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7003CPD Leadership Service Improvement And Integrated Care

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Course Code: 7003CPD
University: Coventry University

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Country: United Kingdom

Write a on the impact of leadership and change on the quality of care provision (including relevant literature to support the points you highlight). This assignment is a proposal for a service improvement within a health care service and you will need to reflect on your experience in health and social care, either as a professional, volunteer, patient/service user or through any other involvement.


The private and the public healthcare organizations are exposed to new challenges and there has been a series of policy papers that have exhorted for the improvement in the public services through the conceptualization and the development. Healthcare organizations rely on the highly developed skills of leaders (Huber 2017). This would be improvement in maintaining the quality of the organizational process and the quality of the healthcare. The healthcare organizations operate for 24 hours therefore it is imperative for the management to maintain the workforce for 24 hours in rotational and shift basis. Therefore it is necessary that the management maintains a proper balanced workforce for the entire day. To maintain such a balanced workforce for the entire day, an effective communication process is necessary in the healthcare organization (Kourkouta and Papathanasiou 2014). Great communicational abilities are basic for wellbeing and social care experts, since they assist them with developing connections and exhibit that they care. It is important to include good correspondence in social care. It helps us to fabricate associations with patients and their family, create associations with the staffs of the organization, leaders and other people that are involved in well-being and social care, give clear data to the clients and care staffs, and helps to kept proper record about the staffs and the clients (Arnold and Boggs 2015). The purpose of the assignment is to provide rrecommendations to improve effective communication among care workers during shift rotation period. The following paper will provide a brief idea about the communication process in the health care organizations, SWOT and PESTAL analysis of effective communication in order to understand the issues and recommendations to overcome the issue in an effective manner. 
Types of Communication within the healthcare organization
Written Communication 
Written communication is essential to the medical field. This gives information to individuals without attendants or medical faculty having to be up close and personal keeping in mind the end goal to impart (Garon 2012). Written communication includes the signs that can be seen through the healing centres that give information about a wide range of sicknesses or meds. Likewise the medical records that the attendants and specialists keep about the patients are a type of written communication.
Communication role 
Communication assumes an essential role all through the medical field. Everything that goes ahead within the medical field and within healing facilities involves communication. All types of communication are utilized which includes: written, nonverbal, and verbal communication (Brock et al., 2013). Technology additionally assumes a noteworthy role in the medical field since it permits the organization less demanding associations all together to impart. Effective communication helps the health professionals to understand the central need of the patients and provide effective service in order to meet their needs and achieve expected outcomes. Communication process helps the patient to understand the treatment process thus helps to gat consent of the patient regarding the treatment process (Arnold, E.C. and Boggs, K.U., 2015).
Verbal Communication 
Communication is the way to achievement of the business and the prosperity of the general’s wellbeing. The most well-known type of communication is verbal. Verbal communication comprises of talking to associates within the healing centre as well as groups of the patients, other offices in the doctor’s facility and in particular the patients themselves. Speaking discretely and candidly determines the mind-set, disposition and climate in the room. Without talking and interacting with patients and families the healing facility would disintegrate (Garon 2012).
Technology in the Healthcare Field 
Technology assumes a basic role in the medical field. The advances in the present current technology are the reason that our healing centres keep running as productively as they do today. On an everyday premise the doctor’s facility and its specialists utilize a wide range of kinds of technology, for example, IP telephones, pagers, PCs, mobile phones and significantly more (Thakur, Hsu and Fontenot 2012). These bits of technology take into consideration the labourers to convey through each other and the diverse wings of the doctor’s facility by means of content, email, medical records, and verbal communication. Without technology in the healing facility the specialists would need to depend on just written communication which basically is a defeat because of the absence of speed.
The principal visit to a specialist is to an amount vital for advancement of a rigorous and productive specialist patient rapport. The improvement of this rapport depends on good collaboration and association with the patient that aids in cure, as well as makes the patient agreeable ideal from the primary visit. This is the creation of a productive healing exercise which goes past the archetypal regular remedial ideal prototypes. Interpersonal correspondence is critical to understand the patient, as well as to honour him as a person with his own needs and issues, as opposed to an illness condition. It likewise inspires the patient to realize his medicinal ailment and efficiently partake in dealing with themselves (Thakur, Hsu and Fontenot 2012).
