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2.1 Rationale
In the healthcare sector, the leaders and managers have a moral and legal
responsibility to assure high security for the patients and to strive to make
improvements in providing care to the patient. These leaders and managers have
the power to mandate systems, policies, organisational climates, and procedures.
Consequently, several authors have argued that it is apparent that leaders and
managers of healthcare hold an obvious and vital responsibility in providing security
and care to the patient and that is one of the top priorities of the management of
healthcare (Goldzweig et al., 2013). Accordingly, the Boards have been called to
undertake the responsibility for safety and quality outcomes. The management and
authorities of the hospitals can support learning and communicate the significance of
patient security over other goals of the organisation. Also, effective leaders
demonstrate active engagement with staff and patients and this has a bearing on
safer care of the patient. Staff nursing plays an essential part as a medical sector
leader. They make sense of mobilising resources, and problems related to the safety
of the patient and putting solutions in place (Ritter, 2011).

Healthcare management and administration are the processes of managing a

healthcare system and the provision of healthcare services. The motive that this is a
vital discipline is that administrators of healthcare are fundamentally accountable for
assuring the healthcare delivery continuation. The actions taken and decisions made
by the managers and leaders of the hospital have a direct impact on the care of the
patient. These authorities can be observed forming strategies and goals, developing
reviewing performances, monitoring quality, and organisational culture, selecting and
employing novel technology or merely supervising every flow of work. Whatsoever
the manager is doing, the effort and time they spend impacts the safety and quality
of the performance, processes, and eventually the outcomes of the patients (Appari
& Johnson, 2010).

Thus, it is important to analyse the roles of the managers and leaders to examine
their impact on the security of the patient. It intends to avoid and lessen risks, harm,
and errors that occur to service users during health care delivery. A keystone of the
discipline is incessant improvement grounded on learning from adverse events and
errors. The safety of the patient is the ultimate to delivering quality essential services
of healthcare. The management of the healthcare sector promotes consistent
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development of the abilities, skills, and knowledge of workers to enhance the quality
of patient compassion, safety, care and the patient experience. The managers and
leaders constantly reward, motivate, and encourage innovation and present
improved and new ways of working. The factors that impact the security of the
patient are the managers and leaders not using monitoring technology, not assuring
that patients are understanding their treatment, and not verifying all the clinical
procedures (Mosadeghrad, 2014).

This study involves various studies which have revealed that the majority of the
issues of the systems within healthcare are present due to poor leadership and
communication. The poor styles of leadership within the healthcare firms would also
increase costs, minimize the level of effectiveness, and cause dissatisfaction among
the staff members which ultimately results in lower patient approval and security
(Weberg, 2012). The suitable leadership can construct a culture within the firm which
is committed to the quality, safety and betterment of the patients while also reducing
conflicts. There would be enhanced productivity and efficiency among the staff
members that advance the overall performance of the hospital (Mosadeghrad &
Yarmohammadian, 2006).

The leadership studies conducted within developed countries are minimal in this
regard and the comparison of various styles of leadership has not exclusively been a
part of the research which could depict the reason behind the poor performance of
leaders. Provided with the socio-economic image that could influence the behaviour
of the managers and their leadership style in consideration of the minimal studies
conducted in healthcare, there is a dire need for similar studies to be directed for
assessing the styles of leadership concerning the well-being and safety of the
patients. Apart from the sector of healthcare, there is evidence of administrative
impact on the safety of the workplace (Vaghee & Yavari, 2013).

Within the healthcare literature, there are non-empirical researches offering

descriptions and propositions on attitudes of the managers and leaders and efforts to
enhance quality and safety (Walshe & Smith, 2011). However, there is a lack of
studies analysing the impact of healthcare leadership and management on
maintaining the security of patients. Thus, the rationale of the current study is to
evaluate the role of healthcare leadership by comparing the forms of
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transformational, transactional and democratic leadership within the quality and

safety of patients. Moreover, the reason for conducting the projected study is to
analyse the challenges and priorities within healthcare organisations concerning the
security of patients and will offer recommendations within the leadership role at the
healthcare facilities to improve safety for patients.

2.2 Aims and Objectives

The aim for this report involves the study and exploration of the impact of leadership
within healthcare upon the maintenance and security of patients. The leadership and
management aspects within healthcare will be studied to essentially comprehend
how they are able to secure their patients.

