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Literature search results

Search completed for:

Search required by: 19th June 2015

Search completed on: 17th June 2015

Search completed by: Richard Bridgen

Search details

NHS Leadership styles, especially in relation to the quality of patient care or mental health.

Resources searched

NICE Evidence; TRIP Database; Cochrane Library; CINAHL; EMBASE; HMIC; PsychINFO; Google Scholar

Database search terms: leader*; style*; type*; kind*; variet*; form; forms; sort; sorts; catagor*; exp LEADERSHIP STYLE; TRANSFORMATIONAL LEADERSHIP; “mental health”; exp MENTAL HEALTH; “quality of patient care”; “quality of care”; NHS; “national health service”; QUALITY OF CARE; QUALITY OF SERVICES; QUALITY OF HEALTHCARE; QUALITY OF NURSING CARE

Evidence / Google Scholar search string(s): "leadership styles" / "leadership styles" ("mental health" OR NHS OR "quality of care" OR "quality of patient care")

Summary

There was quite a lot of research on leadership styles in the NHS, but hopefully not enough to be overwhelming.

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Guidelines and Policy

CHKS

What makes a top hospital? Leadership 2011

See the section on distributed leadership.

King’s Fund

System Leadership, Lessons and Learning from AQuA’s Integrated Discovery Communities 2014

This paper looks at learning from the work undertaken by the Advancing Quality Alliance (AQuA) in conjunction with the King’s Fund in the North West of England between 2011 and 2014. It pays particular attention to the lessons from the City of Manchester case study to consider the right type of leadership for programmes of change towards more integrated models of care

NHS Improving Quality

Leading large scale change 2013

See section 4.

Evidence Reviews

International Journal of Environmental Research and Public Health

Burnout in relation to specific contributing factors and health outcomes among nurses : a systematic review 2013

Work environment related stressors such as working place, poor peer relationships, poor nurse patient relationships, lack of professional recognition or reward [25–27], feedback clarity and supervisor leadership style [28] were related to one or more burnout dimensions.

NIHR Health Services and Delivery Research

A mixed-methods evaluation of transformational change in NHS North East 2014

NIHR Service Delivery and Organisation Programme

Exploring the relationship between patients' experiences of care and the influence of staff motivation, affect and wellbeing 2012

This three-year mixed methods study we explored links between (a) patients' experiences of health care, and (b) staff motivation, affect and wellbeing. The latter may be affected by the leadership style of supervisors and managers.

Leadership and better patient care : managing in the NHS 2011

This study aimed overall to seek out the meanings and perceptions of relationships between ‘leadership’ and ‘patient care’ and how leadership is transmitted across organisations to impact upon service delivery

Understanding the dynamics of organisational culture change : creating safe places for patients and staff 2010

This report explores the characteristics of organisational culture in eight English NHS acute Trusts and how these link to outcomes affecting patient safety and staff well-being. It also goes one step further to access understanding of possible relationships between staff well-being and patient safety and the impact of external and internal contextual influences on

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NHS Trusts. In this regard external influences may relate to: re-configuration of primary care trust (PCT) catchment areas; changes in demand for commissioned services; changes in government policy; technological innovation; demographic changes; Trust merger; societal change and legislative change. Internal influences may relate to Trust culture, structures, processes, leadership and history.

Leadership in healthcare : a review of the literature for health care professionals, managers and researchers 2008

The work has two key objectives:

To review the literature on leadership in healthcare and design a framework which synthesises the literature and provides a clear “road map” of the key areas of the literature and evidence.

To draw out lessons for policy, practice and future research in the area of leadership in health care.

The impact of leadership factors in implementing change in complex health and social care environments : NHS plan clinical priority for mental health crises resolution teams 2007

The purpose of the investigation was to undertake longitudinal research to examine the relationship between quality of leadership and both staff attitudes to work and their well-being at work, and organisation performance.

Published Research – Databases

1. Recovery-focussed leadership in the NHS.

Author(s) McLean, Jane

Citation: Mental Health & Social Inclusion, 01 May 2015, vol./is. 19/2(87-94), 20428308

Publication Date: 01 May 2015

Abstract: Purpose – The purpose of this paper is to explore the leadership qualities and behaviours required to support recovery-focussed practice in mental health. Design/methodology/approach – This paper contrasts the prevailing leadership style within the NHS with the leadership style required to support recovery-focussed practice in mental health. The underlying reasons for, and implications of, this disparity are explored. Findings – The leadership style required to support recovery-focussed practice in mental health services is one based on collaboration, empowerment, service-user led practice, autonomy, shared decision making, distribution of power, compassion, strengths, valuing, recognising and rewarding positive behaviours and using a collective approach. This is fundamentally at odds with that experienced by staff working within the NHS. Originality/value – If NHS services are genuinely to promote the recovery of those whom they serve then the leadership and culture of organisations is critical.

Source: CINAHL

Available in fulltext from Mental Health and Social Inclusion at the LPFT Library and Knowledge Services' eJournal collection

Available in fulltext from Mental Health and Social Inclusion at Emerald Group Publishing Limited

Available in print at Grantham Hospital Staff Library

2. How does a servant leader fuel the service fire? A multilevel model of servant leadership, individual self identity, group competition climate, and customer service performance.

Author(s) Chen, Zhijun, Zhu, Jing, Zhou, Mingjian

Citation: Journal of Applied Psychology, Mar 2015, vol. 100, no. 2, p. 511-521, 0021-9010 (Mar 2015)

Publication Date: March 2015

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Abstract: Building on a social identity framework, our cross-level process model explains how a manager’s servant leadership affects frontline employees’ service performance, measured as service quality, customer-focused citizenship behavior, and customer-oriented prosocial behavior. Among a sample of 238 hairstylists in 30 salons and 470 of their customers, we found that hair stylists’ self-identity embedded in the group, namely, self-efficacy and group identification, partially mediated the positive effect of salon managers’ servant leadership on stylists’ service performance as rated by the customers, after taking into account the positive influence of transformational leadership. Moreover, group competition climate strengthened the positive relationship between self-efficacy and service performance. (PsycINFO Database Record (c) 2015 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Journal of Applied Psychology at ProQuest

3. Leadership, safety climate, and continuous quality improvement: Impact on process quality and patient safety.

Author(s) McFadden, Kathleen L., Stock, Gregory N., Gowen III, Charles R.

Citation: Health Care Management Review, 01 January 2015, vol./is. 40/1(24-34), 03616274

Publication Date: 01 January 2015

Abstract: BACKGROUND: Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. PURPOSE: We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. METHODOLOGY/APPROACH: The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. FINDINGS: The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. PRACTICAL IMPLICATIONS: The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Source: CINAHL

4. Leadership, organizational climate, and working alliance in a children’s mental health service system.

Author(s) Green, Amy E., Albanese, Brian J., Cafri, Guy, Aarons, Gregory A.

Citation: Community Mental Health Journal, Oct 2014, vol. 50, no. 7, p. 771-777, 0010-3853 (Oct 2014)

Publication Date: October 2014

Abstract: The goal of this study was to examine the relationships of transformational leadership and organizational climate with working alliance, in a children’s mental health service system. Using multilevel structural equation modeling, the effect of leadership on working alliance was mediated by organizational climate. These results suggest that supervisors may be able to impact quality of care through improving workplace climate. Organizational factors should be considered in efforts to improve public sector services. Understanding these issues is important for program leaders, mental health service

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providers, and consumers because they can affect both the way services are delivered and ultimately, clinical outcomes. (PsycINFO Database Record (c) 2014 APA, all rights reserved)(journal abstract)

Source: PsycINFO

5. The importance of leadership style and psychosocial work environment to staff‐assessed quality of care: Implications for home help services.

