SUMMATIVE # Content Page # 01 Multi-factorial

SUMMATIVE ASSIGNMENT TITLEA. Multi-factorial influences impacting on the role of the medical leader B. Critically reflect on the impact of your leadership qualities and behaviors, on your team and wider organizational network C. Develop a Professional Dilemma Vignette to be used in your class for teaching professionalism to your undergraduate students under following headings Vignette TitleScenarios/VignetteOptions: A, B, C, DConsequences (what will be the consequences of choosing the options, so four options=4 consequences)What is the problem here? (Autonomy, beneficence, non-maleficence or justice)Learning Objectives (What are  students expected to learn at the end of this)SUBMITTED BY: ANUM FATIMA2105025-715010LEADERSHIP, MANAGEMENT AND PROFESSIONALISIMSUMMATIVE ASSIGNMENTMHPE BATCH-VMODULE-VUHS DMETABLE OF CONTENTSSr. # Content Page #01 Multi-factorial influences impacting on role of leader 302 Critically reflect on your qualities and behavior impacting on organization and team network 803 Develop professional dilemma vignette 1208 References 16Multi-factorial influences impacting on the role of medical leader.

“Disciplined and hard-working leaders are crucial for working of organizations from ‘good’ to ‘great’. (Jim Collins) Who is a leader?A leader is an influential person has ability to lead a group or team without having an official appointment.What is leadership?Leadership is the act of leading a group of people in an organization towards the achievement of goals. What does leadership mean for medical doctors?The process of leadership is about setting a course and motivating others to cuddle it. The doctors and other health care professionals are at the frontier of healthcare system and have an important role to impart in the leadership and management of organization. When ones qualify as a doctor it is generally expected to develop ones role as a leader and manager.

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During medical college, few opportunities might be given to acquire the skills that are required to be a future leader of the health service. Being a part of multidisciplinary teams (MDTs), it is obligatory to acknowledge the leadership of others who have more expertise and experience than ones. However, if any leader makes a decision that leads to poor patient outcomes, a medical doctor should be vigilant to challenge them to attain a good patient outcome.

As medical doctor develop through career, particularly, leadership role will gradually increase.An obscurity of taking into consideration the leadership of healthcare professionals is that, a very less training is available to teach the skills of leadership to a medical doctor. Furthermore, most school of thoughts have developed theories for the business setting and no one is specifically for health care organization. When those theories were applied in health system, the basics were from business context. In view of those theories, published researches present slight evidence that such initiatives can bring a drastic change in patient care or organizational outcomes. Healthcare professionals should practice effective leadership for increasing quality and integration of care.

Now days, leadership is imperative in healthcare to tackle;Enormous pressure on service provisionWays of working and emerging organizationsFailures of careUpholding of patient satisfactionWhat is Role?Role is the function assumed or part played by a person or thing in a particular situation.A medical personnel when assumes the role of leader too, a number of factors may influences upon the role of a medical leader. Therefore, it is vital to have necessary leadership skills in order to work in health care system.

The key aspects of the leadership role involves influencing group activities and coping with change. Multi-factorial influences Multi factorial influences on the role of medical leader are of two types;Internal influencesExternal influencesInternal InfluencesInternal influences may be of following types;Organization InfluencesMission and vision of organizationProcess of leadership in organizationOrganization structure/InfrastructureProcess of communication in organizationTraining opportunities available in organizationCulture of organizationNecessity of bringing changePersonal InfluencesMission and vision of medical leaderCurrent role or designation within the organizationConflict management, problem solving and decision making strategies adopted by leaderPower given to leaderStyle of leadership Task as per situationTradition of organizationPersonal qualities of leaderPersonality or charisma, moral and ethical valuesEducational career of medical leaderCommunication and behavior of leaderRespect for group membersEnthusiasmExperience of medical leaderSpeciality or expertise of medical leaderThe timeLeader’s GenderInternal Environmental or Contextual InfluencesAvailable resources for learningTeamwork relationshipMotivational IncentivesExternal InfluencesPolitical InfluencesLegal InfluencesSocial InfluencesEconomical InfluencesAdvance TechnologyEconomy of PakistanLet’s have a look on current scenario of Pakistan; Government of Pakistan is spending only 0.5-0.6 % of its GDP on health care system since so many decades which is against the benchmarks of World Health Organization (Khaliq, F.

