Leadership for Health Care Team

Leadership for Health Care Team

by Bachchu Kailash Kaini

(MBA, MHA, LLB, BEd, Cert. in Clinical Audit, PhD Student, University of Greenwich)

Leadership is a part of interprofessional care and health care teams are lead by leaders (Health Canada, 2005). Interprofessional care team rarely have a single leader and the leadership role is usually assigned to the most senior member of staff with high status professions or the leader may emerge based on service users’ need and the situation of services (Hammick et al, 2009, pp.54). Health care organisation is a collective sum of many leaders and followers and clinical and non-clinical activities. Sullivan (1998) asserts that health care professionals who are leaders in one or more activities are also followers in other activities. However, roles and positions are of great importance and valued by the health care organisations.

Lippitt (1961, p. 200) describes that the functions of the team leader often include the following:

·         Helping the team decide on its purpose and goals

·         Helping the team focus on own process of working together

·         Helping the team to become aware of its own resources and how best to use them

·         Finding the team to evaluate its progress and development

·         Helping the team to be open and different ideas without becoming immobilised by conflict

·         Helping the team to learn from its failures and frustrations as well as for its success.

Roy Griffiths famous quote ‘if Florence Nightingale were carrying her lamp through the NHS  today she would be searching for the people in-charge’ in his report ‘NHS  Management Inquiry (1983)’ highlights the need of the health care  leaders. The report recommended that clinical doctors should be involved in the local management of health services. In line with this view, the NHS Modernisation Agency was formed to co-ordinate management and leadership in 2001 and a Leadership Centre for Health was initiated at the NHS  Modernisation Agency to connect the roles of the NHS  leaders with service improvement (NHS  Modernisation Agency, 2001). Lord Darzi’s report ‘The NHS  Next Stage Review: High Quality Care for All’ highlights the importance of clinical leadership and as a result national Leadership Council was formed in 2009 by the NHS  Chief Executive.

The King’s Fund (2011) report ‘The future of leadership and management in the NHS : No more heroes’ recognises that the type of leadership the NHS  requires is changing. It further suggests that the model of shared leadership should be adapted for the effective delivery of health service and this requires a focus ‘on the development of organisations and the teams, not just individuals, on leadership across systems of care rather than just institutions, and on followership as well as leadership’ (The King’s Fund, 2011, pp. ix). The report also suggests that 'health service leaders help to promote professional cultures that ‘support teamwork, continuous improvement and patient engagement’.

Drinka and Clark (2000) state that health care professionals who are not designated leaders can have authority and responsibility of leadership including non-financial rewards, punishments and legitimacy. Leadership theory suggests that support for leadership must be earned (Hersey and Blachard, 1982 and Schein, 1985). Hansen and Nohria (2004) state that strong and effective leadership reduces people’s unwillingness to seek and provide help.

The expectations from the organisation and the team members, and the desired outcome are the basis of comparison for their performance.  In case of below the target performance, measures to improve the performance are identified so that mistakes are not repeated.

Leadership plays vital roles at all levels of the health care system for effective implementation of interprofessional care and teamwork. Given the complexity of the health care system, the creation, implementation and maintenance of collaborative interprofessional care teams requires a significant long term commitment (CHSRF, 2006, pp.21). Effective interprofessional care and teamwork are achieved when all the levels within the health care system work together under the dynamic leadership.

Strong leaders in health care team satisfy team members, service users and community needs, and they value all team members’ potential contributions in meeting those needs and achieving shared goals and optimal desired outcomes (IPEC, 2011). Health care team leader interacts with team members in ways that draw out potential contributions and build support for working together through an understanding of the team dynamics (Zaccaro, Heinen, & Shuffler; 2009).