Leadership Intervention Research Articles

The role of anchor institutions in creating value for SMEs: insights from North East of England owner-managers

ABSTRACT The roles universities are seen to play have changed significantly over the last 25 years. The concept of higher education has, and, continues to morph from a distanced, unengaged ivory tower to a highly engaged community-based concept. Yet there is little in the literature about how universities viewed as ‘anchor institutions’ support organisations. Further, there is an omission of specific detail about the impact of universities on SMEs; they are mentioned but only in broader terms. This empirical study is based on the results of a leadership and business development intervention for 50 UK SMEs. The intervention was facilitated and delivered by a North East University we recognise to be an ‘anchor institution’. The study is longitudinal and embeds innovative composite measurement within a value creation framework with a specific focus on identifying how a North East anchored institution creates impact and value for SME owner-managers. Findings include leadership salience to SME owner-managers, increases in SME turnover and significant gross value added. This study contributes to understanding about what the role of a university, as an anchor institution, is in terms of role, SME impact and value creation, with potential for international application.

Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol

BackgroundClinical leadership is fundamental in facilitating service improvements in healthcare. Few studies have attempted to understand or model the different approaches to leadership which are used when promoting the uptake and implementation of evidence-based interventions. This research aims to uncover and explain how distributed clinical leadership can be developed and improved to enhance the use of evidence in practice. In doing so, this study examines implementation leadership in orthopaedic surgery to explain leadership as a collective endeavour which cannot be separated from the organisational context.MethodsA mixed-method study consisting of longitudinal and cross-sectional interviews and an embedded social network analysis will be performed in six NHS hospitals. A social network analysis will be undertaken in each hospital to uncover the organisational networks, the focal leadership actors and information flows in each organisation. This will be followed by a series of repeated semi-structured interviews, conducted over 4 years, with orthopaedic surgeons and their professional networks. These longitudinal interviews will be supplemented by cross-sectional interviews with the national established surgical leaders. All qualitative data will be analysed using a constructivist grounded theory approach and integrated with the quantitative data. The participant narratives will enrich the social network to uncover the leadership configurations which exist, and how different configurations of leadership are functioning in practice to influence implementation processes and outcomes.DiscussionThe study findings will facilitate understanding about how and why different configurations of leadership develop and under what organisational conditions and circumstances they are able to flourish. The study will guide the development of leadership interventions that are grounded in the data and aimed at advancing leadership for service improvement in orthopaedics. The strength of the study lies in the combination of multi-component, multi-site, multi-agent methods to examine leadership processes in surgery. The findings may be limited by the practical challenges of longitudinal qualitative data collection, such as ensuring participant retention, which need to be balanced against the theoretical and empirical insights generated through this comprehensive exploration of leadership across and within a range of healthcare organisations.

The micropolitics of implementation; a qualitative study exploring the impact of power, authority, and influence when implementing change in healthcare teams

BackgroundHealthcare organisations are complex social entities, comprising of multiple stakeholders with differing priorities, roles, and expectations about how care should be delivered. To reach agreement among these diverse interest groups and achieve safe, cost-effective patient care, healthcare staff must navigate the micropolitical context of the health service. Micropolitics in this study refers to the use of power, authority, and influence to affect team goals, vision, and decision-making processes. Although these concepts are influential when cultivating change, there is a dearth of literature examining the mechanisms through which micropolitics influences implementation processes among teams. This paper addresses this gap by exploring the role of power, authority, and influence when implementing a collective leadership intervention in two multidisciplinary healthcare teams.MethodsThe multiple case study design adopted employed a triangulation of qualitative research methods. Over thirty hours of observations (Case A = 16, Case B = 15) and twenty-five interviews (Case A = 13, Case B = 12) were completed. An in-depth thematic analysis of the data using an inductive coding approach was completed to understand the mechanisms through which contextual factors influenced implementation success. A context coding framework was also employed throughout implementation to succinctly collate the data into a visual display and to provide a high-level overview of implementation effect (i.e. the positive, neutral, or negative impact of contextual determinants on implementation).ResultsThe findings emphasised that implementing change in healthcare teams is an inherently political process influenced by prevailing power structures. Two key themes were generated which revealed the dynamic role of these concepts throughout implementation: 1) Exerting hierarchical influence for implementation; and 2) Traditional power structures constraining implementation. Gaining support across multiple levels of leadership was influential to implementation success as the influence exercised by these individuals persuaded follower engagement. However, the historical dynamics of each team determined how this influence was exerted and perceived, which negatively impacted some participants’ experiences of the implementation process.ConclusionTo date, micropolitics has received scant attention in implementation science literature. This study introduces the micropolitical concepts of power, authority and influence as essential contextual determinants and outlines the mechanisms through which these concepts influence implementation processes.