Author(s) Westerberg, Kristina, Tafvelin, Susanne

Citation: Health & Social Care in the Community, Sep 2014, vol. 22, no. 5, p. 461-468, 0966-0410 (Sep 2014)

Publication Date: September 2014

Abstract: Work in home help services is typically conducted by an assistant nurse or nursing aide in the home of an elderly person, and working conditions have been described as solitary with a high workload, little influence and lack of peer and leader support. Relations between leadership styles, psychosocial work environment and a number of positive and negative employee outcomes have been established in research, but the outcome in terms of quality of care has been addressed to a lesser extent. In the present study, we aimed to focus on working conditions in terms of leadership and the employee psychosocial work environment, and how these conditions are related to the quality of care. The hypothesis was that the relation between a transformational leadership style and quality of care is mediated through organisational and peer support, job control and

workload. A cross‐sectional survey design was used and a total of 469 questionnaires were distributed (March–April 2012) to assistant nurses in nine Swedish home help organisations, including six municipalities and one private organisation, representing both rural and urban areas (302 questionnaires were returned, yielding a 65% response rate). The results showed that our hypothesis was supported and, when indirect effects were also taken into consideration, there was no direct effect of leadership style on quality of care. The mediated model explained 51% of the variance in quality of care. These results indicate that leadership style is important not only to employee outcomes in home help services but is also indirectly related to quality of care as assessed by staff members. (PsycINFO Database Record (c) 2014 APA, all rights reserved)(journal abstract)

Source: PsycINFO

6. Burnout in psychiatric nursing: Examining the interplay of autonomy, leadership style, and depressive symptoms.

Author(s) Madathil, Renee, Heck, Nicholas C., Schuldberg, David

Citation: Archives of Psychiatric Nursing, Jun 2014, vol. 28, no. 3, p. 160-166, 0883-9417 (Jun 2014)

Publication Date: June 2014

Abstract: It is important to consider ways in which nurses can be protected from experiencing the effects of burnout. This study examined the relationships between leadership style of psychiatric nurse supervisors, work role autonomy, and psychological distress in relation to psychiatric nurse burnout. Eighty-nine psychiatric nurses from Montana and New York hospitals completed an online survey that assessed their work-related experiences. Overall, results of this study indicate that the participants were experiencing high levels of emotional exhaustion and depersonalization when compared to a normative sample of mental health workers. Results also showed that leadership style and work role autonomy are likely to be environmental factors that protect against burnout in nurses. Finally, it was shown that the relationship between depressive symptoms and the burnout component of personal accomplishment may be influenced by nurses’ perceptions of the leadership style in their work environment. These findings are important because nurse supervisor leadership styles and amount of autonomy are characteristics of the work environment that may be amenable to change through training and intervention. (PsycINFO Database Record (c) 2014 APA, all rights reserved)(journal abstract)

Source: PsycINFO

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7. Review: Clinical leadership characteristics confirmed.

Author(s) Bishop, Veronica

Citation: Journal of Research in Nursing, Mar 2014, vol. 19, no. 2, p. 129-130, 1744-9871 (Mar 2014)

Publication Date: March 2014

Abstract: This article reviews, Clinical leadership characteristics confirmed by David Stanley (see record 2014-07499-005). In view of the recent headlines that the newly formed NHS Commissioning Board must encourage nurse leadership, this paper is a welcome opportunity for policy makers, managers and clinical staff in the health services to take a good look at how many of their preconceptions fall short of reality. The work described is about finding out what makes a good nurse or paramedic, who really leads when it comes to standards and quality. The importance of this paper is that, despite its simplicity, it distills decades of health care studies in relation to quality care. Management and clinical leadership are different. It is to be hoped that a seemingly small matter of semantics will make a significant difference to the reader, and to their preconceptions. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

Source: PsycINFO

8. The roles of individual and organizational factors in burnout among community-based mental health service providers.

Author(s) Green, Amy E., Albanese, Brian J., Shapiro, Nicole M., Aarons, Gregory A.

Citation: Psychological Services, Feb 2014, vol. 11, no. 1, p. 41-49, 1541-1559 (Feb 2014)

Publication Date: February 2014

Abstract: Public-sector mental health care providers are at high risk for burnout, which negatively affects not only provider well-being but also the quality of services for clients and the functioning of organizations. This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public-sector mental health service system. Additionally, given the dearth of research examining differences in burnout levels among mental health subdisciplines (e.g., social work, psychology, marital and family therapy) and mental health programs (e.g., outpatient, day treatment, wraparound, case management), analyses were conducted to compare levels of burnout among multiple mental health disciplines and program types. Surveys were completed by 285 providers across 49 mental health programs in a large urban public mental health system. Variables representing dimensions of organizational climate and transformational leadership accounted for the greatest amount of variance in provider reported burnout. Analyses demonstrated significantly lower levels of depersonalization among wraparound providers compared to traditional case managers. Age was the only demographic variable related to burnout. Additionally, no significant effects were found for provider discipline or for agency tenure and caseload size. Results suggest the need to consider organizational development strategies aimed at creating more functional and less stressful climates and increasing levels of transformational leadership behaviors in order to reduce levels of burnout among clinicians working in public mental health settings for youth and families. (PsycINFO Database Record (c) 2014 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Psychological Services at ProQuest

9. To explore and understand the leadership experiences of modern matrons, within an acute NHS trust.

Author(s) Lawrence, Nigel, Richardson, Janet

Citation: Journal of Nursing Management, Jan 2014, vol. 22, no. 1, p. 70-79, 0966-0429 (Jan 2014)

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Publication Date: January 2014

Abstract: Aim: The aim of this study was to explore and understand the leadership

experiences of modern matrons. Background: Modern matrons were re‐introduced to the National Health Service in 2002, and effective leadership has been identified as being essential for the role to be successful. However, there is minimal evidence of how modern matrons experience effective leadership. Methods: The study used a descriptive generic

qualitative methodology; one‐to‐one semi‐structured interviews were conducted with nine matrons. This was subjected to an inductive thematic analysis. Results: Three themes were found to influence modern matron’s leadership experiences: leadership behaviours, negative influences and leadership investment. They did not follow one leadership style but adapted this to their situation. Various factors appeared to restrict their leadership effectiveness. Conclusions: The findings suggest that exposure to a range of leadership styles should be included in preparation and CPD for the modern matron role and a more consistent job description and job purpose should be developed. Implications for nursing management: Leadership styles such as transformational leadership alone do not meet the complex demands of nursing leaders, and therefore there is a requirement for greater flexibility in leadership development for all health care professionals. (PsycINFO Database Record (c) 2014 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Journal of Nursing Management at EBSCOhost

10. Leadership styles and staff retention among mental health professionals.

Author(s) Johnson, Sharonica M.

