The aim of the Co-Lead research programme is to support quality and safety cultures through the development and implementation of a new model of healthcare leadership - collective leadership.
The research team is studying the development of leaders' networks within the IEHG. In addition, a collective leadership intervention based on healthcare teams' leadership needs is being co-designed. Rather than starting from a top-down competency framework-driven intervention targeted at the individual as leader, development is being informed through a bottom-up service needs-driven co-designed suite of intervention tools targeted at team members as co-leaders. Co-design will ensure that the intervention components are grounded in the needs and real-world experiences of healthcare staff. The engagement of healthcare teams in identifying leadership needs throughout the Co-Lead programme will ensure that the intervention is designed collaboratively; ensuring its relevance and increasing the likelihood that it will be successful in shaping a patient safety culture.
The programme will then implement and test the impact of these interventions on leadership competencies, staff engagement and safety cultures. This approach to conducting ‘research-in-practice’ will ensure rapid implementation and scale-up of the collective leadership intervention should it prove effective in developing leaders that support safety cultures. The research will also contribute to the growing literature on collective leadership through the development of a model that explains the relationship between collective leadership and patient safety cultures.
The research programme comprises 10 work packages (WP):
The aim of this work package is to map the constellations of leadership that develop in the IEHG over a one-year period. Documenting leaders’ interactions and actions with a focus on those that are high level and visible.
- Does collective leadership emerge organically following a re-organisation into networked structures?
- What facilitates and hinders integrated leadership?
Collective leadership development - co-designing the intervention and learning experiences
A new model of leadership development underpinned by the concept of collective leadership will be designed and developed using a co-design approach. In contrast to traditional approaches that focus development on the individual as leader, the programme approach will be on developing the team as a dynamic leadership entity ensuring all members understand and develop the capability for leadership. This represents a radical shift in programme design and delivery.
The collective leadership intervention will be designed to support learning as a dynamic interactive process, and to shift one’s thinking from the traditional concept of the individual learner and the knowledge and expertise being embodied in one individual leader, to the notion of group learning and a shared repository of leadership skills.
- What are the common leadership needs identified by healthcare teams and do these differ from those identified in the healthcare leadership literature?
- Do leadership development needs differ according to team type?
The co-designed collective leadership intervention will be piloted over a 12-month period with four healthcare teams in the IEHG. The intervention will be iteratively refined throughout the process based on the teams’ experiences of using it.
Quantitative and qualitative data collection will take place at baseline prior to implementation of the intervention with teams and again post-intervention to explore the impact of the intervention.
How does collective leadership training and development impact on team performance?
Development of open source blended learning leadership development modules
If the collective leadership development in work packages 2 and 3 shows a positive impact on team performance, the intervention and learning tools will be further developed to provide an open source repository of tools for use across the HSE and within postgraduate leadership programmes.
The material will include PowerPoints, videos, reading materials, podcasts and other learning tools.
Scale-up of leadership development across all hospitals in the IEHG
Awareness raising workshops will be held across the IEHG network. The purpose of these workshops will be to:
- raise awareness about collective leadership and its potential to impact on quality and safety;
- disseminate preliminary findings from the study;
- familiarise participants with the online materials; and
- identify supports needed to implement collective leadership training in each site and feed this back to the HSE.
Implementing and assessing the impact of Leadership-in-Practice Networks
Leadership-in-practice learning networks will be established for a sub-sample of the leaders receiving training in work package 5. These networks will use action learning methodology to build competence in collective leadership.
Are leadership-in-practice learning sets an effective method of building leadership competence and supporting leadership action?
Assessing the impact of collective leadership development on staff’s job satisfaction, work engagement and turnover intention
The role of organisational attributes on the work environment is becoming increasingly important in ensuring that adequate staffing levels can be maintained, particularly in times of shortage. Several studies have shown the link between these organisational attributes and job satisfaction, work engagement, retention and recruitment, decreased mortality and healthier staff. The impact of collective leadership development on work engagement, job satisfaction and intention to leave will be measured in this work package.
- How does collective leadership training and development impact on employees’ job satisfaction?
- How does collective leadership training and development impact on employees’ work engagement?
- How does collective leadership training and development impact on employees’ intention to leave their job?
- What is the relationship between collective leadership, job satisfaction, work engagement and intention to leave?
Assessing the impact of collective leadership on patient safety cultures
Four components of safety culture - reporting culture, just culture, flexible culture and learning culture - will be measured in this work package.
- How does collective leadership training impact on safety cultures in hospitals?
Analysis and dissemination
Data analysis and dissemination will be an ongoing activity throughout the programme life-cycle. Following the completion of all data collection, structural equation modelling will be undertaken to explore and explain the relationships between collective leadership, the work environment variables, and each of the culture components within the measure of patient safety culture. This will enable the development of an overall explanatory model of how collective leadership impacts safety cultures.
Research Capacity Development
The research programme will be informed by more than two decades of research by Prof Mike West on teamwork and leadership. Collaboration with The King’s Fund is a fundamental element of the programme’s research capacity building.
The programme will improve the capacity of the research team to conduct health systems research - particularly in the areas of leadership and patient safety - and will support six PhD students to complete their post-graduate studies in health systems research within the timeframe of the project.