Learning Processes as Key for Success in Workplace Health Promotion Interventions in Health Care.

There is limited previous research on how learning processes contribute to the outcomes of workplace health promotion (WHP) leadership interventions. The aim of this study was to identify the outcomes of a system-based WPH education program for managers and investigated what impact the intervention program had on health-oriented leadership, improvement work, and employee well-being, as well as what factors (i.e., how manager's active work following the intervention and organizational learning climate) contributed to these outcomes. A mixed-methods approach was applied, including qualitative interviews with 23 managers and process leaders, as well as questionnaires to employees and managers representing 17 public health care units in Sweden. The results showed that health-oriented leadership, improvement work, work satisfaction, and vitality increased at workplaces that worked actively to implement WHP following the program. Working actively with WHP and health-oriented leadership was of central importance for success and was a covariate with improved social learning climate, improved developmental leadership, and increased degree of improvement work. All included factors of learning during the intervention were associated with improved job satisfaction, while the increase in vitality seemed unrelated to program implementation. In conclusion, successful outcomes of WHP interventions interact with dimensions of organizational learning climate in the workplace.

Predictors of toxic leadership behaviour among nurse managers: A cross-sectional study.

To identify the predictors of toxic leadership behaviour in nurse managers. Toxic leadership is becoming increasingly prevalent in nursing; however, the literature provides very limited evidence of the different factors that promote toxic leadership behaviour in nurse managers. A descriptive, cross-sectional design was used. Two hundred and forty nurse managers from ten hospitals in the Central Philippines were included in the study. Data were collected using the Nurse Information Form and the Toxic Leadership Behaviours of Nurse Managers Scale (ToxBH-NM). Hierarchical multiple regression was used to analyse the data collected. The mean of average item score of the ToxBH-NM was 1.250 (SD=0.470). Multiple regression analyses identified the years of experience in a managerial role (β=-0.165, p=.031), job status (part time) (β=0.177, p=.002), ward census (30 patients, 40 patients and above 40 patients) ([β=0.231, p=.005]; [β=0.345, p<.004]; [β=0.262, p=.012]), number of units managed (2 units and>3 units) ([β=0.292, p<.001]; [β=0.235, p<.001]), hospital type (private hospital) (β=0.271, p=.007) and hospital level (secondary hospitals) (β=0.226, p=.036) predicted toxic leadership behaviour in nurse managers. Overall, nurse managers were appraised as non-toxic leaders. Nurse managers who held a part-time job status, those who had lower experience in the managerial role and those who were assigned to wards or units with high patient admission numbers reported increased toxic leadership behaviours. Further, nurse managers who managed more than 2 units, those who were employed in private hospitals and those who worked in secondary hospitals reported increased toxic leadership behaviours. Nurse administrators can consider the different predictors identified when planning and developing leadership interventions and organisational strategies (e.g. limiting the number of units per nurse manager, provision of full-time job employment, assignment of assistant nurse managers, formulation of policy specific to managing toxic behaviours), which may assist in the determent of toxic behaviours in nurse managers.

A Systematic Review of Behavioral Outcomes for Leadership Interventions Among Health Professionals.

Healthcare requires effective leadership to improve patient outcomes, manage change, and achieve organizational goals. The purpose of this study was to evaluate interventions aimed at improving leadership behavior in health professionals. A systematic literature review of key databases (PubMed, CINAHL, Embase, and Scopus) was performed in September 2018. Data were extracted and synthesized. Thirty-three articles from 31 studies met the inclusion criteria. Self-reported leadership behavior showed a significant postprogram improvement. Objective observations were more likely to show improved leadership behavior than subjective observations. Face-to-face delivery of leadership development was more effective than online delivery. Interventions incorporating the elements of personal development planning, self-directed learning, workplace-based learning, and reflection were more likely to develop leadership behavior. Leadership interventions had a beneficial effect on the leadership behaviors of participants based on both subjective and objective changes in behavior. In addition to focusing on individual skill development, interventions that aim to develop leadership should consider the organizational, social, cultural, and political contexts in which behavioral change is expected. Workplace-based learning should be included in program development.

