Review of the Literature
Review of the Literature
Leadership challenges continue to pose a threat to the access and acquisition of quality healthcare by all patients in the world. Theoretical frameworks have to be applied in the management of these challenges as health institutions seek to better the conditions of these populations. As such, it is important to appraise the theoretical frameworks usable in this context. Caro (2011) focuses on the aspect of dealing with traumatic brain injuries and other neuro-related conditions that pose a challenge for many health institutions, especially in the developing world. The author suggests that the solution to these challenges relies on the current leadership to shift the paradigms in the healthcare sector. The applicability of this theoretical framework centers on the ability of health institutions to utilize the available resources in the management of these challenges in spite of the constraints involved.
Fried, Piot, Frenk, Flahault, & Parker (2012) discuss the issue of leadership challenges in healthcare based on the current and unexpected condition of the health of today’s populations. Old problems continue to have their cumulative effects and they continue to be felt in light of the emerging challenges. The authors refer to these times as unprecedented because it is impossible to forecast the extent of good and poor health in today’s populations. New complications emerge as the years pass. According to the authors, it is important for the current healthcare leaders to be dynamic and commit to extensive research to solve the ever-changing health dynamics.
Gallagher, Patel, Donaldson, Wilson (2007) conducted a quantitative study in which they examined the current trends in the field of dentistry. The data collected from their fields of study was input into an SPSS analysis system and further analysis of the data included the tests using the Chi Square method in which the authors were looking for linear relations, multiple regressions, logistic regressions, and analysis of factors. They found that a variety of influences such as sex and ethnicity have an important influence on the choice to venture into dentistry. Healthcare has to understand the nature of these influences in order to lead their workforce effectively.
Ghazali (2008) discusses a relevant issue in the context of healthcare leadership especially for those medical institutions that are in the process of change. Ghazali (2008) asserts that one of the greatest challenges in healthcare leadership is the inability to transfer knowledge from one party to another. In order to have effective healthcare institutions, one of the changes needed is the creation of patient-centered care in which patients are aware of the need to have a keen interest in their health. Leaders have to understand the specific needs of the population in order to offer efficient and satisfactory services.
According to Gifford, Davies, Edwards, Griffin, & Lybanon (2007) assert that it is important to incorporate the evidence-based research into the nursing field in order to guarantee quality nursing care. Based on the content of the article, the managerial approach proposed by the authors is one in which the managers invest in research in order to understand the health needs of the population. In fact, the validity and appraisal of the article begin from the proposal that that there is limited research on the constituents of effective leadership practices in nursing. Theoretically, the authors suggest that research will go a long way in solving the existing challenges in the nursing field with respect to leadership.
In the article Healthcare Provider Moral Distress as a Leadership Challenge (2008), moral distress is referred to as a severe problem where nurses feel a loss of satisfaction and integrity in their environment of work. The assertion is that a majority of these nurses often leave the nursing filed on grounds of these feelings, which is a major setback in the provision of quality services. As, such, these authors lay a firm ground on which leaders can lay their strategies of leadership and deal with the exodus in the profession. Employee satisfaction should be ensured through flexible job descriptions.
Leitner & Güldenberg (2010) propose that the application of appropriate generic strategies can help address the challenges experienced by leaders in the provision of healthcare. Generic strategies define the policies adopted by any small market enterprise (health institutions included) in order to attain a competitive advantage over the rest of the participants in the market. Here, it may be presumed that the authors are urging the public sector to emulate the competitiveness in the private health sector. These leaders can learn from each other and eradicate some of the challenges crippling the health of populations. On the same note of generic strategies in institutional leadership, Mannix, Wilkes, & Daly (2015) carry out a qualitative in which they evaluate the importance of moral standings and good ethics in nursing leadership. Their theoretical framework is applicable for leaders in the sense that ethical leadership and acceptable moral standings play an important role in the perception that the employee have. It also affects performance and the eventual quality of healthcare.
