Delving into the link between employee proactivity and knowledge sharing: A multilevel mediated moderation investigation

This study examines why and when proactive employees share knowledge. By integrating the Motivation-Opportunity-Ability Framework and Trait Activation Theory, and incorporating Mindsponge Theory, our multi-level model proposed that job autonomy moderates the impact of proactive personality on knowledge sharing (KS) within and between teams. Transformational leadership exhibits a cross-level effect on job autonomy. Utilizing a two-source, three-time-point research design, we collected data from 63 team leaders and 241 team members across six Chinese companies. Multilevel regression analysis revealed that within teams, increased job autonomy coupled with a proactive personality significantly enhanced KS. Between teams, job autonomy had a positive moderating effect. When job autonomy was low, more proactive teams exhibited less KS, whereas this negative effect was mitigated when job autonomy was high. The cross-level effect of transformational leadership on job autonomy was demonstrated. The theoretical and practical implications of these findings are discussed.

Transformational nurse leadership attributes in German hospitals pursuing organization-wide change via Magnet® or Pathway® principles: results from a qualitative study

BACKGROUND

Budget constraints, staff shortages and high workloads pose challenges for German hospitals. Magnet® and Pathway® are concepts for implementing organization-wide change and redesigning work environments. There is limited research on the key elements that characterize nurse leaders driving the implementation of Magnet®/Pathway® principles outside the U.S. We explored the key attributes of nurse leaders driving organization-wide change through Magnet®/Pathway® principles in German hospitals.

METHODS

Using a qualitative study design, semi-structured interviews (n = 18) were conducted with nurse leaders, managers, and clinicians, in five German hospitals known as having started implementing Magnet® or Pathway® principles. The interviews were recorded and transcribed verbatim. Data were analyzed in Atlas.ti using content analysis. For the analysis, a category system was created using a deductive-inductive approach.

RESULTS

Five leadership attributes and eleven sub-attributes were identified as main themes and sub-themes: Visionary leaders who possess and communicate a strong vision and serve as role models to inspire change. Strategic leaders who focus on strategic planning and securing top management support. Supportive leaders who empower, emphasizing employee motivation, individualized support, and team collaboration. Stamina highlights courage, assertiveness, and resilience in the face of challenges. Finally, agility which addresses a leader's presence, accessibility, and rapid responsiveness, fostering adaptability.

CONCLUSIONS

The study demonstrates leadership attributes explicitly focusing on instigating and driving organization-wide change through Magnet®/Pathway® principles in five German hospitals. The findings suggest a need for comprehensive preparation and ongoing development of nurse leaders aimed at establishing and sustaining a positive hospital work environment.

How Does Transformational Leadership Relieve Teacher Burnout: The Role of Self-Efficacy and Emotional Intelligence

This study explored the underlying mechanisms and boundary conditions of the relationship between transformational leadership and teacher burnout. Specifically, it investigated the mediating role of teacher self-efficacy and the moderating role of teacher emotional intelligence (EI) in this relationship. Data from 539 primary and secondary school teachers were analyzed using Structural Equation Model and hierarchical regression. The results indicate that transformational leadership predicted teacher burnout negatively, self-efficacy mediated the association of transformational leadership with burnout partially, and EI strengthened the association between transformational leadership and burnout. This study has important theoretical and managerial implications as it deepens the understanding of the association between transformational leadership and burnout in the educational field and provides practical suggestions on how to relieve teacher burnout in the school context.

The mediating role of quality of work life and organizational commitment in the link between transformational leadership and organizational citizenship behavior

In this modern era, schools require Organizational Citizenship Behavior (OCB) of organization members as one of the determining elements for the smooth process of achieving school goals. Leadership can transform an organization's entire potential as a learning community towards better organizational change, which is needed to increase OCB. This article aims to analyze the direct and indirect relationship between transformational leadership (TL) and OCB with quality of work-life (QWL) and organizational commitment (OC) as mediators. Another aim is to analyze the role of QWL as a mediator of the relationship between TL and OC. The research sample was 165 permanent teachers from several high schools in Madiun City. Research data was collected through questionnaires, and Structural Equation Modeling (SEM) was used for data analysis. The data analysis results prove a significant direct relationship between TL, QWL, and OC with OCB in a positive direction. The results of testing the role of mediating variables contribute to the novelty of this research, namely: 1) QWL partially mediates the relationship between TL and OC, as well as the relationship between TL and OCB; 2) OC partially mediates the relationship between TL and OCB. The analysis results indicate that increasing teacher OCB can be done effectively through increasing transformational leadership practices, programs to improve the quality of work-life, and increasing teacher organizational commitment.

Relationship between transformational leadership, adverse patient events, and nurse-assessed quality of care in emergency units: The mediating role of work satisfaction

BACKGROUND

Effective leadership plays a pivotal role in healthcare settings, particularly in the fast-paced and high-pressure environment of the emergency room, as it is closely linked to patient safety and the overall quality of care. This study assessed the mediating role of work satisfaction in the relationship between nurses' perceptions of their nurse managers' transformational leadership, reported adverse patient events, and the nurse-assessed quality of care in the emergency units.

METHODS

A cross-sectional survey design was carried out involving 283 emergency room nurses from the Philippines, utilizing standardized scales. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4).

RESULTS

Emergency room nurses perceived their nurse managers as highly transformational. Nurses' perceptions of transformational leadership in their nurse managers were associated with a reduction in reported adverse patient events and an increase in nurse-assessed nursing care quality. Work satisfaction partially mediated the relationship between transformational leadership and nurse-assessed nursing care quality, but it did not serve as a mediator between transformational leadership and reported adverse patient events.

CONCLUSION

The results suggested that enhancing transformational leadership behaviors among nurse leaders can foster work satisfaction in ER nurses, which, in effect, contributes to enhanced nursing quality of care provision in emergency settings.

Taken to the extreme: Transformational leadership, psychological capital, and follower health outcomes in extreme contexts

The purpose of this study is to examine the boundary conditions of transformational leadership, follower psychological capital, and their effects on follower mental health outcomes. Specifically, we utilize archival, multi-wave data from a military sample to examine whether the negative relationship between transformational leadership and adverse follower stress outcomes increases as the context shifts from a relatively safe environment to one in which follower lives are at risk. Additionally, psychological capital, a constellation of personal psychological resources, is also assessed to account for individual buffers against extreme stressors. Findings from the current study suggest that the negative relationship between transformational leadership and follower stress increases significantly when the context shifts to a high-risk, mortality-salient environment.

Transformational leadership, well-being, morale, and readiness: The mediating role of empowerment

Transformational leadership is embedded in the value system of the Canadian military ethos. Research suggests that transformational leadership can be viewed as a form of empowering leadership facilitating empowered psychological states among their followers, which in turn, enhances their performance, wellbeing, and engagement. The current study examined the associations between transformational leadership and Canadian Armed Forces members' psychological distress, morale, and pre-deployment readiness and the mediating role of psychological empowerment in these relationships. A path analysis model of the data collected through a pre-deployment survey completed by Canadian Armed Force (CAF) members (N = 2,391) revealed that transformational leadership was associated with lower psychological distress and greater morale and these relationships were partly explained by increased feelings of empowerment, namely higher levels of autonomy, competence, and meaning. Furthermore, transformational leadership was also associated with higher perceptions of pre-deployment readiness, and this was partly explained by increased feelings of meaning and competence. The results of this research suggest that transformational leadership is an effective strategy to bolster psychological resources and readiness in the CAF.

