Healthcare Leadership: Leading for Creativity, Innovation, and Performance by Changing Organizational Culture in Healthcare

Jijo Paul, Ph.D., M.Phil., EMBA, M.S.M^1,2

1. Varian, a Siemens Healthineers Company, 3100 Hansen Way, Palo Alto, California 94304, United States.
2. Sutter Health-Tahoe Forest Cancer Center, 540 W. Pueblo Blvd, Suite 1, Grass Valley, California 95945, United States.

OPEN ACCESS

PUBLISHED: 31 October 2024

CITATION: Paul, J. 2024. Healthcare Leadership: Leading for Creativity, Innovation, and Performance by Changing Organizational Culture in Healthcare. Medical Research Archives. 12(10): 1-35. https://doi.org/10.18103/mra.v12i4.5345

COPYRIGHT: © 2025 European Society of Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

DOI: https://doi.org/10.18103/mra.v12i10.5909

ISSN 2375-1924

Keywords: Healthcare leadership, creativity, innovation, organizational culture, performance.

Abstract

Introduction

Healthcare leadership is crucial in predicting organizational creativity and innovation, and many studies demonstrated clear evidence of a relationship between leadership and enhancing workplace creativity and innovation. Numerous organizations depend on creativity and innovations for business success, and good leadership is vital to the success of organizational creative efforts. Transformational leadership is indispensable for creativity and innovation. Leadership practically influences formulation, adoption, implementation, and innovation as the leaders oversee strategic decisions, policy-making, control resources, and motivate project progress; furthermore, a study identified that transformational leadership is positively related to employee engagement, employee mindset, and negative emotions in working, thus undermining creativity and innovation.

Leadership is one of the critical factors that can help organizations to innovate and improve performance. Organizational culture is a significant strategic element that influences creativity, innovation, and performance in strengthening the organization as a whole. This study aims to investigate and understand the role of healthcare leadership in creativity, innovation, and organizational performance. The study also highlights the importance of organizational culture in shaping the environment for creativity and innovation.

1) LEADING FOR CREATIVITY AND INNOVATION IN HEALTHCARE

The primary objective of healthcare leadership is to create a new or redesigned approach to a current/impacting problem or project. Innovative meetings focus on creative ideas, designing/redesigning products, or developing new healthcare business/service opportunities. A previous publication explores different types of innovations, including incremental and radical.

The innovation session offers opportunities to work collaboratively with the team, generate ideas, allow everyone to participate, and reflect on the process. A reflection process involves a systematic review of ideas generated during the innovation sessions, allowing for further exploration and refinement of ideas.

Most organizations focus on creating new products in innovative efforts; however, they often find that their resources are inadequate. Innovative leaders should encourage team members to think creatively and provide constructive feedback to the team members and create a continuous partnership with the team to maintain the employees’ psychological safety. The team should be rewarded with innovative ideas, encouraged to work flexibly, and free to take creative ideas forward responsibly. A balanced scorecard is helpful for healthcare organizations, but many organizations fail to implement it effectively.

2. SELECTING SUITABLE PERFORMANCE MEASURES FOR ORGANIZATIONS

a) Objectives and measures in organizations
Objectives are a balance of measures (balanced scorecard) drawn from all four perspectives: financial, customer, internal processes, and learning and growth.

PowerPoint program can be used to create these financial, customer, internal learning, and growth perspectives. The strategy map shows areas of alignment with the hospital’s goals. The balanced scorecard framework would provide the best opportunity to accomplish new objectives by aligning the organization to the new strategy. The next step was to develop a set of process and performance measures, and revisions were made to the scorecard, which provided a more accurate performance summary. Following the original scorecard’s development, the department initiates developing strategies through a cascading process.

Suppose the department’s objective is maximizing financial performance and reducing operating expenses by increasing revenue based on accepted principles. Objectives should include internal processes, objectives like increasing patient satisfaction, and learning and growth objectives.

b) Align Scorecard
The strategy map shows how areas of alignment with the objectives, which display an interconnection between the objectives, each provides a cause-effect relationship.

c) Create a strategy
The strategy directly addresses the causal links that exist between the objectives; each objective has a single cause and one objective. A simple strategy map based on financial, customer, internal learning, and growth perspectives.

