Developing team leadership to facilitate guideline utilization: planning and evaluating a 3-month intervention strategy

Gifford, Wendy; Davies, Barbara; Tourangeau, Ann E.; Lefebre, Nancy

doi:10.1111/j.1365-2834.2010.01140.x

Cited by 38 publications

(67 citation statements)

References 47 publications

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“…, Gifford et al . ). According to our results, nurse leaders can support infrastructures that facilitate learning and the development of nurses’ competencies by providing tools and spaces for shared knowledge creation and reward systems that acknowledge competence development (also Flodgren et al .…”

Section: Discussionmentioning

confidence: 97%

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A systematic review of factors influencing knowledge management and the nurse leaders’ role

et al. 2017

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Section: Discussionmentioning

confidence: 97%

“…Some previous studies have presented positive results regarding enhancing nurse leaders’ capabilities in knowledge management through training programmes (Gifford et al . ) and mentorship programmes (Wallen et al . ).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of factors influencing knowledge management and the nurse leaders’ role

et al. 2017

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“…This process can create an environment that is conducive for implementing a quality improvement plan and for building teamwork. [19][20][21] Third, the introduction of selfevaluation checklists, in general, can improve compliance with best clinical practice. 22 And finally, the HBB QIC progress boards placed in each unit provided a constant reminder to the staff of the quality improvement effort.…”

Section: Discussionmentioning

confidence: 99%

Reducing Perinatal Mortality in Nepal Using Helping Babies Breathe

et al. 2016

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BACKGROUND AND OBJECTIVE: Newborns are at the highest risk of dying around the time of birth, due to intrapartum-related complications. Our study’s objective was to improve adherence to the Helping Babies Breathe (HBB) neonatal resuscitation protocol and reduce perinatal mortality by using a quality improvement cycle (QIC) in a tertiary hospital in Nepal. METHODS: The HBB QIC was implemented through a multifaceted approach, including the formation of quality improvement teams; development of quality improvement goals, objectives, and standards; HBB protocol training; weekly review meetings; daily skill checks; use of self-evaluation checklists; and refresher training. A cohort design, including a nested case-control study was used to measure changes in clinical outcomes and adherence to the resuscitation protocol through video recording, before and after implementation of the QIC. RESULTS: The intrapartum stillbirth rate decreased from 9.0 to 3.2 per thousand deliveries, and first-day mortality from 5.2 to 1.9 per thousand live births after intervention, demonstrating a reduction of approximately half in the odds of intrapartum stillbirth (adjusted odds ratio [OR] 0.46, 95% confidence interval [CI] 0.32–0.66) and first-day mortality (adjusted OR 0.51, 95% CI 0.31–0.83). After intervention, the odds of inappropriate use of suction and stimulation decreased by 87% (OR 0.13, 95% CI 0.09–0.17) and 62% (OR 0.38, 95% CI 0.29–0.49), respectively. Before intervention, none of the infants received bag-and-mask ventilation within 1 minute of birth, compared with 83.9% of infants after. CONCLUSIONS: The HBB QIC reduced intrapartum stillbirth and first-day neonatal mortality and led to use of suctioning and stimulation more frequently. The HBB QIC requires further testing in primary settings across Nepal.

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“…Lastly, task-oriented behaviors involve organizing and planning work activities, clarifying roles and responsibilities, and following up on performance. 19,20 The use of all three types of behaviors contributes to effective leadership 2,15,17,19 for implementing CPGs. 15,18 Inspired by the study by Gifford et al and the model proposed, we developed a leadership intervention to support managers to implement national guidelines for stroke care in outpatient rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

“…Gifford et al 15 applied a leadership model, "the Gifford model, " that focuses specifically on leadership behaviors and activities to support the implementation of CPGs. 15,17,18 The model includes a taxonomy of leadership behaviors categorized as relation-, change-, and task-oriented behaviors. 19 More specifically, relation-oriented behaviors include concerns for the provision of support, recognition, and encouragement of mutual trust and cooperation among team members.…”

Section: Introductionmentioning

confidence: 99%

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

Tistad

Palmcrantz

Wallin

et al. 2016

Int J Health Policy Manag

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Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers' leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention's potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a fourmonth leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers' behaviors or clinical practice at the units. • Pilot studies preceding larger implementation studies are useful to ensure both intervention and data collection feasibility. Implications for the publicTo this day, changes in healthcare are a major challenge; many of today's errors and adverse events could be prevented by using evidence-based practice (EBP). However, implementing EBP is easier said than done, and a complete picture as to what facilitates this process is yet to come. One aspect considered vital is the behavior of managers to facilitate guideline implementation. In this study, we piloted a leadership intervention based on a particular theoretical model to support managers in developing implementation plans. We found that the managers appreciated the model, and found it relevant to their practice. However, few implementation plans reflected their own role in facilitating the implementation of stroke rehabilitation guidelines. Further studies should provide supplementary support to managers, in order to facilitate their guideline implementation.

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Developing team leadership to facilitate guideline utilization: planning and evaluating a 3-month intervention strategy

Cited by 38 publications

References 47 publications

A systematic review of factors influencing knowledge management and the nurse leaders’ role

A systematic review of factors influencing knowledge management and the nurse leaders’ role

Reducing Perinatal Mortality in Nepal Using Helping Babies Breathe

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

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