A pinboard by
Matt Holland

This board is owned by Matt Holland, LKS ASE, Librarian. Contact Matt.Holland@nwas.nhs.uk


Hosts research based articles in the area of coaching and mentoring with a focus on healthcare.


This board collates published research on the coaching and mentoring in healthcare. .


The board is aimed at those working in the area of Emergency Preparedness Resilience and Response. Anyone can look.


The board is updated regularly. Somewhere between daily and weekly depending on the volume of publication.

Who is responsible

This board is maintained and run by Matt Holland, Librarian LKS ASE Matt.Holland@nwas.nhs.uk.

More about LKS ASE

Check the LKS ASE website to find out more about us. Follow us on Twitter, our Twitter handle is @NWASLibrary.


Healthcare middle managers` experiences developing leadership capacity and capability in a public funded learning network.

Abstract: Healthcare middle managers (HMMs) have, as the leaders closest to clinical practice, a crucial position in healthcare today. There is broad knowledge about the demands on HMMs' capacity, their situation in general, and the challenges this presents for the improvement of healthcare quality. There is less knowledge about how to facilitate HMMs` capacity and capability with regard to their leadership and how to handle this in a complex context. The purpose of this study was to identify and discuss the facilitation of HMMs' development of capacity and capability for leadership. A critical hermeneutic design was chosen. Data were collected through three focus group interviews with Norwegian HMMs who participated in a learning network. A user representative (from among the recipients of public healthcare), involved in the same learning network, participated in all three interviews. A qualitative interpretive approach guided the analysis. The results show two main themes: 1. Trusted interaction despite organizational and structural frames and 2. Knowledgeable understanding of a complex context. This learning network facilitated HMMs` development of capacity and capability for leadership. The development included a combination of understanding the complex context, knowledge, trust, and confidence. The approaches in the learning network were based on transformative learning, coherence, reflection, discussion, repetition, knowledge sharing, and short lectures. These approaches can be recommended for the facilitation and support of HMMs.

Pub.: 10 Jun '18, Pinned: 18 Jun '18

Team characteristics and leadership training participation

Abstract: Team Performance Management: An International Journal, Ahead of Print. Purpose By relying on social learning theory, the authors aim to evaluate how team characteristics as evaluated by a team coach impact participation in leadership development program activities. Specifically, the authors hypothesize that teams with high levels of competence and social support would participate more team and program-wide training activities. Design/methodology/approach The authors examine 41 teams (266 participants) in a leadership development program and develop a two-by-two matrix to categorize teams based on their underlying characteristics for the purpose of identifying participation differences. Findings The mixed results indicate how team social support is a key driver for participation in team activities and how team competence is associated with less participation in program-wide activities in a leadership development program. Practical implications The results point to the importance of team characteristics when using teams for education and training programs such as leadership development programs. Team characteristics such as team competence and team social support should be considered when building teams and for team facilitation needs during education and training programs that implore teams to enhance learning. Originality/value Although the use of teams as an organizing strategy is popular, very little research has examined the effectiveness of this strategy by taking a deeper look at team characteristics and how these impact participation in a leadership development program.

Pub.: 12 Oct '17, Pinned: 24 Dec '17

Return on investment in healthcare leadership development programs

Abstract: Leadership in Health Services, Ahead of Print. Purpose Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments. Design/methodology/approach The authors performed a scoping review using the Arksey and O’Malley framework, searching eight databases from 2006 through June 2016. Findings Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail. Originality/value This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations.

Pub.: 15 Nov '17, Pinned: 24 Dec '17

Collective leadership and safety cultures (Co-Lead): protocol for a mixed-methods pilot evaluation of the impact of a co-designed collective leadership intervention on team performance and safety culture in a hospital group in Ireland.

