Transactional Leadership Theory Of Medical Error

Medical error is the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim (AHRQ, 2000); whether or not it is evident or harmful to the patient. Medical errors can occur anywhere in the health care system. They can occur in hospitals as well as in outpatient settings.
Hospital medical errors can involve medicines (e.g., wrong drug, wrong dose, bad combination), an inaccurate or incomplete diagnosis, equipment malfunction, surgical mistakes, or laboratory errors. High medical error rates with serious consequences occurs in intensive care units, operating rooms, and emergency departments; but, serious errors that harmed patients may have prevented or minimized. Understand the nature of the error

and how healthcare providers can learn from errors, and consequently improve patient safety.
Medical errors cost the United States $19.5 billion , in 2008 (According to a study conducted by Milliman in 2010). About $17 billion were directly connected with additional medical cost, including: ancillary services, prescription drug services, and inpatient and outpatient care. Additional costs of $1.4 billion were attributed to increased mortality rates; and $1.1 billion to missed work based on short-term disability claims. The report analyzed claims data to extrapolate an estimated 6.3 million medical injuries, believing that, conservatively, 1.5 million medical injuries were preventable errors. Milliman study concluded that the most significant errors were preventable if better policies and practices were followed.
The numbers of medical errors that occur each year have a sturdy negative impact on the hospital’s bottom line.

A report done by the Institute of Medicine (IOM) estimates a cost of approximately $37.6 billion dollars every year associated to medical errors occurring in in-patient settings or hospitals (AHRQ, 2000).
Nurse managers are responsible for nurse performance and retention, and the manager’s leadership style is critical to the achievement of these outcomes (McGuire & Kennerly, 2006). Transformational and Transactional leadership theory are two leadership styles that have attracted the interest of many researchers. An analysis of these two leadership models will identify strengths and weaknesses of both theories in relation to Hospital medical errors.
Borkowski (2015) distinguished between transactional leadership and transformational leadership by explaining that: transactional leadership is directed toward task accomplishment and the maintenance of good relations between the leader and subordinates throw consideration of performance and reward. And, Transformational leadership, contrasting transactional leadership, is directed toward the influence and management of institutional change and innovation through revitalization and

vision.
The transformational leadership style allows for the identification of areas in which change is needed; by inspiring followers and creating a sense of commitment. Transformational leadership has an important relationship with creating a culture of safety, which in turn is associated with the implementation of patient safety initiatives, and ultimately with positive improvements in patient safety outcomes. This target of patient safety can only be met by instilling “a safety culture [which] is a reflection of transformational leadership that embeds the safety priority into the values of all care providers” (Stichler, 2007, para. 23).
The transactional leadership style pay attention to followers' work in order to find faults and deviations. Unlike Transformational leadership, leaders using the transactional approach are not looking to change the future, they are looking to merely keep things the same. Leaders are willing to work within existing systems and negotiate to attain goals of the organization. The transactional leadership style is effective in crisis and emergency situations, as well as when projects need to be carried out in a specific way. Transactional leadership is more practical in nature because of its emphasis on meeting specific targets or objectives (Robbins & Davidhizar, 2007). But, employees can feel that their opinions are not valued and this style can create a climate of fear.
Journal of Nursing Management published a systematic review of the research literature describing the evidence linking leadership with patient outcomes; most studies were conducted in acute care hospitals. Results showed that transformational leadership was associated with reduced medication errors in four of five studies. as well as decreased restraint use and hospital-acquired infections. Transactional leadership style contributed to increased patient satisfaction in acute care settings. Results linking leadership to patient falls and pressure ulcers were mixed.
This mixed result suggests that features of each style may contribute to patient satisfaction such as, communicating clear care standards and performance expectations in addition to promoting positive team working relationships or encouraging staff participation in unit decision making. Transactional leaders provide diverse advantages through their abilities to address small operational details quickly. Transactional leaders handle all the details that come together to build a strong reputation in the marketplace, while maintenance employees productive on the front line.

Conclusion
The health care system is growing and focus on reducing medical errors is one issue that health care administrators deal with. Quality care is not being delivered consistently throughout US hospitals. Poor quality care is costing payers and society a great deal, and health care leaders and professionals need focus on quality and patient safety.
Transformational and Transactional leadership theories have their various strengths and weaknesses. Both leadership styles are needed for guiding an organization to success. A given leader may exhibit varying degrees of both transformational and transactional leadership. Transformational and transactional leadership theories are not mutually exclusive, and some combination of both may enhance effective leadership.