Citation: Dissertation Abstracts International Section A: Humanities and Social Sciences, Jan 2014, vol. 74, no. 11-A(E), 0419-4209 (2014)

Publication Date: January 2014

Abstract: Due to the shortage of qualified mental health professionals (MHPs) in the United States, many individuals do not receive psychotherapeutic services. Literature shows that leadership styles are related to staff retention in fields such as nursing. However, the nature and extent of the relationship between leadership styles and staff retention in the mental health sector remains unknown. Grounded in Bass's transformational leadership theory, this quantitative research study employed a survey method to assess the relationships among leadership styles, education attainments, and staff retention among MHPs working in for-profit and not-for-profit organizations. One hundred and eighty MHPs completed the Multifactor Leadership Questionnaire 5X Short Form to provide their perceptions of their leaders' leadership behaviors. Staff retention was measured by the percentage of MHPs retained under leaders at the end of the evaluated year. Two-way ANOVAs revealed a significant difference in MHPs' retention rates when leaders used a transformational or the transactional leadership styles when working in not-for-profit organizations. No other significant difference related to MHPs' retention rates was found. This study contributes to America's growing discussion of mental illness and recovery. This study has further implications for positive social change by contributing to literature on the role of leadership styles in staff retention. Leaders within mental health agencies might choose to focus on other factors that might affect staff retention, such as organizational factors and employee characteristics. It is suggested that this study be duplicated with a larger sample that includes MHPs formerly employed with participating organizations. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

Source: PsycINFO

11. Leadership support for ward managers in acute mental health inpatient settings.

Author(s) Bonner, Gwen, McLaughlin, Sue

Citation: Nursing Management, 2014, vol./is. 21/2(26-29), 1354-5760

Publication Date: 2014

Abstract: This article shares findings of work undertaken with a group of mental health ward managers to consider their roles through workshops using an action learning

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approach. The tensions between the need to balance the burden of administrative tasks and act as clinical role models, leaders and managers are considered in the context of providing recovery-focused services. The group reviewed their leadership styles, broke down the administrative elements of their roles using activity logs, reviewed their working environments and considered how recovery focused they believed their wards to be. Findings support the notion that the ward manager role in acute inpatient settings is at times unmanageable. Administration is one aspect of the role for which ward managers feel unprepared and the high number of administrative tasks take them away from front line clinical care, leading to frustration. Absence from clinical areas reduces opportunities for role modeling good clinical practice to other staff. Despite the frustrations of administrative tasks, overall the managers thought they were supportive to their staff and that their wards were recovery focused. [Abstract]

Source: HMIC

Available in fulltext from Nursing Management - UK at EBSCOhost

Available in fulltext from Nursing Management - UK at EBSCOhost

12. Comparing the content of leadership theories and managers' shared perceptions of effective leadership: A Q-method study of trainee managers in the English NHS.

Author(s) Freeman, Tim

Citation: Health Services Management Research, 01 August 2013, vol./is. 26/2/3(43-53), 09514848

Publication Date: 01 August 2013

Abstract: Health service managers face potential conflicts between corporate and professional agendas, a tension sharpened for trainees by their junior status and relative inexperience. While academic leadership theory forms an integral part of contemporary management development programmes, relatively little is known of trainees' patterned subjectivities in relation to leadership theories. The objective of this study was to explore such subjectivities within a cohort of trainees on the National Health Service Graduate Management Training Scheme (NHS GMTS), a ‘fast-track’ programme which prepares graduate entrants for director-level health service management posts. A Q-method design was used and four shared subjectivities were identified: leadership as collaborative social process (‘relational’); leadership as integrity (‘moral’); leadership as effective support of subordinates (‘team’); and leadership as construction of a credible leadership persona (‘identity’). While the factors broadly map onto competencies indicated within the NHS Leadership Qualities Framework which underpin assessments of performance for this student group, it is important not to overstate the governance effect of the assessment regime. Rather, factors reflect tensions between required competencies, namely the mobilisation of diverse interest groups, the ethical base of decisions and the identity work required to convince others of leadership status. Indeed, factor 2 (‘moral’) effectively defines leadership as the embodiment of public service ethos.

Source: CINAHL

Available in fulltext from Health Services Management Research at EBSCOhost

13. Practice what you preach: Developing person-centred culture in inpatient mental health settings through strengths-based, transformational leadership.

Author(s) Beckett, Paul, Field, John, Molloy, Luke, Yu, Nickolas, Holmes, Douglas, Pile, Emily

Citation: Issues in Mental Health Nursing, Aug 2013, vol. 34, no. 8, p. 595-601, 0161-2840 (Aug 2013)

Publication Date: August 2013

Abstract: The experience of nursing staff and consumers in inpatient mental health wards is often reported as being negative. Efforts to improve culture and practice have had limited success, with ineffective leadership, staff resistance, and unresponsive organisational culture identified as common barriers to change. Practice development has been promoted

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as an approach to developing person-centred culture that enables professional development through participation, learning and empowerment. For person-centred practice to flourish, organisational leadership at all levels must reflect the same principles. In preparation for the opening of a new integrated mental health service, an inpatient mental health team participated in a practice development project. An action research approach was used to facilitate a series of “away days,” initially with the nursing team and then other members of the multidisciplinary team (MDT).Transformational leadership principles were adopted in the facilitation of team activities underpinned by strengths and solution-focused practices. Evaluation of the project by staff members was very positive and there was a high level of participation in practice development activities. The project resulted in the creation of a development plan for the ward, which prioritised five key themes: person-centred care, personal recovery, strengths-based principles, and evidence-based and values-based care. The project outcomes highlight the importance of leadership, which parallels the ideals promoted for clinical practice. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Issues in Mental Health Nursing at EBSCOhost

Available in fulltext from Issues in Mental Health Nursing at EBSCOhost

14. Transformational leadership moderates the relationship between emotional exhaustion and turnover intention among community mental health providers.

Author(s) Green, Amy E., Miller, Elizabeth A., Aarons, Gregory A.

Citation: Community Mental Health Journal, Aug 2013, vol. 49, no. 4, p. 373-379, 0010-3853 (Aug 2013)

Publication Date: August 2013

Abstract: Public sector mental health care providers are at high risk for burnout and emotional exhaustion which negatively affect job performance and client satisfaction with services. Few studies have examined ways to reduce these associations, but transformational leadership may have a positive effect. We examine the relationships between transformational leadership, emotional exhaustion, and turnover intention in a sample of 388 community mental health providers. Emotional exhaustion was positively related to turnover intention, and transformational leadership was negatively related to both emotional exhaustion and turnover intention. Transformational leadership moderated the relationship between emotional exhaustion and turnover intention, indicating that having a transformational leader may buffer the effects of providers’ emotional exhaustion on turnover intention. Investing in transformational leadership development for supervisors could reduce emotional exhaustion and turnover among public sector mental health providers. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext at Community Mental Health Journal; Collection notes: Academic-License. Please when asked to pick an institution please pick NHS. Please also note access is from 1997 to date only.

15. Authentic leadership and nurse-assessed adverse patient outcomes.

Author(s) Wong, Carol A., M. Giallonardo, Lisa

Citation: Journal of Nursing Management, 01 July 2013, vol./is. 21/5(740-752), 09660429

Publication Date: 01 July 2013

Abstract: Aim Our purpose was to test a model examining relationships among authentic leadership, nurses' trust in their manager, areas of work life and nurse-assessed adverse patient outcomes. Background Although several work environment factors have been cited as critical to patient outcomes, studies linking nursing leadership styles with patient outcomes are limited suggesting the need for additional research to investigate the mechanisms by which leadership may influence patient outcomes. Methods Secondary analysis of data collected in a cross-sectional survey of 280 (48% response rate) registered

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nurses working in acute care hospitals in Ontario was conducted using structural equation modelling. Results The final model fit the data acceptably ( χ² = 1.30, df = 2, P = 0.52, IFI = 0.99, CFI = 1.00, RMSEA = 0.00). Authentic leadership was significantly associated with decreased adverse patient outcomes through trust in the manager and areas of work life. Conclusions The findings suggest that nurses who see their managers as demonstrating high levels of authentic leadership report increased trust, greater congruence in the areas of work life and lower frequencies of adverse patient outcomes. Implications for nursing management Managers who emphasize transparency, balanced processing, self-awareness and high ethical standards in their interactions with nurses may contribute to safer work environments for patients and nurses.

