hange is vital in the healthcare system of the United States because of its fragmented and its disorganized nature (Arroliga, Huber, Myers, Dieckert, & Wesson, 2014). Creating change in the system is, therefore, necessary to advance health care services, thus, providing quality care and safety to all the patients. Therefore, it is necessary to integrate leadership and management in health care services to be able to transform the health care system (Laureate Education, Inc., 2012c). According to the Wall Street Journal (2014), leadership and management must go hand in hand together. Both are complementing each other to set the right direction for a change (Wall Street Journal, 2014).
The Difference Between Leadership and Management
According to Laureate Education, Inc. (2012c), leadership is about creating change, aligning people towards a set direction for change, establishing direction with people through proper communication and good interpersonal relationships. This has been supported by Marquis and Huston (2017) when they emphasized that leadership is dynamic and leaders are the front-runners for changes, often times do not have delegated authority yet able to obtain power through peer influence, have a wider variety of roles, more into teamwork and team building emphasizing good interpersonal relationships.
Management according to Marquis and Huston (2017) is the process of leading and directing an organization through manipulation of resources by planning, budgeting, and establishing goals for the organization or department. Management is associated with position and power due to legitimate authority which emphasizes control and manipulation of subordinates in the process of decision making, analysis, and setting of goals. Managers understand the complexity and order of an organization and manipulate the resources, but does not lead to change (Laureate Education, Inc., 2012c).
Integrating Leadership and Management
In order to transform and facilitate changes in the health care system, it is empirical that nurse should take its lead and role as leaders in the health care changes. Changes will continue in nursing and the health care industry and therefore it is vital that nurses develop the skills and competencies in both leadership and management functions (Marquis & Huston, 2017). The integration of both leadership and management is necessary if we want to see transformation of our health care system. Changes based on evidence-based practice is vital if we want to see a real transformation in our health care system.
New Product/System Implemented in Peritoneal Dialysis Unit
In response to the advancement of technological innovation, Baxter Company (the main supplier of our peritoneal dialysis supplies) came up with a new innovative peritoneal dialysis machine (cycler) that uses the Sharesource Connectivity Platform utilizing the ‘cloud system’. This will allow the clinicians to monitor PD patients’ treatments at home in the PD center, change prescription online and send the changes to patients’ machine using a modem, and order patients’ supplies online using the Sharesource Portal.
Baxter company introduced this innovative advancement June 2017 and required our PD unit to shift patients from CAPD to APD using this new machine (AMIA Machine) in response to evidence-based recommendation saying that automated peritoneal dialysis is more effective and efficient compared to the continuous ambulatory peritoneal dialysis. Our unit responded positively to this recommendation and came up with a goal to shift ‘ALL’ our patients to APD. Currently, our ratio of patients on APD compared to CAPD is 60% APD and 40% CAPD with a total number of 70 PD patient.
Our nurse manager utilized an organized leadership strategy by allowing a Baxter representative person to initially present the product. It was presented to the nurses first, and then to our three Nephrologists. The presentation was very informative and based on evidence. Secondly, training for the nurse was organized started with our nurse manager first and then followed by the rest of the training nurses. Our nurse manager showed us a great example by being the first to take on the responsibility. When she came back, she encouraged everyone to be trained as well (including the doctors). Our administrator was very supportive and sent us all for the training. As soon as we came back from our training, we immediately started training our patients with the new product. The Baxter company was so supportive that they sent a PD educator to support our unit while we were still learning the new machine.
Advance training and education is one strategy that is very effective in this endeavor. Collaboration with the rest of the multidisciplinary team is another factor why the end result of the change was effective. The attitude of our nurse manager really was the most important factor for success. She took on the lead first and showed us the real example of a real leader who leads the group for a change. She communicated the updates of the changes every meeting to the rest of the team. She presented the vision and goal and lead the group to follow her.
While she was leading the group for the change, she integrated both her leadership and management skills. She requested an additional staff nurse to facilitate the growing PD program. The management is so supportive to the vision and added one more PD nurse to help the program. Currently, our unit is expanding and is successful in this endeavor. Our nurse manager, as a leader and manager, has a vision and goal and is leading the group. And as a manager, she plans well, manipulating her resources (staffing and allocation), she establishes goals for the unit, she involves others in the decision making, and help her staff nurses develop their potentials.
Reflection on Leadership Competencies Required for Success
In my pursuit of leadership and management, I realized that I am a leader and I am an advocate for changes. Leadership is not limited to a position but is dependent on developing a good interpersonal relationship. To become a good leader, I must learn how to lead by having a vision and goal, need to learn how to listen to my subordinates, needs to be developed personally and professionally by educational advancement (EBP), develop others, and learn how to collaborate with the rest of the members of the team.
Arroliga, A.C., Huber, C., Myers, J.D., Dieckert, J.P., & Wesson, D. (2014). Leadership in Health Care for the 21 st Century: Challenges and Opportunities. The American Journal of Medicine, 127 (3), 246-249.
Laureate Education, Inc. (Executive Producer). (2012c). Integrating leadership and management competencies. Baltimore, MD: Author.
Marquis, B.L., & Huston, C.J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott.
Wall Street Journal (2014). What is the difference between management and leadership?
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