leadership

 

The purpose of this assessment is for you to write a structured reflection and develop action plans on your personal responses to your results of
the Kouzes & Posner Leadership Practice Inventory (LPI). This assignment has two (2) parts.
Part 1: You are required to use a reflective model to analyse your LPI results. When reflecting on them refer to the principles of Kouzes & Posner (2017), as well other leadership literature. You may use Rolfe et al (2001) model or other frameworks for this reflection.
Part 2: You are required to complete two (2) action plans for your own leadership development based on your reflection. Each action plan must:
? Identify two (2) Leadership Practices
? Select two (2) Leadership Behaviours
? Identify and justify SMART goals
? Identify and describe strategies for learning and action through Experience, Example and Education
? Identify and explain appropriate and realistic sources and measures of support

 

BRIEF OVERVIEW

The poor care was found visible in the Mid-Staffordshire Foundation NHS Trust, when certain avoidable deaths got associated. The investigations were set up and the witnesses were interviewed. After the report was submitted with multifarious recommendations, by Robert Francis QC, the government stepped in to bring the improvements within the NHS(Department of Health, 2013). House of Common also took the initiative through its Health Select Committee(House of Commons Health Select Committee, 2013). The operation seemed to be fragile when it concerned the delivery of the highest quality of the care to the patients in an inherently complex scenario like that of the NHS. The presence of the robust systems along with various processes for monitoring the performance for the regulation of the standard of care was crucial for providing the patients with the desired services. The review which was done initially transpired that, for making the system work and also to make it successful(The Mid Staffordshire NHS Foundation Trust Inquiry, 2010), the process becomes fully dependent on the core values and also the behaviours of the staff concerned. So, a strong leadership was required at every level for ensuring the basic idea, that the values and also the ideas must be incorporated in such a way, that the outcome of it only reflects patients care by keeping them at the very forefront of it(Department of Health, 2010). 

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FINDINGS INFLUENCING LEADERSHIP

The findings from the report so created by Francis details that, Mid Staffordshire NHS Trust, was fully detached from the Dr. Foster mortality comparator(Dr Foster- MORTALITY COMPARATOR, n.d.). The clinical governance was held to be too poor, due to their attachment on the data so collected, rather than staying focussed on the outcomes. The complaint process so found within the Trust was ineffective in a way that, it was fully ambiguous and not at all transparent. It seemed that the soft intelligence was persistently overlooked and the views so presented by the frontline staff were ignored vehemently, which lead to neglecting the patients. The patients so treated within it, was not provided with the due privacy and dignity. The nursing care which at all did existed was fully poor and at most times it was non- existent. Where the care will involve proper and balanced nutrition, it lacked that immensely, followed by lack of proper hydration facilities, or that of providing pain relief medications(Van Bogaert, P., Timmermans, O., Weeks, S. M., van Heusden, D., Wouters, K., & Franck, E, 2014). But, majorly the wards were suffering from shortage of staffs, and the number which were at all present, were subsequently getting reduced with calling sick from work, and most importantly the staffs lacked the morale. Surprisingly, the imminent danger of the staff shortages was followed with the reconstruction of the emergency wards, including surgical and admission wards too(Van Bogaert, P., Clarke, S., Roelant, E., Meulemans, H., & Van de Heyning, P., 2010). 
So, there can be no disagreement that, the Mid Staffordshire NHS Trust, was in need of a drastic change. So, a reform was much needed. But, the theory of disruption states that (Joseph L. Bower, Clayton M. Christensen, 1995), a reform from within the situation, is nearly impossible. So, as the theory describes, to make a service start applying the very technique at the basic bottom level, then it can relentlessly thrive to move up, which will then affect in gaining the competitive advantage by displacing the competitors. But, from the findings of the report, it transpires that, the service providers themselves are the sole creator of the disruptive services(Shipton, H., Armstrong, C., West, M. and Dawson, J. , 2008). So, through leadership, a willingness needs to be created which will help in abandoning the status quo, by delivering the desired services for the patients, thereby reducing the rates of the avoidable mortalities. So, to create complacency, the full operational model needs a disruption (Joseph L. Bower, Clayton M. Christensen, 1995)

