The present paper aims to highlight the role of leadership in bringing about positive change within a healthcare system that fosters better service delivery. It undertakes a critical analysis of the approach taken by a healthcare leader for establishing a sustainable change in the healthcare setting so that better patient outcomes are achieved. The present paper considers the extent to which the applied strategies were successful in achieving the proposed change pertaining to the service delivery concerned. In addition, it also identifies the challenges emerging while implementing the change process at different levels. The manner in which these challenges were addressed would be mentioned in the paper. While writing this paper, strategies that would have been more beneficial in the selected context would also be highlighted based on literature search. Justifications for decision taken around the poposed change would be another part of the paper. Recommendations would be provided for future directions pertaining to leadership demonstration. The paper would end with a logical conclusion provided to the comprehensive discussion.
Working as a healthcare leader at a reputed Texas Hospital of USA, a professional is expected to demonstrate key competencies and skills that are suitable for the welfare of the organisation. The aim of a healthcare leader is to foster positive changes in the care setting that are in alignment with the mission, vision and values of the healthcare system. One such initiative taken for better patient care delivery services was the implementation of Cyber Security For Medical Devices (CSFMD) at the Texas hospital. The idea encompassed installation of firewalls for enriching the health-related services given. The potential benefit of this system included transparency in working systems, protection from medical device misuse through better security, safeguarding of patients and superior health services provided to patients by medical staffs who are trained and competent. A planned change was considered that was decided in collaboration with other health care professionals, namely physicians, nurses and other staffs of the medical team. Though the proposal for change was a collaborative decision, it was the responsibility of the healthcare leader to act as the vehicle for change. For successful implementation of the change, it was ideal to demonstrate suitable leadership skills that guide the complete process of change.
Leadership strategies utilised relevant to the planned change
For healthcare professionals holding a high position in a healthcare setting, it is logical to demonstrate key leadership skills that promote changes in the setting for the betterment of all stakeholders. Leadership is known to guide such changes holding the potential to transform the manner in which a certain operation is functional within the care organisation (). The leadership style utilised relevant to the planned change of CSFMD implementation was transformational leadership. While implementing the proposed plan for CFSMD, different leadership qualities were brought into practice such as positive attitude, excellent communication, integrity, honesty, empathy, flexibility, courage, accountability, confidence, team management skills, creativity and mentoring ability.
According to Richter et al., (2016) transformational leadership is a form of flexible and adaptive leadership. Through this form of leadership the leaer creates an environment of shared responsibility influencing novice methods of knowing. Transformational leadership is known to act as a motivating factor that enables followers to set up higher ideas as well as moral values. The leader is responsible for setting in deep ideas and notable vaues. This encourages the followers to sustain the change that they perceive to be good and let go of personal interest. Supportive environments are created under such form of leadership (Bansk et al., 2016). As opined by Mitchell et al., (2014) transformational leadership theory has provided its worth in a wide range of healthcare settings across the globe. This form of leadership fosters the development of capacity that brings in increased level of personal commitment towards organisational objectives.
As stated by Birasnav (2014) transformational leadership facilitates a redefinition of vision and mission of individuals that is marked by a renewal of their level of commitment towards goal fulfilment. Spano-Szekely et al., (2016) in this regard has stated that leaders abdiign by such leadership style engender admiration, trust and respect among the followers. Characteristics of a transformational leader are enthusiastic, persistent, role model, continual learner, risk-taking communicator, visionary, risk-sharing, courageous and mentoring. A leader is expected to have the ability to deal with highly complex situations and ambiguity.
While implementing the change pertaining to CSFMD at the Texas hospital a number of challenges were faced that influenced the success of the initiative and the outcome of the same. The key challenge was, however, the fear and apprehension that the team members showcased. The individuals were reluctant to move from the present position to a new position that demanded a new set of roles and responsibilities. They also feared the loss of their job if the complex technology was being implemented in practice. Lack of coordination was also a prime concern. The members did not support regular meetings held and had a negative attitude towards the leader. A lack of positive attitude was evident as the individuals had a rude behaviour and showed less concern for driving the change. It was challenging on the leader’s part to address this scenario. For addressing the barriers cropping up, it was advantageous to apply transformational leadership style in adjunct with Kurt Lewin’s change management model.
The change management model was divided into three stages known as Unfreezing, Management of change and Refreezing. The unfreezing step was beneficial in making the team understand the importance of the implementation of CFSMD technology in the setting. The team was explained that the manual working systems at the hospital were not efficient enough to give adequate output. In addition, it was a time-consuming process and outdated process. The concern of patient safety was also put forward in terms of security management. The reduced revenue generation because of poor services was also brought into notice. The unfreezing stage was further valuable in challenging the beliefs and values of the team members. The advantages of using CSFMD was outlined in details in the manging change phase. At this juncture, the professionals had to be empowered and involved in the team. The third stage of refreezing was marked by initiatives for sustaining the change. This stage witnessed offering reward systems, engaging in feedback provision and celebration of success. This was beneficial for overcoming all barriers in relation to change in practice. Sharing of information was also fostered in this regard.
