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Effects of Leadership Styles on Quality of Care

Effective health care professional’s management is critical to enhancing quality and care integration. The purpose of this research was to evaluate whether an association exists between distinct leadership styles and quality measures for healthcare. Currently, evidence based medicine and care are commonly acknowledged as instruments for creating efficient quality of care (Castle, Engberg 2007). Long term care professionals’ management is essential to strengthen quality and inclusion of care. Quality of care is an essential component for the achievement of high productivity rates in healthcare organizations, and is defined as the extent to be achieved in line with the current professional understanding and competencies of the providers. As a leader, the difficulties they face are supporting good conflict and protecting their staff against damage and damage. Leaders need to restrain staff who enable conflict, no morality, no motivation and continual workplace conflict.  For the employees, the capacity of a leader to model proper workplace behavior. The issue is to define the potential for leadership development in a long-term care environment.

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The prospective management issue in long-term care often starts with collaboration between large companies. Lack of management may lead to a substantial reduction in morality, work efficiency, participation, manufacturing and quality of treatment.  The management function in long-term care is responsible for generating a favorable working atmosphere that focuses on working and increasing moral standards. Leadership is defined as senior management with a focus on behavior, a positive work environment for the implementation of policies and procedures. A good leader can assess their workers ‘ efficiency and assign duties to the department responsible to obtain favorable results. As a ruler, problems need to be resolved because they can help with growing opportunities.

Wang, Yuan & Zhu (2017) identified that positive leadership identified at the time of hire will decrease terminate and increase morale and productivity. It was noted in the research that a higher turnover rate occurs for younger employees than older employees. In any organization it is important that leaders understanding hiring individuals that are a good fit for their organization.

This research consists of qualitative descriptive study that focuses on leadership style, management and performance in long term care settings. The sampling for this research consists of 3 long-care facilities in the rural area of Alabama. The participants include Director of Nursing from each facility, Administrator and one Registered Nurse that obtains a leadership position. The following issues will be addressed: how can effective leadership ensure quality of care, how to determine if you are an effective and ineffective leader.  For further evaluation of this research the Social Exchange Theory is used provide a clear understanding of why leaders succeed or fail. For example, a Director of Nursing should be effective in communication, knowledge of nursing and problem solving capabilities. An ineffective Director of Nursing may react to losing staff, lack of motivation and use intimidation tactics. The bulk of leadership research concentrated on the differentiation of management elements to assess efficiency.

However, Havig et.al (2011) further studied leadership, staffing and quality of care in nursing home settings. Leadership and staff are important factors in providing quality of care. This article used a cross-sectional design to collect the appropriate data. The sample size consisted of twenty-one nursing homes and forty wards and all facilities were none profit. Having, Skogstad, Kjekshus & Romøren (2011) stated that the relationship between staffing levels. The ration of registered nurses and administrators are primary factors in the quality of care. According to the authors, future findings for this research could identify more of the relationship between staffing, nursing, and administrators to determine if each discipline understand that meaning of quality of care. The importance of active leadership, structure, and coordinator is needed to clarify roles and monitor day to day operations.

Registered nurses conduct oversight and clinical functions in hospital care in long-term care environments. The registered nurse in the long-term care setting is responsible for managing the day-to-day clinical operational tasks, strategically planning the care of residents and risk management. The registered nurse is accountable for communication with physicians, pharmacists, citizens and household groups on a daily basis. Registered nurses are regarded agents of performance of service, providing that employees can provide the greatest amount of practical treatment. Registered nurses are regarded mediators between relatives and physicians in many long-term care environments. Continuation of research identified that effective leaders are often described as “transformational” leaders. They practice “delegating significant authority to others, developing co-worker skills and self-confidence, creating self-managed teams, providing direct access to sensitive information, eliminating unnecessary controls, and building a strong culture to support empowerment” (Yukl 2006, p. 271).

The validity of the research is measured with statistically significant correlations between the Administrator and Director of Nursing. According to (Dana & Olson 2007) in order to sustain validity when measuring leadership in long-term care it is understand the importance of organizational culture and structure. Identify the need and compassion for others in needed. Effectively managing staff and understand the concept, policies and regulations of long-term care services.

