DHA 700 Week 6 Leadership in Health Administration Example

The Supervisor Effect: What Leadership Research Taught a Chief Operating Officer About Burnout, Safety and Her Own Style

[Student Name]

University of Phoenix

DHA/700: Introduction to Health Administration in Doctoral Study

Week 6 Assignment

[Instructor Name]

[Date]

The health system, its leaders, survey results and leadership development plans are composites written for a model paper; research findings come from the sources cited.

When the composite rural health system's annual engagement survey came back, the chief operating officer noticed a pattern. Burnout was high overall, but it clustered. Units under four managers had burnout scores nearly twice those under others, even where workloads were similar. Turnover followed the same pattern. The executive realized the difference was leadership, and that she knew little about the evidence on it. This paper reviews leadership in health administration and reflects on her own practice.

Comparing Leadership Styles

Leadership theories describe different emphases. Transactional leadership focuses on exchanges: clear expectations, monitoring and rewards or corrections. It keeps operations predictable but rarely inspires extra effort. Transformational leadership focuses on inspiring a shared vision, intellectual stimulation and individual consideration, drawing people toward goals larger than their tasks. Servant leadership puts the growth and well-being of staff first, on the view that cared-for staff care better for patients. Relational leadership emphasizes the quality of relationships with staff, built through listening, fairness and support. Adaptive leadership focuses on mobilizing people to face challenges that require changes in values and habits. In practice, effective leaders draw on several of these, choosing behaviors to fit the situation.

Evidence: Leaders and Physician Burnout

Leadership affects the people leaders supervise. In a survey of 2,813 physicians and scientists at a large health care organization, physicians rated their immediate supervisors on 12 leadership behaviors; after the researchers accounted for age, sex, years of service and specialty, every additional point a supervisor earned on the 12-item scale went with a 3.3% smaller chance that the physician was burned out and a 9.0% greater chance of satisfaction, and department chairs' leadership ratings correlated with burnout and satisfaction across departments (Shanafelt et al., 2015). The supervisor a clinician reports to may matter as much for burnout as the workload itself.

Evidence: Nursing Leadership and Patient Outcomes

Leadership also affects patients. A systematic review of 20 studies examining nursing leadership practices found that where nurse leaders practiced relationship-centered styles, patients were more satisfied and suffered fewer deaths, medication errors, restraints and infections acquired in the hospital, while calling for further testing of how leadership exerts its influence (Wong et al., 2013).

Evidence: Leadership Style and Quality of Care

A broader review reached a similar conclusion. Reviewing studies from 2004 to 2015, researchers identified 18 relevant articles and found leadership styles strongly correlated with quality of care and related measures, with leadership considered a core element of well-coordinated and integrated care from the perspective of both patients and professionals (Sfantou et al., 2017).

What the Evidence Suggests

Across these studies, relational and transformational behaviors, listening, recognizing contributions, developing people, involving staff in decisions and treating them with respect, are consistently linked with better staff experience and patient outcomes. Leadership is not only a trait of executives; the behavior of frontline supervisors matters most to the people they lead.

Leadership in the System

The executive analyzed the four managers whose units had the highest burnout. Staff comments described managers who were rarely present, made decisions without input and responded to problems by assigning blame. In contrast, managers of low-burnout units held brief daily huddles, asked staff for solutions and thanked people publicly. Several high-burnout managers had been promoted for clinical skill without leadership training.

What Staff Said About Good Managers

Focus groups with nurses and technicians from low-burnout units described what their managers did. One nurse said her manager knew every staff member's children's names and noticed when someone was struggling. A technician said his manager fixed the broken equipment that everyone complained about within a week, which showed that complaints mattered. Several staff said their managers backed them when physicians or families were abusive. These specific behaviors matched the evidence far better than any label.

Why Promotion Without Preparation Fails

Health care often promotes excellent clinicians into management and expects leadership to follow. Without training, new managers fall back on what they know: doing the work themselves, controlling decisions and reacting to crises. The system had no leadership curriculum for new managers.

Reflecting on Her Own Style

The executive turned the lens on herself. A 360-degree feedback survey from her direct reports praised her competence and availability but noted a pattern: when managers brought problems, she solved them herself. Managers said they felt rescued rather than developed. She recognized a transactional, problem-solving habit that served her well as a nurse manager but limited her reports' growth.

What She Will Change

She will ask questions before offering answers, delegate decisions with clear boundaries, hold monthly development conversations with each direct report and publicly credit managers' solutions. She will ask for feedback again in a year and share the results with her team.

A Development Plan for Managers

The system will create a leadership program for all managers: an orientation for new managers on relational leadership, coaching for the four managers with the highest burnout, monthly peer learning circles and inclusion of leadership behaviors in manager evaluations.

Supporting Managers, Not Only Judging Them

The four managers will be offered coaching and relief from some administrative work so they can spend more time on their units. The executive will frame the effort as support rather than punishment, recognizing that the system promoted them without preparation.

Leadership at the Executive Level

The executive also looked upward. Senior leaders set the tone that managers follow. If executives respond to problems with blame or ignore staff concerns, managers will too. The executive team agreed to round on units monthly, share how staff concerns were addressed and include relational behaviors in their own evaluations, so that the development program would not ask more of managers than of executives.

Measuring Progress

Measures include staff burnout and engagement scores by unit, turnover, manager 360-degree feedback, patient experience scores and safety indicators, reviewed every six months.

Leadership and the Rural Context

Rural systems face particular leadership challenges. Managers often know staff outside work, which can strengthen relationships but complicate accountability. Leadership talent is scarce, and there are few peers nearby to learn from. The development program will connect rural managers with peers in other small systems through monthly video calls and an annual in-person gathering, reducing the isolation that many described.

Limits of the Evidence

Most leadership studies are cross-sectional, so leadership and outcomes may influence each other, and unmeasured factors may explain part of the association. Still, the consistency of findings across settings and outcomes supports investing in leadership.

Conclusion

Burnout clustered under certain managers because leadership behavior shapes how staff experience their work. Evidence from a large physician survey and two systematic reviews links relational leadership to lower burnout, better quality and safer care. The chief operating officer's reflection revealed her own habit of rescuing rather than developing managers. A plan to change her behavior, develop managers and measure results turns leadership research into practice.

References

Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards quality of care measures in healthcare settings: A systematic review. Healthcare, 5(4), Article 73. https://doi.org/10.3390/healthcare5040073

Shanafelt, T. D., Gorringe, G., Menaker, R., Storz, K. A., Reeves, D., Buskirk, S. J., Sloan, J. A., & Swensen, S. J. (2015). Impact of organizational leadership on physician burnout and satisfaction. Mayo Clinic Proceedings, 90(4), 432-440. https://doi.org/10.1016/j.mayocp.2015.01.012

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(5), 709-724. https://doi.org/10.1111/jonm.12116