Leadership and Management Principles of Nursing

Huber (2000) has noted that the U.S. health care system is a network of subsystems characterized by complexity and fragmentation. The application of leadership and management principles, theories, and concepts from the nursing perspective is critical in the context of health care delivery systems, organizational change and transition, and quality improvement/risk management. This brief study will explore these three critical issues. The argument will be advanced that nursing plays a key role in ensuring a high quality of health care services in an environment characterized by funding and other resource constraints, rapid technological advances, and a new focus on patient rights.

Huber (2000) contends that nursing leadership in the health care delivery system is an essential element in responding to ongoing needs as well as situational crises. According to Boykin and Schoenhofer (2001), nurse administrators play a key role in articulating the uniqueness of nursing in today's complex, corporatized health care delivery system. Nurse administrators whose viewpoint is grounded in the concept of caring as articulated by Leininger are seen by Boykin and Schoenhofer (2001) as most likely to assist their colleagues, organizations, and patients in maximizing outcomes and resource distributions.

Given that many contemporary health care delivery systems are moving toward integration of delivery systems to realize economies of scope and scal

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d Wilson (1996) as based upon a working collaboration between medical and nursing management. Nurses are being challenged to become leaders in holding institutions and their staff accountable for clinical, quality, and risk issues and also in identifying opportunities to improve the quality of patient care that is rendered by the institution. Calomeni, Solberg, and Conn (1999) explored via a randomized controlled trial, the effect on clinic nurses in the roles of team leaders, of new continuous quality improvement (CQI) initiatives. Quality improvement was seen by these researchers as an important role undertaken by clinical nurses, who are the front line service providers in health care institutions. By directly involving nurses in all of the quality improvement activities undertaken in an institutional setting, Calomeni, et al (1999), assert that major strides can be achieved. Huber (2000), in discussing this issue, maintains that quality is freedom from defects plus value and meeting customer expectations. Nurses represent key elements in ensuring that standards of care and standards of professional performance are maintained and exceeded in the delivery of services. The literature supports the belief that new roles

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