Abstract: There is accumulating evidence implicating the role of leadership in system failures that have resulted in a range of errors in healthcare, from misdiagnoses to failures to recognise and respond to patient deterioration. This has led to concerns about traditional hierarchical leadership structures and created an interest in the development of collective ways of working that distribute leadership roles and responsibilities across team members. Such collective leadership approaches have been associated with improved team performance and staff engagement. This research seeks to improve our understanding of collective leadership by addressing two specific issues: (1) Does collective leadership emerge organically (and in what forms) in a newly networked structure? and (2) Is it possible to design and implement collective leadership interventions that enable teams to collectively improve team performance and patient safety?The first phase will include a social network analysis, using an online survey and semistructured interviews at three time points over 12 months, to document the frequency of contact and collaboration between senior hospital management staff in a recently configured hospital group. This study will explore how the network of 11 hospitals is operating and will assess whether collective leadership emerges organically. Second, collective leadership interventions will be co-designed during a series of workshops with healthcare staff, researchers and patient representatives, and then implemented and evaluated with four healthcare teams within the hospital network. A mixed-methods evaluation will explore the impact of the intervention on team effectiveness and team performance indicators to assess whether the intervention is suitable for wider roll-out and evaluation across the hospital group.Favourable ethical opinion has been received from the University College Dublin Research Ethics Committee (HREC-LS-16-116397/LS-16-20). Results will be disseminated via publication in peer-reviewed journals, national and international conferences, and to relevant stakeholders and interest groups.

Pub.: 05 Nov '17, Pinned: 06 Nov '17

The New Age of Bullying and Violence in Health Care: Part 3: Managing the Bullying Boss and Leadership.

Abstract: PRIMARY PRACTICE SETTING(S):: Applicable to all health care sections where case management is practiced.This article is the third of a 4-part series on the topic of bullying in the health care workplace. Part 3 addresses the dimensions of the bullying boss and leadership, posing major implications for patient safety plus the mental health of staff members. The complex constructs and dynamics broached by the bullying boss and department leadership are explored. These include the underlying forces at play such as power, gender, leadership styles, plus weaves in assessment models. Strategic and proactive management of bullying by leadership is vital to workforce retention and well-being.The increasing incidence and impact of bullying across all sectors have made it a major workforce performance management challenge. Health care settings are especially tense environments, often making it difficult for individuals to distinguish between bullying behavior and high expectations for staff. Bullying impacts both direct targets and bystanders who witness the assaultive behaviors, with ethical implications as well.Case management is poised to promote a safe health care workplace for patients and practitioners alike amid these intricate circumstances. Understanding types of bullying bosses and leadership styles is integral to a case manager's success in the workplace.

Pub.: 11 Oct '17, Pinned: 21 Oct '17

Survey process quality: a question of healthcare manager approach.

Abstract: Purpose The purpose of this paper is to explore how healthcare first-line managers think about and act regarding workplace survey processes. Design/methodology/approach This interview study was performed at a hospital in south Sweden. First-line healthcare managers ( n=24) volunteered. The analysis was inspired by phenomenography, which aims to describe the ways in which different people experience a phenomenon. The phenomenon was a workplace health promotion (WHP) survey processes. Findings Four main WHP survey process approaches were identified among the managers: as a possibility, as a competition, as a work task among others and as an imposition. For each, three common subcategories emerged; how managers: stated challenges and support from hospital management; described their own work group and collaboration with other managers; and expressed themselves and their situation in their roles as first-line managers. Practical implications Insights into how hospital management can understand their first-line managers' motivation for survey processes and practical suggestions and how managers can work proactively at organizational, group and individual level are presented. Originality/value Usually these studies focus on those who should respond to a survey; not those who should run the survey process. Focusing on managers and not co-workers can lead to more committed and empowered managers and thereby success in survey processes.

Pub.: 16 Aug '17, Pinned: 02 Oct '17

The Role of Interpersonal Relations in Healthcare Team Communication and Patient Safety: A Proposed Model of Interpersonal Process in Teamwork.

Abstract: Patient safety is compromised by medical errors and adverse events related to miscommunications among healthcare providers. Communication among healthcare providers is affected by human factors, such as interpersonal relations. Yet, discussions of interpersonal relations and communication are lacking in healthcare team literature. This paper proposes a theoretical framework that explains how interpersonal relations among healthcare team members affect communication and team performance, such as patient safety. We synthesized studies from health and social science disciplines to construct a theoretical framework that explicates the links among these constructs. From our synthesis, we identified two relevant theories: framework on interpersonal processes based on social relation model and the theory of relational coordination. The former involves three steps: perception, evaluation, and feedback; and the latter captures relational communicative behavior. We propose that manifestations of provider relations are embedded in the third step of the framework on interpersonal processes: feedback. Thus, varying team-member relationships lead to varying collaborative behavior, which affects patient-safety outcomes via a change in team communication. The proposed framework offers new perspectives for understanding how workplace relations affect healthcare team performance. The framework can be used by nurses, administrators, and educators to improve patient safety, team communication, or to resolve conflicts.