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The Center for Medicare and Medicaid Services (CMS) identified governance and leadership as a major element of Quality Assurance/Performance Improvement (CMS, 2012). The Center for Medicare and Medicaid Services identifies leadership as performance through various styles of leadership. CMS officials translate rules in long-term care and ensure that all assistants comply with national laws. Leadership is to empower nurses and employees to develop a favorable working atmosphere. This implies highlighting the value of lives maintenance laws of state and national governments. The significance of establishing a favorable working atmosphere, laws and processes to ensure that every office meets the guidelines of national and government legislation must be understood by officials.

Research was performed to evaluate which squad showed adverse behavior towards adversity and group management.  Comprehensive assessment was used to identify the results. Most of the scope concentrated on team building and demonstrate good staff response to multiple management strategies.  Further study would comprise of a wider evaluation of the five-point resemblance scale to determine the sort of reaction provided by each person. In the workforce, the sort of conduct and the person generally grows on the basis of management and the job climate.

The research was quantitated that further focused on leadership and their leadership styles, staff licensed and unlicensed that helps identify the measures of quality of care. The nursing home setting is increasing rapidly. Many families are unable to provide adequate care and the nursing home is the next best option.  A nursing home setting assists with activities of daily living, 24-hour care, and medication administration. However, if the leadership skills are not properly implemented this can cause a hindrance in the quality of care.  Quality of treatment and performance of lives are the two primary components of the nursing home setting. Quality of care relies on clinical outcomes such as drops, accidents, and overall safety and care. Quality of existence emphasizes the well-being of patients and social activities.


  • Castle, N. G., & Engberg, J. (2007). The Influence of Staffing Characteristics on Quality of Care in Nursing Homes. Health Services Research, 42(5), 1822-1847. doi:10.1111/j.1475-6773.2007. 00704.x
  • Center for Medicare & Medicaid Services (CMS) (2012) http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-andSystems/MDSPubQIandResRep/qmreport.html.
  • Dana, B., & Olson, D. (2007). Effective Leadership in Long Term Care: The Need and the Opportunity. Retrieved from https://achca.memberclicks.net/assets/docs/ACHCA_Leadership_Need_and_Opportunity_Paper_Dana-Olson.pdf
  • Havig, A. K., Skogstad, A., Kjekshus, L. E., & Romøren, T. I. (2011). Leadership, staffing and quality of care in nursing homes. BMC Health Services Research, 11(1). doi: 10.1186/1472-6963-11-327
  • Kim, M. (2017). Effects of team diversity, transformational leadership, and perceived organizational support on team-learning behavior. Social Behavior and Personality: An International Journal,45(8), 1255-1269.
  • Phong, L. B., Hui, L., & Son, T. T. (2018). How Leadership and Trust in Leaders Foster Employees Behavior Toward Knowledge Sharing. Social Behavior and Personality: An International Journal,46(5), 705-720.
  • Resnick, H. E., Manard, B., Stone, R. I., & Castle, N. G. (2009). Tenure, Certification, and Education of Nursing Home Administrators, Medical Directors, and Directors of Nursing in For-Profit and Not-for-Profit Nursing Homes: United States 2004. Journal of the American Medical Directors Association, 10(6), 423-430. doi: 10.1016/j.jamda.2009.03.009
  • Trinkoff, A. M., Lerner, N. B., Storr, C. L., Han, K., Johantgen, M. E., & Gartrell, K. (2015). Leadership education, certification and resident outcomes in US nursing homes: Cross-sectional secondary data analysis. International Journal of Nursing Studies52(1), 334–344. https://doi-org.proxy1.ncu.edu/10.1016/j.ijnurstu.2014.10.002
  • Wang, Y., Yuan, C., & Zhu, Y. (2017). Coaching leadership and employee voice behavior: A multilevel study. Social Behavior and Personality: An International Journal, 45(10), 1655-1664. doi:10.2224/sbp.659
  • Yukl, G. (2006). Leadership in organizations, 6e. Upper Saddle River, NJ: Prentice-Hall.

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