Lisa Aufegger, Omair Shariq, Colin Bicknell, Hutan Ashrafian and Ara Darzi
Research in psychology or management science has shown that shared leadership (SL) enhances information sharing, fosters participation and empowers team members within the…
Abstract
Purpose
Research in psychology or management science has shown that shared leadership (SL) enhances information sharing, fosters participation and empowers team members within the decision-making processes, ultimately improving the quality of performance outcomes. Little has been done and, thus, less is known of the value and use of SL in acute healthcare teams. The purpose of this study is to (1) explore, identify and critically assess patterns and behaviour of SL in acute healthcare teams; and (2) evaluate to what extent SL may benefit and accomplish safer care in acute patient treatment and healthcare delivery.
Design/methodology/approach
The authors conducted a review that followed the PRISMA-P reporting guidelines. A variety of sources were searched in April 2018 for studies containing primary research that focused on SL in acute healthcare teams. The outcome of interest was a well-specified assessment of SL, and an evaluation of the extent SL may enhance team performance, lead to safer patient care and healthcare delivery in acute healthcare teams.
Findings
After the study selection process, 11 out of 1,383 studies were included in the review. Studies used a qualitative, quantitative or mixed-methods approach. Emerging themes based on behavioural observations that contributed to SL were: shared mental model; social support and situational awareness; and psychological safety. High-performing teams showed more SL behaviour, teams with less seniority displayed more traditional leadership styles and SL was associated with increased team satisfaction.
Research limitations/implications
Evidence to date suggests that SL may be of benefit to improve performance outcomes in acute healthcare team settings. However, the discrepancy of SL assessments within existing studies and their small sample sizes highlights the need for a large, good quality randomized controlled trial to validate this indication.
Originality/value
Although studies have acknowledged the relevance of SL in healthcare service and delivery, a systematic, evidence-based and robust evaluation of behavioural patterns and the benefits of SL in this field is still missing.
Details
Keywords
Rory Conn, Amit Bali and Elizabeth Akers
The purpose of this paper is to examine the impact of a structured clinical leadership programme on healthcare professionals working within the British National Health Service…
Abstract
Purpose
The purpose of this paper is to examine the impact of a structured clinical leadership programme on healthcare professionals working within the British National Health Service (NHS). Clinical leadership is now regarded as essential in addressing the complex challenges in the NHS, yet few trainees of any healthcare discipline receive formal training. The study describes a peer-led evaluation of a year-long, multidisciplinary, experiential programme, the “Darzi Fellowship”, based in London.
Design/methodology/approach
An anonymous survey was analysed using a mixed-methods approach. Individual and collective experiences of fellows were evaluated, in particular the perceived impact the fellowship had on: the fellows themselves, their “host” organisation and the NHS as a whole.
Findings
A 90 per cent return rate was achieved. In all, 94 per cent reported that the experience had been valuable to them, 85 per cent feeling more empowered to effect change in healthcare systems. Crucial mechanisms to achieve this included increased self-awareness, personal reflection and the freedom to gain a greater understanding of organisations. Particular emphasis was placed on the value of developing clinical networks which promote collaboration across boundaries. Fellows emerged as more reflexive, critical and strategic thinkers.
Practical implications
This paper demonstrates the positive impact that clinical leadership training can have on participants, and the mechanisms by which future leaders can be created.
Originality/value
The novel, non-commissioned, peer-initiated and peer-led evaluation describes the personal experiences of fellows in a unique, multidisciplinary clinical leadership programme. The authors hope this will inform the development of future schemes in the NHS and provide learning for an international healthcare audience.