“A distant mirror”: Sensemaking in the era of Trump

Sensemaking is an ongoing act of constructing a reality to be interpreted. While numerous articles have explored the notion of sensemaking in organizations, far fewer have examined it through the empirical prism of an individual case of sensemaking, with the notable exception of Weick’s seminal contribution and formulation, “The Collapse of Sensemaking in Organizations: The Mann Gulch Disaster” (1993). In this article, we seek to build on the literature of sensemaking in organizations by offering an analysis of the actions of former Republican Senator Jeff Flake, whose leadership interventions we interpret as efforts at sensemaking in the era of Trump. In this context, we focus on the US Senate as an organ of sensemaking established by the framers of the Constitution to be relied upon in times of disruption, confusion, and chaos—a check on presidential power established by the framers of the US Constitution to provide prospective sensemaking for uncharted waters. In analyzing the case of Jeff Flake as sense-maker, we rely on certain definitions of leadership embedded in the era of post-truth. We conclude that Flake’s actions may be seen as a distant mirror (to quote Tuchman, 1978 ) of Weick’s treatment of the storied smokejumper Wag Dodge—a sense-maker whose persuasive powers failed him in the moment, only to be viewed in retrospect as the one who paved the way forward toward survival in the midst of a “cosmological episode.”

THE INFLUENCE OF BEING A MENTOR ON LEADERSHIP DEVELOPMENT: Recommendations for Curricular and Co-Curricular Experiences

While there are well-established personal benefits to being a mentor, such as increased life satisfaction and job performance (Ramaswami &amp; Dreher, 2007), how mentors grow and develop requires exploration. We meet this need by presenting six key themes from two recent research studies related to the experiences that mentors perceived as contributing to their development. The growth of two leadership theories in particular were explored: generativity and Psychological Capital. Six themes emerged: (a) curricular training, (b) exposure to leadership outcomes, (c) being mentored by peers, (d) experiences with mentee, (e) reflection, and (f ) observing a ripple effect. These themes offer insights on how curricular and co-curricular experiences might maximize leadership development of students and ground leadership interventions, such as mentoring, in theory and research.

Addressing operational complexities through re-inventing leadership style: A systemic leadership intervention

This research investigates leadership practice in private organisations in Nigeria. It focuses on learning about the application of leadership styles to address operational complexities in organisations. The research is based on a case study of a commercial livestock farm in Nigeria using systemic intervention as the methodology. Data collection tools, such as a workshop, semi-structured interviews, boundary setting and participant observation, were applied. Key leadership issues identified in the case study were addressed via the creation of an effective approach from different leadership underpinnings. Part of the findings is the difficulty in sustaining the implementation of a particular leadership style(s) due to unstructured nature of complexities involved in the determination of suitable leadership style at different stages of the research. The research wrapped up with the suggestion for further research on systemic leadership intervention to consider exploring the public sector, as well as the need to further review on the use of CATWOE in the research process, to avoid the occurrence of marginalisation in its apllication.

Microfinance and Peer Health Leadership Intervention Implementation for Men in Dar es Salaam, Tanzania: A Qualitative Assessment of Perceived Economic and Health Outcomes.

Men in sub-Saharan Africa continue to experience health disparities that are exacerbated by low employment. This study qualitatively assessed men’s perceptions of the economic and health-care-seeking effects of participation in an integrated microfinance and peer health leadership intervention on violence and HIV risk reduction in Tanzania. Three focus group discussions with 27 men, aged 20 to 44 years, examined the perceived effects on income generation, employability, mental health, and uptake of HIV and related health services. All discussions were recorded, transcribed, and analyzed using deductive and inductive coding methods. Men reported that the benefits of the intervention included increased employability and income-earning activities due to greater access to entrepreneurial training, low-interest microfinancing, and male-oriented group supports to start or strengthen their businesses. Increased wages through business or other forms of employment were also attributed to men’s lower anxiety and distress as financial providers for their families. However, men indicated that apart from the uptake of free HIV testing services, there was limited change in overall health-care-seeking behavior given the high clinic fees and lost time to earn income when attending routine health visits. Men recommended that future microfinance and health promotion interventions provide larger loan amounts, less frequent repayment intervals, and access to health and social insurance. Microfinance and peer health leadership interventions may help to address economic and health disparities in poor, urban men. Efforts are needed to assist lower income men in accessing financial tools as well as fee-based preventive and health-care services.

