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Leadership Performance Gap : Medical / Nursing Research Paper

Medical / Nursing Research Paper
Paper Title: Leadership Performance Gap
Pages: 4
Academic level: University
Discipline: Medical / Nursing
Paper Format: APA
Sources: 4

This Research paper is to wrote based on the following Scenario:

Your team represents the CEO of the hospital: You have been in the position of CEO at a hospital for ten years, and your previous position was as a senior administrator. In the past few years your job has become much more difficult; patients are sicker, lengths of stay are shorter, compliance and other regulations keep accumulating, staff turn over is increasing, and workforce shortages are more prevalent.

Every time you go to a professional meeting, you hear of another colleague who has been “reorganized” out of a job. You feel fortunate to have remained in your position for so long, but at the last board meeting the board made it clear that the hospitals quality MUST improve. Your responsibility is to ensure that the board's request are carried out. At firdt this expectaion seems unreasonable, given that so many things, such as the nursing shortage, are not under yourcontrol. You remember going through a similiar crisis in the 1990's, and you thought you had fixed it back then. Since returning from an executive leadership conference a few weeks ago, you have been doing a loy of soul searching. Your management approach has always worked in the past, but it does not seem tobe working anymore. You were intrigued by one of the keynote speakers at the conference, who described the attributes required by healtcare workers today.  

Free Written Sample


Leadership Performance Gap
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Leadership Performance Gap

Healthcare leaders acknowledge a significant gap between their current practices and those required to meet the critical demands of the future, a new study has found. Eighty-seven percent of healthcare opinion leaders prefer dramatic healthcare reforms including managed care through a government/business partnership, universal access and strong emphasis on disease prevention, and improving the health status of the community. Leaders want a new civilization in healthcare with greater emphasis on the continuum of care, disease prevention, and the healing of communities as well as patients. They want a resource-sensitive system transformed by science, technology, and government policy, with basic healthcare access for all. Although this is their preferred scenario, they have less confidence in the likelihood of this scenario occurring. The leadership study had four parts: a literature search, interviews with leadership experts, a series of focus groups, and a national survey (not a random sample) sent to over 2,500 healthcare opinion leaders, including provider executives, physicians, leaders, insurers, suppliers, consultants, and academics. Nearly 400 responded. There are some of the findings:

A significant leadership gap exists between current practices and future requirements. New competencies and values--only lightly practiced today--will be critically important by the year 2001. The top six competencies and values needed for leading twenty-first-century healthcare organizations are mastering change, systems thinking, shared vision, continuous quality improvement, redefining healthcare, and serving public and community. Leaders want a new civilization in healthcare with greater emphasis on prevention and healing as well as universal, cost-efficient, community-based managed care. However, leaders expect that either of two less-preferred scenarios--Continued Growth/High Tech or Hard Times/Government Leadership--is more likely to occur. To transform healthcare, we must transform its leaders. The gap between the preferred versus the predicted view of the future underscores this urgent need. (Scott, P. and K. Quick 2002) As a major payer of healthcare bills and a major supplier to the industry, we appreciate that no area in our society is undergoing more scrutiny than healthcare. Because intense social and economic pressures force a steady stream of change on our delivery system, enlightened, effective leadership is absolutely essential to meet these challenges in the years ahead. While this text has effective strategies for leadership, it is aimed primarily at staff in the NHS and assumes some prior knowledge of leadership. It could provide a useful framework in other healthcare systems, not only the NHS, as 'leadership for all' is an international vision for healthcare today. Nursing communities around the world are committed and passionate about excellence in nursing care and healthy work environments though effective healthcare leadership.

Healthcare leadership is at a seminal juncture. The field can advance dramatically or languish and regress. It's up to leaders in academia and on the front lines of managing to analyze what is happening and to take timely action.

