Room for improvement? Leadership, innovation culture and uptake of quality improvement methods in general practice

Abstract

Leadership behaviours were infrequently reported and this was associated with a limited culture of innovation in participating general practices. There was little use of quality improvement methods beyond clinical and significant event audit. Practices need support to enhance leadership skills, encourage innovation and develop quality improvement skills if improvements in health care are to accelerate.

A utilização de instrumentos para avaliação da liderança nos serviços de saúde e enfermagem

“…Hence, instruments or tools, whose development is based on different leadership theories/models/styles, can be applied to evaluate leadership. The most abundant theoretical framework in the investigated manuscripts was transformational leadership: more than half the papers addressed this model (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(56)(57)(58) , which corroborates other studies (59)(60)(61)(62) . Transformational leadership is wide, visionary and charismatic, characteristics that made it one of the most popular in the present days.…”

“…The styles/models/theories of leadership found in the selected materials were: transformational leadership (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(56)(57)(58) , cited in 20 papers; transactional leadership (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) , in 11 papers; situational leadership (41)(42)(49)(50) , in four papers; servant leadership (45)(46)48) , in three papers; authentic leadership (51)(52)(53)(54)(55) , in five papers; quantum leadership (38) , in one paper; charismatic leadership (39) , in one paper; and clinical leadership (25,44) , in two papers. Three studies did not mention a specific style/model/theory …”

“…in general, four with nurses and nursing technicians and a few described investigations with a mix of nurses and other professionals. Nineteen instruments were identified to evaluate leadership: Authentic Leadership Questionnaire (ALQ) (five papers) (51)(52)(53)(54)(55) ; Charismatic Leadership Socialized Scale (one paper) (39) ; Clinical Leadership Survey (CLS) (one paper) (25) ; the Coaching tool (two papers) (41)(42) ; Scale of attitudes toward leadership styles (one paper) (33) ; the 360º tool (one paper) (40) ; Global Transformational Leadership Scale (three papers) (56)(57)(58) ; Grid Gerencial (one paper) (43) ; Leadership Effectiveness and Adaptability Description (LEAD) (two papers) (49)(50) ; LMX-Leader-member Exchange (two papers) (46)(47) ; Leadership Practices Inventory (LPI) (six papers) (21)(22)(23)(24)(25)(26) ; Leadership Reward and Punishment Behavior Questionnaire (LRPQ) (one paper) (33) ; Multifactor Leadership Questionnaire (MLQ) (eleven papers) (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) ; Multisource Feedback Tool (MSF) (one paper) (44) ; the Quantum tool (one paper) (38) ; Servant Leadership Questionnaire (SLQ) (one paper) (48) ; Servant Leadership Survey (SLS) (two papers) …”

Cultura de Inovação: Conceitos e Modelos Teóricos

“…Serra, Fiates e Alpersted (2007) destacam a importância de uma cultura inovadora para um ambiente favorável à inovação. Salientam que uma postura inovadora nem sempre é fácil, pois depende de um ambiente favorável, de pessoas criativas e sem medo de errar, de recursos para pesquisas e uma interação muito próxima com o mercado e seus atores, de modo a perceber as oportunidades existentes (Serra, Fiates, & Alpersted, 2007, p. 182 Das concepções de cultura de inovação revisadas neste estudo, dá-se ênfase às características do ambiente organizacional (Dobni, 2008) e dos líderes (Zien & Buckler, 1997); no capital intelectual (Steele & Murray, 2004); na gestão do conhecimento (Janiunaite & Petraite, 2010); nas normas culturais (Apekey, McSorley, Tilling, & Siriwardena, 2011; E. C. Martins & Terblanche, 2003); no ambiente, pessoas, recursos e interação com o mercado (Mambrini et al, 2011;Serra et al, 2007).…”

“…Martins & Martins, 2002;Mclean, 2005;Twati & Gammack, 2006;Zairi & Al-Mashari, 2005;Zien & Buckler, 1997); comunicação e compartilhamento de informações (Das, 2003;Dombrowski et al, 2007;E. C. Martins & Terblanche, 2003;Godoy & Peçanha, 2009;Ismail &;Abdmajid, 2007;Janiunaite & Petraite, 2010;Johannessen & Olsen, 2011); correr riscos (Apekey et al, 2011;Brettel & Cleven, 2011;Das, 2003;Ismail & Abdmajid, 2007;Serra et al, 2007;Valencia, Valle, & Jiménez, 2010). A intenção de inovar e ser bem-sucedido ou estratégia de inovação também foi um aspecto citado por alguns autores, tais como Zien e Buckler (1997); E. Martins e Martins (2002) Das (2003); Dobni (2008); Godoy e Peçanha (2009), entre outros.…”