D. Leadership and Culture
While addressing the physical structure and staffing volume needs of LTC facilities can be achieved with relative ease, bringing about the required leadership and cultural transformation to sustain an excellent care level is a more complex matter.
Leadership mindset has an undeniable impact on an organization’s culture, whether positively or negatively. Any improvements generated in the system as a healthcare leader, or a leader in any industry, always involve behavioural change.
Marrocco, Coke and Kitts (2020) emphasize the importance of leadership in LTC, stating;
“We learned from wave 1 that on-site leadership matters. We heard that homes where leaders were visible and provided clarity around staff roles and responsibilities fared better than those where leadership was less engaged. Homes with effective leaders were better prepared, had less outbreaks, and better-contained outbreaks when they occurred.”
PulvermacherKennedy and Associates (2021) observe that “time and again that when executives or leaders are very focused on self and what they want to do, rather than considering the greater good, the organization suffers as a result. Conversely, when leaders exhibit more inclusive mindsets, traits and behaviours, they feel a sense of purpose and personal satisfaction, which positively influences organizational culture.”
Effective leadership in times of intense stress and crises requires making tough choices (Picard, 2020). There is a natural inclination to think in an either-or fashion. For example, “do I set the bar high and risk losing more staff or do I avoid doing so and retain my complement of necessary employees.” The more effective leadership question uses an “and” rather than an “or.” The leader’s dilemma is, “how do I set the bar high and retain my scarce staff?”.
In affecting behavioural change, the process of coaching senior leaders can illuminate blind spots and boost performance by providing an outside perspective (Kennedy, 2017). However, the notion of the “heroic leader” riding in on his or her steed to save the day is an archaic one. Effective leadership implies building a strong and cohesive leadership team that pulls together in a crisis, challenges one another to design innovative solutions to challenging problems, and works to ensure the successful implementation of the solutions (Pulvermacher, 2020).
Finally, effective leadership requires asking staff how they can help identify or solve problems before they get out-of-hand. Effective leaders aren’t afraid to challenge people through penetrating questions and, above all, allow staff to ask them questions. Only in this manner can the leader nip issues in the bud instead of allowing issues to simmer and subsequently get out of hand.