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ESSAY Organizational Leadership and Interpersonal Team Development

Organizational Leadership and Interpersonal Team Development
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ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 2
Organizational Leadership and Interpersonal Team Development
Healthcare is a complicated system that is affected by the interplay of many factors, in-
cluding regulatory requirements and issues related to quality. Consequently, as much as the in-
dustry could be interpreted in corporate terms, the complexity of factors that underpin its exist-
ence, especially in the US, makes healthcare a unique industry. The objective of this paper is to
assess the effects of regulation, reimbursement, and business strategies on the provision of pa-
tient-centered care. The paper uses evidence from BayCare™, which is a non-profit system of
hospitals most of which operate in Central Florida. To attain the stated objective, the author ap-
plies the Patient-and Family-Centered Care Organizational Self-Assessment Tool (PFCC) to col-
lect data on the organization that would be used to understand the unique leadership concepts in
the healthcare industry. Further connections between the collected data and the leadership con-
cepts are made according to the ideals of the systems and transformational leadership theories.
The author finds that business models, regulatory mechanisms in the industry, and the systems of
reimbursement for health care services significantly influence the provision and accessibility of
patient-centered care in the chosen organization.
A. The Effects of Business Strategies, Regulatory Practices, and Reimbursement Mod-
els on Patient-Centered Care in BayCare

  1. Business Strategies
    The existence of private investors in the healthcare industry makes it similar to the rest of
    the corporate sector. Specifically, the players in the industry, as do the rest of the businesses,
    should balance their interests with those of their clients. For BayCare, although it is a non-profit
    organization, two models of corporate strategy can be used to analyze the effects of business
    practices on the provision and accessibility of patient-centered care. The two practices
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 3
    underscore the need for health care providers the world over to provide their services in a caring
    and passionate way because of its implication on reputation and the regulatory framework. First,
    the organization strives to provide the highest quality of services to the patients because of the
    element of patient satisfaction that is similar to customer satisfaction in business terms. In litera-
    ture, patient satisfaction emerged in the 50s, and it has evolved to its current state as one of the
    factors that contribute to the patient-centered model (Torres, 2017). For example, at BayCare, the
    staff understands that it must always care for the patients in ways that would increase their likeli-
    hood of recommendation to others (About BayCare, 2018). The clinical settings are dotted with
    state-of-the-art technologies and qualified personnel, which ensures that the patients remain
    happy with the quality of care that they receive. Patient satisfaction requirements have further
    contributed to the expansion of the service portfolio at BayCare, which is another significant fac-
    tor that indicates the connection between business strategies and patient-centered care. The or-
    ganization strives to reach to as many persons in the target community as possible. Conse-
    quently, the fifteen hospitals that the organization operates are distributed around Central Florida
    and Tampa Bay, and they are equipped with multi-disciplinary teams that provide a range of ser-
    vices to the populace (About BayCare, 2018).
    Another corporate strategy observable at BayCare Group is that of social responsibility.
    According to the premise of corporate social responsibility, organizations are supposed to bal-
    ance their profitability objective with that of improving the wellbeing of the communities in
    which they operate (Schwartz, 2017). Apart from being a non-profit organization, Baycare en-
    gages in a series of programs that target to improve the wellbeing of the communities in which it
    runs. Among the most notable engagements of the organization is patient and public education
    that seeks to improve public health awareness (About BayCare, 2018). In the context of patient-
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 4
    centered care, it should be noted that patient education helps in bolstering patients’ understand-
    ing of their conditions, including the best personal management practices that could be under-
    taken to deal with both chronic and mild conditions (Barry & Edgman-Levitan, 2012). The
    group’s management considers that it is critical for patients to learn how to manage their condi-
    tions, which is an extension of the nursing program that is adopted by the organization to im-
    prove its approval by the public.
    As much as this analysis does not identify management as a strategy, it is imperative not-
    ing the crucial role that the management of the Group plays in ensuring the success of the two
    business strategies. At BayCare, the management team has the role of directing the attainment of
    the mission and vision statements, which are both centered on patient-centered care (About
    BayCare, 2018). Frequent meetings with employees, for example, help the management to assess
    the performance of the organization in terms of its mission and vision. One notes, therefore, that
    the management has an important role to play in ensuring the success of strategies regardless of
    whether a corporation is for-profit or not-for-profit.
