Doctors’ functional leadership in psychiatric healthcare teams – a reversible leadership logic

The negotiation of sharing leadership in the context of professional hierarchy: Interactions on interprofessional teams

While there is growing recognition of leadership as a collective phenomenon, the question of how leadership is shared in the context of hierarchical asymmetry has been neglected in the collective leadership literature. Our article addresses this gap by examining how sharing leadership is negotiated in team interactions that are steeped in asymmetry deriving from the professional hierarchy. Adopting a leadership-in-interaction approach, we draw on fine-grained analysis of observed interactions on interprofessional teams from two health care organizations to compare the discursive strategies used by professionals in a superior hierarchical position to the ones used by those in inferior positions to share leadership. These strategies are organized into a matrix of interactional moves that resist or enact the professional hierarchy. Empirical vignettes are provided to demonstrate how sharing leadership and hierarchical leadership can be co-present and even intertwined in an interaction. We show that leadership is shared (or not) as a result of how the professional hierarchy gets negotiated in interactions. More specifically, we conclude that the sharing of leadership in this context tends to occur prior to decision making, especially around problem formulation, if the interactional climate allows. Furthermore, it requires concrete effort: Those in superior positions of influence mindfully relax the hierarchy whereas those in inferior positions create moments of sharing leadership through resistance and struggle.

Successful implementation of self-managing teams

PURPOSE

Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is crucial to achieve sustainable results. Therefore, this paper aims to examine how working with self-managing teams can be implemented successfully in the mental health-care sector where various factors for the successful implementation are distinguished.

DESIGN/METHODOLOGY/APPROACH

This qualitative case study is executed by analysing 18 interviews within two self-managing teams in a mental health-care organisation located in the Netherlands. A coding process is executed in two steps. The first step is open coding, to make small summarising notes within each interview section. The second step is refocused coding, where the open codes were collected, categorised and summarised by searching for recurrence and significance. The coding process is made visible within a code tree. This code tree formed the basis for writing the findings.

FINDINGS

Success factors for the implementation of a self-managing team that resulted from this research are a clear task portfolio division, good relationships within the team and a coaching trajectory with attention for a possible negative past.

ORIGINALITY/VALUE

By having used a specific change management model, the Change Competence Model, it can be concluded that a high change capacity will positively influence the success of a self-managing team in the context of a mental health-care organisation.