4. Methodology
Methodology signifies the predominant strategies and rationale and rationale of the
projected research study (Rinjit, 2020). Thus, the techniques and approaches used
in this research are as follows:

4.1 Research philosophy

Research philosophy is correlated with the nature, knowledge, and supposition of the
anticipated research. It handles the particular way of developing knowledge. It
means that the research philosophy is an agenda that gives a guideline on how the
study must be conducted grounded on the conceptions regarding the nature and
reality of the knowledge (Žukauskas et al., 2018). Thus, the current research will be
employing interpretivism research philosophy because it highlights the meaning-
making practices of the researcher on the basis of scientific explanation. Thus, this
philosophy is used because concentrates on systematically revealing those
meaning-making practices, whereas, demonstrates how those practices organize
and construct to produce observable outcomes. Another reason for employing this
philosophy is that it will help in discovering the details about the current leadership
and management systems in healthcare to acknowledge the reality and maybe the
factors behind them. Also, it will assist in obtaining the different points of view and
give accessibility to varied aspects of authenticity. Therefore, the purpose of
choosing this philosophy is to generate new interpretations and richer
understandings of the selected research topic (Alharahsheh & Pius, 2020).
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4.2 Research approach

Research approaches are strategies and measures for research that take the
knowledge from wider suppositions to all-inclusive approaches to interpreting,
investigating, and an assortment of data (Tuffour, 2017). Accordingly, the projected
study will be employing an inductive research approach because this approach will
assist in foreseeing what may happen in the upcoming years or in developing the
possibility of what might be encountered. Also, with this approach, an overall
conclusion can be drawn from observations. Moreover, the reasons for employing
this approach are that it will help in enabling flexibility, and will concentrate closely on
the new theory generation. The substantial reason for using this approach is that the
researcher will be able to acknowledge the possibilities and will be able to obtain
certain options. Also, this approach will assist in fuelling further exploration to
examine if the probable impact or judgement is wrong or right. In this process, the
researcher will explore the management and leadership activities in healthcare
impacting patient security (Liu, 2016).

4.3 Research method

Research methods are the practices, procedures, and tactics in the evidence for
analysis or in gathering information to discover novel information or generate an
improved understanding of the research problem (Rinjit, 2020). Therefore, the
qualitative research method will be executed in this research because it will provide
a comprehensive understanding, will be easily organised, and will maintain
confidentiality. Furthermore, another reason for using this method is that it will
provide quality control with collected data, and will work as a lucrative and
economical approach. Also, qualitative data is preferred for the current research as it
is a content-generating approach and will offer acknowledgements that are specific
to the research topic. In addition, qualitative research will enable creativity to be a
mainspring providing flexibility and offering predictive qualities. Also, it will be
grounded on the incoming, available, and other data formats. The main reason for
selecting this method is that it will enable detail-oriented or scrupulous data to be
collected (Yates & Leggett, 2016).

4.4 Inclusion and exclusion criteria

The inclusion criteria of the anticipated study incorporate the features of the included
studies that the researcher will use to obtain an answer to the projected research
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question (Connelly, 2020). Thus, the study will include articles comprising qualitative
studies with patients, grounded theories, peer-reviewed journals, articles published
in the English language, and sources describing the impacts of management and
leadership. Furthermore, the articles published from 2010 to 2022 will be included,
along with the international literature, primary empirical qualitative studies, and
articles or journals with rich descriptions. On the other hand, the exclusion criteria for
the current research incorporate the characteristics or factors that make the recruited
articles, journals, or textbooks ineligible for the research (Connelly, 2020). Thus,
observational or experimental studies, case studies, studies comprising of abstract
only, and surveys will not be included in the anticipated study. Also, the resources
having inadequate detail, not published in the English language, grey literature, and
not presenting data will be excluded.

4.5 Search strategy

A search strategy is a systematized structure of key terminologies which are utilised
in database searching. It syndicates the main conceptions of the research problem to
regain precise results (Aromataris & Riitano, 2014). Correspondingly, for the
projected research, secondary data will be collected which is the research data that
has been formerly gathered and published and is available and accessible to the
researchers. Secondary data will be used because it will help in saving effort and
time, provide more control on the overall process of data collection, and regulate the
large data volume. Also, the secondary data will be cost-effective and will provide
structured and cleaned data (Johnston, 2017). Accordingly, the search strategy for
the current research will comprise all the probable key terminologies, phrases, and
keywords which will be searched on different online databases. The online
databases that will be used to collect information are PubMed, Google Scholar,
Francis’ report, Springer, and ScienceDirect. The articles and journals that will be
included in the research will be published in the English language under the year
range of 2010 to 2022.