Identifying Strategies to Reduce Missed Opportunities for HPV Vaccination in Primary Care: A Qualitative Study of Positive Deviants.

The objectives of this study were to assess the contextual factors, practice strategies, and sustainability of interventions implemented during a national quality improvement (QI) project to raise human papillomavirus (HPV) vaccination rates. We conducted semistructured interviews with positive deviant practices that successfully reduced missed opportunities by ≥20% for HPV vaccination in the prior year. We assessed leadership support, motivators, interventions used, and sustainability. Key themes related to QI teams included strong leadership support, multidisciplinary teams, having a practice champion, and a collaborative environment. Themes related to the interventions included using a presumptive bundled recommendation for all appropriate vaccines at age 11, previsit planning, and reminders for preventive visits, which were sustainable for most practices 1-year postintervention. Both internal practice-level factors (multidisciplinary teams, collaboration, and previsit planning) and organizational factors (institutional support and health system-level reminders for preventive visits) were key to a successful QI intervention to improve HPV vaccination.

Teacher's withdrawal behavior: examining the impact of principals' innovative behavior and climate of organizational learning

PurposeThe study aims to test an innovative model that explores the direct and indirect relationships between principals' innovative behavior, climate of organizational learning and a teacher's intent to leave his or her school and take a voluntary absence.Design/methodology/approachData were collected from a survey of 1,529 teachers from 107 Arab elementary schools randomly selected from the database of the Israeli educational system. To test the proposed multilevel model, we conducted multilevel structural equation modeling (ML-SEM).FindingsThe analysis confirmed that organizational learning climate is a prominent mediator between principals' innovative behavior and a teacher's intent to leave and his/her voluntary absence.Originality/valueThis research advances our understanding of leaders' innovative construct in an educational context and adds to the body of research directed at identifying administrative support and work-related factors that may negatively relate to a teacher's absenteeism or intent to leave and are amenable to leadership intervention.

Determining and Improving Shared Leadership in an Elite Junior Volleyball Team

Shared leadership contributes to team functioning, collective efficacy, and team resilience. This applied study aimed to increase shared leadership by providing role clarification and tailored leadership interventions and to systematically evaluate the effects of these interventions. A leadership-intervention program was delivered with a female elite junior volleyball team of 20 players (age,M = 15.14,SD = 0.73). The intervention included acquaintance, recognition, analysis, and practice with leadership behavior during training/competition and was conducted before the start of the season. Changes in leadership were evaluated with a social-network analysis. Results showed that after role clarification, social- and external-leadership scores increased significantly. Task-, motivational-, and social-leadership scores improved significantly after the leadership-development intervention. The study offers a detailed description of the intervention and a systematic evaluation of results. Role clarification and a leadership program provide quick and practical avenue to increase awareness and shared leadership skills.

Business Results and Well-Being: An Engaging Leadership Intervention Study.

The present quasi-experimental study tested the business impact of a leadership development program focusing on psychological well-being through the satisfaction of basic psychological needs. Based on the concept of engaging leadership and self-determination theory, the 8-month program targeted midlevel team leaders of the customer fulfilment center of a health systems multinational organization. The program was designed in co-creation between senior leadership and the team leaders that participated in the program. Outcomes showed positive business results through significant increases in a preselected key performance indicator and decreased employee absenteeism. Through changes in autonomy satisfaction and intrinsic motivation, the team leaders (N = 14) benefitted in a moderate to very large extent relative to a similar control group (N = 52). In contrast, team members (N = 148) displayed no such benefits. Specifically, higher levels of autonomy satisfaction are said to lead to higher levels of psychological well-being and motivation. Still, the link with business performance is absent in most organizational studies within self-determination theory, making the present study one of the first to fill this gap. The study discloses the program design, compares the effects to a relevant control group, evaluates the lessons learned, and provides practical suggestions.

