Nurse Leadership and Management in Patient Satisfaction

Patient satisfaction is an essential outcome of health safety and quality. It is both a quality indicator and a competitive advantage because satisfied patients often improve the hospital’s reputation and bolster the facility’s financial flows (McRae, 2017). However, the impacts of nurse leadership and management are considered vital. Donnelly (2003) contends that although leadership and management appear distinct, they are somewhat interrelated, and their scopes in health care safety and quality overlap. Therefore, excellent patient satisfaction is accorded by an integrated approach to nurse leadership and management and associated concepts and frameworks. This paper will look at a comparative study of the two aspects and their effect on patient satisfaction.

Leadership and Management Approaches to Patient Satisfaction

To realize adequate patient satisfaction, leaders work towards organizational growth and progress. To do this effectively, they need to know themselves, develop a vision for their followers, build trusting relationships, and design action plans for the realization of the set goals (Donnelly, 2003). Given the need to provide clients with safe and quality care, the leaders organize their teams and collaboratively work towards ensuring the required standards of care.  Donnelly (2003) recommends that they should establish direction, vision, and the necessary tactics to attain that vision. Since research has shown that the work environment is a crucial ingredient in the realization of a satisfied workforce and better patient outcomes, they should strive to motivate and empower their subordinates to achieve the required working conditions. This way, the staff will work towards delivering adequate patient outcomes, which, in turn, will translate into favorable satisfactions. 

In comparison to leadership, management ensures that organizational resources are used effectively and efficiently. According to Parand, Dopson, Renz, & Vincent (2014), managers have moral and legal obligations to facilitate high-quality patient care through quality improvement strategies. That said, their essential tasks entail orienting the existing staff or hiring additional ones to ensure that patients receive optimum services that guarantee satisfaction. Because of their official roles and accessibility to resources, the managers mandate policies, systems, procedures, and the required organizational culture. By focusing on the number and quality of the workforce attending to patients, the management is likely to optimize client contentment with care. Since existing research ties staff volume, competencies and turnover rates to safe services, allocating sufficient resource to patient management will result in the desired satisfaction levels. 

Since sufficient patient satisfaction is the goal of the care process, leaders and managers apply various concepts to their practices. According to Giltinane (2013), the commonest ones include transactional, authoritarian, transformational, and situational leadership theories. In as much all of them apply to nursing leadership, the alignment of each approach towards patient satisfaction will influence the selection of the most appropriate theory. The transactional leader motivates their followers through rewards and punishments and often emphasizes on organization, supervision and group performance. Although this behavior is task-oriented and efficient in meeting deadlines, its little focus on outcomes (patient satisfaction) limits its adoption (Giltinane, 2013). The authoritarian style is similar to transactional leadership, which, is power-oriented, controlling and closed-minded. Transformational leadership, on its part, concerns with the leaders’ tendencies to inspire and transform subordinates to work beyond expectations, while minimizing self-interests for the team’s well-being. Notwithstanding the theories above, situational leadership looks at resolving circumstantial issues (Giltinane, 2013). Nonetheless, owing to its periodicity, its ability to solve patient satisfaction issues becomes limited. Therefore, these leadership theories can be favorably applied to patient care.

Similarly, management approaches are varied. According to Nassar, Abdou, and Mohmoud (2011), the management styles applicable to health care settings include the authoritative, benevolent, consultative, and participative management techniques. The authoritative style is synonymous to micromanagement, and its adoption implies limited trust in juniors; hence, decision-making is done at the top with the nurses implementing them. Its traditional nature hinders consultation, which is critical in meeting patient expectations (Nassar et al., 2011). Besides this management approach, the benevolent technique extends some trust to subordinates, meaning that some decisions are delegated down the hierarchy. However, this limited decision making prevents proactive advocacy for adequate patient care; hence, its suitability in meeting patient expectations is questionable. Aside from these two, consultative management accords some level of decision making to nurse practitioners, though confidence in junior decisions is not entirely substantial (Nassar et al., 2011). Even though this style efficiently covers some patient expectations, it is not effective in meeting the holistic requirements of the care process. Notwithstanding the above models, the participative management approach allows subordinates to make important decisions regarding their areas of specialization. The top managers only provide the means towards the implementation of those decisions, so long as they advance the organization;s goals. Nonetheless, all of them can be applied to management.

