Transformational leadership is associated with a positive environment meant to attain organizational change, transforming the actual order into a more benefic one for employees, clients and other stakeholders. In the health care domain, transformational leadership stays at the heart of employees’ satisfaction, staff retention, strong hospital administration, with satisfied patients (Robbins & Davidhizar, 2007), likely to become loyal patients (Worman, 2008). Transformational leadership effects also include reducing burnout, decreasing the overall level of employees’ stress, while increasing the level of staff well-being (Weber, 2010). However, the nature of health care system is an atypical one, because, as Rudnik Jr. (2007) observes, it deals with life and death situations, added to emotional and financial burdens. This aspect requires for individuals who can adjust their transformational leadership skills to a situation of urgency and to crisis cases, adapting the attributes specific to transformational leadership to the atypical context defined by hospitals. Therefore, the inspirational and motivational roles specific to transformational leaders need to instill leadership potential of the entire team (Marshall, 2011), and to pervade the emotional and stressful situations of dealing with patients that confront with life and death situations, infusing positive thinking and attitude while diminishing the staff’s frustration and the burnout. Stress, frustration or burnout are natural outcomes that nurses and other medical staff confront with in their daily activities because of their sometimes limited possibilities to save lives or because of their high responsibility and demanding tasks, which are likely to generate employee burnout and low self-esteem. Medley and Larochelle (1995) note that transformational leadership acts like a visionary approach that contributes to hospital workers’ self-actualization, efficient for addressing the personnel crisis in hospitals because of its high retention effect.
Hospital administrations are in a high need of transformational leaders, for managing the personnel crisis, which implies increasing staff retention, and for reaching a positive effect upon patient satisfaction. While transformational leaders candidates can be identified from students and graduates who are engaged in managerial studies or from executives from other fields (Rudnick Jr., 2007), another significant source of transformational leaders for hospitals administration is represented by the hospitals’ administrative employees or working staff (doctors, nurses). Hospitals’ staff and administrative employees are highly familiar with the specificities of the health care environment and with the working procedures imposed by their distinctive health care institution. This makes them suitable pursuers of the hospitals’ administrations. Nevertheless, being familiar with the working procedures of a specific hospital and knowing the specificities of hospital work does not make hospitals’ staff and employees prepared for managerial position, most of all, for transformational leadership roles. On the other hand, their potential must not be neglected. Therefore, in order to address the need of hospitals’ administrations of transformational leaders who would bring positive organizational effects (such as staff retention, employee satisfaction and patient satisfaction), there should be considered the training and preparation of internal resources for transformational leadership roles. Aware of the health care system’s realities and working methodology, internal staff could optimize their knowledge and bring effective change in hospitals, should they benefit of a proper preparation for administering the hospitals as transformational leaders. Marshall (2011) urges for the preparation of nurses in the leadership domain, noting that if in the past the healthcare needs were focused on educational preparation, clinical practice and professional skills development, nowadays, besides these attributes, the health care professionals also require leadership practice.
The health care system deals with increasing complexities that combine the challenges of saving lives, being responsible for patients, answering to families’ emotional distress or dissatisfactions, with the corporate interests, national and international rigors, financial shortfalls, shortages and poor retention of clinicians, human errors and patient safety and ambiguity regarding a health care reform or the emergence of new viruses (Marshall, 2011). In this context, there must be addressed the heath care institutions’ administrations and their preparedness to answer the above-mentioned challenges, aiming to change the current situation and to achieve positive effects.
In order to better visualize the effects of transformational leadership, there must be compared the situation from the hospitals that apply transformational leadership with the situation of hospitals who do not engage in a visionary change managerial approach. In analyzing the comparative situation between hospitals who apply transformational leadership to achieve change and those who do not apply it, the comparison should focus on the working environment, staff moral and their level of stress and dissatisfaction/satisfaction, burnout, employee retention, hospitalization conditions, patient satisfaction and loyalty. These are some indicators that existent studies have found to be affected by the application of the transformational leadership.
Preparing staff to become transformational leaders, instilling the others to find their leadership skills and abilities contributes to an attitude change, which, in time might result in positive effects for health care institutions. There needs to be addressed the urgency of staff training in transformational leadership, as it is correlated with perceived changes in hospitals’ employees behaviors, staff retention and employee satisfaction, which also generates customer satisfaction and loyalty (Worman, 2008).
Marshall, E. (2011) Transformational leadership in nursing: from expert clinician to influential leader. New york: Springer Publishing Company, LLC.
Medley, F. & Larochelle, D., R. (1995) “Leadership and job satisfaction”. Nursing Management. Vol. 26, no. 9.
Robbins, B. & Davidhizar, R. (2007) “Transformational leadership in health care today”. Health Care Management. Vol. 26, no. 3, pp. 234-239.
Rusnik Jr., J., D. (2007) Transformational leadership. Accessed from http://sftest.chausa.org/publications/health-progress/article/may-june-2007/transformational-leadership.
Weberg, D. (2010) “Transformational leadership and staff retention: an evidence review with implications for healthcare systems.” Nurse Administration Quarterly. Vol. 3, no. 3, pp. 246-258.
Worman, L., K. (2008) A correlation study between hospital employees’ perception of senior leadership behaviors and patient loyalty. Michigan: ProQuest LLC.