  2. Regulatory Practices
    Patient-centered care has been among the six aims of the health care of the US since 2001
    after the Institute of Medicine identified a list of factors that define it (Millenson, 2014). The sig-
    nificance of the report in shaping the healthcare system of the nation is the fact that patient-cen-
    tered care was adopted into the regulatory framework of healthcare. While there are many ways
    of interpreting this system in the context of the BayCare Group, analyzing the organization’s
    code of ethics would be the most useful. Therefore, at the organization, the management and the
    rest of the team in charge of patient care comprehend the implications of an ethical conduct in
    their interactions with the patients. Patient-centered care is a ‘relationship’ model of care that
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 5
    requires the healthcare professionals to build proper bonds with their patients. After realizing the
    challenges that could come with relationship-building, the management of the organization de-
    veloped a detailed code of ethics that guide the relationship between staff and the patients, and
    professionalism, autonomy, privacy and confidentiality, and informed consent are among the
    leading regulatory elements that this analysis identifies.
    The staff at the Baycare Group is supposed to maintain the highest professional standards
    possible in their interactions with the patients. According to the organization’s website, profes-
    sionalism is the primary factor contributing to honesty and integrity (About BayCare, 2018). For
    instance, as the website further reports, the code of ethics spells that the caregivers should be
    open and sincere in their communications with the patients, and that they should always do so in
    ways that foster healthy future relationships. In addition, the era of information technologies has
    made it a requirement that healthcare providers in the US and elsewhere manage patient infor-
    mation properly, which explains the significance of privacy and confidentiality, autonomy, and
    informed consent clauses in codes of ethics of health care organizations.
    Since healthy relationships are the core of patient-centered care, health care providers of-
    ten collect sensitive information from the patients, which they must handle appropriately. The
    BayCare Group has prioritized privacy and confidentiality of personal information (About
    BayCare, 2018). Any disclosures of such information are only made according to the provisions
    of the 1996 Health Insurance Portability and Accountability Act (HIPAA). In line with adher-
    ence to the requirements of the HIPAA, the management has spelled out in the code of ethics the
    need to promote patient autonomy. The interplay of the regulatory and corporate issues described
    so far suggests the prioritization of patient-centered care at the hospital.
  3. Reimbursement and Patient-Centered Care
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 6
    The emergence of patient-centered care has transformed the models of reimbursement for
    health care services in the US. Currently, policy is moving health care providers away from the
    conventional pay-for-service models towards a value-based system of paying for services re-
    ceived (Gruessner, 2016). In realization of the changes that have taken place in the recent few
    years, the BayCare Group has now adopted the value-based reimbursement model. Consistent
    with the essentials of patient-centered care, the value-based reimbursement approach that the
    Group has adopted places the quality of services delivered to the patient first, and it is important
    noting the quality of the services are self-reported (Gruessner, 2016). The essentials of value-
    based system of reimbursement, therefore, are in line with the business practices of the organiza-
    tion that rely on patient satisfaction. Altogether, it implies that an evolution in the models of re-
    imbursement for health care around the country has contributed significantly to the promotion of
    patient-centered care by the staff and management of the BayCare Group of hospitals.
    B. Completion of the PFCC Tool and the Accompanying Analyses
  4. A Description of the Healthcare Setting
    Founded in 1997, BayCare is among the leading non-profit healthcare organizations that
    seeks to connect persons and families to a wide service portfolio. The services that the Group of-
    fers are available in fifteen hospitals as well as hundreds of other locations that are conveniently
    located for patient accessibility throughout the Central Florida and Tampa Bay regions. The hos-
    pital system provides outpatient and inpatient services, including home care and wellness, behav-
    ioral health, laboratory, imaging, primary, and acute care (About BayCare, 2018). The mission of
    the healthcare organization is to better the health of each of the individuals that it serves through
    the provision of community-based health care services that define the standard for compassionate
    and high-quality care.
