administrative groups should take part in organizational learning. Senior management initiative and commitment, under the transformational leadership of the CEO, is essential to build and maintain a QI program that aims to improve overall organizational effectiveness. The tension and dialogue around organizational goals continue to exist as the medical and administrative groups are persuaded to work together more closely. In QI, new ways of thinking and co-operating by organizational members gradually lead to improvements in goal attainment on both the cost and quality fronts. The role of the CEO centers on aligning the hospitals strategy, structure, culture, and QI program. This alignment gives organizational members the time to learn new cognition's and behaviors through a number of reinforcing iterations.

Diffusion of initiatives may take place as some members share their new ideas and actions with others in both formal and informal groups. It needs hard work to develop a receptive context for QI, to reinforce new ideas and actions, and ultimately to reap the benefits of an improved organizational effectiveness. References Fleming, I. & Steen, L. (Eds. ). (2003). Supervision and Clinical Psychology. New York: Brunner-Routledge.

Hackman, J. R. , & Wageman, R. (1995). Total Quality Management: Empirical, Conceptual, and Practical Issues. Administrative Science Quarterly, 40 (2), 309. Lebrasseur, R. , Whissell, R. , & Oh, A. (2002). Organisational Learning, Transformational Leadership and Implementation of Continuous Quality Improvement in Canadian Hospitals.

Australian Journal of Management, 27 (2), 141. Lewis, L. K. (2000). Communicating Change: Four Cases of Quality Programs. The Journal of Business Communication, 37 (2), 128. Lyons, T.

F. , & Callahan, T. J. (1996). A Third Role in Performance Appraisal: Suggestion from the Medical Care Quality Appraisal Systems. Public Personnel Management, 25 (2), 133. Mahmoud, E. , & Rice, G. (1998).

Information Systems Technology and Healthcare Quality Improvement. Review of Business, 19 (3), 8. Mang, A. (1995). Implementation strategies of patient-focused care. Hospital & Health Services Administration, 40 (3), 426 - 35. Temple, D.

I. , Tyler, L. , Nelson, A. A. , Winstanley, S. , & Chicota, C. (2004). Clinical Psychology Program Improvement on the Examination for Professional Practice in Psychology. Journal of Instructional Psychology, 31 (2), 175.


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Research essay sample on Values And Beliefs Transformational Leadership

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