Pub.: 26 Aug '17, Pinned: 02 Oct '17

Employee effort - reward balance and first-level manager transformational leadership within elderly care.

Abstract: Negative aspects, staff dissatisfaction and problems related to internal organisational factors of working in elderly care are well-known and documented. Much less is known about positive aspects of working in elderly care, and therefore, this study focuses on such positive factors in Swedish elderly care. We combined two theoretical models, the effort-reward imbalance model and the Transformational Leadership Style model. The aim was to estimate the potential associations between employee-perceived transformational leadership style of their managers, and employees' ratings of effort and reward within elderly care work.The article is based on questionnaires distributed at on-site visits to registered nurses, occupational therapists, physiotherapists (high-level education) and assistant nurses (low-level education) in nine Swedish elderly care facilities. In order to grasp the positive factors of work in elderly care, we focused on balance at work, rather than imbalance.We found a significant association between employees' effort-reward balance at work and a transformational leadership style among managers. An association was also found between employees' level of education and their assessments of the first-level managers.We conclude that the first-level manager is an important actor for achieving a good workplace within elderly care, since she/he influences employees' psychosocial working environment. We also conclude that there are differences and inequalities, in terms of well-being, effort and reward at the work place, between those with academic training and those without, in that the former group to a higher degree evaluated their first-level manager to perform a transformational leadership style, which in turn is beneficial for their psychosocial work environment. Consequently, this (re)-produce inequalities in terms of well-being, effort and reward among the employees at the work place.

Pub.: 30 Aug '17, Pinned: 02 Oct '17

A mixed methods study of emotional exhaustion: Energizing and depleting work within an innovative healthcare team.

Abstract: This mixed methods study documents emotional exhaustion experiences among care team members during the development of an innovative team approach for caring for adults with serious illness. A mixed methods study design was employed to examine depleting work experiences that may produce emotional exhaustion, and energizing aspects of the work that may increase meaningfulness of work, thus reducing emotional exhaustion. The population studied included team members involved in care for adults with serious illness (n = 18). Team members were surveyed quarterly over an 18-month period using the Maslach Burnout Inventory (MBI). The MBI measures burnout, defined as the inability to continue work because of the interactional toll of the work. Analyses of MBI data show that although overall levels of burnout are low, 89% of team members reported moderate/high levels of emotional exhaustion during at least one survey period. In order to understand the kinds of work experiences that may produce or ameliorate emotional exhaustion, qualitative interviews were also conducted with team members at the end of the 18-month period. Major qualitative findings indicate that disputes within the team, environmental pressures, and standardisation of meaningful work leave team members feeling depleted. Having authentic relationships with patients, working as a team, believing in the care model, and practicing autonomy and creativity help team members to restore their emotional energy. Supports for team members' well-being are critical for continued innovation. We conclude with recommendations for improving team members' well-being.

Pub.: 19 Sep '17, Pinned: 02 Oct '17

Patient participation in mental health care - perspectives of healthcare professionals: an integrative review.

Abstract: In contemporary Western liberal society, patient participation has become a key goal in psychiatric healthcare treatment. Health professionals must encourage patients to play an active and involved part in their treatment. According to Danish health law, patients have the right to participate in their treatment, and the mental health system therefore needs to be reformed in order to ensure that treatment is based on individual, liberal, values. However, patient participation is not clearly defined, and it is therefore a challenge to transfer it to clinical practice.This integrative review's aims are to explore how professionals perceive the challenges regarding patient participation in the treatment course in mental health care.An integrative review.Seven studies met the inclusion criteria: six employed qualitative methodologies and one utilised a mixed-methods approach. The empirical studies took place in Norway, the UK and Australia, all in a mental health setting. Three themes were identified: 'Patient participation as collaboration between the healthcare professional and patient', 'Challenges to participation' and 'From a professional's perspective - what expectations do patients have when participating in decision-making?'Different synonymous terms describing the patient's active role during treatment - user participation, collaboration, partnership, user involvement and patient participation - are linked to a recovery-oriented approach, shared decision-making, shared ownership and care plans. This integrative review achieves specific knowledge around patient participation, comparing the situation for adult patients with various mental disorders. However, upon reflecting on the included studies, patient participation is not clearly defined, and it is therefore difficult to transfer it to clinical practice.

