HA515 Unit 1 Leading Versus Managing Analysis Example

Moving the Four O'Clock Blood Draw: A Leadership Versus Management Analysis Splitting One Composite Health System Decision Into the Parts Only Managing Can Settle, the Parts That Need Leading and the Parts That Resist Sorting

[Student Name]

Purdue University Global

HA515: Leadership and Management in Health Care

Unit 1 Leadership Versus Management Analysis

[Instructor Name]

[Date]

The health system, the laboratory and every figure are composite and bracketed; quoted reactions are attributed to roles.

The Decision

On the medical floors of the system's two hospitals, phlebotomists begin rounds at 04:00 so morning laboratory results reach hospitalists by 07:30, before rounds. Patient experience surveys show sleep complaints on those floors well above the system's other units, and studies of medical inpatients have found that overnight disruptions shorten and fragment sleep (Yoder et al., 2012). The chief medical officer has asked the laboratory director to start rounds at 05:30 for patients without urgent orders.

Two Positions Under Test

Zaleznik argued that managers and leaders differ in temperament: managers seek order and control, while leaders tolerate chaos and pursue new directions, and organizations need both kinds of people (Zaleznik, 1977). Kotter argued instead that management and leadership are two complementary systems of action that the same person can practice: in his account, managing handles complexity by planning, budgeting, staffing and monitoring, while leading handles change by choosing a direction, bringing people behind it and keeping them motivated (Kotter, 1990). If Zaleznik is right, the laboratory director would need a different kind of person for the leading parts. If Kotter is right, the director could do both by switching modes.

The Tasks, Sorted

Managing:

1. Model the new phlebotomy schedule so all non-urgent draws finish by 07:00 with the current staff.

2. Check whether the analyzers can process the later surge without delaying results past [08:30].

3. Rework the phlebotomy staffing template and the effect on overtime.

4. Define which orders count as urgent and keep the 04:00 draw.

Leading:

1. Persuade hospitalists that results at [08:30] are acceptable for stable patients, which changes how they round.

2. Make the case to phlebotomists that later starts serve patients, not only patient survey scores.

3. Describe the change to nursing as part of a sleep initiative rather than a laboratory convenience.

Resisting sorting:

1. The staffing change is a scheduling problem and also a question of whether phlebotomists will accept a later shift.

2. The urgent-order definition is a technical rule and also a negotiation with physicians about what urgent means.

The tasks that resist sorting are where the decision will succeed or fail, because they need a schedule and a persuaded person at the same time.

Where the Line Falls

The sorting supports Kotter more than Zaleznik. The director does not need a different personality for the leading tasks; she needs to recognize when a task has a human side that planning cannot settle. The two tasks that resist sorting cannot be split between people: whoever builds the schedule must also persuade the phlebotomists who will work it. Zaleznik's point still has force at the margins. The director's strength is precision, and she admits that persuading hospitalists feels like a different job. That suggests a partner, such as the chief medical officer or a respected hospitalist, for the physician conversation, not a different director.

What the Director Should Do

1. Build the schedule and the urgent-order list with two phlebotomists and one hospitalist, so the managing work includes the people the leading work must persuade.

2. Ask the chief medical officer to present the change to hospitalists, framed around patient sleep and safety.

3. Pilot later rounds on one floor for four weeks, measuring time to results and sleep complaints.

What the Pilot Will Show

If results arrive by [08:30] and hospitalists adjust, the management case holds. If phlebotomists resist the later start, the leadership work was incomplete. Both outcomes are informative, and both should be reported to the chief medical officer.

How Staff Reacted

A night phlebotomist said the 04:00 start lets her finish before day-shift traffic. A hospitalist said he would accept later results "for patients I'm not worried about." A charge nurse said fewer night wake-ups would make her job easier. Each reaction mixes a practical concern with a value, which is why the decision cannot be handled by schedule alone.

Costs of Getting It Wrong

If the director treated the decision as only a scheduling problem, she might issue a new schedule that hospitalists ignore, ordering stat draws at 04:00 to get early results. If she treated it as only a leadership problem, she might win enthusiasm for a schedule the analyzers cannot support. Either error would leave patients waking at 04:00.

Limits

One decision cannot settle a long debate. A larger change, such as a merger, might require different people more than this one does.

Conclusion

The blood draw decision shows managing and leading as two kinds of work that the same director can do, provided she sees which tasks need both. The line between them runs through the middle of the hardest tasks.

References

Kotter, J. P. (1990). What leaders really do. Harvard Business Review, 68(3), 103-111.

Yoder, J. C., Staisiunas, P. G., Meltzer, D. O., Knutson, K. L., & Arora, V. M. (2012). Noise and sleep among adult medical inpatients: Far from a quiet night. Archives of Internal Medicine, 172(1), 68-70. https://doi.org/10.1001/archinternmed.2011.603

Zaleznik, A. (1977). Managers and leaders: Are they different? Harvard Business Review, 55(3), 67-78.