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Infographics

How Nursing Leadership Styles Can

Impact Patient Outcomes and
Organizational Performance
Date: April 19, 2016

Nurses play vital roles in health care organizations. How they are managed by their leaders can drastically
affect their performance and influence patient outcomes. It is important to understand the different
leadership styles that are often found in the workplace, as well as their effects on the staff and those
under their care. To learn more, checkout this infographic created by Bradley Universitys Doctor of
Nursing Practice program.
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Transactional Leadership
A leader of this type will try to ensure that the staff complies with rules by instituting a system of rewards
and punishments. Those individuals who follow his or her instructions and achieve the set targets will be
rewarded accordingly. On the other hand, those who fail to obey and to reach the goals will be punished for
their transgressions. This style is firmly focused on the supervision of subordinates, keeping the
organization running smoothly and improving group performance. There is a keen interest in the work
done by followers to find deviations. This leadership style is effective in managing a crisis and completing
highly detailed projects.

Transformational Leadership
This style is leadership by example. Followers see their leaders behaviors, and they are inspired to change
for the better. They see the hard work from the top as well as the concern for their well-being. They
perform beyond all expectations because they put in more effort than usual. They no longer put
themselves first as they place more importance on what is best for the organization. Leaders provide a
clear vision of the future that motivates staff members to exceed themselves. Old assumptions and
traditions are questioned to come up with novel ideas for solving problems more effectively.

Democratic Leadership
With this style, the team is encouraged to speak up and join in the decision-making process. The open
communication makes all staff members feel that their voices matter. They are more concerned about the
things that go on in the organization knowing that they can influence situations if they act on them.
Workers are given their own personal responsibilities and are accountable for reaching certain targets.
They get feedback on their performance, which allows them to adjust if necessary. The focus is on
improving the quality of the systems and processes, not on finding errors made by the individual team
members.

Authoritarian Leadership
This approach is the opposite of the democratic style as the leader calls all the shots. Decisions are made
rapidly without any form of consultation with the staff. All the power is concentrated at the top, and
individuals at the bottom can only follow. Those team members who disagree and dont do as they are told
are often punished to keep them in line. Knowledge may be kept in the hands of a few to keep the power
within their ranks. When mistakes happen, authoritarians make an example of the offenders by punishing
them in front of their peers. The blame is always on the individuals despite faulty processes. On the other
hand, this style may be required in emergency situations when fast action is necessary.

Laissez-faire Leadership
In this style, very little supervision is exercised by the leaders. They prefer to take a hands-off approach to
daily operations. They would rather let people do what they need to do on their own, perhaps trusting that
they will be able to do well without guidance. While it does promote independent thinking, this approach
can have several negative consequences. Important decisions are not made on time. Few changes ever
happen at the workplace. Quality improvements happen only when the situation begs for it. This style is
frequently used by inexperienced leaders who are still learning, as well as transitional managers who are
simply waiting for someone to replace them.

The Impact of Leadership Style on Patient Outcomes

A number of studies have looked into the relationships between nursing leadership and patient outcomes.
The results are quite fascinating, as they reveal definite links between the two. For instance,
transformational leadership was associated with reduced medication errors in the majority of the studies.
It seems as though things are done much more carefully inside the hospital when this approach is taken.
The style also was related to lower patient mortality in half of the studies. Patients somehow get better
care and treatment, which allow them to survive their ordeal.

The relational types of leadership that include the transformation and collaborative styles have a common
effect on patient satisfaction. People are generally happier with the service that they receive for both acute
care and home health care. The need for restraints is also lessened as patients are much more
cooperative with their nurses. Aside from the lower incidence of medication errors, there are also fewer
reported hospital-acquired infections. If one is going to go to a hospital, then it is definitely preferable to be
admitted to those that champion these relational leadership styles, as the outcome is more likely to be
positive.

Nurse Preferences and Findings

The National Institute of Health as well as the Journal of Nursing Administration published related studies
in the past. It was found that transformational leadership was a positive contributor to a safer climate
within the hospital. It was associated with reduced staff turnover when compared to the others. The
nurses were happier with their work and chose to stay as a result. On the other hand, the laissez-faire
approach was shown to negatively contribute to unit socialization. It also created a culture of blame
among team members that only served to stress everyone unnecessarily.

Additional findings showed that nurses were quickly able to distinguish the difference between
transformational and transactional leadership. They might be similar styles, but the implementation and
results are divergent. Nurses were much more in favor of the transformational approach as it promotes
intrinsic motivation and job satisfaction. They liked the idea of positive behavior influence and
inspirational motivation, considered by many to be the most effective out of all the options out there. In
truth, all the styles have their place and the mark of a good leader is wisdom in implementing the right
style at the right time.

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