Source: CINAHL

Available in fulltext from Journal of Nursing Management at EBSCOhost

16. The NHS needs a new leadership style

Author(s) Smith J.

Citation: The Health service journal, July 2013, vol./is. 123/6359(18), 0952-2271 (19 Jul 2013)

Publication Date: July 2013

Source: EMBASE

Available in print at Pilgrim Hospital Staff Library

Available in print at Louth County Hospital Medical Library

17. Understanding the link between leadership style, employee satisfaction, and absenteeism: A mixed methods design study in a mental health care institution.

Author(s) Elshout, Rachelle, Scherp, Evelien, van der Feltz-Cornelis, Christina M.

Citation: Neuropsychiatric Disease and Treatment, Jun 2013, vol. 9, 1176-6328 (Jun 19, 2013)

Publication Date: June 2013

Abstract: Background: In service oriented industries, such as the health care sector, leadership styles have been suggested to influence employee satisfaction as well as outcomes in terms of service delivery. However, how this influence comes into effect has not been widely explored. Absenteeism may be a factor in this association; however, no studies are available on this subject in the mental health care setting, although this setting has been under a lot of strain lately to provide their services at lower costs. This may have an impact on employers, employees, and the delivery of services, and absenteeism due to illness of employees tends to already be rather high in this particular industry. This study explores the association between leadership style, absenteeism, and employee satisfaction in a stressful work environment, namely a post-merger specialty mental health care institution (MHCI) in a country where MHCIs are under governmental pressure to lower their costs (The Netherlands). Methods: We used a mixed methods design with quantitative as well as qualitative research to explore the association between leadership style, sickness absence rates, and employee satisfaction levels in a specialty MHCI. In depth, semi-structured interviews were conducted with ten key informants and triangulated with documented research and a contrast between four departments provided by a factor analysis of the data from the employee satisfaction surveys and sickness rates. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results: Quantitative analysis revealed sickness rates of 5.7% in 2010, which is slightly higher than the 5.2% average national sickness rate in The Netherlands in 2010. A general pattern of association between low employee satisfaction, high sickness rates, and transactional leadership style in contrast to transformational leadership style was established. The association could be described best by: (1) communication between the manager and employees; (2) the application of sickness protocols by the managers; and (3) leadership style of the manager. Conclusion: We conclude that the transformational leadership style is best suited for attaining employee satisfaction, for adequate handling of sickness protocols, and for lower

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absenteeism, in a post-merger specialty mental health setting. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Neuropsychiatric Disease and Treatment at National Library of Medicine

18. The art of leading and following—A workplace tango.

Author(s) Lobatto, Wendy

Citation: Journal of Social Work Practice, Jun 2013, vol. 27, no. 2, p. 133-147, 0265-0533 (Jun 2013)

Publication Date: June 2013

Abstract: This article describes my experiences of leading a commissioned child mental health service through a process of change in my role as manager. The article uses the metaphor of the Argentine tango to conceptualize my efforts to implement leadership in my work. I look at the influence of the music, the relationship between leadership and followership, and the idea of mutual presence to draw out aspects of my experience. In so doing, I relate theory to practice and bring together various theories of leadership in a creative synthesis. The article draws away from realist notions of management theory to ask how it is that we perform leadership. It suggests that we do so by the provision of an ‘intelligible formulation’ of chaotic events. This can be reached through the reflective understanding of the nature of the work. It can also be striven toward through creative acts of ‘discernment’ of the practices of the agency. These acts are fostered through the distribution of leadership that simultaneously dissolves yet persists. The need for mutual presence is highlighted and the role of leadership outside the immediate circle of authority is examined. The use of the Argentine tango as a metaphor draws together these various strands and provides a clear conceptual framework in this autoethnographic article. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Journal of Social Work Practice at EBSCOhost

Available in fulltext from Journal of Social Work Practice at EBSCOhost

19. Nurse leadership in the managed care setting.

Author(s) van Amerongen, Derek

Citation: Nursing leadership from the outside in., Jan 2013, (2013), p. 227-508 (2013)

Publication Date: January 2013

Abstract: Van Amerongen identifies the significant role of the nurse leader in managed care. According to him the clinical background and expertise that the nurses bring provide important competitive advantage. In addition to clinical knowledge and skills, he identified other important characteristics of successful nurse leaders, namely sensitivity and empathy. What are the hallmarks of a nurse leader in managed care? The managed care approach requires a particular kind of leadership. The basic skill set is similar to that of a nurse leader in any role. Certainly, we will always value sensitivity, empathy, clinical knowledge, and skills in a nurse professional. It is also fundamental that in the 21st century, every medical professional understands that health is more than the absence of disease. A global view of what creates health and improves quality of life, and what factors prevent that, is essential. Perhaps the gravest challenges our medical care system faces are how to improve quality, make the patient experience more positive, and how to do so while moderating the exploding costs of care. This has been called the Triple Aim. There are some particular attributes that are highly valued for a nurse leader working with a managed population who seeks to bring to life the Triple Aim: Be a culture-change agent; Understand the individual is a person first, and a patient last; Create member-centric solutions; Be data-driven: Remember that improving the quality of care is a key objective of the Triple Aim. Quality improvement cannot be done without quantifying what is done; Be ready to be part of a team; If I had to identify one trait that I expect all nurse leaders to have, it is that a

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leader inspires others to do what he or she does. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(chapter)

Source: PsycINFO

20. Transformational leadership in mental health.

Author(s) Svendsen, Dale, Hogan, Michael, Wortham-Wood, Judy

Citation: Modern community mental health: An interdisciplinary approach., Jan 2013, (2013), p. 516-1136 (2013)

Publication Date: January 2013

Abstract: Any organization requires leadership. Certainly mental health organizations are no different. Despite this, very little has been published about the special needs and challenges associated with leading mental health programs, agencies, or systems. But this is in a way counterintuitive. How can it be that there is not more instructive material available to guide those of us who are interested in this work? Perhaps one answer is that, in the past, leaders of mental health organizations rose "through the ranks" directly from clinical positions and did not have management training to bring to this new level of work. Another possibility is that the universe of mental health organizations is relatively small, and not connected to the mainstream of organizational leadership in the business world. Leaders of mental health organizations did have significant training, but it was within a clinical discipline. And while some clinical training is very relevant to filling leadership roles, there is more to it. We would add that mental health leadership duties nearly always used to be performed by psychiatrists who, since the middle of the nineteenth century, learned their trade as superintendents of state hospitals. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(chapter)

Source: PsycINFO

21. Predictors and outcomes of nurse leader job stress experienced by AWHONN members.

Author(s) Kath, Lisa M., Stichler, Jaynelle F., Ehrhart, Mark G., Schultze, Tressa A.

