Graham Dickson and John Van Aerde
The purpose of this paper is to provide a case study demonstrating that LEADS in a Caring Environment Capabilities Framework in Canada can assist physicians to be partners in…
Abstract
Purpose
The purpose of this paper is to provide a case study demonstrating that LEADS in a Caring Environment Capabilities Framework in Canada can assist physicians to be partners in leading health reform.
Design/methodology/approach
A descriptive case-based approach was followed, relying on existing documents, research papers and peer-reviewed articles, to substantiate the effect of LEADS on physician leadership in Canada.
Findings
The Canadian LEADS framework enables physicians to lead by providing them with access to best practices of leadership, acting as an antidote to fragmented leadership practice, setting standards for development and accountability and providing opportunities for efficient and effective system-wide leadership development and change.
Research limitations/implications
A formal systematic review of the literature was not conducted. Findings can only be generalized to other cases if the reader sees contextual similarities between the present study context and the other case’s context.
Practical implications
This case demonstrates that national leadership frameworks have a role in facilitating physician leadership. Other national jurisdictions may wish to explore the Canadian case to determine how to use a common leadership language to engage physicians in health reform.
Social implications
Leadership is a key component of health reform. A common language and set of standards (LEADS) that can engage physicians will benefit patients and citizens in Canada.
Originality/value
This national case study shows how a nationally endorsed leadership framework such as LEADS can facilitate better physician leadership for health reform.
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Anita Joanne Snell, Chris Eagle and John Emile Van Aerde
– The purpose of this conceptual paper is to provide strategies on how to embed physician leadership development efforts within health organizations.
Abstract
Purpose
The purpose of this conceptual paper is to provide strategies on how to embed physician leadership development efforts within health organizations.
Design/methodology/approach
Findings from our previous research, which include an extensive literature review and analysis of 53 interviews with representatives from healthcare organizations across the globe, are integrated within the context of the Influencer© framework to provide a useful and grounded tool for physician leadership development strategies.
Findings
Physician leadership development strategies are identified for each of the six domains within the Influencer© framework.
Practical implications
A number of physician leadership development strategies are provided. They can be used in combination or used independently.
Originality/value
Integrating the knowledge gained from practices in health organizations and from the literature within the Influencer© framework is a unique approach and strengthens the usefulness of the identified physician leadership development strategies.
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Ming-Ka Chan, Graham Dickson, David A. Keegan, Jamiu O. Busari, Anne Matlow and John Van Aerde
The purpose of this paper was to determine the complementarity between the Canadian Medical Education Directions for Specialists (CanMEDS) physician competency and LEADS…
Abstract
Purpose
The purpose of this paper was to determine the complementarity between the Canadian Medical Education Directions for Specialists (CanMEDS) physician competency and LEADS leadership capability frameworks from three perspectives: epistemological, philosophical and pragmatic. Based on those findings, the authors propose how the frameworks collectively layout pathways of lifelong learning for physician leadership.
Design/methodology/approach
Using a qualitative approach combining critical discourse analysis with a modified Delphi, the authors examined “How complementary the CanMEDS and LEADS frameworks are in guiding physician leadership development and practice” with the following sub-questions: What are the similarities and differences between CanMEDS and LEADS from: An epistemological and philosophical perspective? The perspective of guiding physician leadership training and practice? How can CanMEDS and LEADS guide physician leadership development from medical school to retirement?
Findings
Similarities and differences exist between the two frameworks from philosophical and epistemological perspectives with significant complementarity. Both frameworks are founded on a caring ethos and value physician leadership – CanMEDS (for physicians) and LEADS (physicians as one of many professions) define leadership similarly. The frameworks share beliefs in the function of leadership, embrace a belief in distributed leadership, and although having some philosophical differences, have a shared purpose (preparing for changing health systems). Practically, the frameworks are mutually supportive, addressing leadership action in different contexts and where there is overlap, complement one another in intent and purpose.