and Ahmad, W., 2016 SBP Staff Notes). Traditional view of health care industry in Developing CountriesFrom literature review, it has been also evident that traditionally the health care industry remained the most fragmented industry” (Pizzo, 2013). The fragmentation of healthcare industry results from the tradition of independent working of physicians and hospitals with very modest communication or coordination regarding a patient’s care (Dye ; Sokolov, 2013) which results in poor outcomes in terms of patient’s care primarily and ultimately the poor performance of that organization. It is very critical debate on the role of doctor as clinician and a leader too. Impact of Multi-factorial influences Medical doctors who adopted the role of leadership may suffer from various challenges. They impart double role as both leader and clinician while working in health care setting.

And this dual assignment demands more commitment towards the job to satisfy the both roles. It was elucidated by Hoff and Mandell (2001) the dual commitment carried out by a sample of physician executives using data from a national survey by the American College of Physician Executives in 1996. Intense clinical practice and little education of leadership have created a shortage of medical leaders (Kasti, 2015)Medical doctors are occupied, busy professionals and working in stressful environment as this is the nature of their work (Chervenak, McCullough, & Brent, 2013). Continuing medical education, clinical seminars, and workshops makes them engage in clinical opportunities and they find less time to flourish the skills of leadership (Burns & Muller, 2008; Tibbitts, 1996). Many leadership attributes have been identified for being a true leader such as vision, purpose, cooperation, and drive in medical leaders (Babitch & Chinsky, 2005). Effective medical leaders must have a number of skills including inter-professional, communication, technical, problem solving and collaboration. Moreover, personal ethics, trust, and motivation are also required.

These attributes highlights the needed skills, education, and training of current medical leaders. The varying culture of healthcare is more and more challenging to medical leaders (Carney, 2011). Health care industry is constantly changing since last one decade. According to Nilsson and Furaker (2012), the best leaders are those who can impart their knowledge and leadership style as per situation, especially those who are concerned for bringing change in the system. To have an idea of organizational environment is necessary for medical leader. They have to manage the health and illness of general community with ultimate goal of quality care and positive patient outcomes. If patient safety, risk, and ethics stay central, an unvarying need to slash funding without impacting patient care is highly difficult. Leader should have ability to achieve the consensus over the reforms of organization by educating colleagues, staff members and the entire team.

Medical doctors who assume leadership must initiate change for the promotion of clinical integration. Mintz & Stoller, in 2014 explained that the double commitment between patient care and leadership can be complicated for doctors if the environment is bureaucratic.B. Critically reflect on Impact of your Leadership Qualities and Behavior on your Team and wider Organizational NetworkThe health care industry is changing at an unparalleled speed. Every day, leaders are making a number of decisions and suffering problems they have never faced before. A change can be brought even in an overnight. The speed is unremitting, the stakes are sky-scraping, but the benefits are great for those who can lead a team to constantly attain unexpected consequences.Qualities of a Good LeaderWhat makes a leader effective? Most people when probably asked would admit that effective leadership results from certain desirable characteristics from certain desirable qualities which manifest in result, rather than describing it.

