Transformational Allied Health Leadership WHY LEADERSHIP?
22/12/2017TransformationalAllied HealthLeadershipWHY LEADERSHIP?Trish Bradd, South Eastern Sydney Local Health DistrictLeaders Create the vision and set direction: mobilisingfollowers’ efforts by ensuring they share a vision ofwhat can be achieved in the future through thedevelopment and enactment of shared meaning Work with others including: building relationships withfollowers so that they can deliver performance beyondwhat they, the clients or the organisation expectedLeadership Brings about movement and constructive changeProvides a vision for the futureAligns organisational and individual effortsMotivates and inspires employees to achievebeyond expectations Essential for high quality healthcare Demonstrate personal qualities: including caring,establishing trust and instilling confidence in followersReferences: HWA (2012); West et al (2015)Leadership defined leadership in healthcare is being able to cultivatean environment where all employees couldcontribute to their maximum potential in support ofthe mission of the organisation.Three aspects to effective healthcare leadershipare having a compelling vision, energising goalsand a positive organisational climate (Garman etal., 2006)LEADERSHIP IS REQUIREDFOR SAFE, HIGH QUALITY,COMPASSIONATEHEALTHCAREWest et al, 20151
22/12/2017IHI Framework for Safe,Reliable Effective Care6 Essential Capabilities to CreatingHigh-Performing Organisations Leadership and the ability of leaders to identify the “vital fewbreakthrough opportunities” A systems approach Measurement capability at all levels The culture of a learning organisation (with an infrastructure toharvest best practices for sharing and learning to create potentialfor spreading practices with the greatest impact) Team engagement from the bottom up A strong internal capability to improveBosignano, M & Kennedy, C (2012) Pursing the Triple AimReference: Institute for Healthcare Improvement (IHI), .aspxLeadership and cultureCulture change and continualimprovement come from whatleaders do, through theircommitment, encouragement,compassion and modelling ofappropriate behaviours.Berwick Report, ploads/attachment data/file/226703/Berwick Report.pdf013Leadership and cultureLeadership and harveysfi195346.html2
22/12/2017Allied health - researchin leadershipWHY ALLIED HEALTHLEADERSHIP? There is an abundance of leadershipliterature, but not much of it is about alliedhealth (see reference list) What is there suggests:–There is variation in leadership skills acrossallied health professions–Leadership skills can be developed througheducationLeadership Excellence forAllied Health (LEAHP)ProgramWhat is LEAHP? LEAHP is an evidence-basedleadership development program forallied health personnel Underpinned by leadership andpractice development theories Developed specifically for AlliedHealth professionals.LEAHP leadershiptheory Number of leadership theories and approaches Full range leadership theory (Bass & Avolio2004)- Transformational leadership: Collaborative approachwhere leader raises levels of motivation and morality.Purposes and efforts become aligned.- Transactional: Relationships among clinicians is basedon an exchange of some resource valuable to them.- Laissez-faire: Where the leader avoids making decisionsand takes no responsibilityLEAHP practicedevelopment theory(critical social science)Practice development (person-centredness)‘A continuous process of developing person-centredcultures. It is enabled by facilitators whoauthentically engage with individuals and teams toblend personal qualities and creative imaginationwith practice skills and practice wisdom. Thelearning that occurs brings about transformations ofindividual and team practices. This is sustained byembedding both processes and outcomes incorporate strategy’(Manley et al 2008, p. 9)Person-centred Care It’s what we do to, for and with each other with a view tomaximising potential and promote flourishing. Relates to workplace culture and ways of working.Involves: Collective patient and public involvement Compassion, dignity & respect Shared decision making Personalised careRef: Manley et al 2008; Health Foundation 20163
