Implementing collective leadership in healthcare organisations

Fostering collective leadership to improve integrated primary care: lessons learned from the PriCARE program

Case management (CM) is an intervention for improving integrated care for patients with complex care needs. The implementation of this complex intervention often raises opportunities for change and collective leadership has the potential to optimize the implementation. However, the application of collective leadership in real-world is not often described in the literature. This commentary highlights challenges faced during the implantation of a CM intervention in primary care for people with complex care needs, including stakeholders' buy-in and providers' willingness to change their practice, selection of the best person for the case manager position and staff turnover. Based on lessons learned from PriCARE research program, this paper encourages researchers to adopt collective leadership strategies for the implementation of complex interventions, including promoting a collaborative approach, fostering stakeholders' engagement in a trusting and fair environment, providing a high level of communication, and enhancing collective leadership attitudes and skills. The learnings from the PriCARE program may help guide researchers for implementing complex healthcare interventions.

Customers' Perception Towards Accountability of Diagnostic Centres: Evidence from India

Introduction

A deeper comprehension of accountability is beneficial for identifying and fostering tactics to boost accountability and raise the standard of healthcare. The main objective of the present paper is to measure the level of customers' perception of accountability of healthcare diagnostic service providers and to identify the factors that influence the perception of accountability of healthcare diagnostic service customers.

Methods

A questionnaire survey was used to collect data from 393 customers of various diagnostic centers in the city of Guwahati from the state of Assam in India. The reliability of the data was tested using Cronbach's Alpha. Statistical tests were used for the mean, percentage, standard deviation, etc. Factor analysis was performed to find out the factors affecting customers' perception of accountability.

Results

It was found that the overall level of perception of the customers with respect to the accountability of diagnostic centers in Guwahati is of high level. The study reveals four variables that affect how customers perceive the accountability of diagnostic service providers. These are Competency, Responsiveness, Compliance with protocol, and Problem-solving approach.

Discussion

Significant contributions have been made by the present study in terms of the development of a scale to measure customers' perception of accountability of diagnostic centre, and the development of a theoretical model to explain this accountability.

Leadership Development Strategies in Interprofessional Healthcare Collaboration: A Rapid Review

Background

Contemporary healthcare practitioners require leadership skills for a variety of professional roles related to improved patient/client outcomes, heightened personal and professional development, as well as strengthened interprofessional collaboration and teamwork.

Objective/Aim

The aim of this study is to systematically catalogue literature on leadership in healthcare practice and education to highlight the leadership characteristics and skills required by healthcare practitioners for collaborative interprofessional service delivery and the leadership development strategies found to be effective.

Methods/Design

A rapid review was conducted. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) diagram shows that the 11 databases, yielded 465 records. A total of 147 records were removed during the initial screening phase. The remaining 318 records were uploaded onto Rayyan, an online collaborative review platform. Following abstract level screening, a further 236 records were removed with 82 records meeting the eligibility criteria at full text level, of which 42 were included in the data extraction. The Mixed Methods Appraisal Tool (MMAT) was used for quality appraisal.

Results

Results showed variability in methodologies used, representing various healthcare disciplines with a range in population size (n = 6 to n = 537). Almost half of the results reported on new programs, with interprofessional collaboration and teamwork being the most frequently mentioned strategies. The training content, strategies used as well as the length of training varied. There were five outcomes which showed positive change, namely skills, knowledge, confidence, attitudes, and satisfaction.

Conclusion

This rapid review provided an evidence-base, highlighted by qualitative, quantitative, and mixed methods research, which presents distinct opportunities for curriculum development by focusing on both content and the methods needed for leadership programs. Anchoring this evidence-base within a systematic search of the extant literature provides increased precision for curriculum development.

Integrated case management between primary care clinics and hospitals for people with complex needs who frequently use healthcare services: A multiple-case embedded study

INTRODUCTION

Case management (CM) is recognized to improve care integration and outcomes of people with complex needs who frequently use healthcare services, but challenges remain regarding interaction between primary care clinics and hospitals. This study aimed to implement and evaluate an integrated CM program for this population where nurses in primary care clinics worked with a hospital case manager.

METHODS

A multiple embedded case study was conducted in the Saguenay-Lac-Saint-Jean region (Québec, Canada), in four dyads including a clinic and a hospital. Mixed data collection included, at baseline and 6 months, interviews and focus groups with stakeholders, patient questionnaires (patient experience of integrated care and self-management), and emergency department (ED) visits in the previous 6 months.

RESULTS

Integrated CM implementation was optimal when all stakeholders provided collective leadership, and were supportive of the program, particularly the physicians. The 6-month program enabled the observation of positive qualitative outcomes in most clinic-hospital dyads where implementation occurred. Full implementation was associated with improved care integration.