Citation: Journal of Obstetric, Gynecologic, & Neonatal Nursing: Clinical Scholarship for the Care of Women, Childbearing Families, & Newborns, Jan 2013, vol. 42, no. 1, p. E12., 0884-2175 (Jan-Feb 2013)

Publication Date: January 2013

Abstract: Objective: To measure the relationships among stressors (personal factors, job/role factors, hospital factors), job stress, and outcomes experienced by nurse leaders and examine moderation of autonomy and leadership style on outcomes of job stress. Design: A cross-sectional, quantitative design. Setting: Acute and nonacute care settings throughout North America. Participants: A nonprobability convenience sample of 392 was drawn from a population of nurse leaders across the United States and Canada who were members of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). Methods: A mailing list was obtained from AWHONN, and a total of 3,986 recruitment and follow-up postcards were sent to nurse leaders. Participants were asked to complete the survey online or request a hard copy to return by mail. Study variables were measured using previously published scales with demonstrated psychometric properties. Results: Nurse leaders reported stress averages above the midpoint of the scales. Personal factors did not significantly predict stress, but role overload, organizational constraints, and role ambiguity were found to be the best predictors of stress. Job satisfaction, intent to quit, and mental health symptoms were the most significant outcomes of stress. Autonomy moderated relationships between perceptions of stress and outcomes with low autonomy showing greater negative outcomes when levels of stress are higher. Conclusion: Nurse leaders experience significant job stress that may suggest a need to design and implement evidence-based interventions to reduce stress among this group. (PsycINFO Database Record (c) 2014 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing at

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EBSCOhost

22. A review on leadership of head nurses and patient safety and quality of care

Author(s) Verschueren M., Kips J., Euwema M.

Citation: Advances in Health Care Management, 2013, vol./is. 14/(3-34), 1474-8231 (2013)

Publication Date: 2013

Abstract: Purpose - The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care. Design/methodology/approach - We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit. Findings - We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level. Value/originality - This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators. Copyright © 2013 by Emerald Group Publishing Limited All rights of reproduction in any form reserved.

Source: EMBASE

23. Demystifying ward nurse manager's approach to managing change.

Author(s) Moen, Charlotte, Core, Gill

Citation: International Journal of Clinical Leadership, 2013, vol./is. 17/4(251-259), 0965-5751

Publication Date: 2013

Abstract: BACKGROUND: The current literature and Department of Health (DH) policies suggest change should be implemented by frontline clinicians using a transformational leadership approach (Alimo-Metcalfe and Alban-Metcalfe, 2008; Darzi, 2008; DH, 2009, 2010; Govier and Nash, 2009). Despite this, change is still often led by senior managers utilising a 'top down', transactional approach (Edmonstone, 2009; Muha and Manion, 2010; NHS Institute of Innovation and Improvement, 2005). It could be argued that this is primarily due to an absence of clinical leadership due to a paucity of leadership development opportunities for clinicians. In order to encourage frontline clinicians to lead change we firstly need to understand how change is implemented on the frontline and to ascertain their development needs. AIMS: This paper explores how frontline clinical leaders, specifically ward nurse managers (WNMs), implement change and why they choose a particular strategy. The aim is to explore the change process, through investigating change management from the perspective of those leading change. METHODS: A case study methodology was adopted (Cohen et al, 2000; Yin, 2009). The case study comprised 18 WNMs from one acute NHS hospital within the UK. The data were collected via semi-structured questionnaires and interviews. Results The case study demonstrates the WNM's soft approach to change management, based on transformational principles, is in contrast to senior managers who focus on managerial leadership (Edmonstone, 2009). This point is not explicit in the previous literature and two new models are offered to explain this conclusion. ORIGINALITY/VALUE: This study provides new insight into the WNM's

14

approach to managing change and their development needs. This is an important perspective that so far has been neglected. CONCLUSION: WNMs appear to be intuitively adopting change models and using a pragmatic, experiential approach to implement change. However, their progression from change novice to expert is stifled by their poor theoretical evidence base and their lack of experience of leading change. A bespoke 'Leading Change' development programme for WNMs is recommended. [Abstract]

Source: HMIC

24. Is current NHS leadership sufficient or defficient?

Author(s) McComb, Jacquline

Citation: British Journal of Healthcare Management, 2013, vol./is. 19/7(342-347), 1358-0574

Publication Date: 2013

Abstract: Organisations as large and complex as the NHS cannot function effectively without sufficient high-quality interprofessional leadership and development. This will only happen if managers and staff are supported with the necessary skills and have the commitment from the organisation to invest resources in creating leaders if the future vision of the NHS is to be realised. The King's Fund-among other commentators and authorities on the NHS and the Department of Health-share the view that the era of heroic leadership styles are well and truly over. The NHS needs to shift into a model of shared/distributed leadership where staff can work interprofessionally, sharing their skills and knowledge, collectively leading to provide a better service to the patient. This requires engaging with others both internally and externally to the organisation to facilitate this, and also, for the skill of influencing change in the decision-making process. Thus, enabling a better outcome in relation to the future of the NHS. [Abstract]

Source: HMIC

Available in fulltext from British Journal of Healthcare Management at EBSCOhost

25. Demoralization in mental health organizations: Leadership and social support help.

Author(s) Gabel, Stewart

Citation: Psychiatric Quarterly, Dec 2012, vol. 83, no. 4, p. 489-496, 0033-2720 (Dec 2012)

Publication Date: December 2012

Abstract: Demoralization is a commonly observed feeling state that is characterized by a sense of loss of or threat to one’s personal values or goals and a perceived inability to overcome obstacles toward achieving these goals. Demoralization has features in common with burnout and may precede or accompany it. Psychiatrists working in many mental health care organizational settings, be they in the public or private sectors, may be at particular risk for demoralization. This is due partly to stressors that threaten their own professional values because of factors such as programmatic cut backs, budgetary reductions and changing social emphases on the value of mental health treatments. They also may be at risk for demoralization because of the effects on them of the governance styles of the agencies in which they are employed. The leadership or governance style in large organizational settings often is authoritarian, hierarchical and bureaucratic, approaches that are antithetical to the more participative leadership styles favored by many mental health professionals in their clinical activities. Clinical leaders in mental health organizations must exhibit various competencies to successfully address demoralization in clinical staff and to provide a counterbalance to the effects of the governance style of many agencies in which they are employed. Appropriate leadership skills, sometimes too simplistically termed “social support”, have been found to reduce burnout in various populations and are likely to lessen demoralization as well. This paper reviews these important leadership issues and the relationship of social support to recognized leadership competencies. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(journal abstract)

15

Source: PsycINFO

Available in fulltext at Psychiatric Quarterly; Collection notes: Academic-License. Please when asked to pick an institution please pick NHS. Please also note access is from 1997 to date only.