3. MEASURING AND TRACKING PERFORMANCE

Establishing timelines for goals is a significant step toward tracking progress. The department should establish key performance indicators (KPIs) to measure the success of initiatives. Continuous tracking of goal progress is an excellent method to motivate a team; even a tiny win motivates the entire team. They shared the organization’s vision with the team before beginning a tracking process. Define and set clear goals and ensure all team members know what they must do and the expectations must be met.

PowerPoint program can be used to create these objectives causal links to create a strategy map.
financial, customer, internal learning, and growth perspectives.
Figure 1 shows a simple strategy map based on

Figure 1: display drawing of a simple strategy map based on financial, customer, internal, and learning and growth perspectives.

d) Align Scorecard

The strategy map shows key areas of alignment with other units, which display unit interactions with others internally. For example, institution management may treat finance objectives separately for each department. In this case, no cause-effect relationship exists for financial objectives with other departments. However, the other three groups have a cause-effect relationship for the customer, internal process, and learning and growth perspective. The customer care perspective indeed leads in organizations more than learning and growth. If the corresponding objectives in the other units fall into the same BSC perspective, the other units’ customer and learning and growth perspectives fall into. Both customer and learning perspectives are increasing awareness of departmental quality/services and improving patient satisfaction. The learning and growth perspective enhances employee awareness of present best practices in medicine and employee safety. Larger organizations may detect some misalignment and try to balance the scorecard factors equally for all four perspectives; however, this BSC may lack some due to the absence of proper attention.

e) Performance reporting in the organization
The completed scorecard report outlines the organization’s broad goals and guidelines, and these goals are provided to the department’s chief so that the efforts and resources are directed to the exact needs. The goal policies and limitations should be discussed in the departmental meetings, and a balanced scorecard should be generated. The document should be supplied to the department manager once the board of directors has finalized goals and constraints, expecting to align the department to the new strategy. The balanced scorecard framework chooses to operationalize the departmental goal policies and align the resources appropriately to achieve those goals. The departmental staff members conducted several internal strategy meetings to develop an initial set of operational and strategic objectives that aligned with the hospital’s goal policies. The balanced scorecard framework would provide the best opportunity to accomplish new objectives by aligning the organization to the new strategy. The next step was to develop a set of process and performance measures, and revisions were made to the scorecard, which provided a more accurate performance summary. Following the original scorecard’s development, the department initiates developing strategies through a cascading process.Suppose the department’s objective is maximizing financial performance and reducing operating expenses by introducing new initiatives, and its performance can be measured using revenue from patient treatments and general operating expenses based on accepted principles. Based on the customer perspective, objectives like increasing awareness of departmental quality and improving patient satisfaction can be measured using a satisfaction survey. According to the internal process perspective, objectives like resource efficiency or improved patient satisfaction can be calculated using increased volunteer productivity work time and average patient waiting time for treatment. Regarding learning and growth objectives, increased employee awareness of current best practices in medicine and safety parameters can be measured using a survey score or a test to find the percentage of employees who encountered safety issues. A balanced scorecard often includes a section dedicated to listing, describing, and sourcing the measures used. This is an excellent time to compare changes in measurement since the last report and further discuss the limitations of the measures. Suppose the department aims to boost financial performance by reducing operating expenses by introducing new expense-saving initiatives. The performance can be measured using revenue from the patient treatments and the general operating costs based on the accepted principles.

f) Recommendations
Ideally, the balance of measures drawn from all four perspectives (financial, customer, internal processes, and learning and growth) should be equal (weighted 25% each). However, some imbalance is noted in the scorecard (financial and customer), and these perspectives show a higher weightage than other parameters (internal process and learning and growth). The decisions related to additional continuing education, hands-on training, and the facility to access new journals, departmental presentations, vendor presentations, etc., would benefit the working staff. The reported relative imbalance influences employees’ work efficiency to a certain extent, primarily because the department uses high-end technologies to treat patients. It is imperative to keep up-to-date knowledge in healthcare to benefit patients and maintain diagnostic and treatment quality²⁹; the lack of education and training negatively impacts treatment effectiveness. To tackle the imbalance in measures, the department can implement machine/software vendors to increase their engagement through various educational activities, including hands-on training. To resolve internal issues, departments can hold departmental meetings to seek ways to improve internal processes. Collaborating with universities to develop academic activities and access specialty journals for employees would go a long way.