The art and science of managing healthcare organizations have experienced several milestones throughout their history: the early formulation of the field; its professionalization through graduate education and individual credentialing processes; the transition from hospital administration to health administration; and major changes in the skill or knowledge base for competent practice in the latter part of the 20th century. (Herbsleb, J., D. Atkins, D. Boyer, M. Handel, T. Finholt 2002) Each of these milestone eras involved concerted action by practitioners and academics to push things forward-something that is in short supply today. Through visits to Association of University Programs in Health Administration-member programs and other contacts with faculty members and practitioners, it seems to me that the categories have little contact with and, in some cases understanding of, the other. Academics may be busy with their own careers, while practitioners are faced with the demands of managing and leading in turbulent, fast-moving environments. (Doctorow, C., R. Dornfest, J.S. Johnson, S. Powers, B. Trott, M.G. Trott 2002) Although the preoccupations of both groups may be understandable, the result has had harmful effects on the field. Through contact with both groups, it is also striking how often each views the other in ways quite different from how the groups view themselves. There are notable exceptions, but the pattern is sufficiently prevalent to justify concern. Quality research in this area would be illuminating. In the meantime, to the extent that there is a gap, the needs of the field require that it be closed.

A number of organizations, including AUPHA particularly, are actively engaged in closing the gap. This has resulted in a strong base of knowledgeable, committed academics and practitioners. But this base must be expanded substantially to effectively address the critical factors in helping our field meet the fast-changing needs of healthcare.

Fortunately, healthcare leaders and leaders have done much good work to identify the core competencies necessary for effective performance. Unfortunately, the various forms and conclusions of this good work have not been consolidated or codified into a generally accepted set of skills and knowledge. (Bausch, P., M. Haughey, M. Hourihan 2002)

Such a skill set could be applied to the accrediting and credentialing processes. That would allow employers, trustees and the public to know that a credentialed person leading their healthcare organizations meets the test of possessing requisite core competencies. This need not be a cookie-cutter approach or a mandate. Additional competencies could be applied freely by various parties.

The nature of the process of analyzing and distilling the competencies involved would be crucial to the outcome; among other advantages, it would bring academics and practitioners together in an organized fashion.

Along with setting competencies for practice, a defining hallmark of a profession lies in its values. The founding visionaries of our field set into place very clear core values: service to humanitarian enterprise, devotion to quality, mentoring and high ethical standards. Events of the past two decades have given rise to concern that adherence to core values has been waning, that the field is in danger of losing its ethical coherence. Some call it merging into the general corporate world. Others call it the industrialization of medicine. As keepers of the flame, practitioners and academics have a mandate to reinforce our core values through methods geared to the 21st century.

Key leaders in practice and academia have initiatives well under way to re-engineer teaching practices in undergraduate and graduate education. One outcome of this work, along with that of core competencies, would provide a means for demonstrating the superiority of tailored educational programs in healthcare leadership over general leadership. Three areas of needed study are:

Analysis of experiential learning. The historic mainstay, the administrative residency, has declined steadily from being a very prominent component of career preparation. Methods must be found to revitalize this critical learning resource for the future.

Integrating educational experiences. During a recent policy roundtable by the Joint Commission on Accreditation of Healthcare Organizations, it was stunning to have acknowledged that there is virtually no coordination or collaboration nationally among educators in medicine, nursing, pharmacy and health administration. Their graduates practice in settings where teamwork among health professionals is crucial to success, yet there appears to be precious little recognition of such in current teaching and accreditation methods.

Updating teaching processes to reflect changes in healthcare. Careers in physician office practice, organ donor centers, hospice operations, and managed care are examples of practice settings emerging in the late 1980s and 1990s that are now well-recognized.

It will take creative means to ensure core competencies are acquired. These might include a substantial increase in practitioners returning to teach; uncompensated residencies, which might expand the pool of available positions; and a move to mostly electronic accreditation processes. Such ideas, along with timely action, are only possible through a renewed partnership of practice and academia that mobilizes new energy to strengthen healthcare leadership in its service to the public.


Bausch, P., M. Haughey and M. Hourihan (2002) We Blog: Publishing Online with Weblogs, Indianapolis, IN: Wiley.
Doctorow, C., R. Dornfest, J.S. Johnson, S. Powers, B. Trott and M.G. Trott (2002) Essential Blogging, Sebastopol, CA: O'Reilly.
Herbsleb, J., D. Atkins, D. Boyer, M. Handel and T. Finholt (2002) 'Introducing instant messaging and chat in the workplace', CHI 2002, Minneapolis, Minnesota, USA.
Scott, P. and K. Quick (2002) 'Technologies for electronically assisting nursing communication', in Proceedings of IADIS 2002, Lisbon, Portugal, 3-6 June.

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