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

10.1097/jnr.0000000000000397

Michelle CLEARY；Rachel KORNHABER；Deependra Kaji THAPA；Sancia WEST；Denis VISENTIN

health professionals ； leadership ； leadership interventions ； program development ； systematic review

The Journal of Nursing Research

28卷5期（2020 / 10 / 01）

1 - 25

英文

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

1. Ackerman, M.,Malloch, K.,Wade, D.,Porter-O'Grady, T.,Weberg,D.,Zurmehly, J.,Raderstorf, T.(2019).The master in healthcareinnovation: A new paradigm in healthcare leadership development.Nurse Leader,17(1),49-53.
2. Agius, S. J.,Brockbank, A.,Baron, R.,Farook, S.,Hayden, J.(2015).The impact of an integrated medical leadership programme.Journal of Health Organization and Management,29(1),39-54.
3. Barr, J.,Dowding, L.(2019).Leadership in health care.Sage Publications Limited.
4. Bergman, D.,Fransson-Sellgren, S.,Wahlström, R.,Sandahl, C.(2009).Healthcare leadership: Impact of short-term intensiveand long-term less intensive training programmes.Leadershipin Health Services,22(2),161-175.
5. Blaney, P.(2012).Senior nursing leadership-Capacity buildingat the global level.International Nursing Review,59(1),40-47.
6. Boomer, C. A.,McCormack, B.(2010).Creating the conditionsfor growth: A collaborative practice development programmefor clinical nurse leaders.Journal of Nursing Management,18(6),633-644.
7. Boyle, D. K.,Kochinda, C.(2004).Enhancing collaborative communication of nurse and physician leadership in two intensivecare units.Journal of Nursing Administration,34(2),60-70.
8. Brown, S. T.,Kirkpatrick, M. K.,Wrisley, C. D.(2003).Evaluativeparameters of a web-based nursing leadership course fromthe learners' perspectives.Journal of Nursing Education,42(3),134-137.
9. Castillo, C.,James, S.(2013).How to turn ward managers intoleaders.Nursing Times,109(9),18-19.
10. Cleary, M.,Freeman, A.,Sharrock, L.(2005).The development,implementation, and evaluation of a clinical leadership program for mental health nurses.Issues in Mental Health Nursing,26(8),827-842.
11. Cleary, M.,Kornhaber, R.,Thapa, D. K.,West, S.,Visentin, D.(2018).The effectiveness of interventions to improve resilience amonghealth professionals: A systematic review.Nurse Education Today,71,247-263.
12. Collins, D. B.,Holton, E. F.(2004).The effectiveness of managerial leadership development programs: A meta-analysis ofstudies from 1982 to 2001.Human Resource Development Quarterly,15(2),217-248.
13. Cunningham, G.,Kitson, A.(2000).An evaluation of the RCN clinical leadership development programme: Part 1.Nursing Standard,15(12),34-37.
14. Cunningham, G.,Kitson, A.(2000).An evaluation of the RCNclinical leadership development programme: Part 2.Nursing Standard,15(13-15),34-40.
15. Cutcliffe, J.,Cleary, M.(2015).Nursing leadership, missing questions, and the elephant (s) in the room: Problematizing the discourse on nursing leadership.Issues in Mental Health Nursing,36(10),817-825.
16. Daly, J.,Jackson, D.,Mannix, J.,Davidson, P. M.,Hutchinson,M(2014).The importance of clinical leadership in the hospitalsetting.Journal of Healthcare Leadership,6,75-83.
17. Dannels, S. A.,Yamagata, H.,McDade, S. A.,Chuang, Y.-C.,Gleason, K. A.,McLaughlin, J. M.,Richman, R. C.,Morahan,P. S.(2008).Evaluating a leadership program: A comparative,longitudinal study to assess the impact of the Executive Leadership in Academic Medicine (ELAM) program for women.Academic Medicine,83(5),488-495.
