Supervisory Management Project: Management Role in Health Foundation

(I) The Muiriosa Foundation is changing the way in which they document information relating to client care and retaining records. The Muiriosa Foundation has chosen to use EpicCare & EpicTouch web based systems for numerous reasons.

Historically, Care providers documented information by hand. Over time its index of policies and procedures, both developed in house and those required by statutory legislation gives the Muiriosa Foundation in excess of fifty. Each one outlines actions and information that must be recorded. Many have numerous appendices to be completed and this does not include the many and varied types of information processes and communication that is logged between teams. Some examples include; follow up actions, emails, internal reports by Multidisciplinary professionals, and external appointments to name a few. This is a hugely time consuming operation for all staff, from ground level to the Human Resources department and beyond. Not to mention the added difficulty of where and how securely the written information is stored when in use or when obsolete. A now major concern under the Data Protection Act 2018 & General Data Protection Regulation (GDPR).

Epic solutions the creators of the EpicCare and EpicTouch systems are currently used in over 20,000 Healthcare settings. They credit their system with helping Organizations to achieve compliance through Health Information Equality Authority (HIQA). It also increases the quality of care services and also lowers costs associated with the creation and storage of documentation. With the implementation of such online systems, Epic Solutions believe it will help organizations to better oversee and expand their managing abilities. https://epicsolutions.ie

As a manager, one of the main benefits to introducing EpicTouch systems lies with its seemingly flawless integration within the residential homes daily activities. https://epicsolutions.ie/. The system is in my opinion relatively easy to use, whether on a tablet as was originally designed or on a computer. Secondly, as a manager it means that almost all records are logged in one place. Whether I am checking in on day to day activities or checking how an individual has presented through an illness, it is now a less time consuming task. Additionally I can access this information from any location without having to travel to the residential home and examine several different folders.

(II) There are numerous styles of management and leadership that one can employ when undertaking the role of manager. Kurt Lewin has summarized three major styles of leadership which can be used in a managerial role.

AnAutocratic style is one whereby managers make the decisions without consultation with other members of the team. They do so even if having input would be beneficial. This style is most fitting in organizations where decisions need to be made fast and there is no time for scheduling meetings and having input from many directions. In preparing the staff team for the inevitable change of systems I employed an Autocratic style. It is somewhat fitting in Health and Social Care setting, where powers such as the Government, the HSE or HIQA have directed the Muiriosa Foundation to implement certain procedures, policies or other. It is here that managers must take an Autocratic approach as without compliance staff persons are not fulfilling their roles and responsibilities and we are in breach as an organisation. This style is thought to be demoralizing for staff teams and can other negative outcomes such as high absenteeism and staff turn over. This can be seen in Kelly (2014) study on the impact of Leadership Styles in the HSE following the recession in 2008. Kellys findings showed that following the implementation of strict budgets, a moratorium on staff and additional performance measures the managers who participated in the study felt they had no authority and were in essence being micromanaged. I would envision that if this is how the managers felt then their staff teams also felt a lack of consultation.

Laissez-faire style of leadership generally shows managers providing resources but allowing staff to do the work unsupervised and make decisions themselves. This hand off approach can result in staff having poor level performance, feeling unsupported and poor morale (Bhatti et al 2012).  While this style may work for some organizations it is not a style suitable to the Muiriosa Foundation. We have many levels of management and each must be accountable to the next. To do this managers must supervise, direct employees and at the very least have some part in the decision making process.

The use of a Democratic style is in my opinion the ideal approach when not constrained to using an Autocratic style. Democratic style allows all parties to have input while decision making power remains with the manager. Bhatti et al. describe it as best implemented where teamwork and quality are essential components of an organization. The core mission of the Muiriosa Foundation is to deliver high quality care services and it is through the many teams this is achieved. Other benefits are also noted such as higher job satisfaction, increased skill development and motivation. Before implementing the change to the online systems I will outline the difficulties and deficits of our current handwritten system while asking each person to give an example of times where they felt the written records were flawed. This Democratic style allows the team to feel listened to and included in how the change will affect them directly. I will then give them some examples of how the system will help improve or reduce their workload and duplication of information. It is important that each person is given training, the opportunity to ask questions and query how current forms, appendices etc will transfer onto the new system. Staff will need to be assessed on their ability to log the daily information as a bare minimum, and over time it will need to be monitored by myself to ensure its correct use and establish its effectiveness.

Critical recognising my own role as supervisor and the supervisory skills required

One must develop a vast array of skills working as a manager. I believe it is important to have an understanding of our own personality as this can shape how you learn skills and how we use them within teams. With this in mind, I have conducted an analysis of my own personality and how this impacts my communication with others.