Originality/value
To the best of the authors’ knowledge, this is the first paper to map the CanMEDS (physician competency) and LEADS (leadership capabilities) frameworks. By determining the complementarity between the two, synergies can be used to influence physician leadership capacity needed for today and the future.
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Elizabeth Hartney, Ellen Melis, Deanne Taylor, Graham Dickson, Bill Tholl, Kelly Grimes, Ming-Ka Chan, John Van Aerde and Tanya Horsley
This first phase of a three-phase action research project aims to define leadership practices that should be used during and after the pandemic to re-imagine and rebuild the…
Abstract
Purpose
This first phase of a three-phase action research project aims to define leadership practices that should be used during and after the pandemic to re-imagine and rebuild the health and social care system. Specifically, the objectives were to determine what effective leadership practices Canadian health leaders have used through the first wave of the COVID-19 pandemic, to explore how these differ from pre-crisis practices; and to identify what leadership practices might be leveraged to create the desired health and care systems of the future.
Design/methodology/approach
The authors used an action research methodology. In the first phase, reported here, the authors conducted one-on-one, virtual interviews with 18 health leaders from across Canada and across leadership roles. Data were analyzed using grounded theory methodology.
Findings
Five key practices emerged from the data, within the core dimension of disrupting entrenched structures and leadership practices. These were, namely, responding to more complex emotions in self and others. Future practice identified to create more psychologically supportive workplaces. Agile and adaptive leadership. Future practice should allow leaders to move systemic change forward more quickly. Integrating diverse perspectives, within and across organizations, leveling hierarchies through bringing together a variety of perspectives in the decision-making process and engaging people more broadly in the co-creation of strategies. Applying existing leadership capabilities and experience. Future practice should develop and expand mentorship to support early career leadership. Communication was increased to build credibility and trust in response to changing and often contradictory emerging evidence and messaging. Future practice should increase communication.
Research limitations/implications
The project was limited to health leaders in Canada and did not represent all provinces/territories. Participants were recruited through the leadership networks, while diverse, were not demographically representative. All interviews were conducted in English; in the second phase of the study, the authors will recruit a larger and more diverse sample and conduct interviews in both English and French. As the interviews took place during the early stages of the pandemic, it may be that health leaders’ views of what may be required to re-define future health systems may change as the crisis shifts over time.
Practical implications
The sponsoring organization of this research – the Canadian Health Leadership Network and each of its individual member partners – will mobilize knowledge from this research, and subsequent phases, to inform processes for leadership development and, succession planning across, the Canadian health system, particularly those attributes unique to a context of crisis management but also necessary in post-crisis recovery.
Social implications
This research has shown that there is an immediate need to develop innovative and influential leadership action – commensurate with its findings – to supporting the evolution of the Canadian health system, the emotional well-being of the health-care workforce, the mental health of the population and challenges inherent in structural inequities across health and health care that discriminate against certain populations.
Originality/value
An interdisciplinary group of health researchers and decision-makers from across Canada who came together rapidly to examine leadership practices during COVID-19’s first wave using action research study design.
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Maya M. Jeyaraman, Sheikh Muhammad Zeeshan Qadar, Aleksandra Wierzbowski, Farnaz Farshidfar, Justin Lys, Graham Dickson, Kelly Grimes, Leah A. Phillips, Jonathan I. Mitchell, John Van Aerde, Dave Johnson, Frank Krupka, Ryan Zarychanski and Ahmed M. Abou-Setta
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…
Abstract
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.
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Anita J. Snell, Graham Dickson, Debrah Wirtzfeld and John Van Aerde
This is the first study to compile statistical data to describe the functions and responsibilities of physicians in formal and informal leadership roles in the Canadian health…
Abstract
Purpose
This is the first study to compile statistical data to describe the functions and responsibilities of physicians in formal and informal leadership roles in the Canadian health system. This mixed-methods research study offers baseline data relative to this purpose, and also describes physician leaders’ views on fundamental aspects of their leadership responsibility.
