Distributed leadership in healthcare: leadership dyads and the promise of improved hospital outcomes

Purpose This paper aims to extend the consideration of distributed leadership in health-care settings. Leadership is typically studied from the classical notion of the place of single leaders and continues to examine distributed leadership within small teams or horizontally. The purpose is to develop a practical understanding of how distributed leadership may occur vertically, between different layers of the health-care leadership hierarchy, examining its influence on health-care outcomes across two hospitals. Design/methodology/approach Using semi-structured interviews, data were collected from 107 hospital employees (including executive leadership, clinical management and clinicians) from two hospitals in Australia and the USA. Using thematic content analysis, an iterative process was adopted characterized by alternating between social identity and distributed leadership literature and empirical themes to answer the question of how the practice of distributed leadership influences performance outcomes in hospitals? Findings The perceived social identities of leadership groups shaped communication and performance both positively and negatively. In one hospital a moderating structure emerged as a leadership dyad, where leadership was distributed vertically between hospital hierarchal layers, observed to overcome communication limitations. Findings suggest dyad creation is an effective mechanism to overcome hospital hierarchy-based communication issues and ameliorate health-care outcomes. Originality/value The study demonstrates how current leadership development practices that focus on leadership relational and social competencies can benefit from a structural approach to include leadership dyads that can foster these same competencies. This approach could help develop future hospital leaders and in doing so, improve hospital outcomes.

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Return on investment in healthcare leadership development programs

Leadership in Health Services ◽

10.1108/lhs-02-2017-0005 ◽

2018 ◽

Vol 31 (1) ◽

pp. 77-97 ◽

Cited By ~ 7

Author(s):

Maya M. Jeyaraman ◽

Sheikh Muhammad Zeeshan Qadar ◽

Aleksandra Wierzbowski ◽

Farnaz Farshidfar ◽

Justin Lys ◽

...

Keyword(s):

Health Care ◽

Leadership Development ◽

Development Programs ◽

Leadership Development Programs ◽

Content Type ◽

Health Care Outcomes ◽

Leadership Quality ◽

Care Outcomes ◽

Evaluative Instrument ◽

The Impact

Purpose Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments. Design/methodology/approach The authors performed a scoping review using the Arksey and O’Malley framework, searching eight databases from 2006 through June 2016. Findings Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail. Originality/value This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations.

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An evaluation of a leadership development coaching and mentoring programme

Leadership in Health Services ◽

10.1108/lhs-07-2016-0030 ◽

2017 ◽

Vol 30 (3) ◽

pp. 309-329 ◽

Cited By ~ 5

Author(s):

Lyndsay Le Comte ◽

Beverley McClelland

Keyword(s):

Leadership Development ◽

Distributed Leadership ◽

Structured Interviews ◽

Senior Staff ◽

Content Type ◽

Mixed Methods Approach ◽

Group Coaching ◽

Supportive Culture ◽

The Impact ◽

Practical Implications

Purpose The purpose of this paper was to determine the value and impact of the Leadership Development – Coaching and Mentoring Programme at Counties Manukau Health and understand how the skills gained are applied. Design/methodology/approach Mixed-methods approach including surveys of programme participants and senior staff and semi-structured interviews with programme participants. Findings The survey response rate was 24.4 per cent for programme participants and 30 per cent for senior staff. Eight programme participants participated in semi-structured interviews. Of the 70 programme participants, 69 utilised their learning from the programme; 45 of 70 changed their approach to managing staff; and 40 of 68 programme participants reported that meeting with peers for triad group coaching was the most challenging aspect of the programme. Key themes identified through interviews included: working with others; not owning others’ problems; professional support and development; coaching and mentoring; future participants. Practical implications The majority of participants changed their leadership behaviours as a result of the programme, which has resulted in improved communication, a more supportive culture and distributed leadership. These changes contribute to better patient care. Originality value There is a paucity of evidence in the literature about the impact of coaching and mentoring programme on leadership development and how the skills gained in such programmes are applied in practice in a healthcare context. This evaluation helps to address that gap.

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Value-based health-care principles in health-care organizations

International Journal of Organizational Analysis ◽

10.1108/ijoa-07-2020-2322 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Fiorella Pia Salvatore ◽

Simone Fanelli ◽

Chiara Carolina Donelli ◽

Michele Milone

Keyword(s):

Health Care ◽

Quality Of Care ◽

Health Care Organizations ◽

Organizational Changes ◽

Content Type ◽

Health Care Outcomes ◽

Analytical Technique ◽

A Value ◽

Care Outcomes

Purpose This study aims to analyze the value-based health-care model in defining a strategy to guide the evolution of health-care organizations toward a value-oriented model. To improve the quality of care by ensuring economic sustainability, it is necessary to redefine the concept of competition in healthcare and align it with the concept of maximizing value for patients. Design/methodology/approach Performance measurement is a crucial aspect of the analysis of health-care organizations. Porter developed an effective analytical technique and presented the measurement of health-care outcomes based on health conditions, the efficiency of health-care organizations and the type of service provided. Findings Clinical outcomes and data on the costs of care of each patient are essential to evaluate improvement in treatment value over time. Engaging in the evaluation of what happens to patients in their course of care enables the expansion of the measurement of outcomes because it measures all the health services related to it. Originality/value Building a health-care system based on the value and continuous improvement of care and services provided is a goal shared by many countries and international organizations. Today, the analysis of outcomes is important for making informed decisions, directing and planning clinical and organizational changes by improving the quality of care and services.

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ERGs (employee resource groups) benefit employee wellbeing

Human Resource Management International Digest ◽

10.1108/hrmid-02-2019-0028 ◽

2019 ◽

Vol 27 (1) ◽

pp. 45-46 ◽

Cited By ~ 1

Keyword(s):

African American ◽

Native American ◽

Leadership Development ◽

Asian American ◽

Well Being ◽

Structured Interviews ◽

Content Type ◽

South Asian American ◽

The Usa ◽

Employee Resource Groups

Purpose A qualitative study of six employee resource groups (ERGs) in a not-for-profit organization in the USA tested whether they helped minorities to integrate. The positive results showed they act as powerful conduits for learning and development, and help staff well-being. Design/methodology/approach The researcher carried out 39 semi-structured interviews with people from each of the six groups, including executive sponsors. There were 11 participants from the African-American RG, 2 from the Native American RG, 4 from the Asian-American RG, 5 from the Hispanic-American RG, 7 from the LGBT RG, and 3 from the South Asian-American RG. Seven executive sponsors were also interviewed. All participants were asked to describe the organization’s culture and explain how much support they received on diversity issues. Findings Members explained how ERGs offered communities for the exchange of ideas. They helped individuals deal with “micro-aggressions” when the dominant social groups indulged in prejudicial stereotyping. Useful activities were both informal and formal. Informal conversations were helpful, especially for younger members. More formal activities depended on member interests. For example, the African-American and Asian-American RGs hosted a lot of leadership development initiatives. There were events aimed at educating the whole workforce about minority issues. Originality/value The results are important for businesses, and other organizations, because research shows they perform better when they integrate diverse employees.

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