Approaches that Best Fit Personal and Professional Nursing Philosophy

On leadership, transformational leadership appears the best approach to motivating teams for greater efficiency and effectiveness. It;s concepts of nurse subordinate empowerment and democratic approach facilitates collective decision-making and a shared vision for the attainment of patient care goals. On its part, participative management is the best approach to achieving management proficiency. Although decision-making is not entirely limited to top hospital leadership, the fact that it is collaborative means that the bedside nurse can participate. This way, decisions are more inclusive of junior staff. These approaches will be further discussed in the rationales below.;;

Rationales for Selecting Leadership and Management Approaches

Transformational Leadership

The perception of health as a continuum necessitates professional collaboration in the provision of safe and quality patient care. From this perspective, nurses always work in teams that cooperate to facilitate the care process. Since the goal of this collaboration is adequate patient satisfaction, it is imperative that appropriate leadership theories be applied. The outcome-based nature of health care implies that transformation leadership is the best alternative towards this requirement. Giltinane (2013) contends that nurse leaders who exhibit the type mentioned above of leadership transform and inspire their juniors to work beyond their self-interest and expectations. The fact that this approach allows shared roles in decision-making between the leader and followers. Considering that the decisions were collectively negotiated, the clients; interests need to reflect the parties involved. According to McRae (2017), transformation leadership allows nurses to improve their practices and patient-care techniques through empowerment, that enhance outcome goals, hence, sufficient satisfaction.

Participative Management;

Literature has overemphasized the nurses; role in the patient care continuum. Several studies have shown how nurses are close to patients, and how this proximal relationship can be adapted for better outcomes. Since Nassar et al. (2011) indicates that this type of management approach permits important decision-making processes at the junior level. The involvement of nurses in patient-related decisions will allow them to advocate and articulate issues that hinder the realization of better service delivery. However, with such an approach to management where nurse actively participates in patient matters, it becomes easy to identify and respond to issues that impede quality care (Parand et al., 2014). Furthermore, engagements with nurses allow the identification and resolution of nursing shortages, staff retention, and turnover, whose outcomes inhibit better health outcomes. Therefore, participative management enhances the achievement of optimal patient satisfaction.;

Conclusion

Patient satisfaction is an outcome measure of health care quality. Although its realization is pegged on meeting patient expectations, it is imprudent to ignore the role of nurse leadership and management in the process. In as much as leadership and management are distinct concepts, their overlap necessitates their integration in patient care. Transformational leadership and participative management approaches are outcome-sensitive, and, therefore, necessary in the realization of adequate patient satisfaction.

References

Donnelly, G. F. (2003). How leadership works: Myths and theories. Five keys to successful nursing management. Philadelphia: Lippincott, Williams, ; Wilkins.

Giltinane, C.L. (2013). Leadership styles and theory. Nursing Standard, 27(41), 35-39.;

McRae, S.L. (2017). Transforming leadership for patient satisfaction. Nursing Management, 48(2), 51-54. DOI: 10.1097/01.NUMA.0000511923.13387.69

Nassar, M.E., Abdou, H.A., ; Mohmoud, M.A. (2011). Relationship between management styles and nurses; retention at private hospitals. Alexandria Journal of Medicine, 47(3), 243-249. DOI: doi.org/10.1016/j.ajme.2011.06.003

Parand, A., Dopson, S., Renz, A., ; Vincent, C. (2014). The role of hospital managers in qualityand patient safety: A systematic review. British Medical Journal Open, 4(9), 1-15. DOI: 10.1136/bmjopen-2014-005055;