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Background: The purpose of this study was to explore leadership styles within the NCRHA across top management levels, identifying common approaches to and/or styles of, leadership. The research sought to identify any perceived changes in approach that these reported as a consequence of the changed internal and external economic environments (economic environment in Trinidad in the period 2015-2016. In relation to the financial crisis, the heads of department in NCRHA had to change their leadership styles when managing staff, in order to continuously deliver quality`s service to clients. To implement change successfully, there was a need for the organization’s employees to adopt new behaviors in order to continuously deliver a high quality service. By carrying out an exploration of the leadership styles within the NCRHA, it was the intention to glean information from a series of interviews with managers responsible for delivering services across a range of disciplines. Although the researcher was initially unaware of what would be found, it was hoped that the information obtained would provide a richness of data which would enlighten the reader about the difficulties and subsequent approaches that needed to be adopted by leaders as they tried to deliver a service whilst operating in a difficult climate. Study design/Methodology: The research favored a mixed method approach, using quantitative and qualitative methods to gather data; a descriptive, cross-sectional, quantitative survey design was utilized. Data were collected from a convenience sample of medical, allied and non-allied staff at the NCRHA. Eligibility criteria included: • Employment at the NCRHA on or before October 2015 and assignment to the hospital; • Trinidad and Tobago resident status; • Age between 25 yrs and 55 yrs. The sample size was limited to five departments in the NCRHA: clinical (Medicine, Surgery, Radiology,) and nonclinical (Quality, Social Services, and Customer Service) Departments. The sample consisted of 100 participants from these departments. Structured questions were used in researcher-administered surveys. For the conduct of structured interviews, participants were contacted two weeks prior to proposed date and sent the initial questions. The format of the interview was explained to each interviewee and any questions were answered prior to the start. There were no distractions or interruptions during any of the six interviews, which took place outside of the participants’ offices and helped with the process. All interviews were recorded by being transcribed. In this instance, the sample size was six participants with a gender mix of three males and three females who functioned within a blend of clinical and administrative roles, had different levels of responsibility and managed different service. Major findings: The research findings were positively correlated to the research’s aims and objectives. It was noted that, among the middle managers in the system, leadership styles had changed to a significant extent as a result of the economic downturn. There were both strengths and weaknesses in leadership behavior highlighted as a result of the research. Recommendations: In order to maintain the changes, it is necessary to evaluate and take a 360-degree review of all systems, whether attendance policies or financial regulations. This will involve the managers reviewing their own positions, and identifying the strengths and weaknesses of each system. Failure to acknowledge the findings will only serve to undermine the organization’s ability to move forward, further damaging its reputation and stifling the opportunity to meet its potential as a world-class health service.

health economics and outcome research

A Study of the Impact of the Economic Downturn in Trinidad and Tobago(2015-2016) on Leadership Styles within the North Central Regional Health Authority