Investing in people
Alberta's healthcare workers carry heavy burdens-increasing workloads, staff shortages, and high turnover rates. Dr. Greta Cummings proposes that a new style of leadership and management training may be crucial to improving health care.
First-hand knowledge
"When I started nursing I was in charge of four to five patients at a time," says Dr. Greta Cummings. "As I moved into more senior management positions I was in charge of 30 patients, then 100 patients, and eventually over 200 patients." Now an AHFMR Population Health Investigator, she has parlayed this first-hand experience as a healthcare manager into a career in research and teaching at the University of Alberta.
Dr. Cummings has spent 20 years of her career in various leadership positions, including positions involving planning and policy-making. As a senior administrator, she saw the stresses faced by nurses on a daily basis. "I was working in the hospital system in the nineties, during a time of massive cutbacks. I had to lay off so many nurses, and I wanted to know what that had done to the system-and, in particular, to the nurses who were left behind."
Leadership styles of healthcare management
Dr. Cummings studies the impact of leadership style on nurse morale. In particular, she examines the effects of emotionally intelligent leadership. Emotionally intelligent leaders foster relationships in the workplace and spend time investing in the personal and professional development of their staff. "This style of manager does not view an employee as 'just a worker', but as a person," explains Dr. Cummings. "I was really keen on knowing if nurses who worked for this type of leader fared differently from nurses who worked for other types."
Her systematic reviews of existing literature showed that leadership style played a pivotal role in the lives of nurses. Despite experiencing restructuring, layoffs, and increased patient load, nurses who reported to emotionally intelligent leaders were healthier, less emotionally exhausted, and better able to look after their patients than nurses who worked for performance-focused, commanding leaders. "Managing people by projecting the attitude that‘it's my way or the highway' is much less effective in the long run," says Dr. Cummings.
She also points out that a focus on the bottom line likely wastes more money than it saves. "The attitude of 'let's do it my way because we'll get to the bottom line' probably costs the system a lot in terms of turnover and grievances. If we can engage staff in a meaningful way, we will have fewer organizational problems. In the end it will cost less, and we will have better outcomes."
Although the impact of leadership style has been well documented in other sectors, Dr. Cummings's research program is one of the first of its kind to address the effect of leadership styles on the Canadian healthcare system. "Leadership style has farther-reaching implications than job satisfaction," says Dr. Cummings. "It leads to better patient care and retention of nurses; and it will ultimately save the system money. An organization's staff is its most important resource."
Putting theory into practice
Dr. Cummings is now moving on to explore the question of how best to train effective leaders. "We don't have much research on how to develop leadership in health care. How do we develop young leaders? How can we improve patient outcomes through better leadership? Healthcare workers are burnt out, and there are high rates of absenteeism. We haven't solved the problem yet."
Currently Dr. Cummings is working with the Alberta Cancer Board to implement a program called the Leadership Development Initiative (LDI). "Rather than sending leaders out of the system to receive training-after which they have to bring learned skills back and try to change the workplace culture-we're trying to work within the system," explains Dr. Cummings. The LDI has the potential to change the way nurses and other healthcare professionals train, as well as the way they interact with each other and work together.