Leadership Intervention Research Articles

Quantitative systematic review of multi-professional teamwork and leadership training to optimize patient outcomes in acute hospital settings.

To evaluate the impact of multi-professional teamwork (MPTW) and leadership training interventions on patient outcomes in acute hospital settings. Although investigations of teamwork and leadership training in acute hospital settings indicate that such programs can optimize patient outcomes, evidence-based recommendations on the content, duration and frequency of training programs associated with clinical evidence are still absent. Quantitative systematic review. A search was conducted for relevant papers published during the period from 2000-February 2014. Twelve studies met the inclusion criteria and were appraised for quality and a risk-of-bias assessment was conducted. The review used a structured approach for literature search, data evaluation, analysis and presentation. A narrative summary was used to report results. Two MPTW and leadership interventions in stroke units have the greatest impact on patient outcomes in acute hospital settings. The interventions' impact on patient outcomes, explored in the ten remaining studies, is associated with great uncertainty due to several alternative explanations of the findings. Research designs that test such interventions must be improved before recommendations on the ultimate program can be made. This can be achieved by strengthening the design, methodology and descriptions of interventions and the use of more consistent patient outcomes. Building a safety culture adjacent to implementing teamwork and leadership training interventions is essential for improving patient outcomes.

Supply Chain Transformational Leadership, Supply Chain Innovation Performance, and Satisfaction with Relationships and Results: Moderating Role of Supply Chain Innovativeness

Supply chain networks look to transformational leadership and innovation as sources of competitive advantage. Recent theoretical advances have emphasised the need to further investigate these variables in supply chain (SC) literature. The present research attempts to address this call by examining direct and indirect relationships between SC transformational leadership and satisfaction with SC relationships and results. Data from 184 informants was analysed that showed that SC innovation performance mediated the relationship between SC transformational leadership and satisfaction with SC relationships and results. Furthermore, innovativeness capability moderated the mediation, such that the indirect effect of the SC innovation performance on the relationship between SC transformational leadership and satisfaction with SC relationships and results became stronger under conditions of high SC innovativeness. Based on results, we make suggestions for leadership interventions that include a culture level change within the immediate SC to enhance innovativeness capability through greater integration and motivation to innovate.

Appreciative Inquiry and Implementation Science in Leadership Development.

Appreciative inquiry was developed to initiate and animate change. As implementation science gains a foothold in practice settings to bridge theory, evidence, and practice, appreciative inquiry takes on new meaning as a leadership intervention and training tool. J Contin Educ Nurs. 2016;47(5):207-209.

Self-Empowerment of Immigrant Latina Survivors of Domestic Violence

This article presents the results of a self-empowerment leadership intervention program for Latina immigrant survivors of domestic violence in Atlanta, Georgia. It builds on the literature base of the Promotora model, a public health model using peer information sharing as a tool for health promotion. This study used an embedded mixed-methods design with quantitative and qualitative components to evaluate the impact of a peer community leadership program called Líderes Results of single-subject analyses show that the participants experienced change in three components of self-empowerment: intrapersonal, interactional, and behavioral. The qualitative findings revealed that they overcame fear and gained knowledge as well as a sense that they could promote change in their community. These findings add support to a growing literature base that demonstrates how peer model programs can not only positively influence the well-being of the communities they serve but also have transformative effects on peer leaders themselves. Study findings can also inform future efforts to empower survivors through promotora approaches specifically in the context of domestic violence prevention.

Introduction: The Golden Triangle for Examining Leadership Developmental Readiness.

This introduction includes the history of the leadership field that resulted in the creation of the developmental readiness construct, which represents readiness of the leader as well as followers, peers, and the target leader's leader, and how context is to be developed through some form of leadership intervention.

Organizational Contributions to Healthcare Worker (HCW) Burnout and Workplace Violence (WPV) Overlap: Is This an Opportunity to Sustain Prevention of Both?

The effects of Burnout in healthcare workers (HCW) are experienced by the worker, other staff, the institution and patients under their care on a daily basis. Workplace violence (WPV) has a spectrum of forms. In more extreme forms it generally is low frequency but has high impact when it occurs. Healthcare systems’ efforts to reduce Burnout are more likely to remain sustained since the impact is experienced daily and awareness is increasingly publicized. The efforts to reduce WPV are harder to sustain due to the lower frequency combined with daily competing administrative demands despite best intentions. Could efforts to reduce the overlapping organizational contributions to both HCW Burnout and WPV be a strategy to sustain prevention of WPV while preventing Burnout? A model of overlapping organizational contributions to HCW Burnout and WPV is built from supporting literature. Recommendations are made for leadership and management style interventions. Potential benefits would be higher quality and satisfaction in patient care by means of higher satisfaction in the delivery of care, recruitment and retention of excellent staff, retention of high quality institutional knowledge and reputation.

Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services

BackgroundDespite a solid research base supporting evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely implemented and delivered in community-based addiction treatment programs in the USA. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices.MethodsWe relied on a staged and iterative mixed-methods approach to achieve the following four goals: (a) collect data using focus groups and semistructured interviews and conduct analyses to identify implicit managerial strategies for implementation, (b) use surveys to quantitatively rank strategy effectiveness, (c) determine how strategies fit with existing theories of organizational management and change, and (d) use a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytic approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs.ResultsFindings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in vivo and hands-on training. Most strategies corresponded to emergent implementation leadership approaches that also utilize principles of transformational and transactional leadership styles. Leadership behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff members during the uptake of new practices, knowledgeable to properly guide the implementation process, and perseverant to address ongoing barriers that are likely to stall implementation efforts.ConclusionsThese findings emphasize how leadership approaches are leveraged to facilitate the implementation and delivery of EBPs in publicly funded addiction treatment programs. Findings have implications for the content and structure of leadership interventions needed in community-based addiction treatment programs and the development of leadership interventions in these and other service settings.

Vijana Vijiweni II: a cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam.

BackgroundIntimate partner violence (IPV) and sexually transmitted infections (STIs), including HIV, remain important public health problems with devastating health effects for men and women in sub-Saharan Africa. There have been calls to engage men in prevention efforts, however, we lack effective approaches to reach and engage them. Social network approaches have demonstrated effective and sustained outcomes on changing risk behaviors in the U.S. Our team has identified and engaged naturally occurring social networks comprised mostly of young men in Dar es Salaam in an intervention designed to jointly reduce STI incidence and the perpetration of IPV. These stable networks are locally referred to as “camps.” In a pilot study we demonstrated the feasibility and acceptability of a combined microfinance and peer health leadership intervention within these camp-based peer networks.Methods designWe are implementing a cluster-randomized trial to evaluate the efficacy of an intervention combining microfinance with health leadership training in 60 camps in Dar es Salaam, Tanzania. Half of the camps have been randomized to the intervention arm, and half to a control arm. The camps in the intervention arm will receive a combined microfinance and health leadership intervention for a period of two years. The camps in the control arm will receive a delayed intervention. We have enrolled 1,258 men across the 60 study camps. Behavioral surveys will be conducted at baseline, 12-months post intervention launch and 30-month post intervention launch and biological samples will be drawn to test for Neisseria gonorrhea (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) at baseline and 30-months. The primary endpoints for assessing intervention impact are IPV perpetration and STI incidence.DiscussionThis is the first cluster-randomized trial targeting social networks of men in sub-Saharan Africa that jointly addresses HIV and IPV perpetration and has both biological and behavioral endpoints. Effective approaches to engage men in HIV and IPV prevention are needed in low resource, high prevalence settings like Tanzania. If we determine that this approach is effective, we will examine how to adapt and scale up this approach to other urban, sub-Saharan African settings.Trial registrationClinical Trials.gov: NCT01865383. Registration date: May 24, 2013.

ILead—a transformational leadership intervention to train healthcare managers’ implementation leadership

BackgroundLeadership is a key feature in implementation efforts, which is highlighted in most implementation frameworks. However, in studying leadership and implementation, only few studies rely on established leadership theory, which makes it difficult to draw conclusions regarding what kinds of leadership managers should perform and under what circumstances. In industrial and organizational psychology, transformational leadership and contingent reward have been identified as effective leadership styles for facilitating change processes, and these styles map well onto the behaviors identified in implementation research. However, it has been questioned whether these general leadership styles are sufficient to foster specific results; it has therefore been suggested that the leadership should be specific to the domain of interest, e.g., implementation. To this end, an intervention specifically involving leadership, which we call implementation leadership, is developed and tested in this project. The aim of the intervention is to increase healthcare managers’ generic implementation leadership skills, which they can use for any implementation efforts in the future.Methods/designThe intervention is conducted in healthcare in Stockholm County, Sweden, where first- and second-line managers were invited to participate. Two intervention groups are included, including 52 managers. Intervention group 1 consists of individual managers, and group 2 of managers from one division. A control group of 39 managers is additionally included. The intervention consists of five half-day workshops aiming at increasing the managers’ implementation leadership, which is the primary outcome of this intervention. The intervention will be evaluated through a mixed-methods approach. A pre- and post-design applying questionnaires at three time points (pre-, directly after the intervention, and 6 months post-intervention) will be used, in addition to process evaluation questionnaires related to each workshop. In addition, interviews will be conducted over time to evaluate the intervention.DiscussionThe proposed intervention represents a novel contribution to the implementation literature, being the first to focus on strengthening healthcare managers’ generic skills in implementation leadership.