3. DIAGNOSING ORGANIZATIONAL CULTURE AND EMPLOYEE SATISFACTION.

a) Diagnosing organizational culture
The easy way to diagnose organizational culture is to conduct an employee satisfaction survey by gathering responses from the working staff³⁰. A survey can reveal plenty of information about the department and institution, and all members will agree that the quality of work in the department is of utmost importance, leading to greater patient satisfaction³¹. The organization should fully or partially allow its employees to set goals and implement activities. Many organizations are too busy to provide updated mission, vision, values, and goals to stakeholders; the supervisors pay special attention to do this to develop a better organizational culture. Leaders should provide frequent updates about the organization’s mission, vision, and goals³². The survey directly reflects the inner mind of the organization and the organizational culture.

Team members are critical to any organization’s success³³; high-level frequent communication, the opportunity to express member feelings, praise and recognition, and active goal-setting involvement are essential. The present survey information can be compared to the previous surveys to determine improvements or declines since the last survey. The group-level differences can be analyzed, which helps data comparison in various demographics within the organization. This analysis can help to understand unique employee perceptions across departments to target collective efforts better. It is possible to present findings to the leadership team to initiate discussions on takeaways, areas of focus, and potential action plans. Share relevant insights and other statistics with employees to demonstrate that their feedback has been heard. Survey results and analyses can be open to the team members, and they can provide additional insights into the results. Special focus groups with employees can discuss survey results, hindered issues, insights, and actionable steps. Create employee engagement action plans at both the organizational and the team levels³⁴; first, focus on the main areas to work on as an organization and then utilize those broader goals to guide managers at the team level. The plan should include action items, assignments, and timelines. Communicate the current and foreseeable changes based on the survey to the employees regularly, and further continue communications with employees regarding various actions implemented throughout the year.

A competing value map is generated and shown in Figure 2. It can be used to detect the present position of the teams and can be identified as the team located in the human relations model region. This human relations quadrant emphasizes flexibility, internal focus, morale, cohesion, and human resource development as criteria for effectiveness. The organization thrives in this communication, and strong, nurturing relationships with tight social networks. Discussing the extent of present culture relates to the organization’s vision and values and the institutional business strategies; moreover, the leadership should behave consistently and effectively with values. A great culture begins with a good vision and mission statement³⁵; these simple statements guide the values of an organization and provide objectives. These objectives properly align with every employee’s decision. The vision statement is a simple but foundational element of the culture, and the values of an organization are at the core of its culture. The initial step in creating organizational culture is to formulate its mission and vision statements and determine the values that the employees need to hold. Leaders are responsible for identifying the organization’s cultural vision and giving the organization the right direction. Culture comes directly from the behavior of the leaders³⁴; they communicate the culture to the stakeholders involved and inspire the whole organization. The vision statement demonstrates the organization’s future position, which can be utilized to formulate internal decision-making. This statement describes what the organization hopes to achieve and engages the stakeholders to make them more productive³⁷. A few points help the process a little more accessible by examining the vision, defining the mission, and evaluating values. The business strategies and organizational behavior should be consistent with the cultural values.

Figure 2: shows a complete view map that can be used to detect the team’s position, and it can be found as the team is in the Balanced Scorecard.

 

b) Align strategy and culture

A defined goal is the cornerstone of any organization, and the leaders try to work hard toward achieving it³⁸; for example, in building a skilled workforce to provide high-quality medical care to cancer patients, the leaders recruit physicians, nurses, therapists, medical physicists, front desk, administrators, and managers into the department. The providers need accurate information about how to provide care for a person with cancer, which includes the benefits of early diagnosis, addressing the physical, cognitive, emotional, and behavioral symptoms of the disease, and supporting caregivers as they cope with the physical and emotional aspects of their caregiving responsibilities. Enhanced specialist training is undoubtedly needed to prepare them to face unique challenges from cancer patients³⁹. Goal setting is significant, and there are many benefits to setting goals. A specified goal provides a clear focus and direction to help identify whether the team is on the right track. If the leaders set a time to complete tasks, employees can alter their pace accordingly to get it done. Setting goals provides the most straightforward way to measure the organization’s success⁴⁰, and the goal should be well aligned with the institutional mission, vision, and values. Goals and objectives are the building blocks of achieving the institution’s mission and vision.

