Interventions to develop collectivistic leadership in healthcare settings: a systematic review

Abstract

BackgroundCollective or shared leadership approaches have been associated with team performance outcomes in several sectors. Based on this evidence, there have been calls for more inclusive approaches to leadership in healthcare settings, but guidance on how to achieve collective leadership is lacking. This study synthesised knowledge of interventions to introduce collectivistic leadership in healthcare settings.MethodsThe databases of PubMed, PsychInfo, ABI Inform, Cochrane and CINAHL and three grey literature databases were searched. Studies from any country were included if they reported on the development and evaluation and/or implementation of training/interventions to develop collectivistic leadership and reported individual and/or team-level outcomes. Results were synthesised using a narrative approach.ResultsThe searches yielded 4448 records of which 21 met the eligibility criteria and were reviewed. Studies used a variety of interventions; eleven employed a team training approach, four described co-leadership, three explored service improvement, two detailed co-design approaches and one described an individual team development intervention. Most demonstrated moderate to good success in enabling collectivistic leadership, with benefits reported in staff engagement, satisfaction, and team performance.ConclusionsWhilst collectivistic leadership interventions have demonstrated positive outcomes, there is a need for more rigor and consistency in the evaluation of interventions aimed at developing collectivistic leadership approaches in health settings.Electronic supplementary materialThe online version of this article (10.1186/s12913-019-3883-x) contains supplementary material, which is available to authorized users.

Network Analysis of Assistive Technology Stakeholders in Malawi

“…Collective leadership has been documented to be effective at achieving meaningful change at the healthcare provision level and in developing policies where there are multiple stakeholders. 16,17 Our research also highlights the role of differing types of organizations, and their centrality to the delivery of assistive technology. We were interested to see that International NGOs, while playing a critical role in the funding and delivery of assistive technology, are not as central to the network as those organizations which represent people with disabilities, service delivery organizations, and ministries.…”

Identifying the context, mechanisms and outcomes underlying collective leadership in teams: building a realist programme theory

“…While collective leadership is not a panacea to solve the wicked problems inherent in healthcare settings, and there are inevitably occasions that require a more hierarchical leadership approach [60], the evidence strongly suggests that collective leadership interventions can promote more effective teamworking, enhance quality of care and patient safety and improve staff and patient satisfaction [13]. This study has gone beyond the question of effectiveness by interrogating the causal and generative mechanisms that result in the outcomes observed when collective leadership is practiced.…”

“…A realist synthesis of the literature was conducted on studies retrieved during a systematic review of interventions to develop collective leadership in healthcare settings (full search strategy available in published paper) [13]. Twenty-one papers were assessed for rigour and ability to add to the developing programme theory and 19 were included in the final analysis (two were excluded due to insufficient information to inform IPT).…”

“…This approach to leadership may be defined as a dynamic team phenomenon, where the interaction of team members lead the team by sharing leadership roles and responsibilities [9,11], with individuals adopting leadership roles where they have the expertise and motivation to do so [12]. Whilst there is accumulating evidence for the effectiveness of collective leadership in healthcare [13], that is, the outcomes of collective leadership, there is a lack of understanding about how collective leadership interventions operate (reactions and reasonings of actors, i.e., mechanisms), and the conditions which promote or inhibit these outcomes (contextual conditions) [14]. The focus of this study is the context-mechanisms-outcome configurations observed that enable/inhibit the outcomes observed when collective leadership is in practice.…”

Embedding collective leadership to foster collaborative inter-professional working in the care of older people (ECLECTIC): Study protocol

“…Collective and shared approaches to leadership have been found to enhance team effectiveness and team performance outcomes ( D’Innocenzo et al , 2016 ; Wang et al , 2014 ). There is now considerable evidence for the effectiveness of collective leadership interventions in healthcare settings ( De Brún et al , 2019 ). These studies have indicated the positive impact of collective leadership interventions on staff engagement, quality improvement, team-working and patient satisfaction ( De Brún et al , 2019 ).…”