Leadership and Change at Royal Brompton

Introduction

The paper will discuss about course of changes in Braopton Hospital with its necessity. Further the paper even will throw light over the difference between previous and afterwards of the changes. In course of its discussion, it will discuss the leadership strategy in the part of the organization as without effective leadership the changes cannot be successful attaining its goal. At last the paper even will suggest some recommendations through which the organization can have better perspective and future in coming days. The NHS trust has two cardiothoracic Hospital in London. Royal Braompton Hospital of Kingston was 17 years old which was renowned for its largest Treatment Centre regarding cystic fibrosis of Europe and Harefield hospital was the treatment Centre during World War for antipodean soldiers by pioneering the system of replacing artificial heart. In 1998 the two hospitals get merged and named as Royal Brompton and Harefield NHS trust.

Analysis and Evaluation

Joanna smith CIO of Royal Brompton & Harefield NHS foundation was ambitious for Digital transformation as she wanted to make it the largest heart and lungs specialist centre of UK being a unique one in the sector (Katz et al., 2020). In London 2017 Summit, she proposed cloud-first approach along with other cultural changes which became necessary for the organization. Maintaining a tight budget, Smith manages to replace the system to cloud based infrastructure. The initiative introduced digital systems which assured that both healthcare professionals and IT team would work together to initiate patient care. Smith was experienced professional of a pharmaceutical industry with 15 years experience and joined the hospital in 2013. At the time of her joining the organization was financially not stable and there was not any connection between the IT department and other departments of the organization which shared communication gap in the internal infrastructure. She found that organization was suffering from some aspects where leadership with effective strategy was missing and miscommunication plays the main role in the entire organization. Further she even understood that IT Department was not in its proper place.

However with all referred issues the board was in a dilemma for the investment in IT as they found it crucial and it could not really transform the organization over night. On a positive note, Smith alone tried her best and tried to remove different enrooted barriers for implementing innovation (Bossert, and Leisewitz., 2016). In 50% of trust computers no antivirus even were installed and software and systems were age old and outdated. She first decided mission statement to deal with the issue. For the concern she took help of her experience where she was invited to watch a theatre where surgeons were operating heart leaving inflated lungs with a look on the PC screen with mandated screensavers by IT. She said that IT Department needed to be in support of other departments to deliver better service to the patients. IT Department needed not consider it as a separate Department. She had created 3 years road map to build trust for achieving success. She believed that before being involved with internal aspects she needed to prepare the ground to have a strong base. Her strategic key principal was to make trust-cloud first rather than to develop internal IT services which are basically dealings of third party vendors. For the same concern better communications was even needed between other departments and IT Department. The journey was not very easy for her for the organisation. 2 Euro million was spent on networks by the trust where Windows XP was achieved by hybrid cloud infrastructure. WannaCry attack which deals with perimeter defenses and firewalls were even done by investment. Other innovations which smith brought for the organization ware VDI (virtual desktop infrastructure), Skype along with single expanded sign on (Kim et al., 2016). the market assessment was the basic of these transformations as according to Gartner approaching UK cloud and Microsoft would be better for the organization. The approach basically would be 10 to 20 times cheaper compared to other vendors. Along with this Smith even incorporated patient administration system, electronic prescribing followed by document management solutions. Recently another achievement has been reached by the trust as it sets live digitalized case notes through 50 million scanned papers of thousand patients. Along with this the size of the IT Department becomes comfortable as it was double previously though working ability has increased a lot. The department has acquired medical devices, imaging and records.

