The Leadership Role of the Ward Manager in the Hospital

ABSTRACT

Numerous policy and research reports call for leadership to build quality work environments, implement new models of care, and bring health and wellbeing to an exhausted and stretched ward manager. Rarely do they indicate how leadership should be enacted, or examine whether some forms of leadership may lead to negative outcomes. We aimed to examine the relationships between various styles of leadership and outcomes for the ward manager and their work environments.

The search strategy of this multidisciplinary systematic review included 10 electronic databases. Published, quantitative studies that examined leadership behaviours and outcomes for nurses and organizations were included. Quality assessments, data extractions and analysis were completed on all included studies.

34,664 titles and abstracts were screened resulting in 53 included studies. Using content analysis, 64 outcomes were grouped into five categories: staff satisfaction with work, role and pay, staff relationships with work, staff health and wellbeing, work environment factors, and productivity and effectiveness. Distinctive patterns between relational and task focused leadership styles and their outcomes for nurses and their work environments emerged from our analysis. For example, 24 studies reported that leadership styles focused on people and relationships (transformational, resonant, supportive, and consideration) were associated with higher nurse job satisfaction, whereas 10 studies found that leadership styles focused on tasks (dissonant, instrumental and management by exception) were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes.

Our results document evidence of various forms of leadership and their differential effects on the ward manager and work environments. Leadership focused on task completion alone is not sufficient to achieve optimum outcomes for the ward manager. Efforts by organizations and individuals to encourage and develop transformational and relational leadership are needed to enhance nurse satisfaction, recruitment, retention, and healthy work environments, particularly in this current and worsening nursing shortage.

Table of Contents

ABSTRACT2

CHAPTER I: INTRODUCTION3

Background3

Measuring Disease; example the 'International Classification of Diseases' (ICD)3

Measuring Illness; example the (SF36)3

Measuring Sickness; example (SIP)3

CHAPTER II: LITERATURE REVIEW3

Why is leadership important?3

What is leadership?3

Personal qualities3

Delivering the service3

CHAPTER III: METHODOLOGY3

Search strategy, data sources, and screening3

Inclusion criteria3

Screening3

Data extraction3

Quality review3

Analysis3

CHAPTER IV: RESULTS3

Search results3

Summary of quality review3

The outcomes of leadership3

Staff satisfaction with work, roles and pay3

Staff relationships with work3

Staff health and wellbeing3

Work environments3

Productivity and effectiveness3

CHAPTER V: DISCUSSION & CONCLUSION3

Implications for the ward manager and work environment3

Implications for leadership theory generally and in healthcare3

Implications for leadership research3

Implications for the translation of knowledge into practice for healthcare organizations3

Limitations3

Conclusion3

REFERENCES3

Appendix3

The Leadership Role of the Ward Manager in the Hospital

CHAPTER I: INTRODUCTION

Clinical effectiveness and quality of care is high on the political agenda. Strong leadership roles are crucial within the delivery of high standards of care.

Defining “leadership” within the roles of ward managers is necessary to ensure an efficient and cost effective service is being provided to the service user (Willmot, 1998).

Recognizing that the role of the ward manager has significantly changed, as the RCN, 2009 (p10) stated “a review of the literature from 1947 onwards provides a fascinating portrait and history of the ward sister role ...