Effect of leadership styles on turnover intention among staff nurses in private hospitals: the moderating effect of perceived organizational support

Leadership styles have often been proven to support employees in performing their duties better and with more efficiency while enabling them to have extended organizational tenures. Staff nurses are an essential resource of hospitals to ensure proper administration and quality patient health care. The study aims to determine how transformational and authentic leadership styles affect the staff nurses' turnover intention in private hospitals. In addition, it also finds the moderating effect of perceived organizational support. An explanatory quantitative research design with a cross-sectional investigation and a stratified sampling strategy was used for the study. Data from 296 nurses from the eight chosen private hospitals in the Kingdom of Bahrain were gathered using a questionnaire with 24 items. Smart-PLS was employed to conduct PLS-SEM (partial least squares structural equation modeling) to measure direct and indirect effects. The result indicates that transformational, authentic leadership styles and perceived organizational support significantly negatively affect nurses' turnover intention. The study confirms the negative moderating effect of perceived organizational support between transformational leadership and turnover intention and the positive moderating effect of perceived organizational support between authentic leadership and turnover intention. Managers should concentrate on the leadership style to avoid its impact on turnover intention. By considering human resource practices such as communication and training strategies to cope with the negative effect of turnover intention, organizations can enhance employee engagement, improve job satisfaction, and foster a more stable and productive work environment. The present research revealed the adverse impact of turnover intention within hospitals by examining its association with leadership styles. The research made a significant contribution to the existing literature by delving into the impact of leadership styles on turnover intention, focusing on the moderating effect of perceived organizational support. The study's findings shed light on the intricate relationship between leadership practices and employee turnover, providing valuable insights for both scholars and practitioners in the field. The study used a cross-sectional design to collect data and ensured the absence of standard method variance. The research enhanced the social dominance theory (SDT) by examining how perceived organizational support moderates the relationship between leadership styles and turnover intention.

Relationships of Transformational and Paternalistic Leadership Styles With Follower Needs, Multidimensional Work Motivations and Organizational Commitment: A Mediated Model

Paternalistic Leadership (PL) style is suggested to be an emic manifestation of Transformational Leadership (TL) in cultural contexts characterized by high power distance and collectivism. The present study investigated the effects of TL and PL behaviors on employees' multidimensional work motivation and organizational commitment and the mediating effects of satisfaction of psychological needs (needs for autonomy, competence, and relatedness) in these relationships. Data were collected from 423 white-collar employees and analyzed by Structural Equation Modeling. The findings revealed that TL was significantly related to employees' autonomous and controlled work motivations as well as amotivation via its association with the satisfaction of employees' needs for autonomy, competence, and relatedness. PL was associated with employees' autonomous work motivations and amotivation via satisfaction of employees' need for relatedness. Autonomous motivations were positively associated with affective commitment; whereas controlled motivations were positively related to normative commitment. Amotivation was negatively associated with all types of commitment. The findings are discussed in terms of theoretical and practical implications as well as suggestions for future research.

Transformational leadership and organizational learning culture in the health sector: The mediating and moderating role of intrinsic work motivation

BACKGROUND

Transformational leadership and organizational learning culture have become exciting topics to be explored over the last few decades. However, several previous studies have shown certain inconclusive findings regarding the link between transformational leadership and organizational learning culture.

OBJECTIVE

This study fills this gap by developing a clear model and aims to examine the extent of the impact of (1) transformational leadership on organizational learning culture and intrinsic work motivation, (2) intrinsic work motivation on organizational learning culture, (3) intrinsic work motivation in mediating and moderating the relationship between transformational leadership and organizational learning culture.

METHODS

The data of this study are collected from employees working at the community health center in Indonesia. A partial least squares (PLS) based structural equation modeling (SEM) technique is used to analyze the data by utilizing the SmartPLS 3.0 software package.

RESULTS

First, the results concluded that transformational leadership has a significant impact on organizational learning culture and intrinsic work motivation. Second, intrinsic work motivation has a significant impact on organizational learning culture. Third, intrinsic work motivation fully mediates the relationship between transformational leadership and organizational learning culture. Also, intrinsic work motivation moderates these variables' relationships.

CONCLUSION

The theoretical model of previous research on the relationship between transformational leadership and organizational learning culture with intrinsic work motivation as a mediator and moderator variable has yet to be fully developed both in public and private organizations, particularly in the health sector.

Characteristics of transformational leadership development programs: A scoping review

The effectiveness of transformational leadership (TFL) on various outcomes is well known. Accordingly, researchers have developed training programs to enhance TFL behaviours of leaders. Yet, no reviews summarizing the characteristics of TFL training programs exist. The purpose of this review was to examine the characteristics, reporting, and application of TFL-informed programs. A search of six databases yielded 4032 articles, 31 of which met the inclusion criteria. Program characteristics were analyzed using the Template for Intervention Description and Replication (TIDieR) checklist tool, while outcomes were analyzed according to the Kirkpatrick model of evaluation. The most common context for TFL program implementation was healthcare (n = 9). Programs were tailored and often delivered using group workshops and individual feedback. Studies reported variation in the dose of programs, rarely evaluated outcomes multiple times post-baseline, and typically employed Level 3a (subjective ratings of behaviour) evaluation measures. Reporting on program location, modifications, and fidelity was poor. Varying conceptualizations of TFL in different contexts lead to disparities in programs and protocols. Evaluation specialists should consider using tools like the TIDiER checklist to ensure that program characteristics are reported appropriately. Program planners should develop common approaches for planning and evaluating TFL programs to improve transparency and replicability of programs.

Green human resources management practices, leadership style and employee engagement: Green banking context

This paper discusses green human resource management practices, employee engagement, and transformational leadership in green banking. Specifically, we explore how green human resource management practices influence employee engagement, and how the role of transformational leadership influences their relationships. We used a random sample of 363 green bank employees in Indonesia. Data was collected through online surveys and analyzed using regression modeling. The results show that in general, green human resource management practices are positively and significantly related to employee engagement, and transformational leadership is shown to moderate the relationship. However, specifically, green recruitment and selection only affects the behavioral factors of employee engagement, but not affective and cognitive factors. Meanwhile, training and development only affect the affective factors of employee engagement, but not cognitive and behavioral factors. Furthermore, this research presents novel discoveries regarding how the interplay of contextual and institutional factors between transformational leadership behaviors and green human resource management practices can promote employee engagement.

The impact of empowering and transformational leadership on innovative behaviour: the mediating role of psychological empowerment in health-care sector

PURPOSE

The purpose of this study was to test a four-variable research model using organizational behavior, social and technical systems, and leadership theories. This study set out to determine how different leadership philosophies, such as transformational leadership and empowering leadership, affected innovation. In addition, the model's mediating role for psychological empowerment was quantified.

DESIGN/METHODOLOGY/APPROACH

This study used a quantitative approach, which is primarily a questionnaire, to gather information from 320 health-care sector workers at four public hospitals in the Basrah Governorate.

FINDINGS

The majority of the relationships in the research model were shown to be positive by data analysis outcomes. The findings also showed how crucial the mediating variable was in preserving the link between the independent and dependent variables. Discussions were made on the theoretical and practical ramifications and suggestions for additional research.

ORIGINALITY/VALUE

This study concentrated on the application of contemporary leadership styles, gathered information on them and combined them into a single model to boost innovation. This study, which was conducted in the setting of the Iraqi health-care industry, stands out from previous studies because it used a large sample to provide conclusive and significant results, making it a valuable resource for academicians who seek to cultivate innovation.

Practice development amidst a pandemic: a pilot programme to develop leadership in infection prevention and control professionals

PURPOSE

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme's aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.

DESIGN/METHODOLOGY/APPROACH

The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners' interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.

FINDINGS

The authors' evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another's experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.

RESEARCH LIMITATIONS/IMPLICATIONS

Despite a small sample size, the authors' results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.

PRACTICAL IMPLICATIONS

The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.

