Leadership and management in nursing should be collaborative, progressive and geared towards meeting the future demands of healthcare systems (O'Neill, 2013). There are various management and leadership theories used in explaining managers' and leaders' roles in achieving efficiency. Taylor's scientific management theory, for example, was formulated out of the need to scientifically optimize tasks and rationally design the required performance level for enhanced productivity. Taylor believed in the procedures developed after carefully studying the work progress of an individual, instead of decisions based on tradition. This theory aims at enhancing efficiency in organizations by using engineering, mathematical and scientific analysis to increase competence in task completion (Huber, 2014). Additionally, it emphasizes on waste reduction, ensuring there is a fair distribution of goods, and increased productivity. The principle of scientific management theory proposes that the selection and training of workers should be scientifically motivated, any information collected by managers should be analyzed through mathematical formulas, and that workers should utilize scientifically developed techniques (Huber, 2014). The idea of scientific management theory is for organizations to identify effective working techniques, employee training and providing a just reward system with sufficient productivity. This paper examines some of the inefficient routines in health care system Based on the scientific management theory, and it also gives examples of participative decision making that exist in my workplace.
According to Hubber (2014), efficiency is attained if workers are financially satisfied since money is a significant form of motivation, although there are other factors like working conditions. The human motivation for money propels standardization and best practices, which in turn lead to improved efficiency and work ethics. Therefore, since the primary aim of developing the scientific management technique was to enhance workplace efficiency, applying it leads to a significant increase in workers' productivity (lecture, 2018). The theory also developed management functions which include planning, organizing, staffing, directing, and controlling to separate workers and managers. This makes it possible to compare the nursing process elements and the management functions; the managers supervise and grade performance, while workers perform the actual tasks
Efforts of redesigning and measuring nursing workload majorly rely on Taylor's theory. However, despite its effectiveness, there are limitations to the scientific management theory which makes it a challenge when it comes to establishing a productive and well-coordinated healthcare system (Huber, 2014). Healthcare inefficiency is mainly associated with poorly coordinated healthcare providers. Common inefficient routines in healthcare based on this theory include; communication barrier between frontline caregivers and the management, poor patient care due to inadequate resources brought about by financial constraints and understaffing a floor that has high insight rate. Staffing in hospitals is primarily conducted by floor census instead of the acuity level. This results in medical errors, nurse dissatisfaction, and end of shift over time.
Other major routines that lead to inefficiencies include retention of the nursing staff inefficient use of equipment and facilities, like inappropriate scheduling of operating teams. Ineffectiveness in healthcare systems can also be as a result of lack of qualified nurses who can assist in training new staff. Also, inefficiency can be as a result of the overuse of healthcare units and testing equipment. Since scientific management only emphasizes on efficiency, but not quality, there is a tendency of patients repeating tests because of doctor experience confusion due to the inability of locating test results (Huber, 2014). This leads to a misuse of healthcare resources and delayed treatment.
The need for high-quality management requires healthcare activities to utilize a participative management approach (Wheeler, & Foster, 2013). Participative management constitutes interactive empowerment, problem-solving and decision making. Examples of participative decision making in my workplace include the existence of unit-based councils and shared governance. Allowing nurses to participate in shared governance empowers and gives them an opportunity to take part in decision making on issues that affect their practice, thus leading to career advancement site. Participation increases the sense of autonomy, job satisfaction increased knowledge and enables healthcare providers to develop leadership skills (Wheeler, & Foster, 2013). If bedside nurses take part in major decision making, they also get equipped with leadership skills. At times nurses, however, nurses do not perceive participative decision making as one that has a personal meaning; rather, they highly value their bedside role.
Besides the application of shared governance, participative decision making also incorporates the use of unit-based councils. The councils are valuable since they set standards for safe and high-quality evidence-based care. At the organizational level, participative management leads to the enhancement of communication and relationships, patient safety and increased retention of healthcare providers (Wheeler, & Foster, 2013). I believe shared governance is perceived as a means of empowering nurses since it gives them an opportunity to participate in working environments. When healthcare providers are involved in the organization's change, they can participate in the development of planning.
Scientific theory and participative management play a significant role in ensuring quality healthcare management. Scientific management aims to increase standardization and efficiency, by improving personnel and cooperation between employees and managers, to enhance productivity. This does benefit not only the employers but also workers who gain from the training activities.
Huber, D. (2014). Leadership and Nursing Care Management . Elsevier Health Sciences.
Lecture 1. (2018). NRS-451V: Theories and Concepts in Leadership and Management. Phoenix, AZ: Grand Canyon University
O'Neill, J. A. (2013). Advancing the nursing profession begins with leadership. Journal of Nursing Administration, 43(4), 179-181.
Wheeler, R. M., & Foster, J. W. (2013). Barriers to participation in governance and professional advancement: A comparison of internationally educated nurses and registered nurses educated in the United States. Journal of Nursing Administration, 43(7/8), 409-414.
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