Available in fulltext from Psychiatric Quarterly at EBSCOhost

Available in fulltext from Psychiatric Quarterly at EBSCOhost

26. Transformation: Are nurse leaders in critical care ready?

Author(s) Botma, Yvonne, Botha, Hanlie, Nel, Mariette

Citation: Journal of Nursing Management, Oct 2012, vol. 20, no. 7, p. 921-927, 0966-0429 (Oct 2012)

Publication Date: October 2012

Abstract: Aim: The aim was to determine whether nursing leaders met the criteria for transformational and/or transactional leadership. Background: Many changes have occurred in South Africa and are reflected in the health-care systems. As a result, it has become crucial to source leaders who are able to manage the change process effectively so as to ensure the success and survival of our health-care organizations. Methods: The 45-item Multifactor Leadership Questionnaire (Rater) was completed by 41 respondents out of a population of 121. A proportional stratified simple random sampling technique was used to select the raters of seven leaders. Results: Most nursing leaders role-modelled the culture of the organisation but did not stimulate their followers intellectually and did not demonstrate innovative motivation or individual consideration. Consequently, their followers may exhibit a lack of commitment to collective goals, with detrimental effects on the health-care organisation as a whole. Conclusions and implications for nursing managers: Nursing leaders should be trained to become transformational leaders so as to encourage their followers to become innovative and motivated to render high quality nursing care. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Journal of Nursing Management at EBSCOhost

27. The influence of authentic leadership on newly graduated nurses' experiences of workplace bullying, burnout and retention outcomes: A cross-sectional study

Author(s) Spence Laschinger H.K., Wong C.A., Grau A.L.

Citation: International Journal of Nursing Studies, October 2012, vol./is. 49/10(1266-1276), 0020-7489 (October 2012)

Publication Date: October 2012

Abstract: Background: Retaining skilled and engaged nurses is critical during a time of shortage, however growing reports of workplace bullying threaten nurses' health and wellbeing, especially the transition of newly graduated nurses entering the profession. High rates of burnout and turnover among new nurses puts additional strain on limited financial resources in healthcare organizations and can compromise the quality of care provided to patients. Objectives: The purpose of this study is to test a model linking authentic leadership to new graduate nurses' experiences of workplace bullying and burnout, and subsequently, job satisfaction and intentions to leave their jobs. Methods: This study employed a cross-sectional survey design with 342 new graduate nurses (defined as less than two years of practice experience) working in acute care hospitals in Ontario, Canada. Participants completed a questionnaire with measures of authentic leadership, workplace bullying, burnout, job satisfaction and turnover intentions. The model was tested using path analysis techniques within structural equation modeling. Results: The model fit indices suggested that the original hypothesized model did not adequately fit the data (chi²=33.59, df=5, p=.000, chi²/df=6.72, IFI=.937, CFI=.937, RMSEA=.130), thus an additional theoretically justified direct path from authentic leadership to job satisfaction was added, which improved the fit substantially (chi²=5.26, df=4, p=.261, chi²/df=1.32, IFI=.997, CFI=.997,

16

RMSEA=.030). Authentic leadership had a negative direct effect on workplace bullying, which in turn had a direct positive effect on emotional exhaustion. Authentic leadership also influenced job satisfaction indirectly through bullying and emotional exhaustion. Authentic leadership, workplace bullying and emotional exhaustion all had significant direct effects on job satisfaction, which in turn, was related to lower turnover intentions. Conclusions: The findings from this study demonstrate the fundamental importance of authentic leadership in creating supportive working environments. An authentic leadership style may reduce the probability of a unit culture of workplace bullying developing, contributing to a nursing workforce that is less burned out, more satisfied with their job, and ultimately, less likely to leave their position. © 2012 Elsevier Ltd.

Source: EMBASE

28. Reflections on a changing role in clinical management.

Author(s) Lewis, Matthew

Citation: International Journal of Clinical Leadership, 01 September 2012, vol./is. 17/4(227-234), 1757207X

Publication Date: 01 September 2012

Abstract: Introduction Clinicians need to engage in medical management to improve quality and efficiency in the NHS. Doctors are well suited to management roles, since they are educated, influential and familiar with the demands of the health service. However, consultants rarely receive leadership training and might experience problems with the transition into management roles, particularly in relation to conflicts with their other responsibilities to patients, colleagues and life outside work. Aim The objective of this study was to consider the issues relating a consultant entering a senior management role, with reference to my own experience, focusing attention onrole theory and leadership styles. Methods A participant-observer study was conducted in which diary entries or voice memos of significant events were recorded during the first few months of a new management role. Results and discussion In this instance, significant pressures were faced, which were most clearly experienced as conflicts between different roles. The need for preparation, reflection and training are discussed. Conclusion Although doctors are well-equipped to take on managerial roles, they need to appreciate the potential for their various roles to conflict with each other. To mitigate this problem, consultants are likely to benefit from greater awareness of approaches to leadership in the NHS, as well as a regular process of reflection to ensure that their skills are periodically assessed and improved.

Source: CINAHL

29. NHS promises to ensure modern leadership style to improve staff morale

Author(s) Limb M.

Citation: BMJ (Clinical research ed.), 2012, vol./is. 344/(e3746), 1756-1833 (2012)

Publication Date: 2012

Source: EMBASE

Available in print at Pilgrim Hospital Staff Library

Available in print at Lincoln County Hospital Professional Library

Available in fulltext from The BMJ at Highwire Press

Available in print at Louth County Hospital Medical Library

Available in print at Grantham Hospital Staff Library

30. Leadership and mental health nursing

Author(s) Cleary M., Horsfall J., Deacon M., Jackson D.

Citation: Issues in Mental Health Nursing, September 2011, vol./is. 32/10(632-639), 0161-2840;1096-4673 (23 Sep 2011)

17

Publication Date: September 2011

Abstract: This discussion paper argues for the critical importance of successful leadership for effective mental health nursing, observing that nursing leadership has long been regarded problematically by the profession. Using empirical and theoretical evidence we debate what leadership styles and strategies are most likely to result in effective, recovery-orientated mental health nursing. Models of transformational and distributed leadership are found to be highly congruent with mental health nursing values, yet the literature suggests it is a type of leadership more often desired than experienced. We note how the scholarly literature tends to ignore the "elephant in the room" that is organizational power, and we question whether transformational leadership pursued within a specific clinical context can influence beyond those confines. Nevertheless it is within these contexts that consumers experience nursing, effective or otherwise, thus we should advocate what is known about effective leadership wherever it is required. © 2011 Informa Healthcare USA, Inc.

Source: EMBASE

Available in fulltext from Issues in Mental Health Nursing at EBSCOhost

Available in fulltext from Issues in Mental Health Nursing at EBSCOhost

31. Team leadership in the intensive care unit: the perspective of specialists.

Author(s) Reader TW, Flin R, Cuthbertson BH

Citation: Critical Care Medicine, 01 July 2011, vol./is. 39/7(1683-1691), 00903493

Publication Date: 01 July 2011

Abstract: OBJECTIVES: To identify the behaviors senior physicians (e.g., specialists, staff attendings) report using to lead multidisciplinary teams in the intensive care unit. DESIGN: Semistructured interviews focusing on team leadership, crisis management, and development of an environment that enable effective team performance in the intensive care unit. SETTING: Seven general intensive care units based in National Health Service hospitals in the United Kingdom. PARTICIPANTS: Twenty-five senior intensive care medicine physicians. MEASUREMENTS AND MAIN RESULTS: Responses to a semistructured interview were transcribed and subjected to "content" analysis. The interview analysis focused on references to the "functional" behaviors used by leaders to manage team performance and the "team development behaviors" used to build the conditions that enable effective team performance. Seven of the interviews were coded by a second psychologist to measure inter-rater reliability. Inter-rater reliability (Cohen's [kappa]) was acceptable for both scales ([kappa] = 0.72 and [kappa] = 0.75). In total, 702 functional leadership behaviors (behaviors for information gathering, planning and decision-making, managing team members) were coded as being used to manage the intensive care unit, along with 216 team development behaviors (for providing team direction and establishing team norms). These behaviors were grouped together in a theoretically driven framework of intensive care unit team leadership. CONCLUSIONS: Intensive care unit senior physicians report using a variety of leadership behaviors to ensure high levels of team performance. The data described in this study provide insight into the team leadership behaviors used by intensive care unit team leaders and have implications for the development of team leadership training and assessment tools.