Family socioeconomic status and youth leadership potential: Serial mediating effects of parental rearing behaviors and youth self-esteem

To understand the origins of “the seeds of leadership”, the present study explored the relationship between family socioeconomic status (SES) and youth leadership potential. Specifically, we proposed and tested a path model illustrating the mediating effects of parental rearing behaviors and youth self-esteem on the link between family SES and youth leadership potential. In total, 692 Chinese middle school students (316 male and 376 female) from the seventh to ninth grades (aged approximately 12–15 years old) completed measures of family SES, parental rearing behaviors, youth self-esteem, and youth leadership potential. The results fully supported the proposed serial mediation model. Family SES was indirectly related to youth leadership potential via two kinds of parental rearing behaviors (warmth and rejection) followed by youth self-esteem. The serial mediation model obtained in this study sheds light on the origins of leadership potential and benefits the design of youth leadership interventions. The theoretical and practical implications of the research findings are discussed.

Leader Interpersonal Emotion Regulation and Follower Performance

Abstract. Interpersonal emotion regulation (IER) refers to the actions of influencing other people’s feelings. We apply this construct to the context of leadership to determine whether leader IER may explain followers’ performance. Drawing on emotions-as-social-information theory, we argue that leader strategies to improve or worsen followers’ feelings would be related to followers’ affect and thereby to their performance. We tested these proposals using a multisource field study involving 31 leaders and 157 followers. Results from multilevel modeling supported a mediation model in which leaders’ attempts to improve their followers’ feelings enhance followers’ task performance via the followers’ experience of positive affect. In contrast, leaders’ use of affect-worsening actions was associated with the experience of followers’ negative affect, but not related to task performance. These findings contribute by expanding knowledge on the affective underpinnings of the leader–follower relationship and informing the development of leadership interventions aimed to foster employee performance.

Embedding collective leadership to foster collaborative inter-professional working in the care of older people (ECLECTIC): Study protocol

Background: The National Integrated Care Programme for Older People (NICPOP), formerly NCPOP aims to support older people to live well in their homes by developing primary and secondary care services for older people, especially those with complex needs. The programme develops integrated intermediate care which traverses both hospital and community settings through multidisciplinary and interagency teams. This team-based approach to the integration of health services is a novel innovation in Irish health service delivery and will require, over time, a shift in cultures of care to allow for the development of competencies for inter-professional collaboration across the care continuum. The ECLECTIC project will develop an implementation framework for achieving, maintaining and monitoring competencies for interprofessional collaboration among multi-disciplinary teams charged with delivering care for older people across the continuum from acute to community settings. Design: The ECLECTIC research design has been developed in collaboration with the NICPOP. In phase one of the project, a co-design team will collaborate to define and shape competencies for interprofessional collaboration. Phase two will involve the delivery of a collective leadership intervention over a 10-month period with multidisciplinary professionals working with older people across two geographical regions (Mullingar/Midlands and Beaumont/Dublin North). Each group will comprise of members of two multidisciplinary teams charged with coordinating and delivering care to older people across the continuum of acute to community care. Observations of collaborative inter-professional working will take place before, during, and after intervention. In phase three of the study, analysis of the interview and observation data will be presented to the co-design team in order to develop an implementation framework for future teams. Discussion: The co-design process will develop core competencies and performance indicators for collaborative interprofessional working. The resulting implementation framework will be implemented nationally as part of the NICPOP.

