Leadership development in complex health systems: a qualitative study

Abstract

ObjectiveLeadership is associated with organisational performance in healthcare, including quality, safety and clinical outcomes for patients. Leadership development programmes have proliferated in recent years. Nevertheless, very few have examined participant experiences in depth in order to understand which programmatic aspects they regard as most valuable relative to leadership in increasingly complex systems, or whether and how learnings may sustain over time. Accordingly, we explored experiences of participants in an interdisciplinary leadership development programme using qualitative methods over an extended look-back period.SettingHealth and social care sectors in the UK.ParticipantsKey informants from three cohorts of individuals working in leadership roles in health and social care in the UK: 2013/2014, 2015/2016 and 2017/2018. We contacted 32 participants, and 26 completed interviews (81% response rate).Primary and secondary outcomesWe explored (1) whether and how specific skills and competencies developed during the programme were applied and/or sustained over time, and (2) whether and how the impact of the programme changed as alumni progressed through their career.ResultsThree major recurrent themes emerged from participants’ experiences: (1) specific features of the programme meaningfully impact professional development at multiple levels; (2) the coupling of a professional network and practical tools allowed participants to address system-wide problems in new ways and (3) participants describe a level of learning that sustained and amplified over time with increased complexity in their work.ConclusionThis work highlights specific design characteristics of leadership development programmes that may help promote relevance and impact. Programme learnings can be translated into practice in substantive ways, with potential for the benefits of successful leadership development efforts to amplify, not fade, over time.

Identifying and understanding the factors that influence the functioning of integrated healthcare systems in the NHS: a systematic literature review

“…It can therefore be inferred that strong leadership in IHSs is extremely valuable in the delivery of high quality healthcare to patients. However, the relationship between integrated care and the long lasting outcomes on patient health requires further follow-up and research 54…”

Health Management Workforce Capacity-Building in Liberia, Post-Ebola

“…A team of faculty, staff, and practitioners from the Yale School of Medicine, the University of Liberia, and the Ministry of Health collaboratively developed and launched the health management program in Liberia in July 2017. Informed by lessons learned and best practices from similar initiatives in Ethiopia, Liberia, Rwanda, and others [2,9,10], the health management program employed two concurrent strategies: 1) implementation of a hospital-based partnership-mentorship model in the two largest hospitals in the capital city of Monrovia, and 2) establishment of an executive education-style advanced Certificate in Health Systems Leadership and Management (CHSLM) at the University of Liberia (UL) to build management and leadership competencies in the health workforce.…”

“…Stating that "Effective management of health facilities and staff is essential to the optimal delivery of training and services. The 2014-2015 EVD outbreak demonstrated the heightened importance of such management during times of public health crisis," Liberia's Health Workforce Program strategy emphasized the importance of building capacity in health management to help achieve the country's overall goal of building a resilient health system [10].…”

Changing hospital organisational culture for improved patient outcomes: developing and implementing the leadership saves lives intervention

“…‘ Pressure testing ’ involved piloting specific components of the intervention with the aim of obtaining critical feedback on design assumptions and plans, particularly from the ‘end user’ perspective. We developed a draft plan for the intervention based on our prior experience in leadership development programming 19 as well as relevant empirical literature, proposing three main components (described further below): annual convenings of all hospitals, on-site workshops and remote support. We conducted pressure tests with three panels: (1) experts in cardiology attending the American College of Cardiology Scientific Meeting in Washington DC, (2) diverse clinicians and administrators working in cardiovascular care at a large health system in New England, and (3) diverse clinicians and administrators working in cardiovascular care from a large hospital system on Long Island, NY.…”