Source: CINAHL

32. King's Fund urges NHS to adopt shared leadership style that involves care staff.

Author(s) Lipley, Nick

Citation: Nursing Management - UK, 01 July 2011, vol./is. 18/4(4-4), 13545760

Publication Date: 01 July 2011

Source: CINAHL

Available in fulltext from Nursing Management - UK at EBSCOhost

Available in fulltext from Nursing Management - UK at EBSCOhost

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33. From the inside out: The engagement of physicians as leaders in health care settings.

Author(s) Snell, Anita J., Briscoe, Don, Dickson, Graham

Citation: Qualitative Health Research, Jul 2011, vol. 21, no. 7, p. 952-967, 1049-7323 (Jul 2011)

Publication Date: July 2011

Abstract: Health care delivery must be transformed to manage spiraling costs and preserve quality care. Transforming complex health systems will require the engagement of physicians as leaders in their health care settings, in both formal and informal roles. In this article we explore the experience of physician leader engagement and identify factors operating at the individual, team, and organizational levels related to increased or decreased physician leader engagement. Using an inductive approach, our analysis of the transcribed interviews yielded a rich understanding of what motivates physicians to be engaged as leaders, how they experience engagement, the role of the physician leader, how physicians understand other physicians’ engagement, what encourages and discourages their engagement efforts, and the role that education and training has in physician engagement. We conclude by offering strategies that physicians, health care organizations, and educational institutions can implement to increase the engagement of physician leaders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)

Source: PsycINFO

34. Leadership and management in mental health nursing.

Author(s) Blegen, Nina Elisabeth, Severinsson, Elisabeth

Citation: Journal of Nursing Management, May 2011, vol. 19, no. 4, p. 487-497, 0966-0429 (May 2011)

Publication Date: May 2011

Abstract: Background: Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader's influence and regard leadership and management as distinct from the nurses' practical work. Aim: The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. Method: A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995–July 2010. Results: Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Conclusion: Mental health nurses' leadership, management and transformational leadership are positively related in terms of effectiveness and nurses' skills. Implication for nursing management: It is important to consider mental health nurses' management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Journal of Nursing Management at EBSCOhost

35. Good leadership can improve diabetes care for older people with diabetes.

Author(s) Williams, Joy

Citation: Journal of Diabetes Nursing, 01 February 2011, vol./is. 15/2(69-72), 13681109

Publication Date: 01 February 2011

Abstract: The NHS is in a state of constant change; therefore, it is necessary to have good

19

leadership in diabetes nursing. This article focuses on how effective leadership in diabetes nursing. This article focuses on how effective leadership can improve the care of older people with diabetes. The different types of leadership required in different situations is explored, with a particular focus on transformational leadership. There are differences between leaders and managers, and the skills required of a leader are identified. The article also discusses how to balance conflicts and complexities of health care within the organisational culture to improve care for older people with diabetes.

Source: CINAHL

Available in print at Pilgrim Hospital Staff Library

36. Essential leadership skills for motivating and developing staff.

Author(s) Curtis, Elizabeth, O'Connell, Rhona

Citation: Nursing Management, 2011, vol./is. 18/5(32-35), 1354-5760

Publication Date: 2011

Abstract: Achieving and sustaining high quality patient care and containing costs are important aspects of a nurse manager's role, and a successful manager needs to have the skills and ability to motivate and develop staff. This article focuses on how effective leadership can increase motivation and empowerment among nurses, examines the relevance of transformational leadership to motivation, and suggests practical ways of maintaining a motivated work environment. [Abstract]

Source: HMIC

Available in fulltext from Nursing Management - UK at EBSCOhost

Available in fulltext from Nursing Management - UK at EBSCOhost

37. Views and understanding of clinicians on the leadership role and attitude to coaching as a development tool for clinical leadership

Author(s) Budhoo M.R., Spurgeon P.

Citation: International Journal of Clinical Leadership, 2011, vol./is. 17/3-4(123-129), 1757-207X;1757-2088 (2011)

Publication Date: 2011

Abstract: Background: Coaching is a recognised method of leadership development which is utilised for leaders in many organisations but is less so with clinical leaders in healthcare. Coaching has demonstrated potential in leadership development with high returns on investment. This could be transferred to healthcare and may be of benefit in improving quality of care cost-effectively. This would require long-term changes to develop a coaching culture in healthcare. Aim: The aim of this study is to understand the views of clinicians on leadership roles and the use of coaching as a development tool. Method: The study was questionnaire-based with ethical approval from the organisation where the study was done. The study had both qualitative and quantitative elements. Analysis of quantitative measures was done by Chi square test. P = 0.05 regarded as significant. The views on key aspects of leadership were coded against the medical leadership competency framework. Results: Forty questionnaires were sent out and 22 returned (55% response rate). Most of the respondents were in post for at least 10 years and viewed their clinical role as leadership. Significantly more respondents were in post for longer than 10 years and those in post under 10 years were significantly more likely to consider other training tools apart from coaching. The majority rated their leadership at six or higher on a scale of 1-10. Fifty-nine percent had training in leadership and this is reflected in low scores on the need for further training, although most would accept training and that it has a role in leadership development. Regarding leadership roles, respondents' views were coded to the medical leadership competency framework with setting direction having the highest match (30%). The views also had aspects of charismatic and transformational leadership styles. Coaching was felt to be a useful tool in developing leadership although there were some concerns in ensuring confidentiality and match between coach and coached. Most would consider use of a coach but expressed as a whole the view that the coach should be

20

experienced, from outside the organisation and have a healthcare background. Conclusions and recommendations: The study indicates that training in leadership for development is supported by clinicians in leadership roles and that there is support for coaching as a developmental tool with a preference for external coaches with a healthcare background. This appears to be primarily due to seniority of clinicians and concerns around confidentiality and independence. Further work should be explored to promote a coaching culture amongst clinicians. © 2012 Radcliffe Publishing.

Source: EMBASE

38. Leadership styles of nurse managers and registered sickness absence among their nursing staff

Author(s) Schreuder J.A., Roelen C.A., van Zweeden N.F., Jongsma D., van der Klink J.J., Groothoff J.W.

Citation: Health care management review, January 2011, vol./is. 36/1(58-66), 1550-5030 (2011 Jan-Mar)

Publication Date: January 2011

Abstract: Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. This study investigated the relationship between managerial leadership and sickness absence in health care by associating nurse managers' leadership styles with registered sickness absence among their nursing staff. The cross-sectional study included 699 nurses working in six wards (staff range = 91-140 employees) of a Dutch somatic hospital employing a total of 1,153 persons. The nurse managers heading the wards were asked to complete the Leadership Effectiveness and Adaptability Description questionnaire for situational leadership. The Leadership Effectiveness and Adaptability Description scores were linked to employer-registered nursing staff sickness absence. High relationship-high task behavior (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.65-0.85) and high relationship-low task behavior (OR = 0.37, 95% CI = 0.14 -0.98) were inversely related to the number of short (one to seven consecutive days) episodes of sickness absence among the staff. Low relationship-high task styles (OR = 2.44, 95% CI = 1.14-5.22) as well as low relationship-low task styles (OR = 2.44, 95% CI = 1.26-4.71) were positively associated with the number of short episodes of sickness absence. However, the leadership styles only explained 10% of the variance in short episodes of sickness absence. Leadership styles are associated with registered sickness absence. The nursing staff of relationship-oriented nurse managers has fewer short episodes of sickness absence than the staff of task-oriented managers. Training nurse managers in relational leadership styles may reduce understaffing and improve nursing efficiency and quality.

