Distributing Leadership in Health and Social Care: Concertive, Conjoint or Collective?

Currie, Graeme; Lockett, Andy

doi:10.1111/j.1468-2370.2011.00308.x

Cited by 181 publications

(250 citation statements)

References 74 publications

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“…In response to the limitations of the single-actor theories of leadership, the concepts of distributed leadership (Gronn, 2002;Day et al, 2004;Mehra et al, 2006;Gronn, 2010;Thorpe et al, 2011;Bolden, 2011;Cope et al, 2011;Currie and Lockett, 2011;Edwards, 2011), shared leadership (Pearce and Conger, 2003;Pearce, 2004;Ensley et al, 2006;Carson et al, 2007;Pearce et al, 2008b;Fitzsimons et al, 2011;Hmieleski et al, 2012;Nielsen and Daniels, 2012;Hoegl, 2010, 2013) and collective leadership (Contractor et al, 2012;Cullen et al, 2012;Denis et al, 2001;Friedrich et al, 2009;Hunter et al, 2012;Militello and Benham, 2010;Mumford et al, 2012) have received increasing attention. These frameworks explicitly recognize that multiple actors can serve as leaders in teams and groups.…”

Section: Distributed Leadership Theoriesmentioning

confidence: 99%

"Re-thinking Strategic Leadership: On Stars, Clans, Teams and Networks"

Kriger

Zhovtobryukh

2013

AMPROC

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Acknowledgments:The authors wish to thank Louis (By) Barnes (Harvard University), Øystein Fjeldstad (Norwegian Business School BI), Jerry Hunt (Texas Tech University) and Brian Uzzi (Northwestern University) for their helpful comments in developing the early ideas in this article. Finally, special thanks is extended to Merril Simon (California State University, Northridge) for her help in extending the literature base for this paper in significant ways. propositions for the situational appropriateness of each of these four forms and identifies avenues for future research to advance the theory.

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Section: Distributed Leadership Theoriesmentioning

confidence: 99%

"Re-thinking Strategic Leadership: On Stars, Clans, Teams and Networks"

Kriger

Zhovtobryukh

2013

AMPROC

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“…1 (p.1980) Clinical leadership requires clinicians to augment their clinical knowledge and skills with leadership skills that are rarely learned as part of their preregistration educational preparation. 2 While the literature suggests that all clinicians should demonstrate these leadership skills, 3,4 in reality a few outstanding clinicians are usually selected to receive additional onthe-job or formal leadership development. However, there is little robust evidence on best-practice development of clinical leaders.…”

Section: Clinical Leadershipmentioning

confidence: 99%

“…18 In particular, studies have identified essential system and organisational support that values and sustains the work of clinician leaders distributed throughout the organisation. 3 The review of the literature led to our research question: Can practising health professionals develop leadership skills that have a positive impact on the quality and safety of health service and care delivery in their organisation?…”

mentioning

confidence: 99%

Equipping clinical leaders for system and service improvements in quality and safety: an Australian experience

Leggat

Smyth²,

Balding

et al. 2016

Australian and New Zealand Journal of Public Health

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Objective: To develop clinical leadership among health professionals working in public sector organisations to improve their skills in ensuring high quality and safe health services. Methods:A longitudinal pre-post-intervention mixed methods study that included 60 health professionals working in one state in Australia. Results:The program was successful in the development of clinical leaders.Conclusions: An interdisciplinary, inter-sectoral leadership development program involving health professionals from metropolitan, regional and rural areas can be successful in developing knowledge, skills and competencies among these health professionals in health service quality and safety.Implications: Health professionals can participate in a development program to enhance their clinical leadership skills. While this was a post-qualification course, targeting experienced health professionals, the learnings could be applied to pre-qualification education of health professionals.

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“…24,25 At the organisational level of analysis, it has been demonstrated that patient safety is moulded by culture, capacity, processes and governance systems, [26][27][28] and that each is enhanced by distributed (shared, see Glossary) leadership. [28][29][30][31][32][33][34][35][36] At the level of health-care practice, it is known that patient safety is informed by the beliefs and values of health-care professionals, [37][38][39][40][41] and is ultimately underpinned by their personal commitment to care. 42,43 The extent and burden of the problem Despite growing awareness of the challenges posed by patient safety, [44][45][46] and concerted improvements efforts within some health-care systems, 47,48 considerable hospital patient safety problems persist.…”

Section: Overviewmentioning

confidence: 99%

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

Herepath

Kitchener

Waring

2015

Health Serv Deliv Res

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BackgroundHospital patient safety is a major social problem. In the UK, policy responses focus on the introduction of improvement programmes that seek to implement evidence-based clinical practices using the Model for Improvement, Plan-Do-Study-Act cycle. Empirical evidence that the outcomes of such programmes vary across hospitals demonstrates that the context of their implementation matters. However, the relationships between features of context and the implementation of safety programmes are both undertheorised and poorly understood in empirical terms.ObjectivesThis study is designed to address gaps in conceptual, methodological and empirical knowledge about the influence of context on the local implementation of patient safety programmes.DesignWe used concepts from critical realism and institutional analysis to conduct a qualitative comparative-intensive case study involving 21 hospitals across all seven Welsh health boards. We focused on the local implementation of three focal interventions from the 1000 Lives+patient safety programme: Improving Leadership for Quality Improvement, Reducing Surgical Complications and Reducing Health-care Associated Infection. Our main sources of data were 160 semistructured interviews, observation and 1700 health policy and organisational documents. These data were analysed using the realist approaches of abstraction, abduction and retroduction.SettingWelsh Government and NHS Wales.ParticipantsInterviews were conducted with 160 participants including government policy leads, health managers and professionals, partner agencies with strategic oversight of patient safety, advocacy groups and academics with expertise in patient safety.Main outcome measuresIdentification of the contextual factors pertinent to the local implementation of the 1000 Lives+patient safety programme in Welsh NHS hospitals.ResultsAn innovative conceptual framework harnessing realist social theory and institutional theory was produced to address challenges identified within previous applications of realist inquiry in patient safety research. This involved the development and use of an explanatory intervention–context–mechanism–agency–outcome (I-CMAO) configuration to illustrate the processes behind implementation of a change programme. Our findings, illustrated by multiple nested I-CMAO configurations, show how local implementation of patient safety interventions are impacted and modified by particular aspects of context: specifically, isomorphism, by which an intervention becomes adapted to the environment in which it is implemented; institutional logics, the beliefs and values underpinning the intervention and its source, and their perceived legitimacy among different groups of health-care professionals; and the relational structure and power dynamics of the functional group, that is, those tasked with implementing the initiative. This dynamic interplay shapes and guides actions leading to the normalisation or the rejection of the patient safety programme.ConclusionsHeightened awareness of the influence of context on the local implementation of patient safety programmes is required to inform the design of such interventions and to ensure their effective implementation and operationalisation in the day-to-day practice of health-care teams. Future work is required to elaborate our conceptual model and findings in similar settings where different interventions are introduced, and in different settings where similar innovations are implemented.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Distributing Leadership in Health and Social Care: Concertive, Conjoint or Collective?

Cited by 181 publications

References 74 publications

"Re-thinking Strategic Leadership: On Stars, Clans, Teams and Networks"

"Re-thinking Strategic Leadership: On Stars, Clans, Teams and Networks"

Equipping clinical leaders for system and service improvements in quality and safety: an Australian experience

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

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