Numerous schemes are envisioned to promote a doctor’s ability and improve their tactic to case taking and help them assemble a dependable connotation with their patients. In these ventures, interpersonal aptitudes are educated to the doctor with the end goal that they can validate the suitable degree of kindness and anxiety for the patient. This helps the patient in opening up before their experts, accordingly authorising experts to inspire the whole measure of imperative data from a patient (Thakur, Hsu and Fontenot 2012). An impactful medicinal involvement with the patient consequences in an optimistic human services consequence, as well as also leads to tolerant and in addition dexterous fulfilment.
SWOT Analysis 
Healthcare organizations are dynamic and they are changing structurally and culturally in the workplace. Healthcare techniques and technologies demand new form of leadership to respond to the healthcare teams and developing new approaches of leadership to work efficiently. Healthcare sector consist different professional groups and departments and the experts with non-linear interactions between them. Within the healthcare group the subcultures either will be supportive or in conflict with each other. Therefore, the role of leadership will be to elaborate the diversity that exists within the health care organization and manifest its capability in efficiently designing the management processes (Wong, Cummings, and Ducharme 2013). The following is the SWOT analysis of effective communication in health care organizations between the staffs during rotational shift:

Effective communication is one of the most important features of patient centred care. The main strength of effective communication is that it helps the health professionals to coordinate with each other in order to provide adequate treatment to the people with need. It is important to understand the need of each patient in order to provide patient centred care in the health care organization. In this regards communication between the health professionals helps to take roper decision regarding the appropriate treatment process in order to help the patient to recover soon (Dean and Street 2015).
Communication between the health professionals during rotational shift helps them to remain updated regarding the progress in the treatment process thus reduce confusion about the treatment process (Riley 2015).
Communication and coordination between the health professionals during shift rotation period helps them to reduce their work pressure and increase their ability to fulfil their responsibilities in an effective manner. Thus, helps to maintain appropriate work environment in the health care organization. Workforce balance in the health care organization is maintained with the help of effective communication during rotational shift (Riley 2015).

The primary weakness of effective communication among care workers during shift rotation period is the deficiency in the field of marketing. The communication tools and the systems that are required to establish a proper communication system among the caregivers while there is shift rotation is important to be marketed properly and used. Due to lack of development in the technological field the health professionals lack communication and coordination during rotational shift thus fail to share important information regarding the health condition of the patient that creates confusion while providing care service to the patient (Ng et al. 2013).
The main opportunity of effective communication among care workers during shift rotation period in this field is the technological development that has happened over the years and which has been the main impetus of medical advancement are technological innovations (Van 2012). It is seen that the technologically advanced methods of treatment has improved the way communication happens among the caregivers and between the caregivers and the patients. There are dedicated applications and software’s that help in such communication. It would help the health professionals to document the health condition of the patients thus reduce the confusion during treatment (Thakur, Hsu and Fontenot 2012).
The main threat in this case is a faulty communication system that may lead to problems in a smooth management and operation when there is a shift change. Shift change is a phenomenon which must include processes like information handover, patient care details handover and details about the processes to be explained to the new shift employees. Often because of lack of communication or hurry of the care givers whose shift is ending there is not enough information sharing which leads to faulty operation handling. It is a duty of employees of both the shifts to maintain that all the responsibilities are handed over (Kourkouta and Papathanasiou 2014). Such activity could lead to serious harm to the patient and even death could occur in case of high risk patient. In such case question regarding the patient safety could occur. Such situation could lead to the violation of nursing ethics in the health care organization. Legal steps could be taken against the health care organization that could affect the reputation of the organization and reduce productivity (Parahoo 2014).
PEST Analysis
As discussed earlier that the main problem that has been identified in the effective communication among care workers during shift rotation period is the lack of a diverse workforce and absence of patient-centred integrated care (Ahmad 2012). There needs to be better awareness about communication processes. The problem was detected through survey research that was part of a pilot study conducted by a healthcare professional team for a longitudinal study regarding the problems in a hospital.
The political factors that inform the healthcare industry are employment regulations, consumer protection laws, policies on drugs and change in the tax laws and the insurance mandates (Koumparoulis 2013). The company must be properly following all the provisions of the government and the laws of the land even in the field of communication among the employees.