ORIGINALITY/VALUE

ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

The relationships between leader emotional intelligence, transformational leadership, and transactional leadership and job performance: A mediator model of trust

This study utilized the hierarchical linear model and trust as a mediator; designated leader emotional intelligence as a team-level dimension; and designated transformational leadership, transactional leadership, and trust in supervisor as individual-level dimensions. An analysis was performed to explore the relationships between these individual- and team-level variables and the job performance of real estate brokers, as well as the potential role of trust-oriented leadership as a mediator for the relationships between leader emotional intelligence, transformational leadership, and transactional leadership and individual job performance. The empirical results revealed that leader emotional intelligence, transformational leadership, and transactional leadership had direct, significant, and positive relationships with individual job performance. Furthermore, it was also discovered that, with trust in supervisor serving as a mediator, these three variables also had indirect, significant, and positive relationships with employee job performance.

Transformational leadership and work engagement as mediators on nurses' job performance in healthcare clinics: work environment as a moderator

PURPOSE

This study aims to investigate the mediating effect of transformational leadership (TL) and work engagement (WE) on health-care clinic nurses' performance and the crucial role of these variables in the work environment (WEV).

DESIGN/METHODOLOGY/APPROACH

Data were collected from 353 nurses working across various health-care clinics in the United Arab Emirates. This study used descriptive correlational statistics from the Statistical Package for the Social Sciences, the Pearson correlation coefficient, confirmatory factor analysis for model validity, Cronbach's alpha for reliability and path analysis to determine the results.

FINDINGS

The relationship between TL and job performance among nurses in health-care clinics was strongly influenced by WE. In addition, a moderate WEV increased the positive influence of TL on job accomplishment. Furthermore, there were no statistically significant differences between the participants' demographics characteristics and the main variables of the study.

PRACTICAL IMPLICATIONS

Health-care management can support and enhance nurses' job performance through TL, create a more structured WEV and support WE.

ORIGINALITY/VALUE

This study involves a specific investigation into WE as a mediator, WEV as a moderator and the effect of TL on nurses' job performance.

An antidote to what's ailing healthcare workers: a new (old) way of relational leadership

PURPOSE

The purpose of the study's mixed-methods evaluation was to examine the ways in which a relational leadership development intervention enhanced participants' abilities to apply relationship-oriented skills on their teams.

DESIGN/METHODOLOGY/APPROACH

The authors evaluated five program cohorts from 2018-2021, involving 127 interprofessional participants. The study's convergent mixed-method approach analyzed post-course surveys for descriptive statistics and interpreted six-month post-course interviews using qualitative conventional content analysis.

FINDINGS

All intervention features were rated as at least moderately impactful by at least 83% of participants. The sense of community, as well as psychological safety and trust created, were rated as impactful features of the course by at least 94% of participants. At six months post-intervention, participants identified benefits of greater self-awareness, deeper understanding of others and increased confidence in supporting others, building relationships and making positive changes on their teams.

ORIGINALITY/VALUE

Relational leadership interventions may support participant skills for building connections, supporting others and optimizing teamwork. The high rate of skill application at six months post-course suggests that relational leadership development can be effective and sustainable in healthcare. As the COVID-19 pandemic and systemic crises continue to impact the psychological well-being of healthcare colleagues, relational leadership holds promise to address employee burnout, turnover and isolation on interprofessional care teams.

Reconciling general transformational leadership and safety-specific transformational leadership: A paradox perspective

INTRODUCTION

Research exploring the relationship between transformational leadership and safety has used transformational leadership in context-free (e.g., "general transformational leadership," or GTL) and context-specific forms (e.g., "safety-specific transformational leadership," or SSTL), assuming these constructs are theoretically and empirically equivalent. In this paper, a paradox theory is drawn on (Schad, Lewis, Raisch, & Smith, 2016; Smith & Lewis, 2011) to reconcile the relationship between these two forms of transformational leadership and safety.

METHOD

This is done by: (a) investigating whether GTL and SSTL are empirically distinguishable; (b) testing the relative importance of GTL and SSTL in explaining variance in context-free work outcomes (i.e., in-role performance, organizational citizenship behaviors) and context-specific (i.e., safety compliance, safety participation); and (c) examining the extent to which perceived safety concern in the work environment renders GTL and SSTL distinguishable.

RESULTS

Two studies (one cross-sectional, one short-term longitudinal) show that GTL and SSTL are psychometrically distinct albeit highly correlated. Furthermore, SSTL explained statistically more variance than GTL in both safety participation and organizational citizenship behaviors, whereas GTL explained more variance in in-role performance than did SSTL. However, GTL and SSTL were only distinguishable in low-concern contexts but not high-concern contexts.

CONCLUSIONS AND PRACTICAL APPLICATIONS

These findings challenge the "either-or" (vs "both-and") approach to considering safety and performance, cautioning researchers to consider nuanced differences in context-free and context-specific forms of leadership and to avoid further proliferation of often redundant context-specific operationalizations of leadership.

From Evidence-Based Practice to Knowledge Translation: What Is the Difference? What Are the Roles of Nurse Leaders?

OBJECTIVES

Nurses, as the largest healthcare workforce, are well-positioned to apply knowledge translation. The role of nursing leadership in facilitating evidence-based practice has been extensively discussed in the literature, but this is not the case for knowledge translation. The objective of this study was to examine the potential role of nurse leaders in applying knowledge translation across health settings.

DATA SOURCES

We reviewed the existing literature for evidence-based practice as best practice in clinical care; examined how a complex systems approach to knowledge translation may extend beyond evidence-based practice, and considered nursing leadership approaches including transformational leadership.

CONCLUSION

In this discursive article, we discuss the differences between evidence-based practice and knowledge translation, highlight the promise of transformational leadership in facilitating knowledge translation through a complex systems lens, and argue for the importance of nurse leaders in facilitating and supporting complex knowledge translation across healthcare settings.

IMPLICATIONS FOR NURSING PRACTICE

Although future research is needed to test our ideas, we argue that the advanced conceptual understanding generated in this article should inform a roadmap toward a future in which nurse leaders initiate, participate and advocate for complex knowledge translation across healthcare settings.

Theoretical Frameworks of Leadership in Nursing: Critical Reflections

OBJECTIVES

The objective of this article is to present a comprehensive view on the topic of nursing leadership discussing the theoretical frameworks that underpin its manifestation, the leadership styles in nursing, the overall landscape in nursing leadership including the context where leadership is being practiced, and finally looking at the educational pathways for building leadership capacity and sustainability DATA SOURCES: Relevant studies on the topic as well professional associations, national and international organizations' evidence have formed the basis for this article.

CONCLUSION

The role of the nurse leaders is complex and demanding within the context of health care. Its value has been increasingly drawing the attention of national and international organizations. The nurse leader is performing tasks within rapidly shifting environments that require constant changes to best address the organizational goals but remain true to the values and perspectives envisioned by the nursing profession. Through the implementation of corresponding competency frameworks, the capacity and preparedness of nurse leaders can be cultivated ideally in a multidisciplinary context.

IMPLICATIONS FOR NURSING PRACTICE

Nurse leaders are increasingly assuming positions of authority across the structures of health care organizations. There is need to timely and appropriately increase the preparedness of nurse leaders to assume and sustain these challenging and dynamic roles.

Proposal of a service delivery model for supported living community forensic services

PURPOSE

Following serious case review, the Transforming Care agenda (DH, 2015) highlights the need for adults with learning disabilities, autism, mental health issues or behaviors that challenge to be supported within communities rather than hospitals. Poor or absent leadership has been identified as contributing to serious cases of abuse in health-care settings [Department of Health (DH), 2012]. This paper aims to focus on identifying the elements required for good leadership and service delivery in community forensic services (CFS).

DESIGN/METHODOLOGY/APPROACH

The perspectives of 12 support workers working in CFS were obtained through semi-structured interviews.

