Using transformational leadership to improve job satisfaction and empowerment

Eli Larson Pewaukee Veterinary Service, N29W23950 Schuett Dr, Pewaukee, WI 53072.

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Small business owners use a variety of leadership styles. In veterinary clinics, the most common styles are reportedly either autocratic or paternalistic.1 However, these leadership styles can prevent staff members from working in a truly collaborative manner, limiting their effectiveness, causing them to become demotivated, and resulting in decreased job satisfaction and performance.2 Decreased job satisfaction and job performance, in turn, can adversely affect patient care, client satisfaction, client perception of value, and business revenues.

Transformational leadership, in contrast, is a leadership style that focuses on the motives and needs of employees3 and seeks to emphasize employee empowerment, thereby improving job satisfaction, job effectiveness, and, ultimately, patient and client care. The concept of transformational leadership was first developed in the mid to late 1970s, and the approach is based on the idea that focusing on employee motivation will help leaders better guide employees toward the company's stated goals.

In contrast to the transformational leadership style are the transactional leadership and pseudotransformational leadership styles. The transactional leadership style focuses on providing rewards for appropriate employee behavior and punishments for inappropriate behavior. It is similar to the paternalistic style of leadership common in veterinary medicine.1,4

The pseudotransformational leadership style, similar to the transformational leadership style, focuses on the connection between leaders and employees. However, rather than focusing on employee needs, pseudotransformational leaders tend to be self-consumed, exploitive, and power oriented and tend to focus on their own interests, rather than the interests of their employees.3 Such a style is similar in some ways to the autocratic style of leadership.

With the transformational leadership style, leaders are attentive to the needs of employees, are aware of how employees are motivated, and use this knowledge to help employees reach their true potential while achieving the company's goals. Transformational leaders act as role models, articulate their goals, communicate high expectations to their staff, and focus on task-relevant motives.3 They are able to help employees transcend their own self-interests for the sake of the team, while still providing individualized consideration in a supportive climate so that employees’ needs are heard. In essence, transformational leaders act as coaches and advisers to help their employees achieve their best.

By contrast, transactional leaders don't individualize the needs of their employees and offer rewards contingent on employees accomplishing goals set by the leader. This exchange process acts as a motivator, but does little to foster a feeling of team commitment, doesn't encourage employees to rise above their own self-interest to promote the values of the company, and instead encourages a sense of “what is in it for me?” among employees. Transactional leaders may also manage by exception, focusing on corrective criticism, negative feedback, and negative reinforcement. That is, they don't reward appropriate actions, but punish mistakes.

Veterinarians who own veterinary practices often lead with no formal business or leadership training. In general, health-care professionals tend to be intelligent, caring, inquisitive, and sensitive, but they can also be competitive, obsessive, perfectionist, and compulsive,5 and veterinarians are commonly introverts. Thus, veterinarians may not necessarily be well suited for the role of business owner.

Veterinary practice owners will often focus on the interests of the business or its patients and clients, rather than focusing on the interests of staff members, and this may lead to an autocratic or paternalistic leadership style.1 The autocratic leader “exerts a high level of control and team members are given few or no opportunities to make suggestions”4; the paternalistic leader “is viewed as a parent and treats others as his/her children.”1 Alternatively, some owners may adopt a laissez-faire approach “by abdicating responsibility, delaying decisions, offering no feedback, and making little effort to help followers satisfy their needs.”3

Such leadership styles may lead to feelings of a lack of empowerment, low job satisfaction, and a lack of motivation. Most veterinary staff members are strongly committed to their patients and are willing to suffer poor leadership to help those patients. Despite this, poor leadership can eventually lead to poor job performance and high turnover. The American Animal Hospital Association, for example, has reported the annual turnover rate of staff at veterinary practices in the United States to be as high as 30%.6

Poor leadership can lead to burnout, compassion fatigue, and job dissatisfaction among employees.6–8 Working under the stress of a busy medical practice, owners may display anger in response to mistakes or perceptions of incompetence, further dampening motivation and team performance.9 The resulting emotional stress, along with the stress of dealing with emotional clients and severely ill patients, takes a toll on staff members’ well-being. When leaders do not support their staff members, job satisfaction ratings go down, job effectiveness goes down, and burnout and compassion fatigue go up.