Increase in the rate that may fail the investors in the health sector, higher unemployment rate and the reduced purchasing power of the consumers. The impact may fall on the communication system of the care givers as well. The economic problems may cause the management to invest less on employee communication and management system thus could restrict the health care organization to provide adequate service (Koumparoulis 2013).
People have more information regarding their health and therefore there is more awareness. In case of communication the social factor is very important as all communications are social in nature. The care givers are essentially in need of better social conditions and job emoluments. Ensuring this will automatically result in better communication during shift rotation (Kourkouta and Papathanasiou 2014).
Medical companies are engaged in the healthcare distribution and veer towards technology for solutions related to healthcare (Ahmad 2012). Technological innovations maybe used as marketing strategies and communication processes. Health care organizations are veering towards apps to get the doctors connected with the patients. In this particular case technology is important in keeping track of the system and the shift rotation. The outgoing staff members and the staff who are joining the duty must be recorded in terms of duty timings, entry and hours (Thakur, Hsu and Fontenot 2012).
The healthcare organisations must be careful about the responsibilities towards the environment and the wastes which are produced must be handled properly and these should be dumped in designated places. The leadership of the organisation must be aware of the various ways in which environment can be preserved and protected (Gupta 2013). 
The various aspects of legalities in the healthcare sector which needs to be followed by the healthcare organisations include safety of the patients, maintaining all the licenses and registrations that are required, to see whether the medications and the drugs that are used are all legal and permitted by the government (Ahmad 2012). Legal obligations are must to be followed by the healthcare providers in order to communicate effectively.
How the Problem can be overcome:
As mentioned before that lack of communication between the health professionals during rotational shift restrict them to provide adequate treatment and care to the people wit need. Such activity could create minor to severe harm to the patient and could lead to the death of the patient in case of high risk. Thus it is important to introduce effective interventions in order to improve the communication system in the health care organization so that the health professionals could coordinate in an effective manner and provide essential service (Riley 2015). In this regards it is important to identify the factors that affect the communication process in the health care organization. Root cause analysis process could be used in order to identify the factors so that effective strategies could be introduced to reduce the effect of the factors (Card, Ward and Clarkson, 2012). On the other hand the problem can be overcome by two types of leadership: transformational leadership and the collaborative leadership (Huber 2017). The transformational leadership is not limited to the traditional style of transactional leadership (Avolio and Yammarino 2013). Here the goal is to make people work for efficiently by inspiring them and bolstering them to work for a mission. In addition to transformational leadership, I would deploy collaborative leadership in resolving the issues. The highlight of collaborative leadership is that it is both assertive as well as cooperative and would ensure that the individuals work together for the mutual benefit to culminate environmental symbiosis. Collaborative communication strategies help to encourage conversation between the multiple stakeholders through sharing information and skills and in reducing the level of complexity in the organization (VanVactor 2012.).
Root Cause Analysis- Root cause analysis (RCA) is a procedure for basic reasoning used for recognizing the root causes of deficiencies or issues (Card, Ward and Clarkson, 2012). A factor is seen as a root cause if ejection thereof from the issue accuse progression shields the last undesirable come about because of recurring problems; while a normal factor is one that impacts an outcome of the event, anyway isn’t a root cause. Regardless of the way that clearing a causal factor can benefit an outcome, it doesn’t keep its rehash with certainty. RCA is associated with intentionally perceive and make correction to the root causes of events, instead of simply addressing the symptomatic result (Cunico et al., 2018). Focusing cure on root causes has the target of thoroughly neutralizing issue reappearance. Of course, RCFA (Root Cause Failure Analysis) sees that aggregate expectation of rehash by one remedial action isn’t for the most part possible.RCA is commonly used as a responsive methodology for perceiving event(s) causes, revealing issues and settling them. The analysis is usually done after an event has happened. Encounters in RCA make it possibly significant as a pre-emptive system (Dolansky et al., 2013). RCA can be used in the event to check or foresee likely events even before they happen. While one takes after the other, RCA is an absolutely detach technique to event organization (Latino, Latino and Latino, 2016). The probable root causes that has caused the problem in the communication could be identified by such analysis for example lack of economy, lack of leadership, lack of rules and regulation regarding the rotational shift and many others. Identification of such issues could make it easy to introduce interventions in order to overcome them.
