Value and Leadership in the Health Care Field


Valueand Leadership in the Health Care Field

Valueand Leadership in the Health Care Field

Theconcept of value and leadership in healthcare has numerousliteratures that provide fundamental insights on how differenthealthcare systems can have a value-based leadership style. Forpurposes of clarity and preciseness, this literature criticallyanalyzes four literatures from expert authors in healthcaremanagement. All the four sources identify value as the basis ofevaluating healthcare management systems.

Hartleyand Benington (2010) is a book of interest to all who exerciseleadership in the healthcare industry. Leadership includes those whohave formal positions in a healthcare organization such as the ChiefExecutive Officer, clinical director, doctor, nurse and any otherposition that can aid in implementing healthcare policies indifferent individual and collective capacities. Leadership in Hartleyand Benington’s perspective also includes those whose leadership isthrough influencing thinking and actions relevant to healthcare, forexample, local government elected members and officers, and patientgroups(Hartley &amp Benington, 2010).The author’s highlight a new approach to value-based leadership inhealthcare that considers the ability of a healthcare leader to comeup with solutions to the challenges that constantly faces thehealthcare industry as a requisite to effective healthcare. The bestexample provided by authors is the major post-war curable diseases,such as measles and diphtheria. As a condition for value-basedleadership, they consider a leader’s ability to mitigate theeffects of these epidemics that could occur during the war as aperfect measure of their leadership acumen. This is possibly arealistic measure because it measures the leader’s ability tomobilize resources to avert the spread of diseases. Harley andBenington use the same threshold without attaching a numerical valueon the decisions that the healthcare leader. They conclude that sucha leader is capable of dealing with the ever-increasing cases ofchronic diseases that rise from lifestyle changes by not justanticipating, but initiating the required change. Many other authorswould agree with Harley and Benington’s views that the long-termbudget pressures require a ‘predict and prevent’ approach tohealthcare leadership.

DavidGraber and Anne Kilpatrick (20008), have a different perspective ofwhat entails value-based leadership in healthcare. Their assertionsdiffer from those of Harley and Benington. While the latter viewsvalue leadership around the decisions that healthcare leaders totransform the society, the former views value-based leadershipthrough the lens of an overall organizational culture. The culture isinitiated and implemented by the leadership so that is determines thedirection of the healthcare organization. Grabber and Kilpatricksuggest a value system engraved in the organizational structure,which accommodates the expectations of the society notwithstandingthe fact that healthcare organizations have defined structures. Someof the societal expectations the organization suggest could influencethe value-based leadership culture in healthcare organizations arecultural and religious beliefs (Graber &amp Kilpatrick, 2008). Theaction plan for these suggestions is in training and socializinghealthcare employees in respective organizations with the aim ofadding value to the heterogeneity of value systems in theorganization. Unlike Harley and Benington, Graber and Kilpatrick seethe need for healthcare managers to have strategies to deal withcompeting or conflicting values in a healthcare organization.Rewarding healthcare employees who adhere to the set value systems isone way that Graber and Kilpatrick suggest as a potential source ofmotivation and commitment. They are sufficiently specific in definingwhat value-based leadership in healthcare should entail. The featuresof a leader who commits to a value-based leadership style are: theycan establish professional values for the employees they empoweremployees to implement the values within their sphere of influenceand they are cognizant of the values of internal shareholders.

MichaelE. Porter (2010), in his journal article on the New England Journalof Medicine, is undeniably more articulate and more specific inhighlighting the detailed aspects of value-based leadership inhealthcare. Porter, a professor of healthcare, defines value-basedleadership as “one that is capable of achieving the highestpossible health outcome for every dollar that a patient spends inseeking health services (Michael, 2010). Porter asserts that for aleader to achieve the highest possible healthcare outcomes they mustharmonize the interests, aspirations, and activities of allshareholders into one goal. Doing so is possible through initiatingsystems that enhance performance and accountability. AlthoughPorter’s assertions and suggestions appear out fop touch withrealities of the healthcare systems, he does no fail to underscorethe challenges that healthcare leaders face while harmonizing theinterest of different stakeholders. The challenges that Porterhighlights are conflicting goals arising from issues such as costcontainment, satisfaction, profitability, and access to healthcareservices unclear collective goals that cause divergent views andthe slow pace of performance enhancement. Porter succeeds toproviding a working threshold upon which a leader can be evaluated interm of value-based leadership. In Porter’s own words a leader whoensures that the organization has an “efficient healthcare system,creates value in terms of patient satisfaction, and an effectivereward system based on the same patient-oriented value system,”deserves the tag of a value-based leader.

Finally,Swayne, Duncan, and Ginter (2008) agree with the authors discussedabove, that healthcare organizations require value-based leadership.However, they have a subtly different view of what constitutes avalued-based leadership style. The three authors consider strategicmanagement through analytical and emergent approaches as essentialaspects of value-based leadership. Both approaches are valid forapplication, but the authors insist on the need for constantorganizational action to sustain high quality services (Swayne,Duncan &amp Ginter, 2008). Analytical strategies have a logicalsequence of processes or steps that managers adopt in theorganization after comprehensive research on their effectiveness. Theemergent approach, according to Swayne, Duncan, and Ginter, relies onthe intuitive thinking of the leader. Whichever the model that thehealthcare leader decides to use, a value-based leader must have atype of model that provides procedures that guide strategicmanagement in healthcare and incorporate learning and change at thesame time. The authors conclude that for a value-based leader tosucceed, they must approach strategies in a disciplined way toincrease the chances of implementation. Interestingly, Swayne,Duncan, and Ginter give a hint of the possibility of combining bothapproaches to improve value in the provision of healthcare services.

Inconclusion, the authors in the four academic sources concur on thevitality of value-based leadership in healthcare, but they differ inthe approaches to be used by organizations. Hartley and Benington(2006) only provide a general description of a value-based leaderwithout providing specifics. David Graber and Anne Kilpatrick (2012),consider a value-based leader as one who can mitigate the setsstandards in the organization and the divergent aspirations ofstakeholders. Michael E. Porte (2010) values the potency ofhealthcare leadership in terms of the value a patient derives fromevery dollar they pay for the service. Swayne, Duncan, and Ginter(2013) are quite different. They suggest two leadership approachesthat, according to them, define a value-based leader.


Graber,D. R., &amp Kilpatrick, A. O. (2008). Establishing values-basedleadership and value systems in healthcare organizations. Journalof health and human services administration,179-197.

Hartley,J., &amp Benington, J. (2010). Leadershipfor healthcare.Bristol: Policy Press.

MichaelE. P. (2010). Perspective: What Is Value in Health Care? The NewEngland Journal of Medicine .

Swayne,L. E., Duncan, W. J., &amp Ginter, P. M. (2008). Strategicmanagement of health care organizations.San Francisco, CA: Jossey-Bass.