18. Debono, D.,Travaglia, J. F.,Dunn, A. G.,Thoms, D.,Hinchcliff, R.,Plumb, J.,Milne, J.,Erez-Rein, N.,Wiley, J.,Braithwaite, J.(2016).Strengthening the capacity of nursing leaders throughmultifaceted professional development initiatives: A mixedmethod evaluation of the 'Take the Lead' program.Collegian,23(1),19-28.
19. Dellve, L.,Skagert, K.,Vilhelmsson, R.(2007).Leadership in workplacehealth promotion projects: 1- and 2-year effects on long-term workattendance.European Journal of Public Health,17(5),471-476.
20. Duffield, C.(2005).A master class for nursing unit managers: AnAustralian example.Journal of Nursing Management,13(1),68-73.
21. Fennimore, L.,Wolf, G.(2011).Nurse manager leadershipdevelopment: Leveraging the evidence and system-level support.Journal of Nursing Administration,41(5),204-210.
22. Ford, P.,Wynne, M.,Rice, M.,Grogan, C.(2008).A partnershipapproach to leadership development for directors of nursingin older people's services in Ireland-Articulating the impact.Journal of Nursing Management,16(2),159-166.
23. Frich, J. C.,Brewster, A. L.,Cherlin, E. J.,Bradley, E. H.(2015).Leadership development programs for physicians: A systematic review.Journal of General Internal Medicine,30(5),656-674.
24. Gagliano, N. J.,Ferris, T.,Colton, D.,Dubitzky, A.,Hefferman, J.,Torchiana, D.(2010).A physician leadership developmentprogram at an academic medical center.Quality Management in Healthcare,19(3),231-238.
25. Gifford, W.,Davies, B.,Tourangeau, A.,Lefebre, N.(2011).Developing team leadership to facilitate guideline utilization: Planningand evaluating a 3-month intervention strategy.Journal of Nursing Management,19(1),121-132.
26. Gilfoyle, E.,Gottesman, R.,Razack, S.(2007).Development of aleadership skills workshop in paediatric advanced resuscitation.Medical Teacher,29(9),e276-e283.
27. Graham, I. W.,Jack, E.(2008).Promoting leadership: The development of a nurse executive team in an acute hospital trust.Journal of Nursing Management,16(8),955-963.
28. Iles, P.,Preece, D.(2006).Developing leaders or developingleadership? The academy of chief executives' programmes inthe north east of England.Leadership,2(3),317-340.
29. Jiménez, P.,Bregenzer, A.,Kallus, K. W.,Fruhwirth, B.,WagnerHartl, V.(2017).Enhancing resources at the workplace withhealth-promoting leadership.International Journal of Environmental Research and Public Health,14(10),1264.
30. Kirkpatrick, D. L.,Kirkpatrick, J. D.(2009).Implementing the fourlevels: A practical guide for effective evaluation of training programs.Berrett-Koehler.
31. Krugman, M.,Smith, V.(2003).Charge nurse leadership development and evaluation.Journal of Nursing Administration,33(5),284-292.
32. Kwamie, A.,van Dijk, H.,Agyepong, I. A.(2014).Advancing theapplication of systems thinking in health: Realist evaluation of the leadership development programme for district managerdecision-making in Ghana.Health Research Policy and Systems,12,29.
33. Lee, H.,Spiers, J. A.,Yurtseven, O.,Cummings, G. G.,Sharlow, J.,Bhatti, A.,Germann, P.(2010).Impact of leadership development on emotional health in healthcare managers.Journal of Nursing Management,18(8),1027-1039.
34. Leeson, D.,Millar, M.(2013).Using the 7 habits programme todevelop effective leadership.Nursing Management,20(6),31-37.
35. Levine, S. A.,Chao, S. H.,Brett, B.,Jackson, A. H.,Burrows, A. B.,Goldman, L. N.,Caruso, L. B.(2008).Chief resident immersiontraining in the care of older adults: An innovative interspecialtyeducation and leadership intervention.Journal of the American Geriatrics Society,56(6),1140-1145.
36. Liberati, A.,Altman, D. G.,Tetzlaff, J.,Mulrow, C.,Gøtzsche, P. C,Ioannidis, J. P. A.,Clarke, M.,Devereaux, P. J.,Kleijnen, J.,Moher, D.(2009).The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration.PLOS MEDICINE,6(7),e1000100.
