Leadership and management concerns in the organization encompass diverse concepts ranging from the application of appropriate leadership style, skills and traits, depending on the situation, the subordinates’ personalities, and that of the leader; as well as discerning varied situations that necessitate an analytical analysis of alternative courses of action that would assist problem solving and decision making. To comply with the requirements of the current discourse, the aim is to describe the different approaches of nursing leaders and managers to issues pertinent to continuous quality improvement and patient satisfaction, which is included in the list.
Continuous Quality Improvement and Patient Satisfaction
In a health care environment, health care practitioners are expected to adhere to the highest standards of professionalism and quality in the delivery of patient care. According to Leatherman, Ferris, Berwick, Omaswa, & Crisp (2010), quality improvement was defined as “a philosophy (the pursuit of continuous performance improvement) and a family of discrete technical and managerial methods (where) these methods include systematic examination of processes used in service delivery, operations research, teamwork assessment and improvement, the optimal use of measurement and statistics in daily work, benchmarking and participative management techniques” (pp. 237-238). From the definition, it could be deduced that managerial methods and the role that managers play are crucial in the performance of continuous quality improvement, as deemed important in the health care setting.
In another discourse, the role of Clinic Nurse Leaders (CNLs) were seen as important in the promotion of healthy work environments . It was stressed herewith that “the establishment of a healthy work environment requires strong nursing leadership at all levels of the organization, but especially at the point of care or unit level where most front line staff work and where patient care is delivered(where) leadership at the point of care is now often provided by nurses in roles such charge nurse, unit facilitator, or clinical nurse leader” . It is through the promotion of health environments would nurse leaders abilities and skills be measured in terms of improving patient outcomes; one of which could be measured through the ability to improve patient satisfaction. In this endeavor, CNLs were encouraged to use the following strategy and tool towards improving patient outcome and satisfaction, to wit: the “TeamSTEPPS TM is an evidence-based teamwork system aimed at optimizing patient outcomes by improving communication and teamwork skills among healthcare professionals. It was developed for use in clinical practice with funding from the Agency for Healthcare Research and Quality. Tools in the model include the Two-Challenge Rule, Call-Outs, and Check-Backs” .
Nursing leaders, through their orientation, theoretical knowledge, skills and competencies developed in the area of patient care, focus more on both continuous quality improvement and patient satisfaction through the standards of care. These standards include conformity to safety, privacy and confidentiality, provision of holistic approach to nursing care, and observance of adherence to ethical, moral and legal standards as expected of the nursing profession.
Managers’ functions in their performance of their responsibilities in four broad areas: planning, directing, organizing, and controlling. As such, in the aspect of continuous quality improvement, managers are expected to assist in designing strategies that would contribute to improvement of quality through stipulation of performance and quality standards; by motivating nurses and other health care practitioners to adhere to the highest standards of patient care; to inspect medical supplies, resources and the overall health care environment to conform to safety standards and effective operations and full functioning; to ensure that policies and procedures are designed to incorporate incentives (or rewards) for exemplary performance and sanctions (or punishment) for violations of stipulated codes of discipline; and finally, to ensure that costs are minimized to optimize revenues and profits in their areas of endeavor.
Thus, there are similarities between nurse leaders and managers in terms of exhibiting professionalism and focusing on strategies that would assist in continuous improvement of quality. Likewise, there are also similarities in terms of focusing on patient outcome through performance of their respective roles which would ensure that patients are accorded with the highest quality of patient care that would result in patient satisfaction. Finally, both operate within the context of the health care environment which they serve. This means that the performance of their responsibilities are governed by the mission and vision statement of the health organization; as well as the organizational philosophy, culture and goals which should be the ultimate objective for fulfillment.
The disparities lie in the performance of their roles, duties, and responsibilities. While nurse leaders focus on patient care and adherence to standards of care as defined in their profession; managers focus on the performance of their basic responsibilities (planning, organizing, directing and controlling) different facets of the health environment (including human resources, materials, funds, as well as policies and procedures which would ensure conformity to standards that define continuous improvement of quality and patient satisfaction. As above mentioned, CNLs use tools such as the TeamSTEPPS TM, where leaders use teamwork in improving communication and skills among health care practitioners with the aim of improving patient outcome and satisfaction. On the other hand, the managers’ responsibilities are not solely confined to patient care (which one could consider as micro-oriented); but rather, their roles are more macro-oriented in taking accountability and responsibility to the whole health care environment. They use methods which include training and development, motivational techniques, teambuilding, review of policies and procedures, and other management strategies that measure performance against standards.
The Approach that Best Fits One’s Personal and Professional Philosophy of Nursing
Based on the discussion, the approach that best fits one’s personal and professional philosophy of nursing is that which is embodied in the standards of care, as expected from the profession: this means, focusing on the provision of high quality of care to patients through applications of theories in nursing care. This would include the practice of providing the holistic approach to nursing which includes safety; as well as addressing physical, mental, emotional and spiritual needs of the patients. All of these facets should be the focus of nurse leaders in the provision of continuous improvement in quality and patient satisfaction. If the standards of care are effectively undertaken, with the holistic needs of the patient appropriately addressed, then nurse leaders would be ensured that the outcome of the delivery to patient care would be productive, effective, successful and equally rewarding.
The approach is suited to one’s personal leadership style because it contains all the elements required from the nursing profession; as well as integrates all the personal and professional values and beliefs I adheres to in life. This includes respect for the importance of life, respect for diversity and equality, acknowledgement of the need to take care of the patients using a holistic approach, and ensuring that the patients get the best outcome from the health care experience by communicating their satisfaction in the provision of care that was accorded.
The current discourse has successfully achieved the aim of describing the different approaches of nursing leaders and managers to issues pertinent to continuous quality improvement and patient satisfaction through presenting concepts, applications and comparative analysis between the approaches applied by nurse leaders, in contrast to managers. As presented, although there were similarities and differences, it was aptly noted that both are governed by the mission, vision, philosophy and culture of the health organization that defines policies and procedures towards the promotion of continuous quality improvement and patient satisfaction in the long run. Likewise, one selected the nurse leaders’ approach to the provision of continuous improvement in quality and patient satisfaction as the most preferred personal and professional approach due to its perfect fit to one’s personal values, beliefs and adherence to the standards of care. In the end, it is emphasized that both nurse leaders and managers need to work hand in hand to ensure that patients are accorded with the highest standards of care, expected of the health profession.
Agency for Healthcare Research and Quality. (n.d.). About TeamSTEPPS. Retrieved from teamstepps.ahrq.gov: http://teamstepps.ahrq.gov/about-2cl_3.htm
Leatherman, S., Ferris, T., Berwick, D., Omaswa, F., & Crisp, N. (2010). The role of quality improvement in strengthening health systems in developing countries. International Journal for Quality in Health Care, Vol. 22, Issue 4, 237-243.
Sherman, R., & Pross, E. (2010). Growing Future Nurse Leaders to Build and Sustain Healthy Work Environments at the Unit Level. Retrieved from The Online Journal of Issues in Nursing: http://gm6.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol152010/No1Jan2010/Growing-Nurse-Leaders.aspx