Details
Keywords
Panita Surachaikulwattana and Nelson Phillips
Drawing on a case study of the adoption of an American organizational form – the “Academic Health Science Centre” (or “AHSC”) – in English healthcare, the authors develop a model…
Abstract
Drawing on a case study of the adoption of an American organizational form – the “Academic Health Science Centre” (or “AHSC”) – in English healthcare, the authors develop a model of the “translation work” required to translate an organizational form from one organizational field to another. The findings contribute to the literature on translation and shed light on the microfoundations of institutions by examining the complex relationship among agency, meaning, institutions, and temporality that underpin the translation of a contested organizational form. The authors also show the important, but limited, role of agency when translation occurs at the broad field level and argue that the translation of organization forms can, in at least some situations, best be understood as a “garbage can” rather than the linear and agentic view usually described in the translation literature.
Details
Keywords
Louise Stoll, Tim Swanwick, Julia Foster‐Turner and Fiona Moss
An innovative programme of “Darzi” Fellowships in Clinical Leadership provides doctors in postgraduate training with a unique opportunity to engage in improving systems of health…
Abstract
Purpose
An innovative programme of “Darzi” Fellowships in Clinical Leadership provides doctors in postgraduate training with a unique opportunity to engage in improving systems of health care and develop their capability as future clinical leaders. The purpose of this paper is to report an impact evaluation of the programme, highlighting transferable design principles.
Design/methodology/approach
Qualitative and quantitative data were used iteratively and included a review of literature, analysis of background documents and internal evaluation results, face‐to‐face and telephone interviews, observation of educational events, online questionnaires and representative case studies.
Findings
Impact was found at the level of the fellows' learning, their organisations and the wider health system. Identified influencing factors included: clarity of purpose and aims, mutuality of workplace and external learning, learning for transformational change, ambitious but “do‐able” projects, a committed and learning‐oriented sponsor, a supportive organisational culture, high‐quality mentoring, a network of supportive peers, diversity of participants, ongoing monitoring and adaptation, planning for sustainability and the tracking of impact over time.
Research limitations/implications
The extent to which results are generalisable needs to be considered within the constraints of this programme evaluation.
Practical implications
The “Darzi” Fellowship programme is effective and impactful, spawning clinical leadership development throughout a wider system. Whole system engagement of trainee doctors in leadership will require more than a Fellowship programme alone, but it is a start.
Originality/value
The evaluation adds to what we know about leadership development generally and provides a rare study in the medical context generating helpful principles for the design of leadership development programmes, particularly in the clinical setting.
Details
Keywords
Udechukwu Ojiako, Stuart Maguire, Lenny Koh, Tracey Grainger and Dave Wainwright
This paper aims to argue that the implementation of the Choose and Book system has failed due to the inability of project sponsors to appreciate the complex and far‐reaching…
Abstract
Purpose
This paper aims to argue that the implementation of the Choose and Book system has failed due to the inability of project sponsors to appreciate the complex and far‐reaching softer implications of the implementation, especially in a complex organisation such as the NHS, which has multifarious stakeholders.
Design/methodology/approach
The authors use practice‐oriented research to try and isolate key parameters. These parameters are compared with existing conventional thinking in a number of focused areas.
Findings
Like many previous NHS initiatives, the focus of this system is in its obvious link to patients. However we find that although this project has cultural, social and organisational implications, programme managers and champions of the Connecting for Health programme emphasised the technical domains to IS/IT adoption.
Research limitations/implications
This paper has been written in advance of a fully implemented Choose and Book system.
Practical implications
The paper requests that more attention be paid to the softer side of IS/IT delivery, implementation, introduction and adoption.
Originality/value
The paper shows that patient experience within the UK healthcare sector is still well below what is desired.
Details
Keywords
Reviews the latest management developments across the globe and pinpoints practical implications from cutting‐edge research and case studies.
Abstract
Purpose
Reviews the latest management developments across the globe and pinpoints practical implications from cutting‐edge research and case studies.
Design/methodology/approach
This briefing is prepared by an independent writer.
Findings
We now live in a society where litigation claims are commonplace, and health services are far from immune to this problem. In fact, the traditional relationship between doctor and patient has radically changed over the past decade, and the competence and professionalism of all healthcare professionals is now constantly under scrutiny.
Practical implications
Provides strategic insights and practical thinking that have influenced some of the world's leading organizations.