Vaismoradi, Bondas, Salsali, Jasper, and Turunen (2012), contribute to the aspect of nursing leadership through their research. Their qualitative study of the nurse leaders in Iran is essential because it focuses on the facilitation of healthcare. The study evidences the concept of challenges or issues affecting the nursing leadership by aiming to describe and explore the various approaches through which the nurse leaders facilitate the safe care of the patients from the viewpoint of the nurse leaders and the nurses. The qualitative data analysis suggested three major themes in the issue of nursing leadership, including the provision of different environmental prerequisites for the nursing practice, the unity and the integration of the healthcare providers, and the creation of an environment of safe care, which makes this study relevant for the topic.
Stanley (2006) is also a major contributor to the understanding of the issues in nursing leadership. He talks about the recognition and definition of the clinical nurse leaders. One of the most elemental components of his research is the distinguishing of the types of leadership. That is, according to him, there is transformational leadership and congruent leadership. As such, his study suggests that transformational nursing leadership establishes the direction and aligns the people within the nursing institutions. On the other hand, the congruent nursing leadership is motivational, inspirational, open, and approachable. As such, this study is essential because it offers the solution to problem in nursing leadership, which is to implement and execute the two types of leadership in the nursing institutions.
Rujumba, Mbasaalaki-Mwaka, and Ndeezi research on some of the challenges facing the healthcare workers in the provision of the counseling services to the HIV+ children. The descriptive study suggested that some of these issues included the inability of expression of the children, the dependency of the children on the adults for care, the fearful aspect, and the need for more time during the counseling. As such, this study clearly evidences the absence of the role of the nursing leaders in that healthcare institution. Among the issues raised, the lack of the counseling skills, which is an aspect of poor leadership, makes this study crucial for the understanding and discussion of the issues of nursing leadership.
Rosenberg (2008) is another elemental contributor to the question of leadership challenges in the healthcare institutions. Her study focuses on the lack of diversity in the behavioral leadership of healthcare as reflected in the healthcare services. The study is a clear evidence of the issues and the challenges facing the leadership in the nursing sectors. This study presents the diversity issue in the nursing leadership by presenting evidence that most of the top executives and administrators in the behavioral health are non-Hispanic whites. As such, the study suggests that the lack of diversity in the nurse leaders is likely to lead to a widening gap in the ethnic and racial disparities in the healthcare sector.
Murray et al (2011) address the international challenges, especially the educational needs of the family physicians in diabetes. This study relates to the issue of nursing leadership in the sense that it aims to present the data on the gaps as well as the barriers in the care of the patients. This study is of great significance in the explanation of the remedy or the proposed solution for the nursing leadership challenges. That is, the study proposes that these common issues affecting the nursing leadership could be addressed efficiently through the development of educational designs that are adapted to the healthcare systems of each country. As such, this approach could help develop as well as maintain the competencies of the physicians.
Munir and Nielsen (2009) talk about the transformational leadership among the healthcare workers. The study aimed to present the analysis of a study on the investigation of the longitudinal integration between the transformational leaders and the employees as well as the effects of mediating of self-efficacy. The evidence from the study suggested that the self-efficacy of the employees did not mediate the relationship between the employees and the leadership. As such, the results indicated that the training of the nurse leaders or the managers in the behaviors of transformational leadership could have a positive influence on the health of the healthcare workers over time. For this reason, the research is vital in presenting the proposed solution for the nursing leadership challenge.
McAlearney (2006) presents the information on the leadership developments in the healthcare settings. According to her, the challenges associated with the leadership issues in the healthcare industry have influenced the development of the leadership in the healthcare organizations. This study is vital because it offers a proposed solution for the problem facing the industry. That is, conceptual models of commitment to the leadership developments in the healthcare industry have to be influenced by the organizational structure, culture, and strategy. These aspects are important because they influence the decisions for the enhancement of the organizational healthcare effectiveness. For this reason, the study is elemental in the nursing topic discussed.
