human services

KP and LXM Theory of Leadership

Capella University

Priscilla Hill

The Overview of Kaiser Permanente Healthcare Organization

Kaiser Permanente Healthcare is one of the most wide-spread not-for-profit organizations in the United States. The Kaiser Permanente Healthcare organization, which was formed 1945 by Henry J. Kaiser, currently boasts of 11.8 million members, spreading across eight states and the District of Colombia. The Kaiser Permanente is made up of three distinct entities which include (Schilling et al., 2010);

i. Northwest permanent, PC which is the medical wing.

ii. Kaiser Foundation Health Plan, which is the insurance wing.

iii. Kaiser Permanente Hospitals, which is the hospital facilities wing.

The integrated structure at Kaiser Permanente integrated structure is designed in such a way that support the organization's core operational visions and mission, as well as its continued innovations in Virtual Care and Total Health.

Organizational Vision

The Kaiser Permanente organization's vision is, "to be trusted partners in total health, collaborating with people to help them thrive and creating communities that are among the healthiest in the society."

Organizational Mission

The mission; "Kaiser Permanente exists to provide high quality, affordable healthcare services to improve the health of our members and the communities we serve."

Organizational Values

i. Patient-Centered Care-the needs of the patient are put before the personal interest of the organization as well as those interest of the serving physician (Schilling et al., 2010). The membership of the patients in the organization is the primary source of operational funds, not any extra tests or services. The foundation of the success of the organization is primarily based on the satisfaction of the patient, loyalty of the patient as well as patient health’s outcomes.

ii. Evidence-based medical practice-continuous medical research is critical in the operations of the Kaiser Permanente since they believe that medicine is neither 100% art nor 100% science; therefore in order to seal existing gaps as well as to ensure proper and sound medical care, Kaiser Permanente Healthcare organization believes in research (Schilling et al., 2010). Due to this evidence-based medical practice, Kaiser Permanente ensures that their patients do not receive medical care that is ineffective due to age, gender, ethnic background, personal medical history or conditions, as well as medical care plans which have not been proven as having any benefits.

iii. Measurement and Accountability- KP does not rely on medical practitioners who would not wish to be measured and held accountable for every decision they make. To ensure patient-centered care, the level of satisfaction must be measured. To deliver evidence-based medical care; screenings, testing, prescriptions among others must be measured. The integrated operational approach also gives the KP management the ability to have easy access to data, which they can use to assess performance in each institution or organ. The leaders of the primary teams take records of quality, safety, wait times among others through their peers; which are then used to assess measurement and accountability.

The Organizations Focus group

The KP healthcare primarily targets citizens of the United States of America with health-care needs. The client may fall into the category of those who want medical coverage for themselves, or medical treatment. Those given medical coverage under the KP membership, receive free medical treatment.

Overview of the Leader-Member Exchange Theory

The leader-member exchange theory (LMX) originates from an article on transformational leadership which was released in the 1970s. Some of the concepts which were captured in the literature are considered to be outdated (Wang, 2005). The leader-member exchange theory is defined by how a leader maintains a working relationship with his or her supporters, those entrusted with specific responsibilities, advisers as well as advisers. A leader must acquire and maintain their leadership roles. For the leader to be able to attain and maintain his or her position, a leader must work closely with associates, advisers, supporters, trusted persons. Another name for the leader-member exchange theory is the Vertical Dyad Linkage Theory.

The word Dyad denotes two. In this case, “two" denotes the leader and other persons whom the leader works with. Linkage defines the connection maintained in the dyad (Wang, 2005). The Vertical Dyad Linkage denotes primarily how a leader regards those around him or her, according to their degree of support to the leader. As time progresses, the supporter of the leader may be given a formal role with much clouts of power; however, the leader-subordinate association is preserved (Wang, 2005). There are three stages of development of the leader-member exchange relationship (Wang, 2005).

i. The organizational stage is the first stage-At this stage an individual rises from a group due to various factors. A task to be accomplished usually exists, and the approaches of handling the task usually vary from anarchy to a single person being in charge of everything. The rising of a person may be attributed to charisma, intelligence or any other admirable quality. In some scenarios, there is no task to be accomplished, but a person becomes naturally attracted to one another; therefore the sense to socialize emergence in pursuit of belonging.

ii. The second stage is role development-Role development originates from various sources, depending on the purpose of the formation of the group. The tasks available usually define roles. Roles can be coined as a mechanism of rewarding favors done to the group leader.

iii. The third stage is the establishment of the leader-led relationship. Specific factors contribute towards the formation of this relationship. It can be solidified by culture, social mores, economy, charisma, enormity among others.