Leveraging strong social ties among young men in Dar es Salaam: A pilot intervention of microfinance and peer leadership for HIV and gender-based violence prevention

ABSTRACTGender inequality is at the core of the HIV patterns that are evident in sub-Saharan Africa. Gender-based violence (GBV) and lack of economic opportunity are important structural determinants of HIV risk. We piloted a microfinance and health promotion intervention among social networks of primarily young men in Dar es Salaam. Twenty-two individuals participated in the microfinance component and 30 peer leaders were recruited and trained in the peer health leadership component. We collected and analysed observational data from trainings, monitoring data on loan repayment, and reports of peer conversations to assess the feasibility and acceptability of the intervention. Eighteen of the loan recipients (82%) paid back their loans, and of these 15 (83%) received a second, larger loan. Among the loan defaulters, one died, one had chronic health problems, and two disappeared, one of whom was imprisoned for theft. The majority of conversations reported by peer health leaders focused on condoms, sexual partner selection, and HIV testing. Few peer leaders reported conversations about GBV. We demonstrated the feasibility and acceptability of this innovative HIV and GBV prevention intervention. The lessons learned from this pilot have informed the implementation of a cluster-randomised trial of the microfinance and peer health leadership intervention.

3 Dimensions of Care for Diabetes: integrating diabetes care into an individual's world

3DFD (3 Dimensions of Care for Diabetes) is an award winning gold-standard model of integrated care, which was developed and evaluated as a sustainable service for improving glycaemic control and reducing diabetes complications in South London's multi-ethnic, socio-economically disadvantaged and growing diabetes population. This service is fully integrated into the diabetes services across Lambeth and Southwark boroughs. It consists of a liaison psychiatrist who provides clinical leadership and psychiatric interventions, psychologists and two third-sector social support workers who provide social care in the community, working directly with the diabetes teams across the sectors. 3DFD has completed two consecutive pilot phases during which the components of the service have been refined and effectiveness demonstrated. We found high levels of mental illness and unmet need, and effected improvements in glycaemic control, psychological status and health service use. We have produced outcomes which compare favourably with new antidiabetic medications to the market and to the outcomes of the local intermediate teams. We believe this provides the best possible model of care for patients with persistent poor diabetes control despite implementing standard pathways. The full economic evaluation is in progress and preliminary analyses indicate that there will be an annual saving of £33 000, based on the reduction in HbA1c from the first pilot. Copyright © 2015 John Wiley & Sons.

Increased Adoption of Quality Improvement Interventions to Implement Evidence-Based Practices for Pressure Ulcer Prevention in U.S. Academic Medical Centers.

In 2008, the U.S. Centers for Medicare and Medicaid Services enacted a nonpayment policy for stage III and IV hospital-acquired pressure ulcers (HAPUs), which incentivized hospitals to improve prevention efforts. In response, hospitals looked for ways to support implementation of evidence-based practices for HAPU prevention, such as adoption of quality improvement (QI) interventions. The objective of this study was to quantify adoption patterns of QI interventions for supporting evidence-based practices for HAPU prevention. This study surveyed wound care specialists working at hospitals within the University HealthSystem Consortium. A questionnaire was used to retrospectively describe QI adoption patterns according to 25 HAPU-specific QI interventions into four domains: leadership, staff, information technology (IT), and performance and improvement. Respondents indicated QI interventions implemented between 2007 and 2012 to the nearest quarter and year. Descriptive statistics defined patterns of QI adoption. A t-test and statistical process control chart established statistically significant increase in adoption following nonpayment policy enactment in October 2008. Increase are described in terms of scope (number of QI domains employed) and scale (number of QI interventions within domains). Fifty-three of the 55 hospitals surveyed reported implementing QI interventions for HAPU prevention. Leadership interventions were most frequent, increasing in scope from 40% to 63% between 2008 and 2012; "annual programs to promote pressure ulcer prevention" showed the greatest increase in scale. Staff interventions increased in scope from 32% to 53%; "frequent consult driven huddles" showed the greatest increase in scale. IT interventions increased in scope from 31% to 55%. Performance and improvement interventions increased in scope from 18% to 40%, with "new skin care products . . ." increasing the most. Academic medical centers increased adoption of QI interventions following changes in nonpayment policy. These QI interventions supported adherence to implementation of pressure ulcer prevention protocols. Changes in payment policies for prevention are effective in QI efforts.