4.6 Screening strategy

A screening strategy is an approach to identify the research from the literature and
search for including it in the anticipated study. Therefore, for the present research,
the PRISMA framework will be used to identify, screen, and include the articles in the
study. It will help the researcher to improve the reporting of the searched articles. For
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doing so, a PRISMA diagram will be used that will visually summarise the process of
screening articles. Initially, it will record the number of resources found and then will
make the process of selection visible by documenting the decisions taken at different
stages (Arya et al., 2021). The keywords and phrases that will be used for the
searching the articles include; “transformational, transactional and democratic
leadership within healthcare”, “Association of leadership styles and patient security”,
“Healthcare sector challenges in relation to the security of patients”, “Francis’ report
for leadership and patient security”, and “Leadership role at the healthcare facilities
to improve safety for patients”.
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4.7 PRISMA diagram

4.8 Data extraction

Through the process of data extraction, the researchers acquire essential
information regarding the characteristics of the study and findings from the studies
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which are selected for the projected research (Mathes et al., 2017). Thus, for the
current research, 4 different online databases; that are, PubMed, Google Scholar,
Francis’ report, Springer, and ScienceDirect will be used for collecting the
information. The information will be searched with different keywords as mentioned
above and through this process, the records will be identified. In addition, after
removing the articles according to the exclusion criteria, the data will be extracted
from the selected articles. In addition, the CASP tool will be used which will assist
the researcher in reading and checking the relevance, results, and trustworthiness of
the collected data (Long et al., 2020).

4.9 Choosing the correct epistemological perspective

The epistemological perspective helps in providing an outline for deconstructing,
empowering, describing, and predicting worldviews specific to the selected research
topic, augmenting the knowledge base that leads to an improved understanding of
the persistence behind qualitative research (Camic, 2021). Thus, for the current
research, the hermeneutics epistemological perspective will be employed as it will
assist in highlighting the conceptualisation and dialogical practices of the investigator
based on logical and technical explanation. Hermeneutics perspective is formed on
the basis of the social structures and material conditions of scientific work in varied
scientific domains, for example, management and leadership in the healthcare
setting. This perspective will be applied in the study because it focuses on keeping
the discussion ongoing by altering and varying the research problems. Thus, it will
help in concentrating on systematically revealing those conceptualising and
dialogical practices as well as will demonstrate how those practices unify and
construct to produce evident consequences (Pérez et al., 2020).

4.10 Determining the most appropriate goal

The goal of the current research is to assess the role of healthcare leadership by
comparing the forms of transformational, transactional and democratic leadership
within the quality and safety of patients. Moreover, the research also plans to
examine the consequences within healthcare settings in association with the security
of patients as leaders and managers of healthcare hold an obvious and vital
responsibility in providing security to the patient. Furthermore, Francis’ report
indicates the significance of effective patient security; thus, another major goal of the
projected study is to identify healthcare leadership's response to Francis's report
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concerning patient security. In addition, the study also intends to provide

recommendations in association with the leadership role at the healthcare facilities to
improve safety for patients. Lastly, another goal of the research is to analyse how
healthcare management and leadership contribute to improving the culture of safety
as an imperative constituent of lessening and averting errors.
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4.11 Work timeline/Gantt chart

The current research will take six weeks to be completed; in the first week, the
researcher will plan and select the topic for conducting research. In the second
week, the research questions, aims, and objectives will be formulated. Accordingly,
in week 3, different articles, journals, and books will be searched through the
selected online databases to collect the data. In addition, in week 4, the background
of the chosen research topic and literature review will be written. Afterwards, in week
five, with the support of different sources, findings will be discussed along with the
conclusion. Lastly, the research report will be presented to the supervisor and the
report will be amended according to the given feedback.

Activity Week 1 Week 2 Week 3 Week 4 Week 5 Week

6
Planning and
selecting the
research
topic
Setting
research
questions,
aims and
objectives
Searching
articles and
other
resources for
data
collection
Writing a
background
literature
review
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Writing
results and
conclusion
Presenting to
the
supervising
and working
on the
feedback

6. Ethical Consideration
There is a wealth of literature on the subject of effective leadership in health care,
particularly during the last several decades (Rangachari & L. Woods, 2020). Strong
leadership in the social and health service sectors is urgently needed, as it has been
repeatedly shown by a number of societal concerns. sectors. Most research in this
area has taken a qualitative tack, and there has been a dearth of studies that either
employ quantitative data or analyze the effect that leadership has on quality
indicators in the health care sector (Ajami & Bagheri-Tadi, 2013). The majority of
publications highlighted the connection between effective leadership and improved
patient outcomes across a variety of domains. Therefore, effective leadership is
essential for the delivery of care that is coordinated and seamless for both patients
and medical staff. Those who have prolonged, direct contact with patients,
regardless of the setting in which treatment is provided, must have this training
(Ingebrigtsen, et al., 2014). In addition, the results showed that the leadership style
had an impact on the patients' outcomes. Consistent with our main findings, other
research (Hill, 2010) highlights the theoretical interactions between the outcome of
patient and effective leadership as follows: this kind of management produces an
excellent workplace, which in turn creates a positive safety climate, which in turn
ensures outcomes of patient in a positive way.