Leadership, Clinical Judgment, and Patient-Centered Care

Leadership, Clinical Judgment, and Patient-Centered Care

Leadership, Clinical Judgment, and Patient-Centered Care
We have many different types of leaders in healthcare. In my various nursing roles, I, too, have acted as a nursing leader.
Perform a web search and find information that allows you to discuss the following topic:***************
Briefly describe the article you chose. What role does leadership play in improving care? How does this relate to nursing as a profession, as well as to an individual nurse? How are nurses prepared to be leaders? How does the nurse utilize clinical judgment in providing patient-centered care? Please provide the title of the document you found and include the URL.
Nowadays, both evidence-based medicine and nursing are widely recognized as the tools for establishing effective healthcare organizations of high productivity and quality of care. Management and leadership of healthcare professionals is critical for strengthening quality and integration of care. Leadership has been defined as the relationship between the individual/s who lead and those who take the choice to follow, while it refers to the behaviour of directing and coordinating the activities of a team or group of people towards a common goal [1,2]. There are many identified styles of leadership, while six types appear to be more common: transformational, transactional, autocratic, laissez-faire, task-oriented, and relationship-oriented leadership. Transformational leadership style is characterized by creating relationships and motivation among staff members. Transformational leaders typically have the ability to inspire confidence, staff respect and they communicate loyalty through a shared vision, resulting in increased productivity, strengthen employee morale, and job satisfaction [3,4]. In transactional leadership the leader acts as a manager of change, making exchanges with employees that lead to an improvement in production [3]. An autocratic leadership style is considered ideal in emergencies situation as the leader makes all decisions without taking into account the opinion of staff. Moreover, mistakes are not tolerated within the blame put on individuals. In contrary, the laissez-faire leadership style involves a leader who does not make decisions, staff acts without direction or supervision but there is a hands-off approach resulting in rare changes [4]. Task-oriented leadership style involves planning of work activities, clarification of roles within a team or a group of people, objectives set as well as the continuing monitoring and performance of processes. Lastly, relationship-oriented leadership style incorporates support, development and recognition [5].

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Quality of care is a vital element for achieving high productivity levels within healthcare organizations, and is defined as the degree to which the probability of achieving the expected health outcomes is increased and in line with updated professional knowledge and

skills within health services [6]. The Institute of Medicine OM has described six characteristics of high-quality care that must be: (1) safe, (2) effective, (3) reliable, (4) patient-centred, (5) efficient, and (6) equitable. Measuring health outcomes is a core component of assessing quality of care. Quality measures are: structure, process, outcome, and patient satisfaction [6]. According to the National Quality Measures Clearing House (USA), a clinical outcome refers to the health state of a patient resulting from healthcare. Measures on patient outcomes and satisfaction constitute: shorter patient length of stay, hospital mortality level, health care-associated infections, failure to rescue ratio, restraint use, medication errors, inadequate pain management, pressure ulcers rate, patient fall rate, falls with injury, medical errors, and urinary tract infections [7].
There are numerous publications recognizing leadership style as a key element for quality of healthcare. Effective leadership is among the most critical components that lead an organization to effective and successful outcomes. Significant positive associations between effective styles of leadership and high levels of patient satisfaction and reduction of adverse effects have been reported [8]. Furthermore, several studies have stressed the importance of leadership style for quality of healthcare provision in nursing homes [9]. Transformational leadership is strongly related to the implementation of effective management that establishes a culture of patient safety [10]. In addition, the literature stresses that empowering leadership is related to patient outcomes by promoting greater nursing expertise through increased staff stability, and reduced turnout [11]. Effective leadership has an indirect impact on reducing mortality rates, by inspiring, retaining and supporting experienced staff. Although there are many published studies that indicate the importance of leadership, few of these studies have attempted to correlate a certain leadership style with patient outcomes and healthcare quality indicators.

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