FINDINGS

Thematic analysis identified two predominant themes, namely, authentic leadership and effective team practice. A culture of trust and learning occurs when teams are well led. This culture leads to consistent practice which benefits services users and reduces risk of poor practice. Analysis suggests a framework for service delivery which is complimented by aspects of the Total Attachment model.

RESEARCH LIMITATIONS/IMPLICATIONS

The data set was collected from the same organisation and views may have been aligned to existing organisational policy. However, the sample was taken across different teams and geographical locations to collate more generalised experiences of team dynamics. The lead researcher works for the organisation and this dual role may have affected the candour with which individuals shared information during interviews.

PRACTICAL IMPLICATIONS

Using a model to understand the functional dynamics of teams within CFS may support leaders and practitioners to improve service delivery.

SOCIAL IMPLICATIONS

Improving service delivery within CFS may increase opportunity to meet the Transforming Care Agenda.

ORIGINALITY/VALUE

This paper examines staff perspectives and the application of theoretical frameworks to propose a unique service delivery model for supported living within CFS.

Transformational health-care leaders in collaborative entrepreneurial model to achieve UNSDG: a qualitative study

PURPOSE

The agglomeration of specialist health-care facilities has often been restricted to metropolitan areas. This study aims to understand how health-care professionals with transformational leadership behaviors and entrepreneurial aims with a similar vision and expertise play pertinent roles in providing essential specialized health care in rural and semi-urban areas and achieving the United Nations Sustainable Development Goals (UNSDGs).

DESIGN/METHODOLOGY/APPROACH

Qualitative synthesis using focused-group discussions and interviews was conducted in a phased manner. For this, this study has used stakeholder-theory, and dynamic-capabilities approaches.

FINDINGS

This study explores the intricacies of collaborative entrepreneurship (CE)-based health-care ventures in developing regions and reveals five pertinent attributes: strategic control, synergy, commitment, empathy and satisfaction. This study recommends that entrepreneurial collaboration, especially by transformational health-care leaders, can significantly contribute to creating an endogenous health-care ecosystem with advanced facilities and technology-enabled modern infrastructure and augmenting regional development.

RESEARCH LIMITATIONS/IMPLICATIONS

This study was conducted in semi-urban settings in India. Future research should include other sectors and regions to generalize the findings.

PRACTICAL IMPLICATIONS

This study benefits health-care professionals having an analogous vision, skills and entrepreneurial aims.

SOCIAL IMPLICATIONS

Collaboration of health-care professionals and using transformational leadership behaviors can considerably contribute to providing specialist health care in developing areas and enhance patient satisfaction.

ORIGINALITY/VALUE

To the best of the authors' knowledge, this is the first study to discuss the importance of CE in health care in developing areas. In addition, it discusses the benefits of the CE model in achieving the UNSDGs and offers valuable suggestions for health-care professionals and administrators.

The psychological mechanism of construction workers' safety participation: The social identity theory perspective

INTRODUCTION

Safety participation has gained increasing attention as an important dimension of workers' safety behaviors. Although previous studies attempted to identify factors affecting workers' safety participation, only a few studies paid attention to the psychological mechanisms behind it. Therefore, this study aimed to develop and test a research model that explains how management factors are implicated in workers' safety participation. Specifically, this study focused on project-based organizations (e.g., construction projects) because employee psychological mechanisms may have a unique nature in such transient employment.

METHOD

The hypotheses in the research model of the psychological mechanism of construction workers' safety participation are tested using survey data from 261 construction workers.

RESULTS

The results indicated that construction workers' safety participation is influenced by project identification after controlling the shared variance of safety compliance. Project identification also mediates the effects of transformational leadership and communication climate on safety participation.

PRACTICAL APPLICATIONS

This study offers researchers and practitioners an explanation of how management factors influence construction workers' safety behaviors and clarifies the role of project identification play in explaining the effects of management factors on safety compliance and safety participation.

A model of lived experience leadership for transformative systems change: Activating Lived Experience Leadership (ALEL) project

PURPOSE

This discursive paper presents a lived experience leadership model as developed as part of the Activating Lived Experience Leadership (ALEL) project project to increase the recognition and understanding of lived experience leadership in mental health and social sectors. The model of lived experience leadership was formulated through a collaboration between the South Australian Lived Experience Leadership & Advocacy Network and the Mental Health and Suicide Prevention Research and Education Group.

DESIGN/METHODOLOGY/APPROACH

As one of the outcomes of the ALEL research project, this model incorporates findings from a two-year research project in South Australia using participatory action research methodology and cocreation methodology. Focus groups with lived experience leaders, interviews with sector leaders and a national survey of lived experience leaders provided the basis of qualitative data, which was interpreted via an iterative and shared analysis. This work identified intersecting lived experience values, actions, qualities and skills as characteristics of effective lived experience leadership and was visioned and led by lived experience leaders.

FINDINGS

The resulting model frames lived experience leadership as a social movement for recognition, inclusion and justice and is composed of six leadership actions: centres lived experience; stands up and speaks out; champions justice; nurtures connected and collective spaces; mobilises strategically; and leads change. Leadership is also guided by the values of integrity, authenticity, mutuality and intersectionality, and the key positionings of staying peer and sharing power.

ORIGINALITY/VALUE

This model is based on innovative primary research, which has been developed to encourage understanding across mental health and social sectors on the work of lived experience leaders in seeking change and the value that they offer for systems transformation. It also offers unique insights to guide reflective learning for the lived experience and consumer movement, workers, clinicians, policymakers and communities.

The Making of Nurse Leaders in the Nursing Home

Nurse leaders are first and foremost, registered nurses. Nursing leadership is critical for improving the care and quality of life for older adults. Visionary nurse leaders collaborate, motivate, influence, and inspire the achievement of values and goals to improve the quality of life for older adults in long-term care. Professional registered nurses are transformational servant nurse leaders who hold the key to nursing home reform.

Transformational leadership practices of nurse managers: the effects on the organizational commitment and job satisfaction of staff nurses

PURPOSE

This study aims to investigate the perception of nurse managers and staff nurses regarding the transformational leadership (TL) style of nurse managers and determine the effects of the TL practices on organizational commitment and job satisfaction of staff nurses.

DESIGN/METHODOLOGY/APPROACH

This cross-sectional and descriptive study was conducted with 153 nurses (17 nurse managers and 136 staff nurses) working in a university hospital. Data were collected from participants through a demographic questionnaire, leadership practices inventory (self/observer), organizational commitment scale and job satisfaction scale.

FINDINGS

The self-assessment of the TL practices of the nurse managers were more favourable than the assessment of the leadership practices made by staff nurses. The TL practices of the nurse managers accounted for 9% of the total organizational commitment and 24% of the total job satisfaction of the staff nurses.

ORIGINALITY/VALUE

The results indicated that leadership practices by nurse managers need to show greater awareness of the effects of these leadership practices on the organizational commitment and job satisfaction of their staff nurses. Hospitals need to consider how they develop, support and encourage because of the positive impact TL has on health priorities and retention of staff.

Modeling the turnover intentions of Thai health-care personnel in pandemic times: moderating role of Covid-19 burnout

PURPOSE

Covid-19 cases are rising at a high rate in Thailand. Thailand's administration has formulated many initiatives to combat the spread of coronavirus. However, during a pandemic, health-care workers have a diverse range of tasks that make it more challenging to continue working in hospitals. Consequently, the authors modeled the turnover intentions of health-care personnel to capture relevant psychological aspects of employees during the pandemic. Specifically, this study aims to focused on the moderating role of Covid-19 burnout (CBO) in the relationship between transformational leadership (TL) and job turnover intentions (JTI) with job satisfaction (JS) and knowledge hiding (KH) as mediators.