The Myers Briggs Personality Test also known as MBTI, is a self reporting test which indicates an individual's preference for making decisions & how they see the world around them (Briggs-Myers & Briggs 1995). According to the test I show strong preference to being an Extroverted iNtuitive Thinker Judger also known as ENTJ. These personality types enjoy motivating others and encourage self development. These are helpful traits to have in driving the introduction of Epicare within the residential unit.

I also identify with many characteristics of the ENTJ types such as; a tendency to be decisive, logical, frank and take on natural leaderships roles (Bayne 2002). Although such traits are beneficial in my managerial role I must also note ENTJ can also be forceful in pressing their ideas. A trait which I envision other personality types might find overbearing.

Interestingly, ENTJ personality types have also been shown to have a high degree of argumentativeness. According to Loffedo & Opt (2006) being argumentative is in fact a positive communication trait, one which inspires curiosity, asks questions and seeks to find more information.This I feel is an important trait in working in the field of intellectual disability. Such individuals may lack the ability to communicate their own choices or desires. They may be unable to protect and defend their rights and as such we must strive to advocate for all vulnerable people in our care. However, such passion and directness can be viewed negatively by other personality types (Kroeger,Thuesen & Rutledge 2009).They may see argumentativeness as conflict seeking and become defensive if they feel personally challenged.

Discussing the importance of communication, delegation; work planning, change management and conflict management

Communication

Communication is essential to managing a team but excellent communication is core to managing an excellent team. As the in house local manager of a team of ten, it is of paramount importance that I can communicate with such a large team. The awareness of my own personality type allows me to understand that some of my natural traits may lead to poor communication with other personalities. For example, my natural tendency toward argumentativeness is difficult for some of the staff team. They will agree with me even though I note in their posture, body language and by their previous actions that they disagree.  As a result I am able to communicate my message clearly when I adopt a more open communication culture. I do this by asking their opinion on the task/issue and give them the opportunity to be heard. Garon (2012) noted that by creating an open culture of communication within healthcare settings the results showed both  marked improvement on both staff morale and performance as well as improved patient care.

Each person has their own individual strengths and areas of further development. I see it as my role to respect each but continue to encourage the development of all even though it may mean using a variety of ways to support their development and growth. Some individuals may need direction on a one to one basis, where others can be given direction over an email and be able to complete the task to the required standard.

Change management

One of the greatest tasks in any organisation is leading and implementing a change. My role is to understand the change, the rationale for the change and be able to motivate and inspire the staff team. Change is an inevitable thing and should be brought about with understanding and clear objectives. Staff will often ask why does this need to happen? What's wrong with what we are doing now?  How are we to make time for this? As a leader I must be confident in my ability to answer these questions. In this case I have researched Epic Care and Epic Touch systems. I have attended training specific to implementing both systems which was provided by the organisation. I feel that change should be described in a positive way wherever possible. It is both the organisation and my own responsibility to create a clear plan to drive the change. A method which I have aimed to do with the team I work with.

Conflict management

Conflict issues whether big or small are common place particularly for those working in the caring professions. We may encounter conflict with our team members, families, the individuals who use the service, upper management or with members of multidisciplinary teams. Conflict that exists in our teams can ultimately affect everyone. It can cause tension, stress, poor morale, poor work practices, burn out, or dissatisfaction with the service provided. According to Thomas Kilmann Conflict Modes I score highly on Collaborating and Compromising as my preferred style of managing conflict. I like to deal with conflict as soon as it arises or I become aware of it, and deal with issues head on, which shows I am assertive and not withdrawn from issue’s. When dealing with employee vs employee conflict I firstly remind staff that the code of conduct directs them to address issues with the person whom they are in conflict. I encourage them to speak honestly and respectfully to each other, outlining what the particular issue is. Often times, when staff have had an initial venting period they feel comfortable speaking directly with the other person. This has the potential to have a more direct impact and a better result. I believe this is a good example of the Collaborating style of conflict management. It is important that each team member is respected and while we all must work to a certain standard, some people have different ways of doing things. I find it is beneficial to remind the team of our own strengths and weaknesses but encourage them to develop the latter. This demonstrates my tendency toward Compromising which can help to maintain relationships.

Delegation

It is said that one of the greatest resources of any organisation is its people. Muir (1995), states that by providing encouragement and motivation to staff, it benefits the organization and the staff alike. Muir (1995), suggests that by delegating you are showing trust in that person's abilities and strengths. Thus making delegation, when done correctly an effective tool to both achieve organisational outcomes while also developing the staff person's confidence, skills and sense of achievement.