However, exhibits the following qualities: DedicationVisionListeningIntegrityCommunicationHuman relationsCrises ManagerEnduranceAdministrative skillsDecision makingStrategic PlanningExpert opinionImpact of Leadership Qualities and Behavior on my Team and Organizational Network:Being a healthcare service leader I must have a variety of tasks, skills, knowledge and expertise required to fulfill day-to-day responsibilities. Certain operational skills are crucial to an effective leader, therefore, I am required to maintain and develop professional standards, procedures, and policies for various institutional activities. I will also responsible for developing and expanding programs for scientific research, preventive medicine, medical and vocational rehabilitation, and community health and welfare.Excellent, assertive communication skills, both verbal and written, would be of paramount importance to my ability to carry out an effective healthcare operation. Current computer skills and technology-based training are also essential as healthcare machinery and information systems continue to evolve.Some other operational skills necessary for me would include:Information systems management Maintain awareness of advances in data processing technology, medicine, computerized diagnostic and treatment equipment and financing optionsLogistics and researchPatient administrationMaintain quality of service offered to patientsTeam performance measurement and motivationFacilities development and enhancementProject and operations managementA large part of my healthcare administration will be financially and managerially focused, as most of healthcare leaders work in an office environment. Being in charge of managing hospital, community health center, clinic, private medical practice and other health care facilities, my analytical skills necessary to responsibly manage the business side of a clinic, hospital, or other healthcare-based companies will include:Fiscal operations, which can span from accounting, planning budgets, planning and authorizing to expenditures, establishing rates for services, and coordinating financial reportingEconomic knowledge and insightConsultationSupply ordering and inventory managementHuman resources managementDirection, supervision and evaluation of medical, technical, nursing, service, clerical, maintenance and other personnelEducation and training managementPublic relations and MarketingKnowledge of current government regulations, legal and ethical practices, policies and standardsStrategic planningDevelopment and execution of organizational proceduresTo be a successful healthcare leader I should also have strong interpersonal skills to fulfill relational responsibilities, which includes:Internal communication managementDevelop interviewing processesDirect and conduct recruitment, hiring and training of personnelDevelop coaching strategiesLimit conflict and encouraging workplace unityOvercome barriers in communication with staff and outside healthcare administratorsAccording to Becker’s Hospital Review, the healthcare leaders of tomorrow will be “change agents” for their organizations. This means more than simply responding to pressures and challenges as they roll in.

Rather, it requires a proactive approach, anticipating challenges before they arise and staying abreast of industry trends. This means that leadership can never rest on laurels and must be constantly learning, as well as reviewing existing processes in search of greater efficiency and cost-effectiveness.By acquiring above mentioned leadership skills it will be easy to give the direction, support and communication which bring everyone together and make them perform their tasks in the desired. Furthermore, being a leader I’ll be able to identify well who is capable to perform what and he put that person to the task and which enhances the effectiveness of it. This is not possible unless I can get the trust and belief of my subordinates as it is a deliberate process of continuous interaction between leader and subordinate to make the task happen with their coordination and knowledge. I must rely on the fact that effective leaders engage their communications and motivation skills and translate these into explicit behaviors to positively influence change initiatives. Only then it will be possible to have positive and productive impact on my team and organization as a whole.

C. Develop a Professional Dilemma Vignette to be used in your class for teaching professionalism to your undergraduate students under following headings. Answer: Vignette Title: Placing Unreasonable Expectations on a TraineeVignette Scenario: Ms.

XYZ has recently joined a tertiary care teaching hospital as second year Post Graduate Resident Trainee (FCPS) in Obstetrics and Gynecology Department. She had completed her first year resident training in another secondary care teaching hospital and moved to current hospital due to her domestic issues. Currently, she is performing all the tasks under supervision of immediate and most senior trainee of her call batch. Meanwhile, the more senior trainee of her batch has to go on sick leave and she is also due to go on matrimonial leave by the end of current week. Ms.

XYZ has been informed by Senior Registrar of same department that, before you go on leave, you must finish some complicated reconciliation work that includes the presentation of statistical report of cesarean sections done by yours’ call batch in last month in upcoming CME session which is going to be held after two days. The deadline suggested appears unrealistic in view of the complexity of task. In addition, she has little interaction with clerical staff that is responsible for record keeping. Ms. XYZ feels that she is not adequately experienced to do the task alone without assistance of senior one.

She needs additional facilitation and supervision to complete the work as per already established standards. She has a conversation with senior registrar but it seems like that she is unable to offer necessary support. If she tries to complete the task within proposed timeframe but fail to meet the expected quality of presentation, she can face repercussions from senior trainee after her arrival from sick leave. Ms. XYZ feels slightly intimidated by senior registrar, and also feels pressure and challenging to do what she can practice in an effective manner with senior’s assistance.

What is problem here? (Key Fundamental Principles affected)The ethical principles most relevant to this situation are the following;BeneficenceJusticeIntegrityProfessional competence Professional behaviorOptions of Vignette (What to do) Can Ms. XYZ be open and honest about the situation?Would it be correct to fulfill the task that is technically beyond her abilities, without supervision?Is it achievable to finish the work within the deadline and still act meticulously to fulfill the required quality of output?Can she refuse to perform the work without damaging her reputation within the practice? Alternatively, could the reputation of the practice suffer if she attempts to perform the work?Consequences of options (Possible considerations)Consequences of options AIn view of option A, the possible consideration is YES. Likewise, if the answer is NO, she may face problem while presenting the data in CME session at the time of questioning answering to the Head of department and many more experts’ overhear. Possible course of action for option AShe should maintain her integrity which is basic ethical principle of practice and professionalism. She should demonstrate constructive attitude.