37. Macphee, M.,Skelton-Green, J.,Bouthillette, F.,Suryaprakash, N.(2012).An empowerment framework for nursing leadership development: Supporting evidence.Journal of Advanced Nursing,68(1),159-169.
38. Maddalena, V.,Fleet, L.(2015).Developing a Physician Management & Leadership Program (PMLP) in Newfoundland and Labrador.Leadership in Health Services,28(1),35-42.
39. Malling, B.,Mortensen, L.,Bonderup, T.,Scherpbier, A.,Ringsted,C.(2009).Combining a leadership course and multi-source feedback has no effect on leadership skills of leaders in postgraduatemedical education. An intervention study with a control group.BMC Medical Education,9(1),72.
40. Marchionni, C.,Ritchie, J.(2008).Organizational factors that support the implementation of a nursing best practice guideline.Journal of Nursing Management,16(3),266-274.
41. Margolis, L. H.,Rosenberg, A.,Umble, K.,Chewning, L.(2013).Effects of interdisciplinary training on MCH professionals, organizations and systems.Maternal and Child Health Journal,17(5),949-958.
42. Martin, J. S.,Mccormack, B.,Fitzsimons, D.,Spirig, R.(2012).Evaluation of a clinical leadership programme for nurseleaders.Journal of Nursing Management,20(1),72-80.
43. McAlearney, A. S.(2008).Using leadership development programs to improve quality and efficiency in healthcare.Journalof Healthcare Management,53(5),319-331.
44. McAlearney, A. S.,Fisher, D.,Heiser, K.,Robbins, D.,Kelleher, K.(2005).Developing effective physician leaders: Changing culturesand transforming organizations.Hospital Topics,83(2),11-18.
45. Murdock, J.,Brammer, C.(2011).A successful model of leadershipdevelopment for community practice physicians.Physician Executive,37(2),52-54.
46. Peters, L.(Ed.)(2019).The simple truths about leadership.Palgrave Macmillan.
47. Saleh, S. S.,Williams, D.,Balougan, M.(2004).Evaluating theeffectiveness of public health leadership training: The NEPHLI experience.American Journal of Public Health,94(7),1245-1249.
48. Singer, S. J.,Hayes, J.,Cooper, J. B.,Vogt, J.W.,Sales, M.,Aristidou,A.,Gray, G. C.,Kiang, M. V.,Meyer, G. S.(2011).A case forsafety leadership team training of hospital managers.Health Care Management Review,36(2),188-200.
49. Spiers, J. A.,Cummings, G. G.,Langenhoff, P.,Sharlow, J.,Bhatti,A.(2010)."But we can't go back": The effect of raising expectations through organizational leadership development and consequences of failure to follow through.Journal of Leadership Studies,4(1),6-19.
50. Steinert, Y.,Nasmith, L.,Daigle, N.(2003).Executive skills for medicalfaculty: A workshop description and evaluation.Medical Teacher,25(6),666-668.
51. Suhonen, R.(Ed.),Stolt, M.(Ed.),Papastavrou, E.(Ed.)(2019).Individualized care: Theory, measurement and practice.Springer International Publishing.
52. Tourangeau, A. E.(2003).Building nurse leader capacity.Journalof Nursing Administration,33(12),624-626.
53. Tourangeau, A. E.,Lemonde, M.,Luba, M.,Dakers, D.,Alksnis, C.(2003).Evaluation of a leadership development intervention.Nursing Leadership,16(3),91-104.
54. Turner, P.(Ed.)(2019).Leadership in healthcare: Delivering organisational transformation and operational excellence.Palgrave Macmillan.
55. Werrett, J.,Griffiths, M.,Clifford, C.(2002).A regional evaluation of the impact of the leading an empowered organisation leadership programme.NT Research,7(6),459-470.
56. Weston,M. J.,Falter, B.,Lamb, G. S.,Mahon, G.,Malloch, K.,Provan,K. G.,Roe, S.,Werbylo, L.(2008).Health care leadership academy: A statewide collaboration to enhance nursing leadership competencies.The Journal of Continuing Education in Nursing,39(10),468-472.