Leadership - Why is leadership important in health care?

Introduction
This chapter highlights the importance of developing leadership skills alongside your professional skills from the beginning of your career. It describes what we mean by leadership, how it applies in healthcare settings and what role leaders play. It considers the behaviours consistent with good leadership and asks you to consider the leadership style that fits your values and beliefs.


What is leadership?
Leaders inspire and encourage people to take on a goal or series of tasks that are beyond the individual alone. Leadership can be described as the use of particular behaviours that promote engagement, desire to achieve, collaboration, goal setting, delegation of tasks and celebration of achievements. All together, they help create a sense of team work, loyalty and common purpose, which makes achievement of objectives more possible than single enterprise. Leading others is, therefore, relationship based, as well as situational and related to position.
When we talk of leadership we often describe the actions and behaviours used to bring teams or individuals together to work on common goals. Leadership shows itself in many ways; it is affected by the task, the situation, the organisational, professional or team culture and by the psychology of the individuals involved. Leading is also informed and developed by followers; individually and collectively.
When we think of leadership, we often picture people who display the characteristics and behaviours we admire or dislike; or we associate the term with feelings, an emotional reaction that arises from our personal experiences of leading or following. Leadership is also, therefore, a concept that can be either embodied or remain an aspiration.
Leadership can be displayed overtly, for instance in decision making and ‘taking charge’, or subtly, by creating the conditions in which others can thrive and achieve a goal. Leadership behaviours are not confined to the workplace, sports field or politics; they are employed daily as we chart our course through life. Whilst some consider leadership skills to be innate (‘s/he is a born leader’), leadership behaviours can be learned, practiced and improved.
There are many different theories about leadership and different types of leading styles and behaviours. This chapter does not explore these theories but a series of recommendations for follow-up study are made at the end of the chapter.


Why is leadership important in health care?
Leadership is critical to the successful delivery of quality health care, which is delivered most effectively by teams of people. Each person has a specific role or expertise and it is the task of the leader to ensure that all team members can make their contribution and support each other for the benefit of the patient. What makes leading in healthcare different is that the team skills required to deliver good treatment and care can vary from one patient to another. This means that people move in and out of professional leadership situations as dictated by the needs of the patient. All this happens within the construct of a team or unit of people who also need support, leadership and management to help them do their jobs to the best of their abilities. Evidence shows that there is a strong correlation between the quality of leadership, the experience and productivity of individual team members and the quality of patient outcomes (West and Dawson, 2012).
That is, there is a direct link between an organisation with deficient leadership and, for example, higher than average mortality rates. The factor most closely associated with this outcome is that of organisational culture. Organisational culture is shaped by the decisions, actions and inactions of leaders. Put simply, good leaders can create cultures that support good care and safe practice (Schneider and Barbera, 2014).
The recent publication of reports into healthcare quality in the United Kingdom has highlighted the role and impact of leadership in the NHS in their findings (Francis, 2010, 2013; Berwick, 2013). Many of their findings around leadership are replicated in reports into social care, law enforcement and education as well as in health. These reports suggest that in health care, clinicians are insufficiently represented in general leadership positions. Clinical leadership is being encouraged in both the NHS and private healthcare organisations, as evidence of the relationship between good clinical leaders and good healthcare quality is being established through research.


Leadership as a professional responsibility
All registered healthcare professions are regulated by a governing body, which sets and maintains the standards expected of professionals. Your regulatory body will have published information, direction or guidance for you, setting out its expectations of your professional responsibility around leadership. Each professional body will also have expectations regarding competency in leadership and standards of behaviour as a leaders and managers.
As a newly qualified healthcare professional, you will usually work in teams to deliver health care. You will be asked to contribute specialist knowledge and specialist leadership as you develop your career. You will also contribute to team and organisational culture, be asked to follow others at times and work as an equal member of a high performing team. It is essential that you take opportunities to develop your own leadership skills and experience as part of your continuing professional development and that you do so in accordance with your professional regulator.