Prioritizing a clear, concise communication pathway is one of the most critical strategies for organizations to achieve their goals⁴¹,⁴². The ideas expressed by the employees should be listened to, and they should be encouraged to share their knowledge and information during the formulation, implementation, and evaluation stages. This approach would create secure communication between leaders and team members and help to confirm they are all on the same page with the same goal and vision. Continuous employee engagement by holding departmental meetings is essential to achieving the formulated goals in an organizational strategy.

to reach its mission, vision, and goals. Maintaining transparency about successes and failures is significant and helps employees to be more engaged and productive⁴². Conducting a survey related to the department’s mission and vision helps the employees realize their vision and understand how they play a vital role in it. Leaders should explain the organization’s mission and goals and their alignment with the vision since some employees may lean towards one aspect of the vision. Try to get feedback from the team members explaining what went wrong, which may be due to the vision not being challenging enough or too demanding. The stakeholders should feel their work has a purpose, and the leaders should meet them regularly, setting up goals relevant to the employees and discussing the goals that align with the department’s vision. Therefore, employees feel more meaningful and will be more engaged in achieving those goals. Success will come once everybody is on the same page and headed toward it.

A timely imaging service and healthcare staff to get accurate disease diagnosis and treatment, is vital for any healthcare organization. Several patients with cancers are undiagnosed in time until their symptoms have become severe. A timely disease diagnosis is critical for patient management and leads to curative and positive outcomes⁴³. The inability to access proper diagnosis and treatment due to the lack of insurance or limited finances is a significant concern for many patients. Early cancer detection is crucial for positive treatment outcomes, especially when this is true for younger patients with positive diseases. The healthcare organization needs modern devices with expert staff to ensure timely and accurate diagnoses⁴⁴,⁴⁵.

c) Track cultural goals

Cultural goal implementation consists of several actions, including facilitating specific training for care professionals to strengthen the workforce and provide high-quality care to cancer patients⁴⁶,⁴⁷. Educating and training healthcare staff by delivering several grants specifically budgeted for cancer education and training activities would go a long way. The department should continue educating clinical staff on recent research findings and clinical practice tools for assessment, diagnosis, and management. Develop unified medical care nationally using a standard curriculum designed for the workforce to develop further skills to provide high-quality patient care, ensure timely and accurate diagnosis, and follow high-quality cancer care guidelines and measures. Develop resources for integrated care with partners and providers⁴⁸; they can offer numerous webinars to support professionals and caregivers focusing on cancer. The organization should provide professionals with full access to the latest research articles to maximize patient benefits. Collaborating with other cancer organizations, the department can develop scholar programs to assist graduate-level students⁴⁹. Staff can participate in the institution’s various educational, partnership, and research activities to improve knowledge.

A full-time social worker service within the institution can help patients to get their full benefits. Providing access to educational resources for care staff, decision support mechanisms, and initiating chart rounds in the department help ensure every patient receives standard care from the institution. Facilitating a decision support mechanism for clinicians using computer-based systems would be beneficial. Providing interdisciplinary team training for recognizing, assessing, and managing cancer would go a long way. Revising wage standards is another option⁵⁰. Low wages have been identified as problematic for long-term care providers in recruiting and retaining institutional employees, potentially reducing care quality. Establishing and implementing timelines for specific objectives are paramount in achieving goals.

The team follows some basic steps to gain proper alignment with goals, such as setting up intelligent goals, creating a timeline, measuring progress, implementing action, providing support, recognizing hard work, and encouraging development⁵¹. Regular monitoring according to a predetermined schedule is necessary to track progress accurately. Goal tracking enables the department to align all

employees to work towards the same goal so that everyone can contribute to the project for growth and improvement⁴⁰,⁵². Several benefits are noted, such as clarity of purpose, greater unity, increased productivity, fewer mistakes, improved proficiency, more opportunities for future projects, better chance of meeting budget targets, and increased satisfaction. Continuous tracking of goal progress is an excellent method to motivate a team; even a tiny win motivates the entire team. They shared the organization’s vision with the team before beginning a tracking process. Define and set clear goals and ensure all team members know what they must do and the expectations they must meet. Breaking down goals into smaller steps supports employees and managers in staying on track and helps team members to meet the key results, as well as the team to measure progress towards a goal.

The next step is developing milestones to accomplish the achievable organizational goals⁵³. Leaders can set up incremental accomplishments that help team members focus on the subsequent best actions they must tackle. Apply metrics to milestones by framing reliable metrics to support tracking progress toward goals. Key results sometimes include a key performance indicator or a metric. A measurable indicator is required to determine milestones, and creating checkpoints supports checking how the team works towards the goal. The checkpoints support reminding a pause, assessing the team’s progress, and celebrating any milestones reached. Checkpoints are the time to analyze and evaluate progress goals according to the plan or any required corrective actions.