The initiatives are expected to be beneficial for the entire organization. Previously operations got cancelled due to failure of IT Department which are nowhere in the scenario at present. The project get interrupted by several things especially project management was a barrier. Workers of that time were not much convinced to accept the changes or to participate in a training program for new IT setup. However Smith was optimistic and finally the economical aspects are even being improved. The present day has showed that embracing technologies can be the best way out to deal with any issue. Smith was of the view that digitalizing is the best way out to serve the organization and no other way out can replace its effectiveness or efficiency. Apart from the digitalization the organization even targeted efficiency for the clinical services and immense productivity. Being a global leader, the organization needs to deliver excellent present service for which infrastructural changes and incorporation of innovation needs to be there (Saidi et al., 2017). Considering the financial condition of the organization the trust understood that without having transformational changes or operational improvements it could not be able to hold its position in the healthcare sector. In order to achieve the target they have turned their services to patient facing clinical services assuring resource availability. They have reduced patient duration in the hospital by reorganizing the pathways which have been appreciated by the patients through encouraging feedback. Surgery gets scheduled in a better way through which money gets saved and number of patients can avail the service. The initiatives are named as Darwin initiative which compiles more than 50 improvements for the organization. The initiatives are not only for clinical one but it has improved non patient facing functions followed by saving of 60 million which offers better financial stability for the organization. Infrastructure of special cardiology department is made health organization to treat their patients with homely comfort as patients are allowed to stay in their homes for more 4350 days in a year. One-stop long clinic are designed for better patient care. Through the facility asthma patients and interstitial lung diseases can be treated by visiting the hospital one day which offer better chances for treating more number of patients as ongoing patients spend less number of days in hospital each year. Theatre software gets implemented newly which increased capacity of the organization to take care of 65 more number of major cardiac cases. ECMO service reviews bed capacity for the Intensive Care which helps critically ill patients. The initiative made the organization one among five commissioned ECMO centers of UK. Increase of bed numbers even utilizes 80% critical patient rather than 66%. The designing of cardiac surgery has set such an infrastructure which allow patients to come on the very day of surgery which saved 1 Euro million followed by excellent positive feedback from the patients. The transformations through all the initiatives have welcomed immense success and betterment for the organization. All the designed initiatives improve patient safety along with satisfaction which is appreciated by patients’ feedback. World class specialist treatment are being offered by the organization with hardly can be objectified by others. The initiatives even offer better scopes for the future as it allows enough room for incorporating innovation in a greater scale (Rasche et al., 2017). World class clinical leaders are associated with the organization through its attracting, developing, retaining infrastructure. Financial stability has been achieved through the initiative and successful investments make the betterment of technological department and service area through cloud computing and new service models. Patients become a community group for the organization to support further renovation challenging all the barriers for the organization. Gap of communication in several departments now do not exist as well as a better relationship is being formed between all the departments improving patient care. The belief systems are established which get reflected through behavior and thought process. Better values are get integrated for the organization there by better performance reflects consequent strength communication style and employees better behavior. Staffs of the hospitals are not being considered as salaried person rather according to agent theory they are considered as an important part of the organization. Patient facing three core values and four support systems established the theory where staffs are the base of the organization through whom the organization has achieved present status in the sector.

Effective leadership is the most important aspect which being such success for the organization through Innovation and managerial skills. All the leadership style it is hard to identify the exact style for the organization to achieve success (Cleven et al., 2017). In order to have an idea regarding this clear concept needs to be attending for every leadership style with sheer differentiation.

Autocratic style - the leadership style allows the person to feel superior among all and thus decisions taken by him or her needs to be obeyed (Dyczkowska, and Dyczkowski., 2018). In this leadership style command and control are the approach where no space is allowed for any sort of freedom or innovation and people most of the time are being treated as servants.

Authoritative style - the visionary leadership style is for those confident leaders who can design the way perfectly setting expectations and convince the followers to walk on the way. In an uncertain situation these leaders help an organization to decide best way out for Optimization (Fiaz, Su, and Saqib., 2017). This leadership style does not create pressure to be in favor of the taken decisions leather leaders explain their thinking to his or her fellow members and allowed them to choose effective way to address the goal.

Pacesetting style - the style actually initiate service between every team member to the finish line (Khazeh., 2018). Style is mostly concerned with the result and thus most of the time the style ends with immense stress for every member.

Democratic style - style offers enough space for each employee to think on their own way and present their opinion to take a final decision. The participatory leadership style is most convenient to build trust among leader and team members encouraging team spirit (Peker, Inandi, and Giliç., 2018). Researchers prove that the leadership style can be awarded as most successful leadership style to deal with any issue in any organization.

Coaching style - in this leadership style leaders are mostly play as teachers who with potentiality every team member with immense belief that everyone has some unique capability (Puni, Agyemang, and Asamoah., 2016). The leadership style believes that through effective use of unique power of every member the organization can be benefited in a better way.

Affiliative style - the leadership styles states that people come first. In this leadership style leader shares close relation with every people and support their emotional need (Wachira, Karanja, and Iravo., 2018). In order to set a proper harmony and collaboration among everyone the style is recommendable.

Laissez-faire style - the style is just the opposite of autocratic style where no visionary is there and make people compelled to swim with current. It starts with trust factor do most of the time ends in extreme situation by appearing aloof from the team (Wong and Giessner., 2018). Basically the leadership styles suffer from improper direction followed by and success to reach the goal.

Transformational leadership - in this leadership style leaders mostly go with the team and offer enough scopes of changes directed by his vision and guide the team with their inspiration. The leadership style can be successful with the committed team as allowed innovation can best be fitted with the situation when the team members are cooperative and collaborative with each other and directed by a proper understanding label for the ultimate goal (Dupret and Friborg., 2018).