As a manager it is essential that I delegate to staff who have the ability to do the task in question. These individuals will have the skills. knowledge and experience to do such tasks and are extremely valuable to the organisation. While I normally delegate important tasks to those who have a proven record in getting the job done, I am also aware of those that may be lacking in the ability. Occasionally, I may have to delegate to lesser skilled team members. This can mean the task is partially complete or poorly completed but is a better alternative than not done at all. It can also create an opportunity to discuss individual shortcomings and implement supports if required.

 As a manager I believe that all staff have the potential to learn. When I am trying to build confidence or test a person's ability, I may delegate a non important task in the first instance with a view to increasing task importance over time, as well as supporting the staff person with frequent supervisions. This may seem contrary to delegation, in effect creating more work by supporting this person but it I feel it is an investment in that person over. If it is done well could be mutually beneficial for all.

Work planning

Work planning is essential to the smooth running of the organization on a day to day basis. Due to my dual role as Manager and Social Care Worker my daily tasks are lengthy. I have a duty to the individuals whom we support, our team and the Person In Charge to fulfill both roles without one negatively impacting on the other. As such I must plan each day from the start and prioritise tasks. I must first meet the needs of the individuals followed by urgent tasks or follow up and then tackle other less important items. It may mean setting a specific period of time for set tasks and if they can not be completed then I must move on to the next or risk wasting more time.

To ensure the smooth running of the residential house I encourage and actively plan the day with the staff on duty. It is important to do this early on setting time frames and allocating certain people to specific tasks. There was a previous negative pattern among some of the less motivated staff members where their colleagues had to carry out all of the appointments and/or all of the social outings, which resulted in a lot of bad feeling among the team. It is important to share the duties, resources and time fairly.

To ensure time and resources are managed effectively one can also adopt the use of the S.M.A.R.T. template.

Managers and leaders must be Specific in what goal they want to achieve. In other words what is the ideal outcome? How will all parties know when it has been achieved? They must state this clearly, being as Specific as possible.

Goals must be Measurable. Managers should have clear steps in order of how the goal will come about. Managers need to assess how the progress of this goal will be Measured. Staff teams may need to take note of what is working and what is not, providing clear documentation or proof so that measures may be changed if required.

Each person involved should be in Agreement. If any one person is not in agreement the manager should use either an Autocratic or Democratic style of leadership as necessary. They will either need to force compliance or discuss the persons reluctance and persuade toward a common goal.

Each goal should be Realistic in attainment. Setting unrealistic goals can be a waste of time and resources as well as creating poor morale among the team. As a team, we should question the relevance of the goal. Deciding on whether it is worth pursuing or in need of slight modification. Doing this early on, and periodically throughout the process can save time and resources aplenty.

Lastly, each goal should have a Timeframe for achievement. This timeframe should be specific whether it is a day, week or month away.

Reference List

• Bayne, R. (2002). The Myers-Briggs Type Indicator: A Critical Review and Practical Guide.
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• Bhatti, N., Maitlo G. M.,  Shaikh, N., Hashmi, M., A. Shaikh, F.,M. (2012) The Impact of Autocratic and Democratic Leadership Style on Job Satisfaction. International Business Research Vol. 5, No. 2; February 2012. Accessed on 19/06/2019.
• Briggs- Myers, I. and Briggs- Myers, P. (1995). Gifts Differing: Understanding Personality Type. USA: Davies Black Publishing.
• https://epicsolutions.ie/ Accessed 10/3/2019
• Garon, M. (2012).  Speaking up, being heard: registered nurses’ perceptions of workplace communication. Journal Of Nursing Management 20 (3), 361-371,
• Accessed 16/6/2019 https://onlinelibrary.wiley.com
• Kroeger, O., Thuesen, J. M., & Rutledge, H. (2002). Type talk at work: How the sixteen personality types determine your success on the job. New York: Dell Publishing.
• Loffredo, D. A. and Opt, V. S. K. (2006) Argumentativeness and Myers-Briggs Type Indicator® Preferences  Issue 7 July 2006 Journal of Psychological Type® Accessed 2/6/2019 /www.researchgate.net/
• Muir, J. (1995). Effective management through delegation, work study. Vol. 44 Issue: 7, pp. 6-7, www.emeralinsight.com accessed 16/6/2019
• Swansburg, R., C. and Swansburg, R., J. (2002) Introduction to Management and Leadership for Nurse Managers. 3rd Edt. Jones and Bartlett Publishers: London.