Again, the report depicts that, the mechanisms for communicating with organisations were ill- used and for the purpose of sharing the intelligence and also the concerns. The report also reflects that, the important functions were assumed to have been performed satisfactorily by the others, and report further highlighted the dangers which arose out of the corporate memory loss, so happened at the reorganisations(Tourangeau, A.E., Lemonde, M., Luba, M., Dakers, D., & Alksnis, C., 2003). So, there seems to be a constant culture of blame prevailing within the industry, and this culture will inevitably lead towards concealment and suppression, due to the defensive actions being taken proactively. Thus, the failure is prominent, and is proved that the failures of the Mid Staffordshire NHS Trust, only resulted from a lack of good culture within the organisation(Wong, C. A., Cummings, G. G., & Ducharme, L. , 2013). A good culture within an organisation is underlying condition which can help gain the organisation strategy towards a success, and this is where the leadership creeps in, since it is only a good leader who can incorporate a good culture throughout the organisation, and hence leadership is considered to be a preeminent influential factor towards the success of it. There seems to be a fascination, that the personality traits are the attributing factor to become a prominent leader. So, as identified (Yukl, S. , 2013), to create an effective leader, based on the personality traits, the following is in the requirement and i.e., the leaders have the higher energy levels, through which they can remain effective for a longer period, and with the stress tolerance they do not seem to get affected by the rising conflicts and can remain calm during the events followed by crisis, thereby maintaining an equilibrium(Øvretveit, J., Bate,, P., Cleary, P., Cretin, S., Gustafson, D., McInnes, K., McLeod, H., Molfenter, T., Plsek, P., Robert, G., Shortell, S., & Wilson, T. , 2002).

 

