Collective leadership and safety cultures (Co-Lead): protocol for a mixed-methods pilot evaluation of the impact of a co-designed collective leadership intervention on team performance and safety culture in a hospital group in Ireland

Abstract

IntroductionThere is accumulating evidence implicating the role of leadership in system failures that have resulted in a range of errors in healthcare, from misdiagnoses to failures to recognise and respond to patient deterioration. This has led to concerns about traditional hierarchical leadership structures and created an interest in the development of collective ways of working that distribute leadership roles and responsibilities across team members. Such collective leadership approaches have been associated with improved team performance and staff engagement. This research seeks to improve our understanding of collective leadership by addressing two specific issues: (1) Does collective leadership emerge organically (and in what forms) in a newly networked structure? and (2) Is it possible to design and implement collective leadership interventions that enable teams to collectively improve team performance and patient safety?Methods and analysisThe first phase will include a social network analysis, using an online survey and semistructured interviews at three time points over 12 months, to document the frequency of contact and collaboration between senior hospital management staff in a recently configured hospital group. This study will explore how the network of 11 hospitals is operating and will assess whether collective leadership emerges organically. Second, collective leadership interventions will be co-designed during a series of workshops with healthcare staff, researchers and patient representatives, and then implemented and evaluated with four healthcare teams within the hospital network. A mixed-methods evaluation will explore the impact of the intervention on team effectiveness and team performance indicators to assess whether the intervention is suitable for wider roll-out and evaluation across the hospital group.Ethics and disseminationFavourable ethical opinion has been received from the University College Dublin Research Ethics Committee (HREC-LS-16–116397/LS-16-20). Results will be disseminated via publication in peer-reviewed journals, national and international conferences, and to relevant stakeholders and interest groups.

Social Network Analysis as a Methodological Approach to Explore Health Systems: A Case Study Exploring Support among Senior Managers/Executives in a Hospital Network

“…It is anticipated that the network or group will encourage learning across the hospitals in the group and will result in standardization and improvements in access to quality care. The results presented in this paper are part of a larger study and research programme [ 21 ], and the data reported herein are used to highlight the value of SNA in health systems research, and illustrate the types of useful and practical information that may be drawn from the resulting analysis.…”

A qualitative evaluation of participants' experiences of using co‐design to develop a collective leadership educational intervention for health‐care teams

“…19,20 The co-design process evaluated in this study is part of a larger research programme on Collective Leadership and Safety Culture (Co-Lead), which aims to introduce collective leadership to healthcare teams to improve team performance and patient safety culture. 21 The objective of the co-design process was to produce a team-based intervention to develop collective leadership competencies within health-care teams. Introducing a leadership model through team-based training differs from traditional leadership development approaches, and there is little existing knowledge on how best to deliver such an intervention.…”

“…The co‐design process evaluated in this study is part of a larger research programme on Collective Leadership and Safety Culture (Co‐Lead), which aims to introduce collective leadership to health‐care teams to improve team performance and patient safety culture . The objective of the co‐design process was to produce a team‐based intervention to develop collective leadership competencies within health‐care teams.…”

Using Co-Design to Develop a Collective Leadership Intervention for Healthcare Teams to Improve Safety Culture

“…This study is part of a wider research programme on Collective Leadership and Safety Culture (Co-Lead) which aims to introduce collective leadership to healthcare teams across one hospital group to improve team performance and patient safety culture [ 16 ]. In contrast to traditional approaches that focus development on the individual as leader, the approach in this programme is on developing the team as a dynamic leadership entity, ensuring all members understand and develop the capability for leadership.…”