Paper Example on Leadership & Interprofessional Collaboration in Health & Social Care

Introduction

Leadership and collaborative interpersonal practice resonate within the health and social care students that are starting their practice, practitioners with the desire to provide collaborative care to their patients, as well as educators seeking to teach from an interprofessional perspective. These parties make use of a select number of leadership models and their relation to interprofessional collaborative teamwork. As a result, the current multidisciplinary practise within the health system has had various impacts on the health system of the United Kingdom and the rest of the world ("The role of the specialist nurse," 2002). That has caused the stakeholders in the health sector to recognise the need to develop more knowledge of how frontline managers in healthcare can facilitate the development of new roles (Folkman 2019). Still, on the subject of developing knowledge, the managers working in collaborative interpersonal practice encounter challenges in their daily practice. Critical discussions on the topic build the available knowledge on these challenges, as well as the corrective measures. It is also necessary to understand the conditions needed for the teams to emulate interprofessional collaborative teamwork (Bleakley, Hobbs, Boyden and Walsh, 2004). There are quite several issues in the current nursing practice that can be implemented to support collaborative leadership. These collaborative interpersonal practices can be evaluated using a selective means to determine their effectiveness. Nurse leaders are among the healthcare professionals that can influence interprofessional collaborative practice in specific leadership areas (Orchard 2017). Therefore, this discussion will provide a case study to assist in showing how a nurse can facilitate collaborative teamwork in an institutional setting. The discussion will include relevant management theories and models, as well as relational leadership and its impact on collaborative teamwork.

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Leadership and Management in Nursing

While taking on a general outlook and management, it is essential first to understand the difference between the two. On the one hand, leadership enables people and organisation to face adaptive challenges where there is a requirement for new learning (Edmonstone and Western, 2002). On the other hand, management is the application of learning that is already present to deal with situations where the learning is sufficient.

Clinical leadership is one of the new nursing roles that were developed to ensure that highly skilled nurses are prepared for the provision of quality and safe outcomes for patients and patient populations (Storey and Grint, 2012). The concept of clinical leadership is important in healthcare. It is also theoretically consistent with contemporary social psychological literature on the importance of local leadership to useful organisational function (Millward and Bryan, 2005). According to Millward and Bryan (2005), the issue of leadership is central to the National Health Service (NHS) modernisation strategy. The Modernization Agency was established to mobilise and implement various leadership initiatives that are coordinated by a designated Leadership Center.

High profile media cases such as Cardiac surgery at the Bristol Royal Infirmary have raised the eminence of a leadership issue in the public spectrum (Walshe and Shortell, 2004). The cardiac surgery at the British Royal Infirmary was particularly famous for its lack of effective leadership and lack of inter-professional collaboration. The concern over similar cases, combined with the rise of inter-agency healthcare, have contributed to an unexpected increase in organisational complexity, hence making interprofessional collaboration a permanent reality in healthcare (Sabugueiro 1994). One thing to note about integrated teamwork is that it will require the presence of frontal leadership. According to Millward and Bryan (2005), frontal leadership is useful for managing, reflecting, and making the team process visible, as well as the formation of collaborative partnerships that may arise from professional differences. In the case study provided, various leadership approaches had to be implemented to ensure patient safety and provide quality care to the patient. The healthcare practitioners involved had to improvise as they go because the situation kept changing with time. The healthcare professionals also had limited time to make decisions or to seek consultations. It is therefore essential to view the various leadership approaches that were available for use at the time of the endoscopy procedure.

Leadership Approaches and Models

However, when it comes to the NHS, the focus has always been on management rather than leadership. The emphasis on management has been accompanied by a set of assumptions that are seldom questioned (Edmonstone and Western, 2002). The so-called assumptions involve the pervasiveness and legitimacy of hierarchy, which places the so-called heroic leadership in the upper echelons of the organisation. The result is that it risks, ignoring the vast majority of the staff that include the mid-level and junior managers, as well as clinical professionals that become viewed as robot-like followers rather than leaders of any sense (Edmonstone and Western, 2002). The second assumption is that equipping individual with a means of developing their influence and power; they will be able to create more effective leadership. The assumptions prefer such route as compared to the preparation of the staff for a future where the tasks become increasingly complex and exert more demand for working with other professionals or agencies with little or no direct management control. Based on such assumptions, the approach is therefore inappropriate for the case study because it did not prepare for the scenario being discussed. The situation under discussion is already complicated and if the focus on management were to be adopted, the people involved would not have been prepared to deal with it.