Design/methodology/approach
A survey with both quantitative and qualitative fields yielded 689 valid responses from physician leaders. Data from the survey were utilized in the development of a semi-structured interview guide; 15 physician leaders were interviewed.
Findings
A profile of Canadian physician leadership has been compiled, including demographics; an outline of roles, responsibilities, time commitments and related compensation; and personal factors that support, engage and deter physicians when considering taking on leadership roles. The role of health-care organizations in encouraging and supporting physician leadership is explicated.
Practical implications
The baseline data on Canadian physician leaders create the opportunity to determine potential steps for improving the state of physician leadership in Canada; and health-care organizations are provided with a wealth of information on how to encourage and support physician leaders. Using the data as a benchmark, comparisons can also be made with physician leadership as practiced in other nations.
Originality/value
There are no other research studies available that provide the depth and breadth of detail on Canadian physician leadership, and the embedded recommendations to health-care organizations are informed by this in-depth knowledge.
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Jeffrey Braithwaite, Kristiana Ludlow, Kate Churruca, Wendy James, Jessica Herkes, Elise McPherson, Louise A. Ellis and Janet C. Long
Much work about health reform and systems improvement in healthcare looks at shortcomings and universal problems facing health systems, but rarely are accomplishments dissected…
Abstract
Purpose
Much work about health reform and systems improvement in healthcare looks at shortcomings and universal problems facing health systems, but rarely are accomplishments dissected and analyzed internationally. The purpose of this paper is to address this knowledge gap by examining the lessons learned from health system reform and improvement efforts in 60 countries.
Design/methodology/approach
In total, 60 low-, middle- and high-income countries provided a case study of successful health reform, which was gathered into a compendium as a recently published book. Here, the extensive source material was re-examined through inductive content analysis to derive broad themes of systems change internationally.
Findings
Nine themes were identified: improving policy, coverage and governance; enhancing the quality of care; keeping patients safe; regulating standards and accreditation; organizing care at the macro-level; organizing care at the meso- and micro-level; developing workforces and resources; harnessing technology and IT; and making collaboratives and partnerships work.
Practical implications
These themes provide a model of what constitutes successful systems change across a wide sample of health systems, offering a store of knowledge about how reformers and improvement initiators achieve their goals.
Originality/value
Few comparative international studies of health systems include a sufficiently wide selection of low-, middle- and high-income countries in their analysis. This paper provides a more balanced approach to consider where achievements are being made across healthcare, and what we can do to replicate and spread successful examples of systems change internationally.
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Denise M. Cumberland, Andrea D. Ellinger, Tara McKinley, Jason C. Immekus and Andrew McCart
Leadership development programs (LDPs) have emerged relatively recently in the healthcare context as a mechanism not only to develop capable and competent leaders but also to…
Abstract
Purpose
Leadership development programs (LDPs) have emerged relatively recently in the healthcare context as a mechanism not only to develop capable and competent leaders but also to retain them. The purpose of this paper is to describe a perspective on practice by illustrating a case example that showcases a pilot LDP for newly promoted healthcare leaders. The details about how it was developed and implemented collaboratively by a healthcare consortium and higher education institution (HEI) to address shared healthcare leadership talent pipeline and retention challenges are provided.
Design/methodology/approach
This perspective on practice describes how a consortium of competitive healthcare organizations, a type of branded Inter-organizational Relationship referred to as “Coopetition,” contracted with a HEI to design, develop and launch a pilot LDP, referred to as the Academy for Healthcare Education and Development program, using the analyze, design, develop, implement and evaluate model.
Findings
The significance of this illustrative case example is discussed along with some initial lessons learned based upon this pilot LDP that 24 program participants completed. Implications for research, theory and practice are presented, followed by limitations and a conclusion.
Originality/value
Inter-organizational relationships, particularly coopetition, are relatively new in the healthcare sector, along with collaboration with HEIs to develop interventions to solve compelling industry problems. This illustrative case example offers insights that address scholars’ calls and practitioners’ needs to explicate different approaches for LDPs to build the healthcare leadership talent pipeline.