DESIGN/METHODOLOGY/APPROACH

This research collected data using self-administered questionnaire. A two-stage partial least square-structural equation modeling (PLS-SEM) is carried out as an analysis technique to measure the linear relationship among constructs. The study tests hypotheses (direct and indirect effects) using 310 sample size of health-care personnel.

FINDINGS

The findings indicated that CBO intensified the JTI of health-care personnel and strengthened the association of JS and KH with JTI during the Covid-19 pandemic. TL had a negative indirect effect on JTI. In addition, JS had a negative impact on JTI.

ORIGINALITY/VALUE

The study highlights the importance of TL and JS as ways to reduce or alleviate JTI in health-care personnel during the Covid-19 pandemic in Thailand. Furthermore, CBO and KH can enhance JTI in health-care personnel.

A stepped-wedge randomized trial investigating the effect of the Leadership and Organizational Change for Implementation (LOCI) intervention on implementation and transformational leadership, and implementation climate

BACKGROUND

This study evaluates the Leadership and Organizational Change for Implementation (LOCI) strategy and its effect on implementation leadership, transformational leadership, and implementation climate.

METHODS

A stepped wedge cluster randomized study design enrolling 47 first-level leaders from child- and adult-specialized mental health clinics within Norwegian health trusts across three cohorts. All therapists (n = 790) received training in screening of trauma exposure and posttraumatic stress, and a subgroup of therapists (n = 248) received training in evidence-based treatment methods for posttraumatic stress disorder (PTSD). First-level leaders and therapists completed surveys at baseline, 4, 8-, 12-, 16-, and 20-months assessing leadership and implementation climate. General linear mixed-effects models were used to investigate whether the LOCI strategy would lead to greater therapist-rated scores on implementation leadership, transformational leadership, and implementation climate.

RESULTS

After introducing the LOCI strategy, there was a significant increase in therapist-rated implementation and transformational leadership and implementation climate. The increase was sustained at all measurement time points compared to non-LOCI conditions, which demonstrated a steady decrease in scores before LOCI.

CONCLUSIONS

The LOCI strategy can develop better transformational and implementation leadership skills and contribute to a more positive implementation climate, which may enhance successful EBP implementation. Thus, LOCI can help leaders create an organizational context conducive for effective EBP implementation.

TRIAL REGISTRATION

Retrospectively registered: ClinicalTrials NCT03719651 , 25th of October 2018. The trial protocol can be accessed from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417075/ .

Validation of the Norwegian versions of the Implementation Leadership Scale (ILS) and Multifactor Leadership Questionnaire (MLQ) in a mental health care setting

Background

The implementation of evidence-based practices (EBPs) is of crucial importance in health care institutions and requires effective management from leaders. However, there is a lack of assessment tools sufficient to evaluate the degree to which the employees´ rate how well their leaders are at implementing EBPs. This emphasises the need for validated and widely used scales relevant for EBPs.

Methods

The current study evaluated the psychometric properties of the Multifactor Leadership Questionnaire (MLQ) and Implementation Leadership Scale (ILS) in a Norwegian mental health care setting.

Results

Results from confirmatory factor analyses indicate that the MLQ and ILS are valid instruments for measuring general and implementation leadership. The scales demonstrate good convergent validity. In addition, attitudes towards EBPs did not seem to be associated with the ILS and MLQ, further supporting the applicability of the instruments.

Conclusions

The two scales demonstrate good psychometric properties in a Norwegian mental health care setting, which suggests that the MLQ and ILS are valid and reliable tools for measuring leadership in an implementation setting. More research is greatly needed to disentangle the link between perceived leadership and objective measures of successful implementation of EBPs.

Trial registration NSD 690,133, NSD 60,059/3/OOS.

Knowledge hiding in organizational crisis: The moderating role of leadership

The COVID-19 pandemic has caused organizational crises leading to shutdowns, mergers, downsizing or restructuring to minimize survival costs. In such organizational crises, employees tend to experience a loss or lack of resources, and they are more likely to engage in knowledge hiding to maintain their resources and competitive advantage. Knowledge hiding has often caused significant adverse consequences, and the research on knowledge hiding is limited. Drawing upon the Conservation of Resources and Transformational Leadership theories, a conceptual framework was developed to examine knowledge hiding behavior and its antecedents and consequences. We collected data from 281 Vietnamese employees working during the COVID-19 pandemic. Our results show that role conflict, job insecurity, and cynicism positively impact knowledge hiding behavior. Knowledge hiding behavior negatively affects job performance and mediates the antecedents of knowledge hiding on job performance. Transformational leadership moderated the impact of role conflict on knowledge hiding.

Leadership style based on the study of multifactor leadership questionnaire in Palu Anutapura hospital

OBJECTIVE

Leadership style that can accommodate changes in uncertain times. The purpose of this study was to describe the leadership style of the head of the room in terms of the scale and construct of the Multifactor Leadership Questionnaire.

METHODS

This research was a descriptive type that was conducted at the Anutapura Hospital in August 2020. There were 22 treatment rooms and the researchers took all the heads of treatment rooms to be sampled. Collecting data using a Multifactor Leadership Questionnaire (MLQ-5X).

RESULTS

The results showed that 63.6% tend to use transformational leadership styles, 9.1% tend to use transactional leadership styles and 27.3% are based on the leader's outcomes.

CONCLUSIONS

The dominant transformational leadership style used by the head of the room because it is considered effective in facing the era of globalization and modernization.

Leading through the first wave of COVID: a Canadian action research study

PURPOSE

This first phase of a three-phase action research project aims to define leadership practices that should be used during and after the pandemic to re-imagine and rebuild the health and social care system. Specifically, the objectives were to determine what effective leadership practices Canadian health leaders have used through the first wave of the COVID-19 pandemic, to explore how these differ from pre-crisis practices; and to identify what leadership practices might be leveraged to create the desired health and care systems of the future.

DESIGN/METHODOLOGY/APPROACH

The authors used an action research methodology. In the first phase, reported here, the authors conducted one-on-one, virtual interviews with 18 health leaders from across Canada and across leadership roles. Data were analyzed using grounded theory methodology.

FINDINGS

Five key practices emerged from the data, within the core dimension of disrupting entrenched structures and leadership practices. These were, namely, responding to more complex emotions in self and others. Future practice identified to create more psychologically supportive workplaces. Agile and adaptive leadership. Future practice should allow leaders to move systemic change forward more quickly. Integrating diverse perspectives, within and across organizations, leveling hierarchies through bringing together a variety of perspectives in the decision-making process and engaging people more broadly in the co-creation of strategies. Applying existing leadership capabilities and experience. Future practice should develop and expand mentorship to support early career leadership. Communication was increased to build credibility and trust in response to changing and often contradictory emerging evidence and messaging. Future practice should increase communication.

RESEARCH LIMITATIONS/IMPLICATIONS

The project was limited to health leaders in Canada and did not represent all provinces/territories. Participants were recruited through the leadership networks, while diverse, were not demographically representative. All interviews were conducted in English; in the second phase of the study, the authors will recruit a larger and more diverse sample and conduct interviews in both English and French. As the interviews took place during the early stages of the pandemic, it may be that health leaders' views of what may be required to re-define future health systems may change as the crisis shifts over time.

PRACTICAL IMPLICATIONS

The sponsoring organization of this research - the Canadian Health Leadership Network and each of its individual member partners - will mobilize knowledge from this research, and subsequent phases, to inform processes for leadership development and, succession planning across, the Canadian health system, particularly those attributes unique to a context of crisis management but also necessary in post-crisis recovery.

SOCIAL IMPLICATIONS

This research has shown that there is an immediate need to develop innovative and influential leadership action - commensurate with its findings - to supporting the evolution of the Canadian health system, the emotional well-being of the health-care workforce, the mental health of the population and challenges inherent in structural inequities across health and health care that discriminate against certain populations.