The Leader-Member Exchange Theory and Management of Multidisciplinary Human Service Organizations.

As changes occur in the health policies and programs, which are primarily premised on the desire to control the expenditure as well as to produce sustainable healthcare service programs, the urge to establish a responsible leadership structure has also become apparent (Laschinger et al., 2007). Due to the challenges faced in the social systems, which presents itself in an intricate change pattern, leadership is considered to be one of the primary stepping stones towards ensuring a sound and sustainable social human services; such as in hospitals. A practical application of the leader-member theory, in the provision of multidisciplinary human services, such as in healthcare facilities, should be anchored on patient satisfaction.

Patient satisfaction is a primary factor in determining the quality of services which are being offered in the facility, as an indicator of efficient leadership system (Laschinger et al., 2007). Therefore the desire to achieve client satisfaction, is very critical in the planning and organization of service delivery, in order to align expected results with the needs of the client. Client satisfaction, for instance in healthcare institutions such as the KP, is understood as the extent to which the medical care given to a patient is in line with his or her expectations with regard to quality of care, the environment of service, availability of service, continuity of service, and efficiency of service providers which is reflected on the level of outcome (Laschinger et al., 2007). To this extent, the role of leader-member theory in influencing and guiding the future services in a multidisciplinary human service organization, for instance, the KP institution, with regard to client satisfaction cannot be underrated.

The Leader-Member Exchange Theory and KP

The leader-member exchange theory applies extensively in the Kaiser Permanente healthcare. This is reflected in the pursuant of satisfying its vision and mission, through the initiation of organizational core values of the organization.

The KP healthcare services have measurement and evaluation of services as a mechanism of realizing its goals. This approach is anchored on the basis that those physicians who, in the process of evaluation and measurement of service delivery, prove to be fruitful and competent may be rewarded through being given lucrative and influential positions in connection to the management of the institution (Ramsay et al., 2009).

Similarly, individual employees who are found not to be competent, based on the outcome of service delivery evaluation and measurement may be discontinued from working in the institution. The evaluation and measurement of the service delivery competence are to ensure the degree of service delivery is as per the needs of the client (Ramsay et al., 2009). Client satisfaction is considered a stepping stone in winning the trust of the leader, hence may result in the reward of an individual for producing super services to the client.

Conclusion

The changes in the society and business environment at large is being considered as very critical in the adoption of leadership systems which will result in value system congruence (Schilling et al., 2010). The leader-member exchange theory has been considered to be very useful in cultivating into employees some sense of loyalty, which might lead to the offering of services which are critical in meeting the needs of the client. The client is the most critical asset for any human service organization, both for-profit and non-profit, as the satisfaction of the client will lead to client loyalty and improvement of the organization's reputation.

Reference

Laschinger, H. K. S., Purdy, N., & Almost, J. (2007). The impact of leader-member exchange quality, empowerment, and core self-evaluation on nurse manager's job satisfaction. Journal of Nursing Administration, 37(5), 221-229.

Northouse, P. G. (2016). Leadership: Theory and practice (7th ed.). Thousand Oaks, CA: Sage

Ramsay, A., Fulop, N., & Edwards, N. (2009). The evidence base for vertical integration in health care. Journal of Integrated Care, 17(2), 3-12.

Schilling, L., Chase, A., Kehrli, S., Liu, A. Y., Stiefel, M. M., & Brentari, R. (2010). Kaiser Permanente’s performance improvement system, part 1: from benchmarking to executing on strategic priorities. Joint Commission journal on quality and patient safety, 36(11), 484-498.

Wang, H., Law, K. S., Hackett, R. D., Wang, D., & Chen, Z. X. (2005). Leader-member exchange as a mediator of the relationship between transformational leadership and followers' performance and organizational citizenship behavior. Academy of Management Journal, 48(3), 420-432.