CONTEMPORARY LEADERSHIP THEORY

Leadership culture can generally be understood as that product which resulted out of collective actions of the leaders who acted together for achieving the organisational success(Tourangeau, A.E., Lemonde, M., Luba, M., Dakers, D., & Alksnis, C., 2003). As the negative culture mirrors all levels of NHS system, through prominent lack of consideration while considering the risks towards the patients, showing defensiveness, thereby looking inwards while maintaining secrecy, by causing the misplacement of assumptions so based on trust, or that of the acceptance that poor standards cannot be replaced and most importantly, a constant failure in keeping the patient at the first and the foremost position(Van Bogaert, P., Clarke, S., Roelant, E., Meulemans, H., & Van de Heyning, P., 2010). So, it can be well understood that, a single leader cannot bring a miraculous success within an organisation, and neither the fact that a huge number of quality leaders can only bring success, but what actually brings success is the compact and combined behaviour of all the quality leaders who are only focused to achieve the goals of the organisation(Shipton, H., Armstrong, C., West, M. and Dawson, J. , 2008). So, to develop an institutional culture and to cause it for creating the impact of it through performance by all the individuals within the organisation, is crucial. As (Schneider B, Ehrhart M, Macey W. , 2013) that, the behaviours are the only factors which articulate the contributing values. So, the need for the collective leadership within health care industry is necessary for overcoming the challenges the industry often faces. The word Collective leadership is defined as the distribution along with the allocation of those leadership power which reflects capability, with an existing expertise with a motivation to make it work. So, the responsibility of leadership must be shared by all member of the organization, to create an effective culture, with right mindset, so basically this collective leadership culture is not based on the skills but the determination followed by the motivation, that the goals must be achieved. Thus, this framework in a way is a sharp contrast which reflects both flexibility as well as stability and also is a combination of focus which must be both internally placed and also externally so as to make the culture effective. (Newdick C, Danbury C. , 2013) have identified that, the biases in reasoning if cognitive then that, might lead to influential interactions which will then be a contributing factor in achieving harmony and might also render the conflict, based on the specificity of the situations. On the other hand, (Dixon-Woods M. et al. , 2013) notes that, the treatment of the employees and the process of managing them can be the contributing factor towards the component of culture, in the healthcare industry. Similarly, (Sarac C, Flin R, Mearns K, Jackson J. , 2011), also propounded that, an openness must be maintained while communicating and the non- punitive responses in view of the error should be reported frequently, so that the safety within the patient culture can be uplifted. But, again, for the maintenance of the culture within the organisation, the safety climate must also be uplifted to maintain the relation with the patient care by the staffs of the health service providers (Agnew C, Flin R, Mearns K., 2013). But, many organisations, are prone to focus their development for achieving the competencies within the leaders in an individual approach. So, both in an individual aspect as well as on a collective basis the mindset must be developed through the implementation of strategy. 
Again, the Francis Report(The Mid Staffordshire NHS Foundation Trust Inquiry, 2010), points towards the failure in tackling the insidious culture which was utterly negative and involved the attitude of tolerating the poor standards, thereby causing the disengagement from performing the responsibilities so desirous of a leader. The report(The Mid Staffordshire NHS Foundation Trust Inquiry, 2010) also emphasises on the very aspect that, finances and the achievement of targets were prioritised while ignoring the very underline operation of a health care industry in providing quality care towards the patient. (Rawlinson N. , 2008), points out that, health care sectors are subject to constant criticism for focussing themselves on the targets to be achieved, rather than rendering high quality service, and this then becomes the major cause of their detachment or rather this target driven approach causes the distraction and so they fail in rendering the desired service to the patients(Nuckols T, Bell D, Paddock S, Hilborne L., 2009). But, on the other hand, for the development and also for the implementation of the leadership, there must be a discovery which is supported by a design and then that will automatically follow the delivery of it. The phase of discovery is involved in the collection of data along with the intelligence, about the goals or the mission and also for the contingent challenges which might arise from future events. In this very process, the organisation gains the insights for identifying the capabilities which they will look for within a leader, based on their requirements and also for the purpose of achieving goals. Designing phase seeks to develop the capabilities which were so identified in the discovery phase, and in so doing this phase helps in sustaining those capabilities within the leader. Lastly, the synchronising process where the delivery is in involving the elements of the organisation with the individual leadership, in furtherance of maintaining the target culture. The Francis Inquiry report (The Mid Staffordshire NHS Foundation Trust Inquiry, 2010)highlighted a persistent lack of staff support and indicated that the engagement of clinicians is crucial at all levels and a leadership must be created based on trust. On the other hand, the staff views were not taken in to consideration and were utterly disregarded. As the report points out that, the employees who were not in a management role complained regularly and were then disregarded and a deaf ear was turned towards them. So, there is again a serious lack of supported development, which was identified, and thus a need to develop the same became crucial(Newdick C, Danbury C. , 2013). Appraisal, or rewarding must be done at regular intervals so that the staff or the employees become recognised and also that the feedback generation must be implemented so as that the performance so done can be provided evaluated. 
The report(The Mid Staffordshire NHS Foundation Trust Inquiry, 2010) recommended creation of cultures of continuous improvement by recognising the achievement, for rendering a high quality, and also a compassionate care which can be achieved by encouraging staff in to reporting those concerns and also by giving priority towards the sole concern of patient wellbeing. Again, if a staff is well-treated then the patients will have the effect of it and will be treated well, since, it is only the staff wellbeing which is the underlying foundation based on which the sole compassionate care can be built and thereby achieved(Van Bogaert, P., Timmermans, O., Weeks, S. M., van Heusden, D., Wouters, K., & Franck, E, 2014). So, the basic requirement is the courage, with persistence and also the professionalism for realising the very mission of the organisation is due from all leaders, and hence any failure if arises in listening the feedback from the patients concerned must be removed, and then if the feedback is valued against, then that can be the sole contributing reason in to providing a continued quality care. It is only the patients, who can be considered as having gained the knowledge from their experience, so their experience along with the quality of care so delivered will be the first-hand evidence in evaluating it(Nuckols T, Bell D, Paddock S, Hilborne L., 2009).