The transactional leadership approach focused n short term targets. It emphasised on resources use and rational with the quantifiable and rational(Howie and Hall 2006). The transactional leadership approach is an indicator of the close relationship that exists between the organisations in the United Kingdom (U.K) and the machine metaphor. According to Edmonstone and Western (2002), the transactional leadership approach is also heavily gendered. That means that it tends to equate male preferences with power, formal authority and guarding of information, while the female preferences are associated with the sharing of power and information, and interactive style. The female preferences also tend to lean towards the enhancement of self-worth. The case study does not reveal the genders of the people involved. However, an effective strategy should be one that makes use of all the involved parties regardless of their genders.

Another powerful approach to nursing leadership is one that states that leaders cannot manipulate or control the culture in their organisations. According to Bate (2010), leaders can only shape the direction of the culture as it emerges. Based on this alternative approach, leadership is not an individual effort but instead a collective activity. The logic behind it is that there are limitations to what a single person can do. The approach of leadership as a collective cultural activity is in line with the idea of transformational leadership. Kouzes and Posner (2014) argue that leadership exists in all levels of the organisation and thus, it is shared across a large number of people and that makes it everyone's business. The approach comes from the concept of empowerment and change, which challenges the status quo and creates a new vision that excites the emotional and creative drives of the individuals to strive beyond the ordinary to deliver the exceptional (Kouzes and Posner, 2014). Such an approach is a deviation from the "command and control" format of the transactional-based models. It recognises the presence and contribution of middle and low-level managers and thus may be suitable for the case study. The scenario contains input from all parties involved in a managerial level. An assistant practitioner did the introduction while the student nurse assisted the assistant practitioner in positioning the patient in the procedure room - the registered nurse (RN) and the patient's ID band and WHO checklist. The student nurse then checked the patient's observation as well as administering 2L of oxygen despite the presence of other more qualified healthcare practitioners in the room. The student nurse high level of participation can only be useful in a leadership approach that recognises and encourages leadership and management from mid-level and low-level staff members.

Recent developments in the field of healthcare also introduced the model of shared leadership; also known as distributed leadership (Willcocks and Wibberley, 2015). Shared governance in acute hospital services and self-managed teams in community nursing emphasise on the use of nearby leaders or staff members as leaders as compared to distant personnel (Edmonstone, 2000; Baileff, 2000). Shared governance tends to be typical of a transformational approach and the creation of self-managed teams is common in transactional approaches. The shared leadership would have been useful in the given scenario because of its ability to utilise the available leadership resources rather than outsource them. When the assistant practitioner noticed bleeding from the stomach, they had to call additional reinforcements to lend an extra hand. However, the team members displayed self-management that negated the need for the nurse leader and the team member to continuously managed the team. It also allowed several events to coincide. One of the weaknesses of dualistic approaches such as transactional or transformational models is that they suggest simplistic or choice.

In situations such as the case study where the rate of complexity is high, there is a need for both transformational and transactional leaders. In the scenario given, the nurse leader can be seen taking the transformational route while the team leader takes the transactional approach. The nurse in charge moved to inform the significant haemorrhage team who came in and took over the procedure. The nurse in charge recognised that the amount of change needed was high and therefore moved to implement the changes needed by bringing in the haemorrhage team. On the other hand, the team leader recognised the need for organisation, supervision and performance. There was no room for second-guessing because of time. Since nursing practice now operates on evidence-based theory, the team leader needed to operate based on already established previously defined requirements. As a result of the transactional technique by the team leader, the haemorrhage team was able to maintain the routine.

Challenges to Inter-Professional Collaborative Practice

Interprofessional collaborative practice is often described as the best way to provide care (Pilon, Ketel, and Davidson, 2015). As briefly mentioned in the previous section, inter-professional based collaborative practise has its fair share of advantages that makes it useful in the modem day health institutions. However, there are also potential challenges that have to be overcome for inter-professional practice to become effective or useful in the field of healthcare(Mccray, Palmer, and Chmiel 2016). The deliver...