Transformational leadership, transnational culture and political competence in globalizing health care services: a case study of Jordan's King Hussein Cancer Center

Jeffrey L Moe,Gregory Pappas,Andrew Murray

doi:10.1186/1744-8603-3-11

Jeffrey L Moe, Gregory Pappas + Show 1 more

Open Access

https://doi.org/10.1186/1744-8603-3-11

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Abstract

BackgroundFollowing the demise of Jordan's King Hussein bin Talal to cancer in 1999, the country's Al-Amal Center was transformed from a poorly perceived and ineffectual cancer care institution into a Western-style comprehensive cancer center. Renamed King Hussein Cancer Center (KHCC), it achieved improved levels of quality, expanded cancer care services and achieved Joint Commission International accreditation under new leadership over a three-year period (2002–2005).MethodsAn exploratory case research method was used to explain the rapid change to international standards. Sources including personal interviews, document review and on-site observations were combined to conduct a robust examination of KHCC's rapid changes.ResultsThe changes which occurred at the KHCC during its formation and leading up to its Joint Commission International (JCI) accreditation can be understood within the conceptual frame of the transformational leadership model. Interviewees and other sources for the case study suggest the use of inspirational motivation, idealized influence, individualized consideration and intellectual stimulation, four factors in the transformational leadership model, had significant impact upon the attitudes and motivation of staff within KHCC. Changes in the institution were achieved through increased motivation and positive attitudes toward the use of JCI continuous improvement processes as well as increased professional training. The case study suggests the role of culture and political sensitivity needs re-definition and expansion within the transformational leadership model to adequately explain leadership in the context of globalizing health care services, specifically when governments are involved in the change initiative.ConclusionThe KHCC case underscores the utility of the transformational leadership model in an international health care context. To understand leadership in globalizing health care services, KHCC suggests culture is broader than organizational or societal culture to include an informal global network of medical professionals and Western technologies which facilitate global interaction. Additionally, political competencies among leaders may be particularly relevant in globalizing health care services where the goal is achieving international standards of care. Western communication technologies facilitate cross-border interaction, but social and political capital possessed by the leaders may be necessary for transactions across national borders to occur thus gaining access to specialized information and global thought leaders in a medical sub-specialty such as oncology.

Highlights

Following the demise of Jordan's King Hussein bin Talal to cancer in 1999, the country's AlAmal Center was transformed from a poorly perceived and ineffectual cancer care institution into a Western-style comprehensive cancer center
The case study narrates a series of organizational changes that are highly contextual to the specifics of the King Hussein Cancer Center (KHCC) and Jordan
The case study provides a point of comparison with other cases of transformational leadership and supports the broad utility of that theory in an international health care setting

Summary

Introduction

Following the demise of Jordan's King Hussein bin Talal to cancer in 1999, the country's AlAmal Center was transformed from a poorly perceived and ineffectual cancer care institution into a Western-style comprehensive cancer center. Renamed King Hussein Cancer Center (KHCC), it achieved improved levels of quality, expanded cancer care services and achieved Joint Commission International accreditation under new leadership over a three-year period (2002–2005). Globalization, some argue "internationalization," [1] is occurring across many industries, and with increasing frequency and magnitude in health care services [2,3]. New technologies have made cross-border economic transactions, communication and data exchange less expensive, more broadly available and more applicable to health care requirements. Health care services have become "tradable" through international commercial arrangements and sanctioned by global trade policies (e.g. General Agreement on Trade Services through the World Trade Organization). The full extent of globalizing health care services (GHCS) includes government to government activity and increasingly non-governmental organizations. While there is a growing "globalization" literature for industry in general, which documents cases, methods, best practices, and an emerging body of theory, there is little work on the differentiating aspects of GHCS [9]

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