Consequences of options BIn view of option B, the possible consideration is NO. She should try to get the issue resolved with senior registrar. She should not perform a task which is technically difficult and beyond her abilities as she has not performed it even in secondary care teaching hospital. It would be highly unethical if she doubts her competency. Likewise, if the answer is YES, she is presenting technically difficult task and mistakes in data presentation that may show her professional incompetency. Possible course of action for option BShe might explore the opportunity of another colleague of same batch whom has an experience of presentation and technical expertise. She can complete task under her supervision. Consequences of options CIn view of option C, the possible consideration is NO.

She has little interaction with clerical staff; in addition, she has already discussed the matter with senior registrar and found no assistance on her behalf. It would be tough for her to complete it efficiently along with routine duties. Likewise, if the answer is YES, she may catch another professional misconduct while performing duties and may worsen the situation. Possible course of action for option CShe should consider how best to raise the matter to senior one like head of department or supervisor who is providing her facilitation as supervisee. It would be diplomatic to suggest senior registrar that she should raise the matter together, and present your respective view. She should be conversant for extension of date or presentation her data in another CME session while an expert person may present in current CME session.Consequences of options DIn view of option D, the possible consideration is NO. Simply refusing may cause significant problems to future practice and affect the reputation in any case as disobedient and incompetent resident.

Possible course of action for option DShe should admit her deficiencies in front of head of department and should seek assistance from the senior one. However, she should document all the steps what she has taken to resolve the dilemma and let the head of department decide in her better interest. Moreover, established SOP’s are also helpful to resolve the issue.Options of Vignette (What to do)? Consequences of options (Possible considerations) Possible course of action for optionsCan Ms. XYZ be open and honest about the situation?In view of option A, the possible consideration is YES. Likewise, if the answer is NO, she may face problem while presenting the data in CME session at the time of questioning answering to the Head of department and many more experts’ overhear. She should maintain her integrity which is basic ethical principle of practice and professionalism.

She should demonstrate constructive attitude. Would it be correct to fulfill the task that is technically beyond her abilities, without supervision?In view of option B, the possible consideration is NO. She should try to get the issue resolved with senior registrar. She should not perform a task which is technically difficult and beyond her abilities as she has not performed it even in secondary care teaching hospital. It would be highly unethical if she doubts her competency.

Likewise, if the answer is YES, she is presenting technically difficult task and mistakes in data presentation that may show her professional incompetency. She might explore the opportunity of another colleague of same batch whom has an experience of presentation and technical expertise. She can complete task under her supervision. Is it achievable to finish the work within the deadline and still act meticulously to fulfill the required quality of output?In view of option C, the possible consideration is NO. She has little interaction with clerical staff; in addition, she has already discussed the matter with senior registrar and found no assistance on her behalf. It would be tough for her to complete it efficiently along with routine duties.

Likewise, if the answer is YES, she may catch another professional misconduct while performing duties and may worsen the situation. She should consider how best to raise the matter to senior one like head of department or supervisor who is providing her facilitation as supervisee. It would be diplomatic to suggest senior registrar that she should raise the matter together, and present your respective view. She should be conversant for extension of date or presentation her data in another CME session while an expert person may present in current CME session.Can she refuse to perform the work without damaging her reputation within the practice? Alternatively, could the reputation of the practice suffer if she attempts to perform the work?In view of option D, the possible consideration is NO. Simply refusing may cause significant problems to future practice and affect the reputation in any case as disobedient and incompetent resident.

She should admit her deficiencies in front of head of department and should seek assistance from the senior one. However, she should document all the steps what she has taken to resolve the dilemma and let the head of department decide in her better interest. Moreover, established SOP’s are also helpful to resolve the issue.References:Khaliq, F. and Ahmad, W., 2016. SBP StaffNotesFunk, D.C.

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