DISCUSSION AND CONCLUSION

Integrated CM between primary care clinics and hospitals is a promising innovation to improve care integration for people with complex needs who frequently use healthcare services. Collective leadership and physicians' buy-in to integrated CM are important to foster the implementation.

Leadership and Managerial Skills in Dentistry: Characteristics and Challenges Based on a Preliminary Case Study

Dentistry is changing rapidly in a dynamic and challenging mode and is incorporating digital technology, communication, and managerial skills for profitable enterprises. On the new dental horizon, the profession requires engaging and inspiring role models and leaders. Ιdentifying and developing human soft skills can improve quality issues and guarantee a sustainable dental business. The concept of leadership is a very complex and multidimensional phenomenon as observed from the current literature. In different commercial environments, there has been a huge discussion on the specific characteristics of an effective leader. In dentistry, the subject needs further investigation. This article aims to bring up the importance of dental leadership and highlights the need of identifying dental leaders committed to excellency. It also challenges the need for educational shift on dental leadership management. Finally, it aims to support and develop educational transformations based on positive preliminary data observed by incorporating a new, relevant subject in the dental curriculum.

Relevant HRH leadership during public health emergencies

BACKGROUND

Inadequate leadership capacity compounds the world's workforce lack of preparedness for outbreaks of all sizes, as illustrated by the COVID-19 pandemic. Traditional human resources for health (HRH) leadership has focused on determining the health workforce requirements, often failing to fully consider the unpredictability associated with issues such as public health emergencies (PHE).

MAIN ARGUMENTS

The current COVID-19 pandemic demonstrates that policy-making and relevant leadership have to be effective under conditions of ethical uncertainty and with inconclusive evidence. The forces at work in health labor markets (HLM) entail leadership that bridges across sectors and all levels of the health systems. Developing and applying leadership competencies must then be understood from a systemic as well as an individual perspective. To address the challenges described and to achieve universal health coverage (UHC) by 2030, countries need to develop effective HRH leaderships relevant to the complexity of HLM in the most diverse contexts, including acute surge events during PHE. In complex and rapidly changing contexts, such as PHE, leadership needs to be attentive, nimble, adaptive, action oriented, transformative, accountable and provided throughout the system, i.e., authentic, distributed and participatory. This type of leadership is particularly important, as it can contribute to complex organizational changes as required in surge events associated with PHE, even in in the absence of formal management plans, roles, and structures. To deal with the uncertainty it needs agile tools that may allow prompt human resources impact assessments.

CONCLUSIONS

The complexity of PHE requires transformative, authentic, distributed and participatory leadership of HRH. The unpredictable aspects of the dynamics of the HLM during PHE require the need to rethink, adapt and operationalize appropriate tools, such as HRH impact assessment tools, to redirect workforce operations rapidly and with precision.

Conceptualisations of Leadership and Relevance to Health and Human Service Workforce Development: A Scoping Review

PURPOSE

This scoping review was undertaken to determine leadership definitions and approaches relevant to health and human service (H&HS) workforce development. This review provides a preliminary analysis of the potential size and scope of available research literature to inform ongoing research with the ultimate aim to inform a future systematic review in relation to leadership development interventions.

METHODS

Following the methodology proposed by Arksey and O'Malley and using PRISMA-ScR, a systematic search was conducted using seven databases (PubMed, Health Business Elite, Medline, CINAHL, Ovid, Scopus, and Web of Science). Articles were screened and assessed for eligibility. From eligible studies, data were extracted to summarize, collate, and make a narrative account of the findings.

RESULTS

Employing pre-selected criteria, a total of 424 records were identified and 171 full-text articles were assessed. The majority of the papers were studies undertaken by researchers based in North America. Leadership in the H&HS sector was addressed in 35% of the articles. The narrow disciplinary or workforce fields of the nursing and medical professions in hospitals and acute care settings dominated the literature.

CONCLUSION

The findings suggest that while leadership has been studied extensively in the health system, there is a paucity of leadership development research specific to the broader H&HS sector. This review emphasises the need for further research, including a more critical examination of leadership development interventions and their application to the H&HS sector.

Role of emotional intelligence in effective nurse leadership

Emotionally intelligent leaders demonstrate a sensitivity to their own and other people's psychological health and well-being, directing others towards common goals while developing effective personal relationships with their colleagues and team members. Emotional intelligence is particularly relevant in the context of the coronavirus disease 2019 pandemic, where nurse leaders need to demonstrate this skill when supporting their teams to manage high levels of stress, exhaustion and the risk of moral injury. This article explores emotional intelligence, discusses its importance as a characteristic of effective nurse leaders and managers, and suggests practical activities that leaders can undertake to develop their emotional intelligence skills.