ORIGINALITY/VALUE

An interdisciplinary group of health researchers and decision-makers from across Canada who came together rapidly to examine leadership practices during COVID-19's first wave using action research study design.

Effect of Transformational Leadership on Nursing Informatics Competency of Chinese Nurses: The Intermediary Function of Innovation Self-Efficacy

Nursing informatics competency has crucial functions in the development of a hospital and patient safety. On the basis of the theory of self-concept, there has been an inadequate study of the influence of transformational leadership on nursing informatics competency mediated by innovation self-efficacy. A descriptive correlational research design was conducted for 586 Chinese nurses from five public hospitals. The measurements were obtained from a questionnaire on transformational leadership, nursing informatics competency, innovation self-efficacy, and a sociodemographic datasheet. We identified a positive correlation between transformational leadership and nursing informatics competency. Innovation self-efficacy had a mediating effect. Managers need to provide measures to shape their transformational leadership style and promote innovation self-efficacy of nurses, which enhances nursing informatics competency of nurses.

Leadership in times of crisis. School principals facing COVID-19

This article analyzes the personal leadership resources utilized by a sample of school principals in Catalonia (Spain) during the confinement and post-confinement periods due to the COVID-19 crisis. A questionnaire was designed, validated, and provided to the principals from Primary Education schools to carry out the study. The questionnaire analyzed personal leadership resources used by the principals during the confinement and post-confinement periods, compared to a former ¨normal situation¨. The data analysis results confirmed that the role of the principals was crucial in redirecting the situation and completing the academic course satisfactorily. The principals scored their leadership resources remarkably high in the former normality and maintained proactivity at a similar level during the crisis. However, other resources scored lower during the same period. As a direct result, there was a high degree of adaptation to this situation from the principals. The results indicate that principals do not lead in the same manner in times of crisis as in normal times. Age, experience, and type of school influence the results only in former normal situations but not in times of crisis.

Are preventive measures adequate? An evaluation of the implementation of COVID-19 prevention and control measures in nursing homes in China

BACKGROUND

The novel coronavirus disease 2019 (COVID-19) pandemic has become a challenge for nursing homes in China. Nursing homes are particularly dangerous places in terms of the spread of COVID-19 given that they house vulnerable, high-risk populations. As such, several useful guidelines for coping with COVID-19 in nursing homes have been provided. However, the actual implementation rates of such guidelines are unknown. This study aims to document the adherence of nursing homes to the Ministry of Civil Affairs guidelines for COVID-19 prevention and control in nursing homes.

METHODS

A cross-sectional study was conducted among 484 nursing homes in 136 cities of 28 provinces in China. A self-report questionnaire was created based on the Ministry of Civil Affairs guidelines for COVID-19 prevention and control in nursing homes (first edition). The questionnaire and the Transformational Leadership in the Public Sector Scale were sent to nursing home managers via the Wenjuanxing app online from February 7 to 29, 2020. Ultimately, 461 of 960 nursing homes participated, for a response rate of 48.0%.

RESULTS

The average overall implementation rate of COVID-19 prevention and control measures was 80.0% (143.97/180). The average implementation rates for hygienic behaviour management and access management were lower, at 75.3 and 78.7%, respectively. Number of medical staff and transformational leadership score of nursing home's manager were associated with total implementation score (p < 0.05). A total of 69.8% (322/461) of the nursing home managers had serious resource problems, and inadequate protective supplies (72.0%) and staff shortages (47.7%) were the two primary problems. The nursing homes that located in urban, with large nursing home size, had hospital-nursing home cooperation and the transformational leadership score of manager> 60, had a lower risk of having serious resource problems.

CONCLUSIONS

Overall, the implementation of prevention and control measures by nursing homes are insufficient during the epidemic in China. More medical staff, adequate resource, cooperation with hospitals, and higher transformational leadership of manager are required to improve the implementation rate. It is urgent for nursing homes to maintain the safety of residents and staff.

The effects of knowledge sharing and person-organization fit on the relationship between transformational leadership on innovative work behavior

Previous studies reveal a gap in the literature regarding the role of knowledge-sharing behavior and person-organization fit as mediating variables in assessing the impact of transformational leadership on innovative work behavior. Additionally, some studies show that transformational leadership and person-organization fit influence innovative work behavior, while other studies have found that they do not. This study investigates the effects of transformational leadership, person-organization fit, and knowledge-sharing behavior on teachers' innovative work behavior and explores the role of knowledge-sharing behavior and person-organization fit as mediator variables. The study utilizes the partial least squares (PLS)-structural equation modeling (SEM) method to analyze data from 260 private elementary school teachers in South Jakarta, Indonesia. The result showed that transformational leadership does not positively affect innovative work behavior directly; however, the effect of transformational leadership on innovative work behavior becomes positive through knowledge-sharing behavior. Person-organization fit and knowledge-sharing behavior are shown to affect innovative work behavior positively, although the mediating variable did not increase the effect of person-organization fit on innovative work behavior.

British and Finnish nurses' attitudes, practice, and knowledge on deteriorating patient in-service education: A study in two acute hospitals

AIM

The aim was to assess both nurses' attitudes about in-service education, and the impact had by attending in-service education on nurses' management and knowledge of deteriorating patients.

BACKGROUND

In-service education cannot reach its best potential outcomes without strong leadership. Nurse managers are in a position of adopting leadership styles and creating conditions for enhancing the in-service education outcomes.

DESIGN

We conducted a comparative cross-sectional study between British and Finnish nurses (N = 180; United Kingdom: n = 86; Finland: n = 94).

METHODS

A modified "Rapid Response Team Survey" was used in data collection. A sample of medical and surgical registered nurses were recruited from acute care hospitals. Self-reporting, self-reflection, and case-scenarios were used to assess nurses' attitudes, practice, and knowledge. Data were analyzed by Mann-Whitney-U and Chi-square tests.

RESULTS

Nurses' views on education programs were positive; however, low confidence, delays caused by hospital culture, and fear of criticism remained barriers to post education management of deteriorating patients. Nurses' self-reflection on their management of deteriorating patients indicates that 20-25% of deteriorating patients are missed.

CONCLUSION

Nurse managers should promote a no-blame culture, mitigate unnecessary hospital culture and routines, and facilitate in-service education focusing on identification and management of deteriorating patients, simultaneously improving nurses' confidence.

The use of Lean tools to reduce inpatient waiting time in a Thai public hospital: an action research study

PURPOSE

The aims of this paper are to illustrate the use of Lean tools to reduce inpatient waiting time and to evaluate critical success factors of Lean implementation in an inpatient pharmacy in a Thai public hospital.

DESIGN/METHODOLOGY/APPROACH

This study was carried out through action research methodology by following four key phases: identification of problems; planning action; taking action; and evaluation. In the "taking action" phase, Lean tools, including value stream mapping and 5S were implemented to improve dispensing process in an inpatient pharmacy. In the "evaluation phase", the critical success factors of Lean implementation in an inpatient pharmacy were evaluated by the participants.

FINDINGS

Lean methodology was successfully implemented to reduce the waiting time associated with a three days dose distribution system. As a result of Lean application, the average process time reduced from 8.81 to 7.2 min and the standard deviation reduced from 5.49 to 4.45 min. Moreover, the support of middle management and the leadership were the key success factors of Lean implementation in an inpatient pharmacy.

PRACTICAL IMPLICATIONS

Hospitals can improve the dispensing process by using Lean tools which are easy to apply and use. This study is appropriate for hospital managers looking for changes in pharmacy services or other departments.