Staff members experiencing burnout have a feeling of extreme “exhaustion of physical or emotional strength as a result of prolonged stress or frustration … Those experiencing burnout feel empty, hopeless, and emotionally detached.”8 Contributing factors to burnout include employee conflict, lack of control over work schedule, and lack of positive feedback from peers, leaders, or clients. Burnout typically is associated with stress in the work environment7 and can cause employees to leave the organization. Compassion fatigue is associated with the relationship between health professionals and patients or clients and may lead staff members to leave the profession entirely.

Staff members with low job satisfaction will have a direct effect on client satisfaction.10 It is, therefore, in a veterinary clinic's best interest to improve job satisfaction. One way to do this is by adopting a transformational leadership style.

Veterinary clinics often adopt a health-care team approach. At the author's clinic, there are three well-defined teams of individuals. The client service team focuses on reception duties, the technical team focuses on patient care, and the kennel team focuses on duties related to the boarding facility. Leaders of team-based businesses must lead and motivate not just individuals but also teams, and team outcomes must be recognized along with individual outcomes. A transformational leadership style has been shown to improve team-focused behaviors and team performance.11 In a team environment, employee job satisfaction and psychological well-being are enhanced by “establishing a sense of being in control as an individual [and] as being part of a competent group.”12

One way veterinary clinics could use transformational leadership principles to improve job satisfaction is by creating a sense of empowerment among employees. Employee empowerment is associated with improvements in job satisfaction,6,13–15 especially when a team-based approach is used. This has been shown to indirectly influence customer satisfaction.13

Empowerment involves delegating authority or responsibility from leaders to employees. Staff members are given a sense of control over their own work and allowed to take an active role in determining how they will satisfy their job requirements.16 Beyond providing individual staff members a sense of empowerment, however, it is also important to foster a perception of team empowerment. This is accomplished when team members hold a collective belief among themselves that they have the “authority to control their proximal work environment and are responsible for their team's functioning.”13

Once a leader has an understanding of an individual staff member's knowledge base and level of confidence, then working toward empowering that staff member becomes possible. This should be accomplished slowly so as not to overwhelm the employee with too much authority too early. As Roberson17 points out, “Empowerment is not a gift … [it] must be earned through hard work, a deep understanding of the organizational capabilities and strategy, and a passion for the customer's long-term wellbeing.” Employees often desire empowerment long before they are ready, but providing empowerment too early may set staff members up for failure, resulting in a decrease in job satisfaction.12

Leaders have a responsibility to understand when to offer empowerment and to coach staff members toward successful use of that empowerment. It is important that when empowerment is offered, it is not offered without rules,17 and if mistakes are made, then leaders will need to focus on their own failings and work on improving staff members to encourage a more acceptable outcome.

To set up staff members for successful empowerment, the leader should set performance policies that share information, provide training opportunities, and include a participative leadership approach.15,16 The first step is ensuring that policies are in place to support staff members and provide a sense of consistency. Additionally, training should be pursued so employees are given a sense of confidence that they have the knowledge necessary to accomplish the task. To offer a perception of empowerment, it is important that staff members have a sense of being able to participate in some of the decision-making processes within the organization. Staff members should feel that their voices are heard and that they are empowered to comment on organizational policies.

Not all staff members will request or desire to have this empowerment. Some will be more advanced and more skilled at it than others. Thus, leaders must understand their followers to allow for proper empowerment. Roberson17 cautions that offering too much empowerment too quickly will have detrimental effects on the organization. Truly and fully empowered employees are the top performers. They commonly are staff members who have a true dedication to the organization and strive to put the needs of the organization over their own. Transformational leadership qualities will naturally encourage empowerment. When many members of a team feel empowered to the point that the team feels it is in control of its own environment, then overall client satisfaction will improve along with patient care because the team will have greater overall effectiveness.13–16

The relationship between transformational leadership and job satisfaction is clear and proven.12 By using aspects of transformational leadership such as individualized consideration, motivation, stimulation, and influence, transformational leaders help to develop teams. When members of the team feel individually appreciated, there will be an overall feeling of team satisfaction. There is a direct association between a sense of team efficacy and self-efficacy in the health-care setting. In other words, when the team feels that it is capable of accomplishing a task, individuals within that team also report a sense of ability. The transformational leader should challenge, coach, and encourage teams to perform by having high expectations of what each team can accomplish. Then the leader should celebrate those accomplishments with the team and encourage the individual members to rise above their own self-interest. This dramatically improves overall job satisfaction and well-being.12

To improve staff satisfaction and motivation, it is also important for team members to have substantial trust in their leaders.11 Encouraging and nurturing trust among team members is important because trusting relationships create improved perceptions of the leadership and increased job satisfaction.11 Individuals with a higher level of trust in their leaders report higher job satisfaction. Trust between followers and leaders can be established through an open climate for discussion and exchange as part of the clinic's culture. An empowered team will only occur if team members trust each other, trust their own efficacy, have open discussions, and trust that their leader will support them.

