Managerial Strategies to Strengthen Transformational Leadership, Communication and Decision-Making in Hospital Emergency Nursing

Abstract

Effective management of nursing human talent in critical care units constitutes a decisive pillar for the quality of the State’s healthcare response. The aim of this study was to propose a system of managerial strategies based on transformational leadership to strengthen communication channels and decision-making among nursing personnel working in the General Emergency Department of the Central Hospital of San Cristóbal, Táchira State, Venezuela. The research was framed under the feasible project modality, supported by a descriptive field design with a mixed approach (qualitative-quantitative). The census sample consisted of 54 nursing professionals assigned to the service. A Likert-scale structured questionnaire was used for data collection, validated through the judgment of five experts, with a reliability calculated using Cronbach’s Alpha coefficient ($\alpha = 0.89$). Preliminary results showed that, although there is a high level of trust toward the immediate supervisor (96.29%), there are critical gaps in individualized consideration (35.18% unfavorable perception), dissatisfaction with the work environment (44.44%), and a marked absence of formal recognition and incentive systems (72.22%). It is concluded that there is an imperative need to implement a transformational managerial model that optimizes two-way communication flows, eradicates organizational silence, and promotes participative decision-making under the premise of bounded rationality, guaranteeing institutional, technical, and legal feasibility within the framework of New Public Management.