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 7
    The group adopted several core values that guide in the realization of the mission, and
    they include dignity, excellence, responsibility, respect, and trust that are a reflection of the or-
    ganization’s responsibility to attain excellence in the communities that they serve (About
    BayCare, 2018). Currently, the Group has an approximated 27600 employees, a bed capacity of
    3459, 5240 physicians and medical professionals, fifteen hospitals, thirteen imaging facilities,
    fifteen urgent care centers, and four surgery centers. Collectively, the staff and facilities that the
    organization owns has allowed it to manage 63165 outpatient surgeries, 176,228 discharges,
    675,645 ER visits, and 875,576 home health visits so far that have seen the community value rise
    to $319 million (About BayCare, 2018). The corporate website of the hospital indicates that it
    complies with the directives of the Civil Rights Law that bars discriminatory practices in the de-
    livery of care on the basis of religion, sex, disability, age, national origin, color, or race (About
    BayCare, 2018). Therefore, it is notable that the number of patients indicated have diverse back-
    grounds because of the commitment to avoid discrimination.
    *The Completed PFCC has been attached separately
  5. Strengths and Weaknesses of the Organization According to the PFCC Domains
    Table 1 summarizes the strengths and weaknesses of the organization according to the
    different domains assesses. Any score below 3 was considered a weakness, while that that be-
    tween 3 and 5 was strength.
    Domain Strengths Weaknesses
    Leadership/Operations • Statement of commitment to patient
    and family-centered care
  • Inclusion in policy
  • Explicit explanation and assessment
    of patient-centered care
  • Not applicable
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 8
    Mission, Vision, and Val-
    ues
  • The vision, mission, and value state-
    ments reflect patient-centered care
  • Bill of Rights reflects patient-cen-
    tered care
  • Not applicable
    Advisors • Not applicable • Patients and their families
    are not properly repre-
    sented on the hospital com-
    mittees
  • The patients and their fami-
    lies participate sparingly in
    safety and quality rounds
  • The patient and family ad-
    visory councils are not well
    established
    Quality improvement • The patients and families inform stra-
    tegic goal development
  • The patients and their families are ac-
    tive in task forces
  • The patients and families participate
    in safety and risk meetings
  • The patients and their families attend
    the NPSF, IHI and other meetings
  • Not applicable
    Personnel
  • There is expectation for collaboration
    between staff and patients in the de-
    velopment of job description policies
  • The patients and their families en-
    gage in interview teams
  • The staff is prepared to enhance pa-
    tient-centered care
  • The patients and their fami-
    lies do not welcome new
    staff at new staff members
    Environment and Design • The clinical environment supports
    family presence and interdisciplinary
    collaboration
  • The patients and their fami-
    lies do not participate fully
    in clinical design projects
    Information and educa-
    tion
  • Web portals are useful
  • Clinical emails at the facility are ro-
    bust
  • Patients and their families help in ed-
    ucation
  • Patients and their families are encour-
    aged to use the resource rooms
  • Not applicable
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 9
    Diversity and Disparities • Careful selection and assessment of
    diversity language
  • The patients and their families have a
    timely accessibility to interperimeter
    services
  • There are navigator plans for the un-
    derserved and minority patients
  • Education material suit the literacy
    levels of the patients
  • Not applicable
    Charting and Documen-
    tation
  • The patients can access electronic
    and paper records
  • The patients and family members are
    able to chart
  • Not applicable
    Care support • Families are not restricted to visit
  • Families can engage in rounds and
    change shifts
  • The patients and their families find
    support, disclosure and support
  • Family presence is allowed
  • The families are allowed to initiate
    rapid response systems
  • Family presence is allowed during
    rescue events
  • The patients access updated medical
    histories at each visit
  • Not applicable
    Care • The patients and their families collab-
    orate with clinicians
  • The patients and their families are lis-
    tened to and treated well
  • The staff involves patients and fami-
    lies in planning for transitions care
  • Pain is managed respectably in a col-
    laborative approach
  • Not applicable
    Table 1: the strengths and weaknesses of the BayCare Group of hospitals according to the different domains of the
    PFCC
    C. Identification of an Area of Improvement
    The data presented from the PFCC analysis suggests that the hospital group has not done
    well in the advisory domain. Consequently, the domain is the primary area that is in need of im-
    provement.
  1. Strategy to Improve Patient Centeredness
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 10
    The idea and fundamental principles of patient-centered care revolve around the levels of
    attention that caregivers give to the patient’s needs. The PFCC assesses the levels to which an
    organization inclines to an inclusive approach to care, which is why any effective strategy should
    be founded on a similar principle. The primary issue identified in the operations of BayCare con-
    cerns the inclusion of patients and their families on the hospital advisory committee. Conse-
    quently, the best approach to mitigating the problem would be to adopt an inclusive approach
    that would underpin the importance of collaboration between employees, patients, and their fam-
    ilies. The Sharma, Angel, and Bui (2015) model would be the most useful in addressing the is-
    sue.
