Leadership and Implementation of Evidence-based Practices in Health Care Organizations

Abstract

Making organizations helpful in health care generally means ensuring the delivery of cost-effective approaches to reduce human suffering. Strong leadership can facilitate implementation of innovations and evidence-based health care by fostering an organizational context that is supportive of change, encouraging buy-in from staff, and increasing both implementation fidelity (fidelity to the implementation strategy) and intervention fidelity (fidelity to the clinical intervention). In the current era of health care reform, in which provider accountability for cost-effective intervention is paramount, examining the role of transformational leadership in the implementation process of evidence-based care is critical. Transformational leadership has great potential to support the enactment of changes in health care organizations. In addition, although there has been some criticism, transformational leadership has a great deal of empirical support across settings, cultures, and countries. Despite a growing body of support, there is limited knowledge regarding how organizational culture and climate embedding mechanisms are utilized and how these are a function of or relate to transformational leaders’ influence on followers’ implementation behaviors. Each of the four different studies included in this symposium addresses one or more of these issues related to embedding factors associated with the implementation context. Together, the papers help to advance knowledge about the role of leadership in shaping followers’ attitudes and behaviors about implementation of evidence-based treatment practices in mental health and addiction health service organizations. Each of the four papers relies on unique samples and advanced quantitative and qualitative methods to provide a multifaceted perspective on leadership and implementation, an underresearched area in health care. Together, the papers in this symposium advance implementation science by providing concrete understanding of leadership in real-world health care settings. Implications for methods, theory, and translation of findings into practice are discussed. Leadership and Climates for Implementation of Culturally Responsive and Evidence-Based Practices Presenter: Erick Guerrero; U. of Southern California Presenter: Yinfei Kong; U. of Southern California Presenter: Gina Rosen; U. of Southern California Leadership Intervention to Improve the Implementation of Evidence-Based Health Care Practices Presenter: Howard Padwa; U. of California, Los Angeles Presenter: Lesley Harris; U. of Louisville Organizational Support Moderates the Effect of Leadership on Organizational Citizenship Behavior Presenter: Gregory A. Aarons; U. of California, San Diego Presenter: Mark G. Ehrhart; San Diego State U. Presenter: Elisa Maria Torres; UC San Diego The Effects of Transformational Leadership and Leader-Member Exchange on Attitudes toward Feedback Presenter: Karissa Fenwick; U. of Southern California, School of Social Work Presenter: Kim Brimhall; U. of Southern California