Source: EMBASE

39. From inhumane to humane: A longitudinal study of leadership transformation.

Author(s) Miller, Geri, Marchel, Carol, Gladding, Sam

Citation: The Humanistic Psychologist, Jul 2010, vol. 38, no. 3, p. 221-235, 0887-3267 (Jul 2010)

Publication Date: July 2010

Abstract: Phenomenological interview methods were completed with 9 mental health professionals (psychologists, counselors) who volunteered as Red Cross Disaster Mental Health Workers in response to the 9/11 disaster in New York. Interviews were completed shortly after the disaster and repeated 5 years later to understand how 9/11 experiences changed participants' leadership in their work. The unprecedented characteristics of the 9/11 disaster provided a uniquely significant context for the leadership demands for workers at 9/11. Experiences at 9/11 continued to impact professional and personal work of the participants in meaningful ways many years after the experiences. Follow-up interviews suggested individual and evolving changes in leadership style and professional practice, ranging from internalized/reflective leaders to externalized/active leaders. (PsycINFO

21

Database Record (c) 2012 APA, all rights reserved)(journal abstract)

Source: PsycINFO

Available in fulltext from Humanistic Psychologist at EBSCOhost

40. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review.

Author(s) Cummings, Greta G., MacGregor, Tara, Davey, Mandy, Lee, How, Wong, Carol A., Lo, Eliza, Muise, Melanie, Stafford, Erin

Citation: International Journal of Nursing Studies, Mar 2010, vol. 47, no. 3, p. 363-385, 0020-7489 (Mar 2010)

Publication Date: March 2010

Abstract: Context: Numerous policy and research reports call for leadership to build quality work environments, implement new models of care, and bring health and wellbeing to an exhausted and stretched nursing workforce. Rarely do they indicate how leadership should be enacted, or examine whether some forms of leadership may lead to negative outcomes. We aimed to examine the relationships between various styles of leadership and outcomes for the nursing workforce and their work environments. Methods: The search strategy of this multidisciplinary systematic review included 10 electronic databases. Published, quantitative studies that examined leadership behaviours and outcomes for nurses and organizations were included. Quality assessments, data extractions and analysis were completed on all included studies. Findings: 34,664 titles and abstracts were screened resulting in 53 included studies. Using content analysis, 64 outcomes were grouped into five categories: staff satisfaction with work, role and pay, staff relationships with work, staff health and wellbeing, work environment factors, and productivity and effectiveness. Distinctive patterns between relational and task focused leadership styles and their outcomes for nurses and their work environments emerged from our analysis. For example, 24 studies reported that leadership styles focused on people and relationships (transformational, resonant, supportive, and consideration) were associated with higher nurse job satisfaction, whereas 10 studies found that leadership styles focused on tasks (dissonant, instrumental and management by exception) were associated with lower nurse job satisfaction. Similar trends were found for each category of outcomes. Conclusion: Our results document evidence of various forms of leadership and their differential effects on the nursing workforce and work environments. Leadership focused on task completion alone is not sufficient to achieve optimum outcomes for the nursing workforce. Efforts by organizations and individuals to encourage and develop transformational and relational leadership are needed to enhance nurse satisfaction, recruitment, retention, and healthy work environments, particularly in this current and worsening nursing shortage. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)

Source: PsycINFO

41. Leadership from the bottom up: Reinventing dementia care in residential and nursing home settings.

Author(s) Chalfont, Garuth, Hafford-Letchfield, Trish

Citation: Social Work and Social Sciences Review, Jan 2010, vol. 14, no. 2, p. 37-54, 0953-5225 (2010)

Publication Date: January 2010

Abstract: A number of recent policy initiatives have sought to improve the quality of dementia care in residential and nursing homes. Drawing on current literature and themes identified from in-depth interviews with four managers working in these settings, this paper discusses the potential for different styles of leadership in developing a suitable organisational culture in which quality dementia care might develop and thrive. It argues that alongside valuable strategic imperatives coming from the UK National Dementia Strategy (DH, 2009), there is a corresponding need for more ‘bottom-up’ approaches within dementia care settings themselves through the empowerment of staff. It argues that this would enable more participatory approaches to organisational development. The paper

22

specifically discusses the concepts of both ‘climate’ and ‘culture’ in institutional care for older people and how these features can be enhanced to support a more person-centered approach. Particular emphasis is given to the significance of leading a culture of learning, which we view as crucial to any transformation process. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)

Source: PsycINFO

42. The leadership equation: Strategies for individuals who are champions for children, youth, and families.

Author(s)

Citation: The leadership equation: Strategies for individuals who are champions for children, youth, and families., Jan 2010, (2010) (2010)

Publication Date: January 2010

Abstract: This book articulates the role and characteristics of leadership needed to develop effective human service delivery systems, particularly systems of care for children and youth with mental health challenges. Combining literature from various leadership perspectives, the authors of each chapter explore new dimensions of leadership, from mental models to culture, from old-style leadership to new, from a fundamental values base to resiliency, and from community organization to innovation. All of this is accomplished under the umbrella of the "leadership equation," a strategic approach from which individuals can chart their own leadership journey. This text helps mental health administrators and program developers : (1) choose the right leadership style for different contexts and situations; (2) master the shift between multiple leadership functions within their organization or system; (3) develop specific skills and attitudes associated with good leadership; (4) build productive, collaborative relationships with a wide array of professionals and agencies; (5) overcome personal, organizational, and environmental obstacles to effective leadership; and (6) strengthen resilience by using proven strategies for managing stress and adversity. Practical worksheets are included to help readers address conflict, improve their resiliency, and collaborate effectively during team meetings. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(introduction)

Source: PsycINFO

43. Adaptation and innovation.

Author(s) Blau, Gary M., CrossBear, Shannon, Mallery, Coretta

Citation: The leadership equation: Strategies for individuals who are champions for children, youth, and families., Jan 2010, (2010), p. 141-374 (2010)

Publication Date: January 2010

Abstract: Effective leadership requires adaptation and innovation (Anthony & Huckshom, 2008; Quinn, 1996). Many authors write that a leader must be flexible and creative in dealing with individuals, organizations, and systems (Anthony & Huckshorn, 2008; Quinn, 1996; Sternberg, 2007) because of the ever-changing environment in which human services are delivered. Constant flexibility and creativity are not easy to achieve. This chapter will shift the emphasis beyond individual qualities of good leadership to a broader context of an operating style and set of skills and ideas that can be cultivated and developed. Such an approach is consistent with the system of care philosophy (Stroul & Blau, 2008) and the values of collaboration, engagement, and shared decision making. With this as a backdrop, this chapter is dedicated to identifying a set of challenges that leaders face because of traditionally established modes of thinking. Such thinking may limit a leader's ability to adapt and respond effectively. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(chapter)

Source: PsycINFO

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