 

References

Agnew C, Flin R, Mearns K., 2013. Patient safety climate and worker safety behaviours in acute hospitals in Scotland.. Journal of Safety Research, Volume 45, pp. 95-101.
Department of Health, 2010. Hard Truths. The Journey to Putting Patients First. Volume One of the Government Response to the MidStaffordshire NHS Foundation Trust Public Inquiry., s.l.: s.n.
Department of Health, 2013. Patients first and foremost. The initial government response to the report of the Mid Staffordshire NHS Foundation Trust public inquiry, London: Stationery Office.
Dixon-Woods M. et al. , 2013. Culture and behaviour in the English National Health Service: overview of lessons and a large mutimethod study.. BMJ Quality & Safety.
Dr Foster- MORTALITY COMPARATOR, n.d. MORTALITY COMPARATOR. [Online] 
Available at: http://www.drfoster.com/tools/mortality-comparator/
House of Commons Health Select Committee, 2013. After Francis: making a difference, London: The Stationery Office Limited.
Joseph L. Bower, Clayton M. Christensen, 1995. Disruptive Technologies: Catching the Wave. 
Newdick C, Danbury C. , 2013. Culture, compassion and clinical neglect: probity in the NHS after Mid-Staffordshire.. Journal of Medical Ethics.
Nuckols T, Bell D, Paddock S, Hilborne L., 2009. Comparing process- and outcome-oriented approaches to voluntary incident reporting in two hospitals.. Joint Commission Journal on Quality and Patient Safety, Volume 33, pp. 34-47.
Øvretveit, J., Bate,, P., Cleary, P., Cretin, S., Gustafson, D., McInnes, K., McLeod, H., Molfenter, T., Plsek, P., Robert, G., Shortell, S., & Wilson, T. , 2002. Quality collaboratives: lessons from research. Quality and Safety in Health Care , Volume 11, pp. 345-351.
Rawlinson N. , 2008. Harms of target driven care.. BMJ, p. 337.
Sarac C, Flin R, Mearns K, Jackson J. , 2011. Hospital survey on patient safety culture: psychometric analysis on a Scottish sample.. BMJ Quality & Safety, Volume 20, pp. 842-848.
Schneider B, Ehrhart M, Macey W. , 2013. Organizational climate and culture.. Annual Review of Psychology, Volume 64, pp. 361-388.
Shipton, H., Armstrong, C., West, M. and Dawson, J. , 2008. The impact of leadership and quality climate on hospital performance. International Journal for Quality in Health Care, 20(6), pp. 439-445.
The Mid Staffordshire NHS Foundation Trust Inquiry, 2010. Robert Francis Inquiry report into Mid-Staffordshire NHS Foundation Trust, s.l.: s.n.
Tourangeau, A.E., Lemonde, M., Luba, M., Dakers, D., & Alksnis, C., 2003. Evaluation of a leadership development intervention. Canadian Journal of Nursing Leadership, Volume 91, pp. 91-104.
Van Bogaert, P., Clarke, S., Roelant, E., Meulemans, H., & Van de Heyning, P., 2010. Impacts of unit- level nurse practice environment and burnout on nurse-reported outcomes: a multilevel modelling approach. Journal of Clinical Nursing , 19(11-12), pp. 1664-1674.
Van Bogaert, P., Timmermans, O., Weeks, S. M., van Heusden, D., Wouters, K., & Franck, E, 2014. Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events-A cross-sectional survey. International Journal of Nursing Studies, 51(8), pp. 1123-1134.
Wong, C. A., Cummings, G. G., & Ducharme, L. , 2013. The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of Nursing Management, 21(5), pp. 709-724.
Yukl, S. , 2013. Leadership in Organizations. 8 ed. s.l.:Pearson Education Limited..

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