Parent-Involved Prevention of Child Sexual Abuse: A Qualitative Exploration of Parents’ Perceptions and Practices in Beijing

Parents are vital to the successful prevention of child sexual abuse (CSA). A better understanding of parents’ perceptions and practice of CSA is essential for developing and implementing effective parent-involved prevention programs. Therefore, the purpose of this article is to explore how and why parents in China perceive and respond to the CSA problem in the way that they do. Semi-structured interviews were conducted with a sample of 26 parents of preschool- or primary school-aged children in Beijing, who were purposely selected to be diverse in gender, age, and socioeconomic status. The results show that parents’ definition of CSA included four levels of sexual activities and invoked some additional factors. Parents perceived that CSA risks differed between all children and their own children, between boys and girls, and between poor and nonpoor children. They insisted that perpetrators were more likely to be familiar rather than strangers. There were some barriers hindering their CSA preventive practice, especially their ability or willingness to discuss CSA with their children. Furthermore, parents’ perceptions and practices were analyzed and discussed within a Chinese sociocultural context, and compared with those in Western developed countries. This study’s findings suggest that in the absence of government leadership and professional intervention services for CSA, parent-involved CSA prevention should be developed in mainland China and that CSA prevention education for Chinese parents should be a key part of these initiatives.

Neurofeedback in the workplace: from neurorehabilitation hope to neuroleadership hype?

Brain-computer interface neurofeedback has rapidly become an engaging topic for occupational research at large. Notwithstanding some criticism, research and practice have begun converging on the efficacy of brain-computer interface neurofeedback as a part of holistic interventions in rehabilitation. Yet, its use in vocational contexts has recently blossomed into wider attributes, beyond rehabilitation practice per se, additionally targeting performance enhancements and leadership interventions in healthy individuals. By exploring this emerging scenario, this paper aims to provide an interdisciplinary forum of analysis on the deriving implications for rehabilitation professionals, signaling how these may invite both possible threats for the field and opportunities to engage in novel translational partnerships.

Changing Cities, Changing Culture

The Problem With the rapid increase of urban populations, managing urban sustainability has become one of the most important development challenges of the 21st century. As cities plan for a sustainable future, human resource development (HRD) professionals have the potential to facilitate collaboration across multiple organizations and at various scales (neighborhood, ward, city, metropolitan area) and to foster culture change that embraces ecological protection, economic development, and social equity. Although the role of HRD in crises management as a result of major environmental disasters is discussed in the literature, the field of HRD is in its infancy in examining its role and approaches in greening the society and addressing urban environmental challenges proactively. The Solution This conceptual article examines sustainability and urban sustainability and their linkage with HRD, discusses the emergent roles of HRD in crisis management, presents opportunities and challenges for Green HRD as a proactive process, and concludes with a call for the moral imperative for HRD in urban sustainability in implementing long-term change processes with a social justice and equity agenda. The Stakeholders This article informs local government agencies, nonprofit and for-profit organizations, community groups, and their HRD leaders involved in urban sustainability planning and implementation on approaches to building new adaptive capacity and fostering culture change through collaborative learning and leadership interventions.

The Impact of Arts-Based Leadership Development on Leader Mind-Set

The Problem Arts-based leadership interventions have gained a foothold in the leadership development literature; however, few studies have investigated their effectiveness. These interventions include music, drama, art, and performance and are utilized to develop dimensions of leader mind-set. The Solution In this study, an arts-based intervention (leadership drawing exercise) is evaluated. Utilizing a quasi-experimental, pre-test, post-test design, we evaluate the impact of an arts-based intervention on four dimensions of leader mind-set: emotional intelligence, leader identity, openness to experience, and feedback orientation. Leaders in the arts-based intervention showed significantly greater improvement in emotional intelligence, leader identity, and feedback orientation. The Stakeholders This article informs leadership development researchers, those making decisions about investment in leadership development and those who deliver leadership development. The article will be of interest to organizations that have to justify investment in leadership development.