Transformational leaders need to understand how perceptions of their emotions have the ability to affect employees’ feelings. Leaders with high emotional intelligence understand and regulate their emotions to accomplish their goals and stimulate growth in others.2 With transformational leadership, the leader supports staff members not only intellectually, but also emotionally. To facilitate successful change, the emotional motivation of staff members must be tapped; otherwise, changes will fail.18 Successful transformational leaders tend to have higher emotional intelligence, which directly impacts staff job satisfaction.

Leaders of veterinary clinics should pay particular attention to how their emotions are perceived by staff members. Veterinarians are, in general, compassionate individuals, but they may encounter many emotions throughout the day and may face additional stress related to running a business. It is not uncommon for stress and frustration to manifest as angry outbursts toward staff members, especially in clinics with leadership styles leaning toward autocratic or paternalistic approaches. Such angry outbursts will have a detrimental effect on motivation and team performance.9 This is especially true if the clinic has taken pains to hire staff members who have high agreeability factors.

As an example of how transformational leadership can impact a companion animal veterinary practice, consider heartworm prevention. Every staff member should feel comfortable with the topic of heartworm prevention, as a result of training on the disease process and prevention approaches, and should feel empowered to discuss heartworm prevention with clients through the adoption of strong and simple policies explaining the clinic's preferred approach. The leader should set specific goals for staff members concerning their knowledge base and sales of heartworm preventative. These goals should then be used to coach and encourage staff members. By placing trust in the ability of individuals and the team to accomplish client education along with sales of heartworm preventative, the leader will establish a perception of trust within the team. If mistakes are made or goals are not met, emotional outbursts should be avoided. Rather, these failures should be viewed as opportunities to challenge the team and the process. If changes are to be made, those changes should be discussed with staff members, and staff members should be given an opportunity to comment on those changes.

Through empowerment, trust, a feeling of efficacy, coaching, and positive emotion, staff members will be able to fully develop their abilities. They will be confident in their ability to discuss heartworm prevention (or any other important component of the business) with clients, colleagues, and leaders. This will improve their overall job satisfaction and psychological well-being. They will look beyond their own self-interest and toward the interests of the organization, clients, and patients.

Many aspects of team performance, such as heartworm prevention sales, can be measured. A baseline can be taken, new tactics can be implemented, and sales can be measured over time. This would be a directly quantifiable aspect of team efficacy. Another measurement tool for the leader who wishes to improve staff satisfaction is surveys. In particular, the Multifactor Leadership Questionnaire can be used to assess the leader's viewpoint before and after transformational leadership training has occurred. Surveys among staff members with regard to job satisfaction may also be helpful, but could become tedious.

Other measurable data to assess team satisfaction may include turnover rate, days of missed work, frequency of late arrivals, and frequency of disciplinary problems. It is expected that with a higher perception of empowerment and job satisfaction, individual and team performance will improve. Team performance may be measured by assessing patient care parameters, direct sales of recommended products, and client satisfaction (as measured via surveys). Baseline values for any or all of these tools can be determined and results can be checked after various changes have been attempted.

The popular and peer-reviewed veterinary literature is rife with consultants trying to answer the question of how to motivate staff and encourage better customer service. By applying aspects of transformational leadership, it is possible for clinic leaders to definitively alter the culture of their practices and improve overall job satisfaction. Improved job satisfaction will decrease turnover, decrease missed days, and improve team performance, individual performance, customer satisfaction, patient care, and business performance. Emotional intelligence and transformational leadership can be taught to those committed to the idea,2 and through such practices, there will be organizational improvement. To encourage job satisfaction, leaders should use a transformational leadership approach to develop empowerment initiatives, encourage efficacy, develop trusting relationships, and focus on how the leader's emotions affect the performance of the entire team.

References

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