Incorporating software and tools allows the team members, project leaders, and stakeholders to monitor the collective efforts toward organizational goals easily⁵³. All leaders know the importance of setting goals in an organization, but monitoring progress is an entirely different process. Tracking goals using milestones and other metrics is essential for the team members to remain motivated during the process, reach the finish line, and celebrate accomplishments. Numerous methods can be used to track project milestones, including paper, email, online management systems, software, etc. Online management systems properly track the critical milestones of the projects, and this system allows tracking of the work progress of the team members and their communications. In addition, everyone can watch the teammates’ progress to ensure they are all meeting their individual goals. Goal reports help clarify the organization’s vision for growth and writing a business report is best achieved when the goals are outlined in an intelligent format. The goals should be specific, measurable, attainable, realistic, and time-bound⁵¹. The goals report consists of a degree of measurability to the progress of goals that supports the organization’s efforts toward meeting them. The goals should be achievable, provide parameters with basic questions, and be realistic; moreover, they should be assessed for effectiveness and progress. Created goals should be realistic; goals do not require financial sanctions. Take an honest look at the company, then craft the goals based on where the organization wants to go, given its limitations. Open communication with employees and stakeholders can help formulate a precise and realistic picture, and a timetable should be included when writing a department goals report. The timetable can provide deadlines to meet the goals and help to push the team to achieve the goals; moreover, the timing should be more straightforward and realistic.

Conclusion

Innovation sessions in healthcare provide novel opportunities and redesigned approaches to problems by inviting team members to participate in brainstorming sessions to identify opportunities for innovation. Innovation requires a more comprehensive approach to organizational growth for market innovation and business expansion, moving beyond new products and services. Innovations encourage divergent thinking within the team, and the leaders should support the

diverse thinking processes for future innovations. Innovations depend on psychological safety, which depends on the leader’s language, tonality, and approach to discussions. Leaders try to provide constructive feedback to the team members and create a continuous partnership with the team to maintain the employees’ psychological safety. The team should be rewarded with innovative ideas, encouraged to work flexibly, and free to take creative ideas forward responsibly. A balanced scorecard is helpful for healthcare organizations, but many rely heavily on measures of one type at the expense of the other. Organizational performance reporting for goal policies with management limitations should be developed using a balanced scorecard method, and the document should be provided to the managers once the goals are finalized, with the expectation of aligning the team with the new strategy.

Conducting an employee satisfaction survey in the organizational culture, and a survey can reveal in-depth institutional information and improvements. The survey reflects the inner mind of the organization and the organizational culture, and the team members are critical for its success. The survey results are discussed in the group with other managers to determine hindered issues, insights, and actionable steps; moreover, employee engagement action plans can be created by focusing on predetermined goals. Excellent communication is necessary for various actions implemented annually; consistent leadership behavior with institutional strategies and values is essential. A great culture begins with an organizational vision and mission statements; these simple statements guide leaders by providing objectives and values. The goal should be aligned well with the institutional building blocks of the mission, vision, and values, and the stakeholders are on the same page with the same goal and vision. Transparency in the success and failures of an institution helps employees be more engaged and productive. Organizational culture improved department, decision support tools, or revised wage standards for long-term care providers. Establishing timelines for goals is a significant step to managing and achieving goals on time, and regular monitoring is required to track progress. Goal tracking enables the department to align every employee working toward the same goal, motivating the team. Develop milestones to accomplish overarching goals and apply metrics to milestones by framing reliable metrics to support tracking the progress toward goals. Key results sometimes include a key performance indicator or a metric, creating checkpoints to support checking a team’s progress toward a goal. The collective efforts toward organizational goals can be monitored using software tools; tracking goals using milestones and other metrics is essential for the team members to remain motivated. Goal reports help the organization’s vision for growth and expansion and formulating a business report is best achieved when the goals are outlined in an intelligent format. Organizational goals should be realistic, specific, precise, measurable, attainable, and time-bound to be implemented effectively. The healthcare organizational culture is a complex, multi-dimensional concept with no existing generalized assessment method; however, maintaining workplace culture is essential to produce creativity and innovation for brighter organizational performance.

Conflict of Interest:None.

Funding Statement: None.

Acknowledgements:None.

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