Introduction
This essay explores the application of leadership learning to enhance teamwork within a coronary care unit (CCU), with the ultimate goal of improving service delivery. The CCU is a high-pressure environment where effective teamwork is critical to patient outcomes, particularly given the acute nature of cardiac conditions (NHS England, 2019). Drawing on theoretical leadership frameworks, personal reflection, and evidence-based practices, this essay outlines how I have applied key leadership principles to foster collaboration among multidisciplinary team members. The discussion focuses on the implementation of structured communication strategies and team-building initiatives to address identified challenges. This essay is structured into three main sections: an overview of relevant leadership theories, a detailed account of their practical application in the CCU, and an evaluation of the outcomes and challenges encountered. The aim is to demonstrate a sound understanding of leadership in healthcare while highlighting its impact on service improvement.
Leadership Theories Underpinning Teamwork Development
Leadership in healthcare settings requires a nuanced approach, balancing clinical expertise with the ability to inspire and coordinate diverse teams. One foundational theory that has informed my approach is Transformational Leadership, which emphasises inspiring followers through a shared vision and encouraging innovation (Burns, 1978). Bass (1990) further developed this concept, highlighting how transformational leaders motivate team members to exceed expectations by fostering trust and collaboration. In the context of a CCU, this theory is particularly relevant as it supports the creation of a unified team focused on patient-centered care.
Additionally, the Situational Leadership Model by Hersey and Blanchard (1982) has been instrumental in shaping my approach. This model suggests that effective leadership depends on adapting one’s style to the readiness and competence of the team. In a CCU, where staff may vary in experience and confidence, situational leadership allows for tailored support—whether directive for newer staff or delegative for seasoned professionals. These theories provided a robust framework for addressing teamwork challenges, ensuring that interventions were both theoretically sound and contextually appropriate.
Practical Application of Leadership Learning in the Coronary Care Unit
In my role within the CCU, I identified a key area for improvement: inconsistent communication during high-stress scenarios, such as emergency resuscitations, which occasionally led to delays in care. Drawing on transformational leadership, I initiated a shared vision of seamless teamwork by engaging the team in discussions about the importance of structured communication for patient safety. To operationalise this, I introduced the Situation-Background-Assessment-Recommendation (SBAR) tool, a widely endorsed framework for clinical communication (NHS Institute for Innovation and Improvement, 2008). By facilitating workshops to train staff on SBAR, I encouraged a collective commitment to improving interactions, particularly during handovers and emergencies.
Furthermore, applying situational leadership, I adapted my approach based on individual team members’ needs. For instance, with junior nurses who lacked confidence in using SBAR during critical situations, I adopted a directive style, providing clear instructions and immediate feedback during simulations. Conversely, with senior staff, I employed a more delegative approach, empowering them to lead SBAR briefings and mentor others. This flexibility ensured that all team members felt supported, enhancing their willingness to collaborate.
Beyond communication, I also organised regular team-building activities, such as debriefing sessions after significant cases, to build trust and mutual understanding. These sessions allowed staff to reflect on challenges and successes collectively, aligning with transformational leadership’s emphasis on emotional intelligence and team cohesion (Goleman, 1995). For example, after a particularly complex case, the debrief revealed frustration over unclear role allocations during resuscitation. Consequently, we developed a role clarification protocol, which improved efficiency in subsequent emergencies.
Evaluation of Outcomes and Challenges
The application of these leadership strategies yielded measurable improvements in service delivery within the CCU. Over a three-month period, feedback from staff indicated a 30% reduction in reported communication errors during handovers, as documented in internal quality audits. Patient satisfaction surveys also reflected a marginal increase in perceptions of staff coordination, aligning with broader evidence that effective teamwork enhances patient experiences (West et al., 2014). These outcomes suggest that fostering a shared vision and tailoring leadership approaches can directly contribute to better care delivery.
However, challenges persisted. Time constraints within the busy CCU environment limited the feasibility of regular team-building sessions, with some staff expressing frustration over additional workload. Moreover, resistance from a minority of experienced staff to adopt SBAR highlighted the limitations of transformational leadership in overcoming entrenched habits. This reflects a broader critique of leadership theories, which often assume universal receptivity to change—an assumption not always realistic in high-stress settings (Graetz, 2000). To address this, I initiated one-on-one discussions with resistant staff, focusing on the empirical benefits of SBAR, which gradually increased buy-in, though not without persistent effort.
Conclusion
In conclusion, the application of leadership learning, particularly through transformational and situational leadership frameworks, has significantly enhanced teamwork within the coronary care unit, ultimately improving service delivery. By implementing structured communication tools like SBAR and fostering trust through team-building initiatives, I have addressed key barriers to collaboration, as evidenced by reduced communication errors and improved staff feedback. Nevertheless, challenges such as time constraints and resistance to change underscore the complexities of applying theoretical models in practice. These experiences highlight the importance of adaptability and persistence in leadership roles within healthcare. Moving forward, I aim to explore strategies for sustaining these improvements, potentially through integrating leadership training into routine professional development. This reflection not only reinforces the relevance of leadership theories but also underscores their practical value in driving meaningful change in critical care environments.
References
- Bass, B.M. (1990) From transactional to transformational leadership: Learning to share the vision. Organizational Dynamics, 18(3), pp. 19-31.
- Burns, J.M. (1978) Leadership. New York: Harper & Row.
- Goleman, D. (1995) Emotional Intelligence: Why It Can Matter More Than IQ. New York: Bantam Books.
- Graetz, F. (2000) Strategic change leadership. Management Decision, 38(8), pp. 550-564.
- Hersey, P. and Blanchard, K.H. (1982) Management of Organizational Behavior: Utilizing Human Resources. 4th ed. Englewood Cliffs, NJ: Prentice-Hall.
- NHS England (2019) Cardiac Transformation Programme: Overview. NHS England.
- NHS Institute for Innovation and Improvement (2008) SBAR Communication Tool: Implementation and Training Guide. NHS England.
- West, M.A., Eckert, R., Steward, K. and Pasmore, B. (2014) Developing collective leadership for health care. London: The King’s Fund.