22/12/2017LEAHP ProgramLEAHP ProgramDoes LEAHP work? Robust evaluation as part of research program ofwork using mixed-methods evaluation SESLHD Participants31 females; 2 malesRange of allied health disciplines Stratified randomisation into 2 primary groups:Control (business as usual)Intervention Intervention group then randomised into 2groups:Those who received 1:1 coachingThose who did not receive coachingWhat does the LEAHP Programinvolve?Attendance at three days of faceto face workshops as well as fiveaction learning sets scheduledacross a 10 month period.Coaching is also available as partof the program.Schematic Illustrationof Methodology (2014-15)Intervention Group A:Individual (n 8)CONTROLGROUP: n 17INTERVENTIONGROUP: n 16Business as usualTwo groups – A & B Practice development,leadership and facilitationworkshops (3 days) Five Action Learning Sets Individual and team training,as requiredIntervention Group B:Individual (n 8)As abovePLUS Individual coachingLEAHP ProgramBASELINE DATA Collected in March 2014 (n 33) Two surveys with several parts:Survey 1: Demographics; Workplace measures satisfaction, person-centred care, quality and safety; theUtrecht Workplace Engagement Scale (UWES)Survey 2: The Multifactor Leadership Questionnaire(MLQ) (Bass & Avolio, 1997)LEAHP ProgramREPEAT BASELINE DATA Collected in March-April 2015 (n 30)Control: n 16Intervention: n 14 Loss of 3 subjects, 2 from intervention group &1 from control (2 x maternity leave; 1promotion) These 3 excluded from analysisLEAHP ProgramDoes LEAHP work? Statistically significant (quantitative)differences were found in self-reportedleadership performance, workplacemeasures and workplace engagement forLEAHP participants (intervention group)before & after the leadership program,compared with a control group Excellent results from qualitative evaluation4
22/12/2017LEAHP ProgramDoes LEAHP work? Very high overall satisfaction with the program Feedback that it was a practical course, withstrategies/ideas that could be implemented aftereach session High trust, high engagement Change in clinical practice (enhanced personcentred care) Role of coachingNSW Allied HealthLeadership Study Study investigated the opinions and perceptionsof senior allied health leaders in relation to alliedhealth leadership, governance and organisationfrom an Australian public health perspective. The target group was the NSW Health AlliedHealth Directors/Advisors N 17 LHD/SNs (1 declined ethics consent)Themes from the studyAttitudes and approaches“.the story of how we can contribute is much moreimportant than the ‘poor me’ conversation, to be influenceat the table and how people see us as allied health,whatever profession that is.” DAH-13“.we need to bring our best attributes. to be part of thesolution and that’s how we I think begin to demonstrateour value not only as allied health professionals andmanagers but also to the organisation.” DAH-5ImplicationsWithin the context of study limitations: Transformational leadership can be developedas can leadership efficacy & workplaceengagement Coaching can assist to build confidence Person-centred approaches (practicedevelopment) resonates with AHP Experiential, work-based learning can lead topositive change It is worth investing in allied healthleadership developmentThemes from the studyContribution and worth“I think one of the challenges for allied health is that wedon’t often articulate what we bring to the table and our skillset.” DAH-1“You would never hear a medical or a nursing professionalsay that weren’t unique and had something amazing tocontribute” DAH-4Themes from the studyPatient care:“A lot of those initiatives are all about allied health as majorcomponents of making them successful ” DAH-10Allied health organisation:“.having the Director of Allied Health positions and thenmaking sure within the District that there are appropriatestructures and governance means we’re not alwayshaving to say ‘what about us?’ but we’re in a position tocontribute in a meaningful way at the right table.” DAH-115
22/12/2017Themes from the studyInfluence“I’ve certainly seen in some particular instances whereallied health are becoming far more integral inorganisational structures in terms of Executives and otherswhere they’re completely ignored.” DAH-7Themes from the studyAllied health competencies“Allied Health Managers need to broaden their individualprofessional identity and function, manage in the broaderallied health environment in order to influence the systemand manage up effectively.” DAH-11Diversity“[Because of our specialisation] . clinicians anddepartment heads have difficulty realigning themselveswith a change of service or directions of the organisations.”DAH-12Leadership and cultureNSW Allied Health Leadership SurveyAllied health culturalframeworkNSW Allied Health Leadership SurveyAllied health defined Patient-focused professionals who work in teams toprovide, high quality health care.The culture of allied health is being person-centred,team-based, inclusive and holisticAllied health ways ofworkingNSW Allied Health Leadership SurveyImplications Build and grow influence State our value and contribution Realign our efforts towards more strategic issuesinfluencing governance, performance,professional standards and advocacy Broaden our vision and scope across alldiscipline leaders alongside those managingacross allied health services Application to both clinical and research areas6