Pub.: 25 Sep '17, Pinned: 02 Oct '17

Student-led leadership training for undergraduate healthcare students.

Abstract: Purpose Effective clinical leadership is crucial to avoid failings in the delivery of safe health care, particularly during a period of increasing scrutiny and cost-constraints for the National Health Service (NHS). However, there is a paucity of leadership training for health-care students, the future leaders of the NHS, which is due in part to overfilled curricula. The purpose of this study was to assess the impact of student-led leadership training for the benefit of fellow students. Design/methodology/approach To address this training gap, a group of multiprofessional students organised a series of large-group seminars and small-group workshops given by notable health-care leaders at a London university over the course of two consecutive years. Findings The majority of students had not previously received any formal exposure to leadership training. Feedback post-events were almost universally positive, though students expressed a preference for experiential teaching of leadership. Working with university faculty, an inaugural essay prize was founded and student members were given the opportunity to complete internships in real-life quality improvement projects. Originality/value Student-led teaching interventions in leadership can help to fill an unmet teaching need and help to better equip the next generation of health-care workers for future roles as leaders within the NHS.

Pub.: 26 Sep '17, Pinned: 02 Oct '17

Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

Abstract: Despite common assumptions that doctors are well placed to lead hospitals and healthcare organisations, the peer-reviewed literature contains little evidence on the performance of doctors in leadership roles in comparison with that of non-medical managers.To determine whether there is an association between the leader's medical background and management performance in terms of organisational performance or patient outcomes.We searched for peer-reviewed, English language studies using Medline, Embase and Emerald Management between 2005 and 2017. We included quantitative, qualitative and mixed method empirical studies on the performance of senior healthcare managers where participants were described as doctors or leaders and where comparative performance data were provided on non-medical leaders. Studies without full text available, or no organisational, leadership behaviour or patient measures, were excluded.The search, conducted in Medline (n=3395), Embase (n=1913) and Emerald Management (n=454) databases, yielded 3926 entries. After the application of inclusion and exclusion criteria, 16 studies remained. Twelve studies found that there were positive differences between medical and non-medical leaders, and eight studies correlated those findings with hospital performance or patient outcomes. Six studies examined the composition of boards of directors; otherwise, there were few common areas of investigation. Five inter-related themes emerged from a narrative analysis: the impact of medical leadership on outcomes; doctors on boards; contribution of qualifications and experience; the medical leader as an individual or part of a team and doctors transitioning into the medical leadership role.A modest body of evidence supports the importance of including doctors on organisational governing boards. Despite many published articles on the topic of whether hospitals and healthcare organisations perform better when led by doctors, there were few empirical studies that directly compared the performance of medical and non-medical managers. This is an under-researched area that requires further funding and focus.

Pub.: 28 Sep '17, Pinned: 02 Oct '17

The Relationship Between and Factors Influencing Staff Nurses' Perceptions of Nurse Manager Caring and Exposure to Workplace Bullying in Multiple Healthcare Settings.

Abstract: The aim of this study was to examine the relationship between, and factors influencing, staff nurse perceptions of nurse manager caring (NMC) and the perceived exposure to workplace bullying (WPB) in multiple healthcare settings.Workplace bullying is commonplace, increasing, and detrimental to the health and availability of our nursing workforce. Positive relationships between a nurse manager (NM) and staff increase staff satisfaction and reduce turnover. Still unknown, however, is whether a caring relationship between manager and staff can reduce staff nurse perception of exposure to WPB.On the basis of Watson's theory that caring is reciprocal in nature, a descriptive correlational design was used to assess 156 staff nurses' self-report of NMC and their exposure to negative acts using the Caring Factor Survey-Caring of the Manager and the Negative Acts Questionnaire-Revised instruments.There is a significant inverse relationship between NMC and exposure to WPB in the nursing workplace. Gender, work environment, and a high workload influenced these findings.This study highlights the importance of caring leadership to reduce exposure to negative behaviors. The data lend support to the idea of educating NMs regarding the application of caring behaviors to support staff at the point of care.

Pub.: 29 Sep '17, Pinned: 02 Oct '17