Originality/value
The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy‐to‐digest format.
Details
Keywords
Abstract
Details
Keywords
Peter Jones, David Hillier and Daphne Comfort
The purpose of this paper is to explore some of the challenges in putting government policy on the development of a new generation of primary health care centres into practice, at…
Abstract
Purpose
The purpose of this paper is to explore some of the challenges in putting government policy on the development of a new generation of primary health care centres into practice, at a time when a growing number of property companies are moving into the primary health care market.
Design/methodology/approach
The paper begins by outlining the government policy issues driving the development of primary health care centres, it describes the ways in which these centres are being developed and discusses some of the issues involved in putting government policy into practice.
Findings
The paper reveals that the government's plans to develop a new generation of primary health care centres have provoked considerable controversy and it explores five sets of issues, namely the quality of health care; location and accessibility; economies of scale and cost savings; the changing balance of public and private sector provision; and impacts within the wider urban environment.
Originality/value
The paper provides an accessible review of the debate surrounding the development of primary health care centres and as such it will be of interest to those working in, engaging with, and studying the primary health care property market.
Details
Keywords
Santus Kumar Deb, P.P. Mohanty and Marco Valeri
The purpose of the study is to investigate the potentiality and dimensions of promoting handicraft family business practices in handicraft as well as the extent to highlight the…
Abstract
Purpose
The purpose of the study is to investigate the potentiality and dimensions of promoting handicraft family business practices in handicraft as well as the extent to highlight the local tradition and culture.
Design/methodology/approach
This study is an insight from the existing relevant literature on family-owned businesses in handicrafts from time immemorial. Furthermore, data were collected from the 300 respondents using a purposive sampling procedure in which the rate of response was 67%. The structural equation modeling (i.e. SmartPLS 3.0) was used to analyze the construct and test the hypothesis.
Findings
According to the result, among the 4 hypothesized paths all were supported, but out of 22 relationship paths, 15 paths are considered significant This study shows the relationship among the promotional factors, economic factors and motivational factors, and support and challenges factors have a crucial effect on the adoption of handicraft family business.
Research limitations/implications
The findings of this study will assist the tourism scholars and managers to apprehend an authentic relationship between age-old practices of the family business as well as the legacy of the family business in art and crafts to empower the local people.
Originality/value
The study is a foremost to ascertain the critical success factors of the adoption of family business practices in art and crafts through rural tourism to empower the local economy.
Details
Keywords
Anshu Duhoon and Mohinder Singh
The increased interest among academicians to explore more about tax management behavior is evident in the literature on corporate tax avoidance. This paper aims to illustrate the…
Abstract
Purpose
The increased interest among academicians to explore more about tax management behavior is evident in the literature on corporate tax avoidance. This paper aims to illustrate the multiple aspects that influence the tax avoidance behavior of corporations and its impacts through the systematic review method.
Design/methodology/approach
This study used “Tax Avoidance” OR “Tax Aggressiveness” OR “Tax Planning” as search strings to extract the relevant literature from the Scopus database. This study is a comprehensive analysis of existing literature on corporate tax avoidance behavior. Further, the keyword network analysis has been used to find out the most explored and dry research areas related to corporate tax avoidance behavior using VOSviewer software.
Findings
The study finds that taxation decision is an important managerial decision. Managers adopt tax avoidance tactics to boost postax profits to meet the shareholders’ expectations, particularly of risk-averse shareholders, and sometimes for their benefit also. With this, this study also finds that firms’ characteristics, political connections and corporate social responsibility activities also impact taxation decisions. In addition, the study identifies that tax-avoiding behavior has a contradictory impact on firm value, market growth and corporate transparency disclosure decisions.
Research limitations/implications
The study assists the researchers by providing a brief overview of tax avoidance behavior, for corporates in understanding the implications of tax avoidance, and for policymakers to fix the taxation loopholes and bring necessary tax reforms.
Originality/value
This study adds to the existing literature by providing a thorough overview of theories, determinants and outcomes of corporate tax avoidance behavior.