Identifying the context, mechanisms and outcomes underlying collective leadership in teams: building a realist programme theory

BackgroundThere is accumulating evidence for the value of collective and shared approaches to leadership. However, relatively little research has explored collective leadership in healthcare and thus, there is a lack understanding of the mechanisms that promote or inhibit the practice of collective leadership in healthcare teams. This study describes the development of an initial programme theory (IPT) to provide insight into the mechanisms underpinning the enactment of collective leadership.MethodsThis IPT was informed by a multiple-method data collection process. The first stage involved a realist synthesis of the literature on collective leadership interventions in healthcare settings (n = 21 studies). Next, we presented initial findings to receive feedback from a realist research peer support group. Interviews with members of teams identified as working collectively (n = 23) were then conducted and finally, we consulted with an expert panel (n = 5). Context-mechanism-outcome configurations (CMOCs) were extrapolated to build and iteratively refine the programme theory and finalise it for testing.ResultsTwelve CMOCs were extrapolated from these data to form the initial programme theory and seven were prioritised by the expert panel for focused testing. Contextual conditions that emerged included team training on-site, use of collaborative/co-design strategies, dedicated time for team reflection on performance, organisational and senior management support, inclusive communication and decision-making processes and strong supportive interpersonal relationships within teams. Mechanisms reported include motivation, empowerment, role clarity, feeling supported and valued and psychological safety which led to outcomes including improvements in quality and safety, staff and patient satisfaction, enhanced team working, and greater willingness to share and adopt leadership roles and responsibilities.ConclusionsThis study has identified preliminary support for the contexts, mechanisms and outcomes underpinning the practice of collective leadership. However, it must be noted that while they may appear linear in presentation, in reality they are independent and interlinked and generative of additional configurations. This paper contributes to the nascent literature through addressing an identified gap in knowledge by penetrating below the surface level inputs and outputs of an intervention to understand why it works or doesn’t work, and for whom it may work.

Understanding the impact of a collective leadership intervention on team working and safety culture in healthcare teams: a realist evaluation protocol.

There is accumulating evidence for the value of collective and shared approaches to leadership across sectors and settings. However, relatively little research has explored collective leadership in healthcare and thus, there is little understanding of what works for healthcare teams, why, how and to what extent. This study describes the approach that will be adopted to the realist evaluation of a collective leadership intervention with four heterogenous healthcare teams in four different settings. A realist evaluation will be conducted. Realist evaluation is a theory-based approach to evaluation. It enables the use of mixed-methods to explore the research question of interest. Development of an initial programme theory (IPT) constitutes the first phase of the approach. This IPT will be informed by interviews with members of teams identified as working collectively, an examination of extant literature using realist synthesis, and will be refined through consultation with an expert panel. A multiple case study design will be adopted to explore the impact of the intervention, including quantitative scales on teamworking, leadership and safety culture, realist interviews with key informants and observations of teams during intervention sessions. Analysis of data will be guided by the IPT to refine the theory and context-mechanism-outcome configurations. Findings from the cases will be compared to identify patterns or demi-regularities and to explore if the intervention operates differently in different contexts. This analysis and synthesis of findings across the teams will inform the development of a middle range theory that will not only add to our understanding of how collective leadership influences teamwork and patient safety, but also provide guidance for future collective leadership interventions. Favourable ethical opinion has been received from the University College Dublin Ethics Committee. Results will be disseminated via publication in peer-review journals, national and international conferences and to stakeholders/interest groups.

Abusive supervision and employee engagement and satisfaction: the mediating role of employee silence

PurposePrevious studies have found that abusive supervision undermines employees' work motivation and attitudes, namely work engagement and job satisfaction. However, less is known about the mechanisms by which abusive supervision negatively relates to employees' work engagement and job satisfaction. Drawing on conservation of resources theory, this study examines employee silence as a mediating mechanism linking abusive supervision to employees' work engagement and job satisfaction.Design/methodology/approachSurvey data were collected from a sample of 233 full-time employees of a large hotel service company in Taiwan. Structural equation modeling analyses were conducted to test the hypotheses.FindingsThe results showed that abusive supervision has a positive association with employee silence. Moreover, the results showed that employee silence mediates the negative associations of abusive supervision with employees' work engagement and job satisfaction.Practical implicationsThe results suggest that organizational managers should provide supervisors with leadership interventions to prevent the occurrence of abusive supervision. Furthermore, organizational managers should provide employees with opportunities to voice their concerns through the use of organizational communication and participation, which can reduce employee silence and subsequently foster employee engagement and satisfaction at work.Originality/valueThis study advances our understanding of how abusive supervision results in poor work motivation and attitudes among employees. This contributes to the literature by identifying employee silence as a suitable mediating mechanism linking the negative associations of abusive supervision with employees' work engagement and job satisfaction.