HCM 5020 Module 1 Strategic Leadership Paper Example

Leading a Department That Is Losing People and Patients: Choosing a Leadership Style for Hospital Imaging Services

Student Name

Master of Science in Healthcare Management, Thomas Edison State University

HCM-5020: Healthcare Administrator Leadership

Mentor Name

Month Day, Year

Leading a Department That Is Losing People and Patients: Choosing a Leadership Style for Hospital Imaging Services

Eight months ago I became director of imaging services at a composite 260-bed community hospital in Monmouth County, New Jersey. The department employs about 95 people, including radiologic and CT technologists, MRI and ultrasound staff, nuclear medicine technologists, schedulers and transport aides, and it works with an independent radiology group under contract. I inherited three problems. Technologist turnover reached 22% last year, so we rely on travel staff on nights and weekends. Emergency department physicians complain that CT scans for suspected stroke and abdominal pain take too long from order to completed images. And our share of the region's outpatient MRI and CT has fallen as two freestanding imaging centers opened nearby. This paper evaluates what role leadership plays in these problems, which leadership style is most likely to improve them and how my own skills and gaps fit that need.

The Role of Leadership in a Clinical Department

It is tempting to see these problems as staffing, process and market issues that leadership can only manage around. The evidence suggests leadership plays a larger part. Cummings et al. (2018) systematically reviewed 129 studies of how nurse leaders' styles relate to staff and workplace outcomes. The patterns were consistent: relational styles, which emphasize people and relationships, were associated with higher staff satisfaction, better well-being and stronger relations among staff, while in many studies, leaders who concentrated mainly on tasks had less satisfied staff. Imaging technologists are not nurses, but they work under similar conditions, around the clock in a hospital where clinical demands are unpredictable, so the pattern is likely to apply.

The effect of leaders on clinicians' well-being can also be measured directly. Shanafelt et al. (2015) surveyed 2,813 physicians at a large academic system and found that each one-point increase in a composite score of their immediate supervisor's leadership behaviors was associated with a 3.3% lower likelihood of burnout and a 9.0% higher likelihood of satisfaction. The behaviors rated included keeping people informed, encouraging them to suggest improvements, treating them with respect and supporting their career development. For a department losing a fifth of its technologists each year, these findings mean that what supervisors do every day is a main lever on retention, not a soft extra.

Evaluating Leadership Styles for This Situation

Each of the department's problems calls for different leadership behavior. Turnover is mostly a relational problem. In stay interviews, technologists who remained said they valued the team on their shift and a supervisor who listened, while exit interviews cited unpredictable schedules, being floated without notice and feeling that complaints went nowhere. A transformational approach, in which the leader articulates a shared purpose, pays individual attention to staff and invites them to rethink how work is done, fits this problem well.

The CT delay is a process problem that needs both relational and task focus. Technologists, transport, emergency nurses and radiologists each own part of the timeline. The leader must convene them, keep the focus on data and hold people to agreed standards. Here a transactional element, clear expectations and follow-through on agreed targets, is necessary; relational warmth alone will not shorten the time to images.

The market problem is strategic. Winning back outpatient volume requires a leader who can read competitors, make a business case to executives and negotiate with the radiology group over scheduling and report turnaround. That calls for strategic and political skill more than any single style.

The best fit, therefore, is a primarily transformational style that sets direction and builds commitment, combined with transactional discipline on measurable process targets. Situational adjustment matters too: new technologists need more direction, while experienced lead technologists need more autonomy.

Recent research supports that blend. Avolio et al. (2009), reviewing the leadership literature, traced the field's movement away from a single leader's style toward leadership that is shared or distributed across a team, and toward the quality of the relationship a leader builds with each follower. That view points to a practical step for this department: developing the four shift supervisors as leaders in their own right, so that technologists on nights and weekends experience good leadership even when the director is not in the building.

Critiquing My Own Skills

A leader's style is limited by her skills. My background is as a CT technologist who became a supervisor and then a manager at a larger hospital, so my strengths are technical credibility and process improvement. Staff trust that I understand their work, and I am comfortable with data. A 360-degree feedback survey completed by 22 staff, peers and my vice president in my third month, however, identified two gaps. First, I tend to solve problems myself rather than coaching supervisors to solve them, which leaves my four shift supervisors underdeveloped and makes me a bottleneck. Second, I have limited experience presenting a strategic business case to executives and negotiating with physician groups, both of which the outpatient problem requires.

My development plan addresses both. For coaching, I have begun weekly one-to-one meetings with each supervisor focused on their decisions, not mine, and I will ask them to lead the next turnover and CT improvement efforts with my support. For strategic skills, I have asked my vice president to let me co-present the imaging plan at the next capital committee meeting and will complete the hospital's leadership program module on negotiation. A second round of the same feedback survey a year from now will show whether these gaps have narrowed.

Expected Outcomes and Measures

If the leadership approach is working, three measures should improve within a year: technologist turnover should fall from 22% toward the hospital average of 14%, the median time from CT order to completed images for emergency stroke and abdominal pain patients should fall, and outpatient MRI and CT volume should stabilize. I will also track two leadership measures: staff ratings of their supervisors on the hospital's annual engagement survey and the share of supervisors who say they have the authority to solve problems on their shifts.

Conclusion

Leadership is a central lever on the problems my department faces, not a backdrop to them. A transformational style that builds commitment, combined with transactional discipline on process targets and adjusted to each person's experience, fits a department losing people and patients. Its success depends on whether I can develop my supervisors and build the strategic skills I lack, and both will be measured.

References

Avolio, B. J., Walumbwa, F. O., & Weber, T. J. (2009). Leadership: Current theories, research, and future directions. Annual Review of Psychology, 60, 421-449. https://doi.org/10.1146/annurev.psych.60.110707.163621

Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19-60. https://doi.org/10.1016/j.ijnurstu.2018.04.016

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