Throughout the process of applying change management model of Kurt, transformational leadership was integral part of it. While demonstrating such leadership, it is the responsibility of the leader to communicate the need for implementing robust technological advances in the setting. The motivational factor driving change was rewards for achieving the newly set target. This step can be criticised and opposed on ethical and humanitarian grounds. In contrast to considering rewards system for successful implementation of change, other motivational aspects should have been relevant, mainly focusing on morales and values (Weib & Suib, 2016). Mullen et al., (2017) have criticised transformational leadership and stated that there remains an un-clarity of the components of the leadership style; namely inspirational, intellectual, idealized, and individualized. While a group of scholars support rewards as an ethical inspirational factor, others oppose that gains and benefits coming from rewards are not suitable as inspirational factors. Further, the leader in the present context should have come up with individualistic approaches that suit the temperament and decision-making process of stakeholders. In addition, impression management is also criticised to a considerable extent. Manipulation of the ideas and thoughts of the stakeholders might not have been the appropriate method of bringing about the change (Hillen et al., 2017). It would have been better if the decision was more of a concerted effort of all stakeholders rather than only of the leader.
Ethical implications were not considered at the core while bringing about the proposed change in service delivery. There was an absence of adequate consultation with the relevant stakeholders before determining the best possible method of implementing the change. The healthcare consumers, other healthcare professionals and the wider community were not consulted before finalising on the change process of CFSMD. According to Schmitt et al., (2017) a leader is supposed to act in an ethical manner while bringing about a change in the system. This incorporates the valuable input from all stakeholders, both the service users as well as service providers. Pinck and Sonnentag (2017) in this context had stated that decision making process of a healthcare leader must be resting upon the insights provided from perceptions and opinions of stakeholders who would be ultimately effected by the change. Informing the individuals about the proposed change prior to its implementation would not serve the purpose of being ethical and justified.
The outcome of the leadership style was in alignment with the objectives of the proposed change. The leader was enabled to overcome the issues regarding change management process. The team members could be encouraged to cover up for the gaps generated in service performance. The team members could also be motivated to have a collaborative approach towards work. The leader was also successful in being ethical and linking the change with the needs of the hospital. The flexible approach was efficient in moving away from the manual system to a better and advanced technology implementation. Problems arising within the team were solved through mutual understanding.
Analysis of decisions around the planned change
At the core of the change management process lay transformational leadership. Kellly (2012) attacked transformational leadership for being elitist and having disproportionate focus on the ‘heroic’ aspects of this leadership style. As condemned by the authors, the success of such leadership is always at the expense of the concerns and distress of the followers. Contained in this disparagement is the conception that transformational leaders possess particular traits which others do not have access to. Subsequently, the fate of followers is undeniably fixed to the aspirations of leaders who might be dominant.
Northouse (2015) put forward a strong criticism of transformational leadership in the context of organisational settings. In their article, the authors have commented that transformational leaders are much charismatic and it is this aspect that makes leadership mythologizing. The base of this leadership style is not strong as the foundational stone is composed of mere trust and expectations. Taylor (2012) in this ground stated that transformational leadership might not be responsible in a direct manner for increasing the self-efficacy of the individuals in the realm of bringing about change. Trust and respect are to sole two components that drive the followers to act in a manner as desired by the leader. The outcomes of the process might be as per the needs of the leaders, but they are not as per the views of the followers under certain circumstances.
Mitchell et al., (2014) further highlighted that undermining transformational leadership is justified. The reason for this is that leaders of this genre might abuse power depending on situations. In light of this, it is also to be highlighted that a section of the followers might be dependent characters forming bonds with the leaders that are not suitable. Further, as the authours note, the leadership lacks the balances of countervailing interests and power effective for avoiding dictatorship. Hillen et al., (2017) argued that the effectiveness of transformational leadership is to be questioned, more specifically the morality of the leadership style. The authors had to opined that leaders with this leadership style motivate the followers through appealing to stronger emotions and the ultimate impact on the followers is not adjudged. Such leaders are to exert a powerful influence over the other individuals who are to offer respect and dignity. Thriving on manipulation and power is not suitable. The manner is which the leadership style is executed is crucial for its success in different settings.
Though transformational leadership have been applied in different healthcare contexts, its suitability is to be adjudged depending on the context in which it is to be applied. In health care settings, transformational leadership might be more of negative outcomes than positive. The followers might be playing a passive role where they would act as dependent variable. Any healthcare professional implementing this leadership style must stick to the essence of the leadership approach. This implies that only positive insights from the leadership style are to be considered (Barr & Dowding, 2016). Communication, transparency and ethics are an integral part of the leadership style it is to be made successful. Rather than focusing on the perceptions of the leadership style, the outcomes of the process are to be analysed. Lastly, a healthcare leader might apply transformational leadership in combination with other leadership style to get desired results (Gopee & Galloway, 2014).
Transformational leadership has been successful in diverse range of settings and professions; the health care sector being one. Transformational leadership and its core principles of idealised influence and intellectual stimulation are applicable to healthcare organisations for bringing about change. It is to be highlighted that transformational leaders are responsible for elevating individuals from low levels of need to higher levels while maintaining focus on the need for survival. Collective purposes for all individuals lies at the core of such practice. Such form of leadership when applied to a healthcare setting must consider proper communication between leaders and followers. The success of change proposed on the degree of transparency and clarity maintained while implementing the change through leadership. Collaboration among individuals is only possible when individualised consideration, inspirational motivation and charisma are considered. At a healthcare setting such as Texas hospital, transformational leadership must look beyond promoting performances and effecting huge changes through traditional methods. The capacity for organizational transformation must be accompanied by moral responsibility, for transformational leaders to outline influential institutional cultures.
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