    According to the model advanced by Sharma and colleagues, a successful prototype
    would have five domains each with different projects. The first domain is that of engaging the
    clinic leadership to ensure that they are committed to supporting the inclusion of patients in the
    advisory committee and respecting their contributions to success of the boards. The second do-
    main entails the need for diverse recruitment of the patients to the advisory board. One of the ap-
    proaches to doing this is to ask the staff and providers for nominations and to notify the patients
    of such opportunities through recruitment letters and emails (Sharma, Angel, & Bui, 2015). The
    third domain entails a careful inclusion criterion, especially one that would ensure that the re-
    cruited patients would cooperate with other members in ensuring the success of the board at
    strategizing. The fourth domain, as the authors suggest, is that of the need for adequate funding
    that would ensure a smooth running of the board. In line with the vision and mission of the advi-
    sory board, the fifth domain is the need for the committee to devise a mission and vision state-
    ment that would foster the attainment of the objective of patient-centered care.
    Application of the Systems Theory to the Strategy
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 11
    Before detailing the application of systems theory to strategy, it is imperative noting the
    components of the model. According to Kast and Rosenzweig (2013), the systems model has six
    components, which are sub-system, synergy, open and closed systems, system boundary, flow,
    and feedback. The sub-system component of the theory argues that parts of a whole system make
    the whole system. Applying this idea to the execution of the strategy means that different depart-
    ments of the organization would be involved, including those concerned with communications,
    patient education and wellbeing, and others. The synergy component of the model suggests the
    need for the different systems to work together to attain the set objective. Therefore, it would be
    useful to appoint a team that would be charged with the execution of the strategy through ensur-
    ing proper interdepartmental coordination.
    The systems theory suggests that all organizations are open systems because of the way
    in which they interact with the environment. The team in charge of executing the strategy would
    inquire from others not included in the team about the best practices that should be applied. The
    fourth component, which is the system boundary, directs the need for the team in charge of the
    program to respect the autonomy of the different departments involved. Coordination would be
    handy in avoiding any confusion that might arise during the process. The flow component sug-
    gests that the process should be in constant movement, and for the case of the strategy, the mem-
    bers appointed should remain active in their engagement with others. The last part is feedback,
    and it suggests the need to assess the efficacy of the chosen strategy.
  2. Financial Implications
    The proposed strategy would have financial implications because of the need to develop
    educational material, undertake the necessary adjustments to the clinical settings, and to train the
    team involved in execution. Nevertheless, the implications would not be immense considering
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 12
    that the proposed method does not necessitate significant changes to the organizational structure
    and infrastructure.
  3. Method of Evaluating the Efficacy of the Strategy
    Since the proposed strategy is part of a patient-centered model of care, self-reporting
    would be the most suitable method of evaluating the efficacy of the proposed solution. The ap-
    proach to assessing the effectiveness of the strategy would include a patient and family survey on
    their perceived inclusion levels that would be done after one month upon the implementation of
    the strategy.
    D. Multi-Disciplinary Team
    Potential Members and their Roles
    Table 2 indicates the potential members and the roles that they would play in the execution of the
    strategy
    Members Role
    Physicians, nurses, and family
    members
    Those that involve directly in caring for the patients
    Patient representative To represent the interests of the patients and coordinate
    the interaction of the patients and the rest of the team
    A representative from the man-
    agement of the hospital
    Operational management and coordination of the core
    functions involved in patient care
    Social worker Supporting services that help in the facilitation of patient
    care
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 13
    Subordinate hospital staff The performance of indirect and task-specific services
    that would lead to the provision of an environment that
    fosters patient support.
    A representative from the State
    Department of Health
    To articulate the Federal Policy on diversity and inclusion
    of people on teams.
    Table 2: the team and personnel in charge of strategy execution
  4. The Significance of Cultural Diversity in the Team
    The team developed to deal with the inclusion of patients on the hospital advisory board
    should be culturally diverse. The reason for this idea is the fact that patient-centered care is de-
    signed to provide care to the patients at individual levels. Consequently, cultural diversity would
    be useful in understanding the implications of care to the patients, including their perceptions
    and beliefs concerning healthcare, their likes and dislikes, and other aspects (Campinha-Bacote,
    2011). Altogether, culturally diversity would help in avoid generalized care, which might not
    meet the requirements of some of the patients and their families.
