IHP 505 Module 6 Leadership Paper Example

Leading the Change I Am Asking For: Leadership Behaviors for a Clinic Microsystem

[Student Name]

Southern New Hampshire University

IHP 505: Leadership in Clinical Microsystems

Module Six Paper

[Instructor Name]

[Date]

Leading the Change I Am Asking For: Leadership Behaviors for a Clinic Microsystem

Northgate Family Medicine is about to ask a great deal of its staff: fewer appointment types, a temporary push to reduce the backlog, new roles for medical assistants and daily huddles. Whether that change succeeds depends heavily on whether staff trust the person leading it. A recent staff survey was sobering: only 38% of employees agreed that they felt comfortable raising concerns with management, and front-desk staff scored lowest. This paper examines what research says about effective leadership in health care teams and sets out the behaviors I, as practice manager, will practice.

Leadership Styles and Outcomes

Wong et al. (2013) systematically reviewed research tying the conduct of nurse leaders to what happens to patients. They found that relational leadership styles, which focus on people and relationships, such as transformational leadership, resonant leadership and leadership emphasizing consideration of staff, were associated with higher patient satisfaction and lower rates of adverse events, complications and mortality in several studies. Task-focused or dissonant styles were more often associated with poorer outcomes. Although the review focused on nursing leaders and most studies were cross-sectional, the pattern supports the idea that how leaders relate to staff affects the care patients receive.

What Relational Leadership Looks Like

Relational leadership is visible in ordinary behaviors: knowing staff by name and understanding their work, explaining the reasons for decisions, asking for input before deciding, recognizing effort and following through on commitments. Transformational leadership adds articulating a compelling vision and helping staff grow. For Northgate, the vision is simple and meaningful: patients seen by their own clinician when they need care, and staff who go home on time.

Psychological Safety

Edmondson (1999) asked why some teams learn from mistakes while others hide them. Studying dozens of teams inside one company, she gauged whether members believed that confessing an error or raising a worry would not cost them standing with colleagues or bosses. Where that trust ran high, teams did far more of the work of learning: they asked for input, tested their assumptions out loud and dug into what had gone wrong, and those habits tracked with better results. She named the shared belief team psychological safety and found that team leaders' conduct did much to create or destroy it. Northgate's 38% comfort score points to low psychological safety, a real hazard for the coming change, because staff who stay quiet will not tell anyone when a new schedule or role is failing.

Psychological safety is not the same as comfort or low standards. Edmondson's teams that learned most were often the ones most willing to hear uncomfortable news. The goal at Northgate is a team that can say this schedule is not working without fear, while still holding high expectations for patient access.

Leadership and Well-Being

Shanafelt and Noseworthy (2017) reviewed evidence on clinician burnout and argued that organizations and their leaders are responsible for its main drivers, including excessive workload, inefficient work processes, lack of control and flexibility, problems with work-life integration, loss of meaning and weak social support. They described strategies leaders can use, such as acknowledging and measuring burnout, developing and evaluating leaders' skills, creating targeted interventions with front-line input, cultivating community at work and aligning values. They also cited evidence that clinicians who rate their immediate supervisors highly on leadership behaviors report less burnout and more satisfaction.

Behaviors I Will Practice

Drawing on these sources, I will practice five behaviors. First, I will attend every morning huddle and ask at least one front-desk or medical assistant staff member for their view before discussing plans. Second, I will respond to every concern raised within two days, explaining what will happen or why not. Third, I will admit my own mistakes openly, such as the time I approved a schedule template that double-booked a clinician, to show that errors can be discussed. Fourth, I will protect staff time by ending huddles on time and removing one low-value task for every new task added. Fifth, I will recognize specific contributions publicly each week.

Table 1. Leadership Behaviors and Their Sources

Note. Behaviors are designed to be observable by staff.

Building Safety During the Change

Change itself can threaten psychological safety, because staff fear being blamed if new processes fail. I will frame the scheduling redesign as a series of experiments in which problems are expected and useful. Each huddle will include a two-minute question, what is not working, and I will thank people for raising issues, even when they are critical of my decisions. Front-desk staff, whose ties to the rest of the team are weakest, will have a standing agenda item.

Measuring Trust

I will repeat the staff survey item on comfort raising concerns every three months, reported by role, aiming to reach 70% within a year. I will track the number of concerns raised at huddles and the share addressed within two days. A brief annual burnout measure and turnover rates will show whether well-being is improving. I will also ask a trusted colleague to observe two huddles a quarter and give me feedback on whether my behaviors match my intentions.

Limits

Much of the leadership evidence comes from nursing units and cross-sectional studies, so it shows associations rather than proof. My own role has limits: I cannot change health system policies on staffing or pay. Being honest with staff about those limits is itself part of trustworthy leadership.

Conclusion

The scheduling change will ask staff to take risks, speak up and try new roles. Research suggests they will do so only if they trust the leader and feel safe. By practicing relational behaviors, building psychological safety and protecting well-being, and by measuring whether staff notice, I can lead the change I am asking them to make.

References

Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350-383. https://doi.org/10.2307/2666999

Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout. Mayo Clinic Proceedings, 92(1), 129-146. https://doi.org/10.1016/j.mayocp.2016.10.004

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(5), 709-724. https://doi.org/10.1111/jonm.12116