Transformational leadership- Transformational leadership is defined as a leadership where a skilled leader functions with groups to differentiate obligatory modification, preparing a desire to control the alteration through inspiration, and implementing the fine-tuning with conferred persons from a group (Amanchukwu, Stanley and Ololube 2015). Transformational leadership assists to upgrade the motivation, resolve, and job performance of followers through an collection of components; these include relating the adherent’s sensation of personality and self to a endeavor and to the cumulative character of the organization; performing works which will make the leader a great example to the supporters and followers to move them and to fetch their eagerness up in the undertaking; testing supporters to take more noticeable ownership for their performance, and considering the leader and inadequacies of followers, allowing the forerunner to regulate adherents to errands that improve their work. In complexity to transformational leadership, value-based leadership styles center around the utilization of prizes and disciplines so as to accomplish consistence from supporters. Transformational pioneers look towards changing the future to motivate supporters and achieve objectives, while value-based pioneers try to keep up existing conditions, not going for advance (Avolio and Yammarino 2013).
Collaborative Leadership- Collaborative leadership is the kind of leadership required to get compelling and effective outcomes crosswise over inner or outside authoritative limits. A collaborative pioneer contributes time to manufacture connections, handles clashes in a valuable way, and offers control. Conversely, customary leadership is more totalitarian where the pioneer takes total control over his group and takes choices without counselling his group members. The new approach of collaborative leadership has indicated that power is most important factor in an aggregate group (Cherry 2012). Collaborative leadership enable the staffs to involved with best thoughts of the gathering and adopt a group strategy in issue solving. They trust open data sharing is the foundation of progress. Progressively the accessibility of broadly educating more will be the chances to create and actualize innovative ways to deal with issue solving. The implementation of combined effort provides members of the group a voice. Pioneers are for the most part open to proposals and thoughts from their group and perceive that conceptualizing and alternate points of view can bring one of kind experiences (VanVactor 2012).
These leadership styles are useful in overcoming the problems of communication within the healthcare organisation, and implementing an appropriate system of shift rotation so that the system runs properly and the administration is unhindered (Amanchukwu, Stanley and Ololube 2015). The communication system will be improved by the usage of emails, memos, text messages and bulletin boards. Proper training will be provided to the care givers so that the system may be used efficiently. The shift rotation period involves creating addition time for effective communication among the care workers. The current trend is just about 10 to 15 minutes time for communicating patient’s information during shift handover. With the introduction of this improvement, it will increase to 30 minutes for effective communication (Manohar et al. 207). 
The various methods in which the evaluation will be performed are as follows.
Focus Group Interview
Focus group interview is a device for subjective statistical surveying where a group of individuals are chosen and some information is got about their assessment or recognitions about a specific theme. The base is intuitive where the members are allowed to examine with each other (Silverman 2016). There is a prepared mediator and a little group of respondents. Members are typically comparative in wording or either socioeconomics or psychographics or purchasing conduct/states of mind. Members are obscure to each other. It is a device for getting criticism about items or subjects. It gives data about different parts of an item that is yet to be propelled in the market with the goal that the item can be altered. It gives understanding into why certain sentiments or discernments are how they are.
Survey Research 
Survey research is the accumulation of information achieved by asking people questions either written, face to face, through telephone or through internet. Leading surveys is a kind of essential study, which is the collection of information from the direct source (Silverman 2016). The data gathered may likewise be gotten along these lines by different collections in auxiliary research. Survey research is used to accumulate the emotions, convictions and emotions of chosen collections of people, frequently decided for statistic inspecting. These socioeconomics include age, gender, ethnicity, culture and salary levels.
Meetings can be held face to face or via telephone and are regularly a more individual type of research than surveys. There are some issues that need to be considered while making a survey for example including content, wording, reaction configuration, arrangement of questions and grouping. Such decisions can influence the proper responses given by the people that has taken part in the survey.
Questionnaires can be made in both, “quantitative and qualitative” style depending on upon the idea of investigations. In particular, responses assimilated over close ended queries with different conclusion response supplements are analyzed utilizing quantitative approaches and they may comprise pie-charts, bar-diagrams and rates (Silverman 2016). Responses acquired to open-ended poll questions are dissected utilizing qualitative methods and they consist of talks and basic analyses without application of numbers and calculations. Advantages of surveys include extended rapidity of data accumulation, very low or no costs associated with the process at all, and bigger quantities of impartiality compared with plentiful elective strategies for vital data gathering. However, questionnaires have definite detriments, for sample, choice of random response choices by respondents without rightfully examining the investigation. Besides, there is usually no probability for respondents to express their extra contemplations about the issue because of the nonappearance of an applicable inquiry (Burns 2012).