Obtained initiatives by Smith can be referred as authoritative leadership style as from the starting phase of her joining to the organization demands for a vision to have changes for betterment. From this point of view it can be stated that she obtained the visionary leadership style where it designs all the necessary systems and software. Self confidence, empathy and ability to adapt are the most important virtues of an authoritative leader. The qualities can easily be found in Smith as through her self confidence she convinced the board members to invest in IT Department with the firm believe that it would not be a loss for the organization in future. Her empathy helps her to understand that she cannot be succeed in her attempt until and unless co-workers co-operate with her and for the same she shows the ability of adaptation to make her co-workers belief that collaboration is much needed. In the initial stage, staff of the organization were not in favour of the decision of cloud computing neither they agree to have proper training for the infrastructure (Asamani., 2016). However she did not compelled them to abide by her decision rather she opened up all the insignificant details of her planning to attain a better understanding in their part. From her activities it is clear that neither she allows the team to decide the future of the organization nor just throwed her decision to them. Instead of this, she behaves like a friend of everyone makes clear the decision with the vision to everyone and directs the way to be taken. Thereby it can be stated that the taken leadership style help Smith in many ways. First of all, her attempts bring clarity as everyone properly directed and guided with clear goal (NawoseIng’ollan, and Roussel., 2017). The vision is clear to everyone and thus no scope for miscommunication is there in the entire infrastructural changes. Most importantly sheer inspiration, motivation and goodwill have the best use of the workforce effectively and successfully meeting the goal. Darwin initiatives obtained by the organization mainly depends on innovation and transformational leadership style is the most effective to allow innovation with much space and scope for everyone (Hentschel et al., 2018). The initiatives are ascribed under the transformational leadership style as taken initiatives are only for betterment of the organization where hardly anyone gets scopes to show their ego. Rather everyone is welcomed with their own thought process and innovation. Entire organization accelerated for the betterment thereby it has been seen that not a single person rather every stakeholder effectively and efficiently manages themselves with sheer motivation. All the obtained initiative are somewhat carrying certain risk though with the help of the effective leadership style the risks are previously calculated and thus ends with success. For the concern basically everyone like clinical professionals and non clinical professionals play the role of a leader in their own way by offering their views. However the final decision is taken by board members and thus they can be referred as transformational leaders by taking the difficult decisions for the betterment of the organization. On the other hand the leadership style is being stated as transformational as according to the rules of transformational leadership here also collective organizational conciseness play the most important role as participation of everyone help to reach the goal (Ahmed, Mohamed and Manaf., 2017). As it is already stated that enough space is there for innovation and for views thereby inspiration is much needed which is offered by the board members properly to each employee. Effective application of agent theory even confirms the leadership style as transformational by making each employee as important part of the organization entertaining their new ideas where the only concern is to achieve excellence in the part of the organization. Apart from this, adaptability and proactiveness is there in the organizational culture and board members become the real guide for the concern with a vision which they think is realistic and achievable and convince the team to believe the same.

Conclusion

The paper have discussed all the course of changes in Brampton Hospital where it has been seen that changes by Smith and Darwin innovations play an important role for the organization to achieve betterment and success in its course. In the course of it discussion it has been seen that Smith most importantly deals with changes in IT Department followed by a cooperative and collaborative environment in the internal system of the organization where previously there was a huge gap followed by mess. However Darwin changes mostly found its success through innovation as in this regard everyone is allowed to showcase their own innovation and views. Thereby following the nature of changes this has been described as transformational leadership whereas Smith initiatives are counted as authoritative leadership. Practicing both the leadership styles successfully the organization attain success in its course though certain things might have a better look out.

Recommendation

However it cannot be ignored that employees work as per directions thereby innovations in their part cannot be accomplished in Smith’s attempts. It might be better for the organization if Smith can have democratic leadership style in her attempt to some extent to allow everyone to showcase their abilities or skills (Alghamdi, Topp, and AlYami., 2018). Further the attempt of Smith can help her to avoid her mistakes and might bring the success quickly. Certain disadvantages of transformational leadership style cannot be ignored in Darwin initiatives as excessive curiosity for innovations sometimes become a barrier by making the idea as unrealistic. The leadership style allowed room for risk factors where it cannot be ignored that inefficient decision can bring an uncertain situation for the organization. Thereby it would be better for the organization to make a good mix of the transformational leadership style with pacesetting style as it puts pressure for result and thus most of the risk factors can be avoided (Kraus., 2017).

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