ORIGINALITY/VALUE

This is the first study that has applied Lean tools to improve the dispensing process in an inpatient pharmacy in Thai hospitals. This study offers important insights into the critical success factors of Lean employment in the inpatient pharmacy.

How Surgical Leaders Transform Their Residents to Craft Their Jobs: Surgeons' Perspective

BACKGROUND

Surgeons should transform their residents to take the lead in their jobs and optimize their working conditions, so-called job crafting. We investigated the actions undertaken by surgeons with a transformational leadership style to encourage residents' job crafting, about which there is at present a paucity of information.

METHODS

We performed a qualitative study based on principles of constructivist grounded theory. In-depth interviews were held with a purposive sample of surgeons who were perceived as transformational leaders by their residents. During data analysis (open, axial, and selective coding), we compared inductive codes with deductive codes drawn from the job demands-resources and transformational leadership theories to reach a consensus on the interpretation of data and identification of the main themes.

RESULTS

Sixteen surgeons participated. Surgeons undertook five actions that enhanced job crafting in residents. They: one) modeled positive behaviors of a good surgeon; two) used a stepwise individual approach toward autonomy; three) connected with the resident as a person; four) supported residents in handling complications and errors; and five) they coached the resident to deal with competing interests. These actions had four consequences for residents. They led to: one) more responsibilities in patient care; two) more constructive relationships in the workplace; three) less pressure from workload and surgical care duties; and four) less personal difficulties and errors in patient care.

CONCLUSIONS

The actions undertaken by surgeons with a transformational leadership style have a positive association with the residents' ability to craft their jobs. This knowledge has implications for surgeons' leadership development with a view to workplace education.

Capitalising on the transformational opportunities of early clinical academic career training for nurses, midwives and allied health professionals

BACKGROUND

A highly skilled workforce is required to deliver high quality evidence-based care. Clinical academic career training programmes have been developed to build capacity and capabilities of nurses, midwives and allied health professionals (NMAHPs) but it remains unclear how these skills and roles are operationalised in the healthcare context. The aim of this study was to explore the experiences of early career clinical academic NMAHPs who have undertaken, or are undertaking, clinical academic master's and doctoral studies in the United Kingdom.

METHODS

We conducted 17 in-depth semi-structured interviews with early career clinical academics which included; nurses, midwives and allied health professionals. The data were analysed using thematic analysis.

RESULTS

Two themes emerged from the data; identity transformation and operationalising transformation. Both these highlighted the challenges and opportunities that early clinical academic training provided to the individual and organisation in which they practiced. This required the reconceptualization of this training from the pure acquisition of skills to one of personal and professional transformation. The findings suggest that individuals, funders, and organisations may need to relinquish the notion that training is purely or largely a transactional exchange in order to establish collaborative initiatives.

CONCLUSION

Stakeholders need to recognise that a cultural shift about the purposes of research training from a transactional to transformative approaches is required to facilitate the development of NMAHPS clinical academics, to enable them to contribute to innovative health and patient care.

Transformational Leadership and Turnover Intention in Child Welfare: A Serial Mediation Model

PURPOSE

This study examined a serial mediation model testing the effects of STS on turnover intention through executive leaders' use of transformational leadership as perceived by child welfare workers and then organizational commitment while controlling for age, gender, and social work degrees.

METHOD

Survey data were collected from 264 child welfare workers at one Midwestern state.

RESULTS

The results supported the serial mediation model, corroborated by the finding that the impact of STS on turnover intention has disappeared as a result of transformational leadership and organizational commitment between the two variables.

DISCUSSION

The findings of the study provide practical implications for training transformational leadership styles to leaders training at the middle manager and executive leadership levels in child welfare agencies.

Change in frontline supervisors' safety leadership practices after participating in a leadership training program: Does company size matter?

INTRODUCTION

The majority of construction companies are small businesses and small business often lack the resources needed to ensure that their supervisors have the safety leadership skills to build and maintain a strong jobsite safety climate. The Foundations for Safety Leadership (FSL) training program was designed to provide frontline leaders in all sized companies with safety leadership skills. This paper examines the impact of the FSL training by size of business.

METHODS

Leaders, defined as foremen or other frontline supervisors, from small, medium, and large construction companies were recruited to participate in a study to evaluate the degree to which the FSL changed their understanding and use of the leadership skills, safety practices and crew reporting of safety-related conditions. We used linear mixed modeling methods to analyze pre-post training survey data.

RESULTS

Prior to the training, leaders from small and medium sized companies reported using safety leadership skills less frequently than those from large ones. After the training, regardless of business size, we observed that the FSL training improved leaders understanding of safety leadership skills from immediately before to immediately after the training. Additionally, leaders reported greater use of safety leadership skills, safety practices, and crew reporting of safety-related conditions from before to two-weeks after the training. However, those from small and medium sized companies reported the greatest improvement in their use of safety leadership skills.

CONCLUSIONS

The FSL training improves safety leadership outcomes regardless of the size company for which the leader worked. However, the FSL may be even more effective at improving the safety leadership skills of leaders working for smaller sized construction companies or those with lower baseline levels of safety leadership skills. Practical applications: The majority of construction companies employ a small number of employees and therefore may not have the resources to provide their frontline leaders with the leadership training they need to be effective leaders who can create a strong jobsite safety climate. The Foundations for Safety Leadership (FSL) training can help fill this gap.

The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: a cross-sectional study

Background

Transformational leadership style is considered to be of importance to increase patient safety, to facilitate a balance between job resources and job demands, and to create a sound patient safety culture within health care services. However, there is limited research assessing these associations within the context of nursing homes. The aim of this study was to assess the association between transformational leadership, job demands and job resources; and patient safety culture and employees’ overall perception of patient safety in nursing homes.

Method

A cross-sectional survey of employees in four Norwegian nursing homes was conducted (N = 165). Multiple hierarchical regression analysis was used to assess the explained variance of transformational leadership, job demands and job resources on patient safety culture and overall perception of patient safety.

Results

Transformational leadership explained 47.2% of the variance in patient safety culture and 25.4% of overall perception of patient safety, controlling for age and gender (p < 0.001). Additionally, job demands and job resources explained 7.8% of patient safety culture and 4.7% of overall perception of patient safety (p < 0.001).

Conclusion

Implementing transformational leadership style may be important in creating and sustaining sound patient safety culture in nursing homes. Furthermore, leaders should make an effort to facilitate a good work environment with an optimal balance between job demands and job resources, as this in turn might have a positive influence on patient safety culture.

The association of leadership styles and nurses well-being: a cross-sectional study in healthcare settings

Introduction

the nurses´ perception of their supervisors´ leadership styles has a substantial impact on their well-being. Effective leadership in health care is crucial in improving and enhancing the effectiveness of health care systems. This study aims to assess the leadership styles of nurse leaders as perceived by employees, and to explore the relationship between perceived leadership styles and the quality of life of nurses in Lebanese hospital settings.

Methods

it was a cross-sectional study conducted in 2017 and involved a sample of 250 nurses chosen randomly in eight hospitals. The survey included questions on socio-demographic and health-related characteristics, Multifactor Leadership Questionnaire 5X Short Form, and the Short Form Health Survey-12 V2 (SF-12v2).

Results

the managers used enough transformational leadership style, whereas they used fairly often transactional leadership. The Laissez-faire style was adopted from time to time by the managers. Male nurses perceive their managers as transformational significantly more than female nurses (2.94 vs. 2.73; p = 0.05). Transformational leadership style was statistically related to all scales scores of the SF-12v2 (p < 0.001) except the Social Functioning domain (p = 0.42). The transactional leadership style was associated with the Vitality scale scores (p < 0.001). The physical (p < 0.05) and Emotional Role (p < 0.001) and the mental health summary measure (p < 0.05) were lower in persons who perceived the leadership style of their manager as Laissez-faire.

