Implementing The Leadership Theory in Geriatric Teams

1
Implementing The Leadership Theory in Geriatric
Teams
For Treating a Patients with Severe Disfiguration

• D. Garfinkel, M.D. ,T. Sinai, J.Ben-Israel, M.D.,
  
• The Shoham Geriatric Medical Center
• ISRAEL

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Leadership Theory (Bass 1982)

• Widely used in industrial organizations, much
  less in medical settings
• Main Concepts
• 1. Group Empowerment
• 2 . Reframing
• 3. Leadership Modeling (personal example)

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The Patient
A 62 year old man with Squamous Cell Carcinoma
(SCC) - a malignant skin cancer. The SCC was
Neglected so that large parts of the face
were destroyed resulting in Severe
Disfiguration. Admited after Suicide
Attempt Moderate- Severe Congestive Heart
Failure Chronic Anemia (Serum Hemoglobin 4.5 g/dL)
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The Task

• Preparing a Multi-Disciplinary Team for a
  deviate procedure
• Overcoming Total Refusal of the Staff to
  Treat a Patient
• Leading a Group Process in the Ward

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METHODS - The Process

• Twelve 3 hour sessions
• with all staff
  members
• Led by the Chief Physician Headnurse,
  Monitored by the Consultant (Psychologist)
• According to the principles concepts of
  Leadership Theory (Group Empowerment, Reframing,
  Leadership Modeling )
• 12 sessions - 8 before, 4 after the patients
  admittance

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METHODS - QUESTIONNAIRE

• The staff filled in Questionnaires at 5 Crucial
  points during the process
• Parameters
• A. Self esteem
• B. Image of hospital
• C. Image of patient
• D. Job ranking
• Factor analyses multiple regression

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Results

• 19 staff members participated in the
• process for 6 months
• A linear positive correlation between
• time and all 4 factors
• Positive ranking of the process was at its
• highest level 4 months after conclusion

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Results
The most significant finding 65 of staff
members changed position towards the patient -
from complete refusal of all contact with the
patient initially, to regarding him as family
or friend 4 months later .
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Conclusions

• Leadership theory models may serve as
  effective tools for preparing multidisciplinary
  teams in long-term care facilities, to cope with
  difficult patients.
• Through a group process, team members can
  significantly improve their attitude towards
  difficult to treat patient, while contributing
  to increase their own self esteem, job ranking
  and image of their institute.