The unrepresentative house

Purpose – Argues that the British House of Commons is acutely unrepresentative of the population that it serves. A range of party leadership interventions that have sought to increase the possibilities for women and those from minority groups to become MPs are evaluated, but regulating in this way is found to have largely failed. Alternative policy solutions are proposed that seek to increase the “supply” of candidates from such backgrounds. Design/methodology/approach – Conducts document analysis of political parties’ equality and diversity policies and assesses their impact upon their proportion of MPs or parliamentary candidates from minority backgrounds. Findings – Argues that the real problem lies in the lack of engagement in the political process and a shortage of candidates from such backgrounds putting themselves forward for nomination in the first place. Thus, authentic parliamentary diversity cannot be created through enforcement but needs to be fostered organically through supportive longer-term measures alongside electoral reform. Practical implications – Advances the view that greater diversity is required for parliamentary legitimacy but top-down interventions have been counterproductive; barely improving the proportion of MPs from minority backgrounds and actually presenting threats to party autonomy and quality of democracy. Social implications – Shows how structural problems complicate the ease with which women and those from working-class, ethnic minority and disability backgrounds can engage with the political process and then successfully become parliamentary candidates. Reforming the political culture and targeted policies aimed at reversing the barriers to entry may create a more level playing field by encouraging them to stand. Originality/value – Offers a timely case study of the neglected and longstanding lack of representation in Parliament that is uniquely interrogated from an HRM perspective.

Leadership and Licensure for Drug Treatment and the Implementation of Co-Occurring Disorder Treatment in Community Mental Health Centers.

Using a random sample of 48 outpatient mental health programs in low-income and racial and ethnic minority communities, this study examined directorial leadership, drug treatment licensure, and implementation of evidence-based protocols and practices to address co-occurring mental health and substance abuse disorders (COD). Understanding of findings was enhanced with focus groups at six clinics. Most programs (81 %) offered COD treatment. Directorial leadership was positively associated with COD treatment (β = 0.253, p = 0.047, 95 % CI 0.003, 0.502) and COD supervision and training (β = 0.358, p = 0.002, 95 % CI 0.142, 0.575). Licensure was negatively associated with COD treatment (β = -0.235, p = 0.041, 95 % CI -0.460, -0.010) and COD supervision and training (β = -0.195, p = 0.049, 95 % CI -0.389, -0.001). Although lack of financial integration may limit the effect of licensing on COD treatment implementation, the response of leaders to regulation, funding, and human resources issues may encourage COD treatment practices. Implications for leadership interventions and policy are discussed in the context of health care reform.

Charismatic and Transformational Leadership Styles: A Cross-Cultural Perspective

Culture’s influence on leadership processes is generally accepted. However, differing leadership styles will be differentially impacted by the cultural context in which they seek to operate. The current paper examines two seemingly similar but distinct leadership styles, charismatic leadership and transformational leadership in the context of cultural dimensions of individualism-collectivism and tightness-looseness. A conceptual framework is presented to describe the interaction of these leadership styles and cultural dimensions. It is argued that charismatic leadership would be the preferred leadership style in individualistic and loose societies, whereas transformational leadership style would be more acceptable in collectivistic and tight societies. These insights have practical implications for design of leadership intervention programs for businesses spanning more than one culture.

A logo-leadership intervention: Implications for leadership development

Orientation: Logo-leadership development challenges leaders to move beyond financial or individual gain to accepting leadership as a calling.Research purpose: The objective of the study was to ascertain whether an intervention embedded in the life and teachings of logo-therapist Viktor Frankl affects the way aspiring leaders construct leadership in terms of meaning (logo-leadership).Motivation for the study: A consideration of Frankl’s life gives rise to the question of whether aspiring leaders can learn from and use his life teachings as an inspiration in the discovery of meaning for themselves as leaders.Research approach, design and method: Participants comprised 20 students registered for an MCom degree at a South African metropolitan university. The research process involved three phases: (1) a pre-intervention questionnaire, (2) an appreciative inquiry intervention and (3) a post-intervention questionnaire. Framework analysis and a comparative method were used to analyse the data.Main findings: A meaning-centred leadership development intervention may impact the leadership role orientation of aspiring leaders, changing it from a predominantly career orientation to a calling. However, this effect largely occurred on an explicit (extrinsic) level.Managerial implications: Organisations that wish to develop logo-leadership may consider using the life teachings and work of Frankl as a development tool.Contribution/value-add: This study contributes theoretically to a relatively new development within the field of Frankl’s logotherapy, leadership with meaning (logo-leadership). On apractical level, this study introduced the concept of logo-leadership for leadership development and suggests that leadership may be influenced by exposure to a leadership intervention.