Conclusion

this study highlights the existence of a positive effect of leadership styles in the wellbeing of nurses, and confirms that nursing management has been identified as a challenge in the Lebanese hospitals.

Nurses' and nurse managers' perceived transformational leadership behavioural practices: a survey

PURPOSE

The purpose of this paper is to compare the perceived transformational leadership practices of charge and staff nurses. Transformational leadership is effective in promoting change in organisations, with the leader guiding followers towards a common vision.

DESIGN/METHODOLOGY/APPROACH

A quantitative, descriptive, comparative survey design was used. All charge nurses (N = 151) and staff nurses (N = 1,950) in six health entities in Malta were included. A mixed mode survey design was used. Data were collected using the Leadership Practices Inventory and analysed using ANOVA and the Kruskal-Wallis test.

FINDINGS

An overall response rate of 15% (n = 315) was achieved. Both staff and charge nurses perceived transformational leadership to be practiced. Charge nurses scored consistently higher than staff nurses. In long-term care environments, charge nurses are more likely to "model the way", while in acute settings, they were more likely to "enable others to act".

RESEARCH LIMITATIONS/IMPLICATIONS

Transformational leadership appears to be applied by charge nurses in Malta. The response rate achieved was low and may limit the generalisability of the results of the study.

PRACTICAL IMPLICATIONS

Nurse managers need to adapt their transformational leadership style based on the context in which they work.

ORIGINALITY/VALUE

Regular feedback from nursing staff should be sought for charge nurses to be aware of the extent to which they are implementing transformational leadership.

Peer-enabled staff training in residential care settings as means for promoting person-centred dementia care

Background: Person-centred care (PCC) is regarded as best practice within dementia care, however there is a gap between the understanding and the implementation of this type of care practice. The Peer Enablement Program (PEP) incorporates a group problem solving model for promoting PCC of residents with moderate to advanced dementia living in care facilities.Objective: Trained PEP facilitators introduced the program to selected staff from an organisation with 99 facilities across Australia. The objective of this study was to identify what particular aspects of the PEP these facilitators valued for advancing PCC and care culture change.Method: An embedded mixed methods study design guided this investigation. The qualitative component of the study focussed on the insights of the nine PEP facilitators who presented the workshops. This information was supported and contrasted with descriptive data generated from 322 workshop feedback forms by attendees over the course of the three workshops presented nationally.Results: Facilitators identified peer support as the most valued aspect of the PEP. It promoted collaboration among attendees; supported development of their occupational identities as transformational leaders; and created communities of practice with potential to sustain advances in PCC.Conclusions: The PEP has the potential to advance PCC. Further research is needed to evaluate the long-term sustainability of these advances and to determine if this program can be utilised more widely, both in a national and international context.

Safety specific transformational leadership, safety motivation and personal protective equipment use among firefighters

Personal protective equipment (PPE) use, although normally the last line of preferred hazard control, is vital to protecting firefighters. It is vital that research identify factors that positively influence firefighter behaviors associated with PPE use. Data were collected from 742 career firefighters working for metropolitan fire departments in both the eastern and western United States. Structural equation modeling was used to assess the hypothesized model and relationships between safety-specific transformational leadership, safety motivation and effective use of personal protective equipment. Safety-specific transformational leadership was positively associated with firefighter safety motivation and safety motivation was positively associated with personal protective equipment use. There was also a significant direct relationship between safety-specific transformational leadership and personal protective equipment use. Transformational leadership has not been an emphasis in the fire service because of its hierarchical structure and paramilitary-like traditions. Current fire service stakeholders have called for changes in leadership strategies and the overall culture within the fire service. This research provides additional evidence that safety-specific transformational leadership can bolster safety motivation among firefighters and can result in enhanced safety performance, including the proper and effective use of personal protective equipment.

Integrated care systems and nurse leadership

There will be significant changes to the way in which primary and community health services are provided in the wake of the NHS Long Term Plan published in January 2019. Community nurses are already preparing themselves for these changes by exploring models of care that are patient-centred and link to neighbourhood, place and system levels. This article discusses two examples of such models of care, the Buurtzorg and Embrace model, both from the Netherlands. Styles of leadership and associated development, both within nursing and on a multi-professional basis will be crucial to ensure success. This article outlines Alban-Metcalfe's engaging transformational leadership model as a potential platform to move to flatter, more diverse teams and collective leadership.

A cross-level moderating effect of team trust on the relationship between transformational leadership and cohesion

We draw on the concept of the shared mental model to explain the cross-level direct and moderating effects of team trust on the relationship between coach transformational leadership and cohesion. Using hierarchical linear modelling, we analysed 597 national level high school and university volleyball players to test our research model. Our results revealed that, (a) at the individual level, coach transformational leadership has a positive effect on athletes' perceptions on cohesion and (b) team trust, a group-level construct, is positively related to social cohesion and moderates the coach transformational leadership-cohesion relationship. The moderating effect demonstrates that the positive effect of coach transformational leadership on cohesion could be enhanced when high levels of team trust are shared within the group. Implications for coach education and sport psychology in terms of theory and research are discussed.

Emotional intelligence, gender and transformational leadership among nurses in emerging economies

PURPOSE

In spite of the observation that nurse managers' style of authority in sub-Saharan Africa is one of antagonistic vibe and lordship, there is not much information on the kind of leadership provided in the hospitals by nurse managers. Following the notion that transformational leadership is a solution to many leadership problems and often creates valuable positive change in followers, this study aims to examine the level of transformational leadership behavior of nurse leaders; determining the effects of the sub-constructs of emotional intelligence (EI) on the transformational leadership behavior of leaders; and determining whether there is a difference in the exhibition of transformational leadership behavior due to the gender of leaders.

DESIGN/METHODOLOGY/APPROACH

The study uses five of the major public hospitals in the Greater Accra Region (the capital) of Ghana. Evidence of such links would be considerable for Ghanaian healthcare providers in their quest to find potential nurse leaders to train, so as not to dwell highly on the seniority criterion in the selection of leaders. Using a quantitative approach, the Wong Law EI Scale (2002) and leadership items adapted from Rafferty and Griffin (2004) were used to collect the data. A descriptive statistics (mean) revealed that nurse leaders from the selected hospitals exhibited a high level (M= 3.90, SD = 0.14) of transformational leadership behavior.

FINDINGS

A multiple regression analysis revealed that three of the sub-constructs of EI significantly affected transformational leadership with the "self-emotion appraisal" construct having the strongest effect on transformational leadership behavior (β = 0.508, p = 0.000). However, the others' emotion appraisal sub-construct did not significantly affect transformational leadership. Furthermore, the results from the independent sample t-test revealed no significant difference in the exhibition of transformational leadership due to gender.

PRACTICAL IMPLICATIONS

Based on the findings, when leaders are trained to be emotionally intelligent and their skills are fostered, they are more likely to exhibit transformational leadership behaviors, which will further result in organizational effectiveness and follower satisfaction. Hospitals must focus on the control of one's emotions at work, and subsequently, understanding others' emotions. In developing transformational leaders, there is the need to identify some tools that will increase EI level, more specifically, traits related to the understanding of others' emotion. The findings from this study indicate that one of the factors to check when selecting nurse leaders should be their EI and not necessarily a matter of seniority in many cases in emerging economies.

ORIGINALITY/VALUE

The originality of this study is in the fact that it focuses on an emerging economy, which is under researched. In Ghana, the criteria for promotion of nurse leaders' is based strictly on seniority and age and not on factors such as the leaders EI. The profession of nursing is such that leaders need to understand that certain soft skills such as EI are considered necessary to transform the hospitals and staff they lead. This study, therefore, sheds light on these key areas from the perspective of an emerging economy, which are usually not in the domain of literature in the area of healthcare leadership.