  5. Leadership Style
    Transformational leadership as described in literature is one of the most preferred styles
    of management across different fields, especially healthcare. The significance of the style of
    leadership in the development of the team in charge of executing the strategy is the idea that it
    strives to create autonomy among the members (Gabel, 2013). When the leaders in charge of the
    teams apply this approach to management, they inspire the rest of members to strive to lead the
    way in attaining the set objectives. In relation the case study of BayCare, transformational lead-
    ership would contribute significantly to the attainment of the four fundamental process that are
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 14
    necessary for team success, which are coordination, affective, motivational, and cognitive
    (Gabel, 2013).
  6. How the Team Would Work Together
    The team listed in table two is multidisciplinary, and it has a leader who coordinates at
    the group level. In line with the constructs of the systems theory, the administration of the hospi-
    tal would coordinate the overall activities of the rest, which would ensure a smooth flow of activ-
    ities. For example, the leadership of the team would lead the rest in setting the vision and mis-
    sion statements that would inform the specific objectives that would be met. The rest of the task
    of the leadership would be to inspire the rest using the transformational leadership style to realize
    the set goals and to evaluate the success of the team on each success metric.
  7. Approach to Communication and the Intended Outcome of the Strategy
    Meetings would be the most appropriate method of communicating the objectives of the
    strategy. It would be important for the team holds meetings frequently to assess the milestones
    realized towards the attainment of the objective of the inclusion of patients and their families on
    the hospital board. At the organizational level, meetings with the healthcare staff would be nec-
    essary to communicate the objectives of the team at first, but subsequent communications may
    involve structure emails and flyers that would also be issued to the patients and their families at
    regular intervals of say one month.
  8. Tools for the Assessment of Self-Assessment Skills
    Because of its prior use in this paper, the PFCC tool would be applied in assessing the ef-
    ficacy of the proposed strategy. Furthermore, the TEAM (Team Evaluation and Assessment
    Measure) tool proposed by the National Center for Inter-professional Practice and Education
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 15
    (NCIPE) would be used to access the efficiency of team development and performance (Taylor
    et al., 2016).
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 16
    References
    About BayCare. (2018). baycare.org. Retrieved 25 October 2018 from https://baycare.org/
    Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-
    centered care. New England Journal of Medicine, 366(9), 780-781.
    Campinha-Bacote, J. (2011). Delivering patient-centered care in the midst of a cultural conflict:
    The role of cultural competence. The Online Journal of Issues in Nursing, 16(2).
    Gabel, S. (2013). Transformational leadership and healthcare. Medical Science Educator, 23(1),
    55-60.
    Gruessner, V. (2016). Patient-centric strategy key for value-based care reimbursement. Re-
    trieved 25 October 2018, from https://revcycleintelligence.com/news/patient-centric-
    strategy-key-for-value-based-care-reimbursement
    Kast, F. E., & Rosenzweig, J. E. (2013). General systems theory: Applications for organization
    and management. Academy of Management Journal, 15(4), 447-465.
    Millenson, M. L. (2014). New roles and rules for patient-centered care. Journal of General Inter-
    nal Medicine, 29(7), 979-980.
    Schwartz, M. S. (2017). Corporate social responsibility. Routledge.
    Sharma, A., Angel, L., & Bui, Q. (2015). Patient advisory councils: giving patients a seat at the
    table. Family Practice Management, 22(4), 22-27.
    Taylor, C., Brown, K., Lamb, B., Harris, J., Sevdalis, N., & Green, J.S.A (2016). Team Evalua-
    tion and Assessment Measure (TEAM). Nexusipe.org. Retrieved 2 November 2018, from
    https://nexusipe.org/advancing/assessment-evaluation/team-evaluation-and-assessment-
    measure-team
    ORGANIZATIONAL LEADERSHIP AND INTERPERSONAL TEAMS 17
    Torres, A. (2017). The business of healthcare: how patient satisfaction plays. acoep-rso.org. Re-
    trieved 25 October 2018, from https://www.acoep-rso.org/the-fast-track/the-business-of-
    healthcare-how-patient-satisfaction-plays-a-role/

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