Ahmad, A.E.M.K., 2012. Macro-environment influences on health service strategy in Saudi private sector hospitals: An empirical investigation. International Business Research, 5(5), p.49.
Amanchukwu, R.N., Stanley, G.J. and Ololube, N.P., 2015. A review of leadership theories, principles and styles and their relevance to educational management. Management, 5(1), pp.6-14.
Arnold, E.C. and Boggs, K.U., 2015. Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.
Avolio, B.J. and Yammarino, F.J. eds., 2013. Introduction to, and overview of, transformational and charismatic leadership. In Transformational and Charismatic Leadership: The Road Ahead 10th Anniversary Edition (pp. xxvii-xxxiii). Emerald Group Publishing Limited.
Brock, D., Abu-Rish, E., Chiu, C.R., Hammer, D., Wilson, S., Vorvick, L., Blondon, K., Schaad, D., Liner, D. and Zierler, B., 2013. Republished: interprofessional education in team communication: working together to improve patient safety. Postgraduate medical journal, 89(1057), pp.642-651.
Burns, L.R. ed., 2012. The business of healthcare innovation. Cambridge University Press.
Card, A.J., Ward, J. and Clarkson, P.J., 2012. Successful risk assessment may not always lead to successful risk control: A systematic literature review of risk control after root cause analysis. Journal of Healthcare risk management, 31(3), pp.6-12.
Cherry, K., 2012. Leadership theories.
Cunico, H.A., Dunne, J., O’connor, J. and Silva, A., International Business Machines Corp, 2018. Root cause analysis. U.S. Patent Application 15/836,973.
Dean, M. and Street Jr, R.L., 2015. Patient-centered communication. Textbook of palliative care communication, p.238.
Dolansky, M.A., Druschel, K., Helba, M. and Courtney, K., 2013. Nursing student medication errors: a case study using root cause analysis. Journal of professional nursing, 29(2), pp.102-108.
Garon, M., 2012. Speaking up, being heard: registered nurses’ perceptions of workplace communication. Journal of Nursing Management, 20(3), pp.361-371.
Gupta, A., 2013. Environment & PEST analysis: an approach to external business environment. International Journal of Modern Social Sciences, 2(1), pp.34-43..
Huber, D., 2017. Leadership and Nursing Care Management-E-Book. Elsevier Health Sciences.
Koumparoulis, D.N., 2013. PEST Analysis: The case of E-shop. International Journal of Economy, Management and Social Sciences, 2(2), pp.31-36.
Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice. Materia socio-medica, 26(1), p.65.
Latino, R.J., Latino, K.C. and Latino, M.A., 2016. Root cause analysis: improving performance for bottom-line results. CRC press.
Manohar, S., Thongprayoon, C., Cheungpasitporn, W., Mao, M.A. and Herrmann, S.M., 2017. Associations of rotational shift work and night shift status with hypertension: a systematic review and meta-analysis. Journal of hypertension, 35(10), pp.1929-1937.
Menaker, R. 2009 “Leadership Strategies in Healthcare”. The Journal of Medical Practice Management24 (6), 339-43
Ng, K.B., Leung, G.K., Johnston, J.M. and Cowling, B.J., 2013. Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis. Hong Kong Medical Journal.
Parahoo, K., 2014. Nursing research: principles, process and issues. Macmillan International Higher Education.
Riley, J.B., 2015. Communication in nursing. Elsevier Health Sciences.
Silverman, D. ed., 2016. Qualitative research. Sage.
Thakur, R., Hsu, S.H. and Fontenot, G., 2012. Innovation in healthcare: Issues and future trends. Journal of Business Research, 65(4), pp.562-569.
Van Wijngaarden, J.D., Scholten, G.R. and van Wijk, K.P., 2012. Strategic analysis for health care organizations: the suitability of the SWOT?analysis. The International journal of health planning and management, 27(1), pp.34-49.
VanVactor, J.D., 2012. Collaborative leadership model in the management of health care. Journal of Business Research, 65(4), pp.555-561.
Wong, C.A., Cummings, G.G. and Ducharme, L. 2013 “The relationship between nursing leadership and patient outcomes: a systematic review update”. Journal of nursing management, 21(5), 709-724

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