22/12/2017Emergent Approach toChange (Kotter, 2012)Implications1. Power through connection and relationships, not justhierarchies2. Shared purpose3. Making sense through emotional connection, not justrationale argument4. Viral (grass roots driven) creativity supported by Executiveleadership - many change agents, many acts of leadershipConsidering your own context, whatcapacity do you have to be an agent oftransformational change?5. Open approaches, sharing ideas and data, co creatingchange6. Distributive and adaptive leadership – creating the conditionsand nurturing networksQuestionsReferences Bradd P, Travaglia J, Hayen A 2017 Leadership in Allied Health- AReview of the Literature, May 2017 Asia Pacific Journal of HealthManagement Vol.12. No.1, pp.17-24http://dx.doi.org/10.1071/AH16135 Bradd P, Travaglia J, Hayen A 2017 Allied health leadership in NewSouth Wales: a study of perceptions and priorities of allied healthleaders, March 2017 Australian Health Review Garman, A., Butler, P. & Brinkmeyer, L. 2006. Leadership. Journal ofHealthcare Management, 51, 360-364. Joubert, L., Boyce, R., McKinnon, F., Posenelli, S. & McKeever, J.2016. Strategies for allied health leadership development :enhancing quality, safety and productivity. Melbourne, Victoria:Victorian Department of Health & Human Services. West M., Armit, L., Eckert, R., West, T. & Lee, A. 2015. Leadershipand Leadership Development in Health Care: The Evidence Base.Faculty of Medical Leadership and Management.7
Underpinned by leadership and practice development theories Developed specifically for Allied Health professionals. LEAHP leadership theory Number of leadership theories and approaches Full range leadership theory (Bass & Avolio 2004) - Transformational leadership: Collaborative approach
Transformational Leadership, Transactional Leadership, Higher Education Institution, Transformational Change, Transformation in Higher Education Realm, Academic Work, Constructs of Transformational Leadership, Authentic leadership, Pseudotransformational Leadership, Multifactor Leadership Quesionna
School principal's transformational leadership: theoretical framework Transformational leadership, which is related with the word to transform, is defined as leadership which changes or transforms others (Harris, 1999, p. 10). Transformational leadership theory was first substantiated by J. M. Burns in his work 'Leadership'. Burns
of instructional leadership are incorporated into transformational leadership in the element of improving the instructional program (Sun & Leithwood, 2012). Transformative leadership. Transformative leadership is distinctly different from transactional and transformational leadership. The transformational leader is reform-minded but not a
Transformational Leadership Perspective in a Complex Research Environment . Timothy N. Atkinson and Tom Pilgreen . University of Central Arkansas . ABSTRACT Transformational Leadership is a popular topic among leadership scholars, but for research administrators, Transformational Leadership might seem like an enigmatic approach given its
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2. Theoretical Context of Transformational Leadership Transformational leadership has attracted the attention of many researchers who specialize in the field of leadership within organizations (Bass &Riggio, 2014; Givens, 2008). Therefore, research has shown that the application of transformational leadership to organizations yields positive .
Four Key Elements of Transformational Leadership The transformational leader works with four key elements that provide both a framework and a process. Firstly, the transformational leader shapes a compelling vision and serves as the primary example of that vision. The transformational leader says I want you to do what I am doing.
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