Nursing
Introduction
The term management and leadership are often interchanged and interpreted as the same, but that is not always the case in nursing profession. This is because not every nurse can be considered as a good leader, and the same can be said about nursing leaders that are not necessarily managers. Primarily, a nursing manager holds the decision-making power in assigning organizational position, and is expected to carry out control over specific duties and processes. On the other hand, leaders may not have the same authority as managers, but the power that nursing leader posses is inherited from their communication and interpersonal skills that help influence others. Both qualities are integral in the effective performance of nursing practices particularly in terms of improving service quality and patient satisfaction.
The discussion will demonstrate the similarities and contrast between leadership and management approaches in quality improvement and patient satisfaction. Furthermore, the discussion will also explore the difference between leadership and management roles based on key principles and theories. More importantly, a recommendation for the best approach that accord with the personal and professional nursing philosophy will be explained as to why it fits as a solution for service quality improvement and patient satisfaction. At this point of the discussion, it can be assumed that both leaders and managers should share the same qualities particularly the critical thinking skills in order to ascertain a meaningful outcome towards nursing practice improvement and increasing patient satisfaction.
Defining Quality Improvement and Patient Satisfaction
Patient satisfaction is considered as a result of the combined efforts of the healthcare organization and care professionals in delivering care in which the positive or negative outcome depends on the service quality, efficiency, and ease of access. For other organizations, patient satisfaction is an important driver for organizational improvement. Several approaches were attributed in ensuring high patient satisfaction in care delivery and practice models were introduced to sustain the highest possible satisfaction. On the other hand, quality improvement is largely correlated to patient satisfaction because the level of service quality affects the level of satisfaction. The correlation between the two factors encompasses the bridge between the nurses’ and patients’ perception of care. According to Trail-Mahan et al. (2016), quality improvements directly influence patient satisfaction particularly in critical aspects of care situations and patient condition such as pain management.
In this sense, it is important for nursing professionals to determine the factors that influence patient satisfaction in order to initiate a more effective approach in service quality improvement. In a study by Al-Abri and Al-Balushi (2014), it was found that patient satisfaction survey is an effective tool towards quality improvement. For nursing leaders and managers, it is important to discuss what defines a quality care. According to Mhlanga et al. (2016), he concept of quality in nursing care involves six important attributes namely safety, efficiency, patient-centeredness, timeliness, equity, and practice effectiveness. These attributes can be well situated as the core elements of a quality improvement model in which a patient survey is instrumental in determining whether patient satisfaction is at hand. However, given that patient satisfaction is an indicator of quality care, the critical challenge for nurses is to integrate improvement approaches according to their roles as leaders or managers. For starters, leadership roles can be paramount in advocating and introducing evidence-based practices to influence other practitioners to do the same. On the other hand, managers can utilize their authority and management skills in implementing new processes and policies that promotes quality.
Approach to Service Quality and Patient Satisfaction
Comparing and contrasting leadership and management approaches for service quality improvement and patient satisfaction requires recall of the key theoretical principles. It is important for healthcare professionals to identify theories on leadership styles that are relevant to the nursing practice (Giltinane, 2013). In the subject of quality improvement, creative leadership theory suggests that reinventing what is already in effect enable nurses to create new solutions to critical situations by familiarizing with relevant healthcare trends. For a creative nurse leader, being aware of the various healthcare trends such as advances in information technology, globalization, and service-based organization growth enable them to focus on quality (Clark, 2009). Creative leadership is attributed to behavioral theory in which the proponents assume that leaders are made, not born. In this sense, anyone can be a nursing leader provided that the opportunity for growth is present.
Given that a nurse leader demonstrates the principle of behavioral theory, putting leadership in practice is also a different story, but in an objective to initiate quality improvement and patient satisfaction initiatives, democratic and Laissez-faire leadership style can be considered as the more appropriate. On the other hand, nursing management theories suggests that achievement motivation theory, which is divided into two segments namely achievement and affiliation. In advancing service quality and patient satisfaction in the nursing care settings, one of the factors for consideration is whether or not the nurses are motivated to carry out their duties because motivation is an integral part of quality enhancement. However, under the achievement motivation theory, money is considered as part of the reward to motivate employees. Although it is a normal practice in most organizations to include monetary reward as motivational tool, it does no encompass the same motivational effect on nursing practice.
