The Collective Leadership for Safety Culture (Co-Lead) Team Intervention to Promote Teamwork and Patient Safety.

Aoife De Brún,Zuneera Khurshid,Steve Macdonald,Una Cunningham,Róisín O’Donovan,Sabrina Anjara,Eilish Mcauliffe,Lisa Rogers

doi:10.3390/ijerph17228673

Abstract

Traditional hierarchical leadership has been implicated in patient safety failings internationally. Given that healthcare is almost wholly delivered by multidisciplinary teams, there have been calls for a more collective and team-based approach to the sharing of leadership and responsibility for patient safety. Although encouraging a collective approach to accountability can improve the provision of high quality and safe care, there is a lack of knowledge of how to train teams to adopt collective leadership. The Collective Leadership for Safety Cultures (Co-Lead) programme is a co-designed intervention for multidisciplinary healthcare teams. It is an open-source resource that offers teams a systematic approach to the development of collective leadership behaviours to promote effective teamworking and enhance patient safety cultures. This paper provides an overview of the co-design, pilot testing, and refining of this novel intervention prior to its implementation and discusses key early findings from the evaluation. The Co-Lead intervention is grounded in the real-world experiences and identified needs and priorities of frontline healthcare staff and management and was co-designed based on the evidence for collective leadership and teamwork in healthcare. It has proven feasible to implement and effective in supporting teams to lead collectively to enhance safety culture. This intervention overview will be of value to healthcare teams and practitioners seeking to promote safety culture and effective teamworking by supporting teams to lead collectively.

Highlights

There has been increasing focus on the crucial role of leadership to promote effective patient safety
This paper provides an overview of the design, development, and testing of this complex intervention, describes the content and resources offered by the intervention and reflects on its contribution as well as the potential for this intervention to promote safety culture and effective teamworking through supporting teams to lead collectively
We employed a mixed methods realist evaluation in the pilot testing of the Co-Lead intervention [22]. This involved a multiple forms of data collection, including non-participant observation of team sessions, one-on-one interviews with team members and a survey to evaluate collective leadership, team working and safety culture

Summary

Introduction

There has been increasing focus on the crucial role of leadership to promote effective patient safety. Patient safety has become a focus of research and intervention internationally as a result of major investigations in the US [1] and the UK [2] emphasising the significant impact of errors and system failures on patient safety, morbidity and mortality. Leadership is often suggested as a viable and powerful target for intervention, given its influential role in shaping healthcare cultures that provide high quality and safe care [3]. While leadership approaches have emerged that represent a shift away from the single-leader approaches (for example, transformational leadership and adaptive leadership), historically leadership development in healthcare has primarily focused on the heroic, individual-as-leader model [4], often taking individuals out of the system, training them in a university. Public Health 2020, 17, 8673; doi:10.3390/ijerph17228673 www.mdpi.com/journal/ijerph

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