In contrast to the theoretical position of the nursing management, leadership theory demonstrates a more profession-centered objective for quality improvement, which when applied in management practice should encompass the affiliation part of the achievement motivation theory. High-affiliation involves wanting to know how people feels and determining how a nurse is doing in terms of his/her work, which is strongly associated with concerns about patient satisfaction. Furthermore, management theory provides an assumption based on McGregor’s Theory Y enable nurse managers to help employees use their creativity and ingenuity in solving work problems (Clark, 2009), which is accords with the concept of creative leadership theory. When both management and leadership theories are applied in practice particularly for the purpose of enhancing service quality and patient satisfaction, several approaches emerge in the process.
Through leadership approach, quality improvement and positive patient outcome can be achieved through the integration of healthcare technologies in nursing practices. For example, the Veterans Affairs have implemented a patient engagement technology to assist the 8.7 million VA enrollees in its healthcare system (Weston and Roberts, 2013). This integration of IT in patient engagement enabled nurses of VA to efficiently and effectively provide care to patients because of quick access to information, which enabled better clinical decision-making. Similarly, concepts in nursing management also delivered the same efficiency and high quality service to patients through regular nursing rounds (Nagarandeh et al., 2014). This is one aspect in nursing management that goes beyond the context of implementing ideas inherited from leadership roles. For one, nursing clinical rounds is a management practice that enhances patient satisfaction by increasing patient engagement through constant interaction and responds to concerns, which is highly appreciated by patients particularly in recovery process.
Recommended Approach Perspective
Conclusion
Both leaders and managers should share the same qualities particularly critical thinking skills, creativeness in leadership, and patient-centeredness in management policies in order to ascertain a meaningful outcome towards nursing practice improvement and increasing patient satisfaction. Nursing leaders may not necessarily hold authority in the healthcare organization, but their vision of a better service quality towards greater patient satisfaction is achievable through creative solutions. On the other hand, effective management through better practice policies and process could also deliver the same patient outcome expectations.
References
Al-Abri, R. & Al-Balushi, A. (2014). Patient Satisfaction Survey as a Tool Towards Quality Improvement. Oman Medical Journal, 29(1), 3-7. http://dx.doi.org/10.5001/omj.2014.02
Clark, C. (2009). Part 1 – Theories of Leadership and Management. In C. Clark, Creative Nursing Leadership and Management (1st ed., pp. 3-52). Burlington, MA: Jones & Bartlett Learning. Retrieved from http://www.jblearning.com/samples/0763749761/49761_PT01_Clark.pdf
Giltinane, C. (2013). Leadership styles and theories. Nursing Standard, 27(41), 35-39. http://dx.doi.org/10.7748/ns2013.06.27.41.35.e7565
Mhlanga, M., Zvinavashe, M., Haruzivishe, C., & Ndaimani, A. (2016). Quality Nursing Care: A concept analysis. Journal Of Medical And Dental Science Research, 3(1), 25-30. Retrieved from http://www.questjournals.org/jmdsr/papers/vol3-issue1/D312530.pdf
Negarandeh, R., Hooshmand Bahabadi, A., & Aliheydari Mamaghani, J. (2014). Impact of Regular Nursing Rounds on Patient Satisfaction with Nursing Care. Asian Nursing Research, 8(4), 282-285. http://dx.doi.org/10.1016/j.anr.2014.10.005
Trail-Mahan, T., Heisler, S., & Katica, M. (2016). Quality Improvement Project to Improve Patient Satisfaction With Pain Management. Journal Of Nursing Care Quality, 31(2), 105-112. http://dx.doi.org/10.1097/ncq.0000000000000161
Weston, M. & Roberts, D. (2013). The Influence of Quality Improvement Efforts on Patient Outcomes And Nursing Work: A Perspective from Chief Nursing Officers at Three Large Health Systems.OJIN, 18(3). Retrieved from http://www.nursingworld.org/Quality-Improvement-on-Patient-Outcomes.html
