Taking a case study approach to assessing alternative leadership models in health care
Abstract
Good leadership is essential to patient-centred care and staff satisfaction in the healthcare environment. All members of the healthcare team can be leaders and evidence-based theory should inform their leadership practice. This article uses a case study approach to critically evaluate leadership as exercised by a charge nurse and a student nurse in a clinical scenario. Ineffective leadership styles are identified and alternatives proposed; considerable attention is given to critiquing both ‘heroic’ and ‘post-heroic’ transformational leadership theories. The concept of power will also be discussed, as power and leadership are closely related, and the importance of empowering members of the healthcare team through altering organisational structure is emphasised. This article advocates leadership that encourages innovation, enhances patient-centred care, encourages excellence and has ethical integrity. Recommendations of appropriate models of leadership are provided, while existing gaps in the healthcare leadership literature are highlighted.
References
- Clinical leadership: reflection saves lives. 2017. https://tinyurl.com/y8m5ksqm (
accessed 25 May 2018 ) Google Scholar - A critical review of leadership theory. In Leonard HSLewis RFreedman AMPassmore J, eds. The Wiley-Blackwell handbook of the psychology of leadership, change, and organizational development. Chichester: Wiley-Blackwell; 2013: 13–47 Google Scholar
- Leadership: time for a new direction? Leadership 2005; 1(1):51–71. https://doi.org/https://doi.org/10.1177/1742715005049351 Crossref, Google Scholar
- Engaging leadership: creating organisations that maximise the potential of their people. London: Chartered Institute of Personnel and Development; 2008. https://tinyurl.com/y7ucd6uy (
accessed 25 May 2018 ) Google Scholar - The impact of leadership factors in implementing change in complex health and social care environments: NHS Plan clinical priority for mental health crises resolution teams. London: National Institute for Health Research; 2007. https://tinyurl.com/q48ckx6 (
accessed 25 May 2018 ) Google Scholar - Authentic leadership development: getting to the root of positive forms of leadership. Leadership Quarterly 2005; 16(3):315–338. https://doi.org/https://doi.org/10.1016/j.leaqua.2005.03.001 Crossref, Google Scholar
- Leadership and performance beyond expectations. London: Free Press; 1985 Google Scholar
- Empowerment and being valued: A phenomenological study of nursing students' experiences of clinical practice. Nurse Educ Today. 2011; 31(4):368–372. https://doi.org/https://doi.org.10.1016/j.nedt.2010.07.008 Crossref, Medline, Google Scholar
Care Quality Commission . The state of health care and adult social care in England 2015/16. 2016. https://tinyurl.com/jjdy7ez (accessed 25 May 2018 ) Google Scholar- When charismatic leadership goes too far. 2016. https://tinyurl.com/gsux97y (
accessed 25 May 2018 ) Google Scholar - Charismatic leadership: the elusive factor in organizational effectiveness. San Francisco CA: Jossey-Bass; 1988 Google Scholar
- The hidden treasure in nursing leadership: informal leaders. J Nurs Manag. 2011; 19(4):517–521. https://doi.org/https://doi.org/10.1111/j.1365-2834.2011.01253.x Crossref, Medline, Google Scholar
- Report of the Mid Staffordshire NHS Foundation Trust public inquiry. Executive summary. 2013. https://tinyurl.com/y7dzpogs (
accessed 25 May 2018 ) Google Scholar - The Bases of Social Power. In: Cartwright J, ed. Studies in social power. 1959. Ann Arbor, MI: Institute for Social Research; 150–167 Google Scholar
- Power and effective nursing practice. Nurs Outlook. 1986; 34(3):129–34 Medline, Google Scholar
- The importance of emotional resilience for staff and students in the ‘helping’ professions: developing an emotional curriculum. 2013. https://tinyurl.com/j9rl36m (
accessed 25 May 2018 ) Google Scholar Health Foundation . Person-centred care made simple. 2014. https://tinyurl.com/y78hgtyl (accessed 25 May 2018 ) Google Scholar- Transformational leadership in nursing: towards a more critical interpretation. Nurs Inq. 2013; 20(1):11–22. https://doi.org/https://doi.org/10.1111/nin.12006 Crossref, Medline, Google Scholar
- Empowerment an essential ingredient in the clinical environment: a review of the literature. Nurse Educ Today. 2015; 35(3):487–492. https://doi.org/https://doi.org/10.1016/j.nedt.2014.11.014 Crossref, Medline, Google Scholar
- The Curse of the Superstar CEO. Harvard Business Review 2002; September. https://tinyurl.com/l2kd9zc (
accessed 25 May 2018 ) Google Scholar King's Fund . The future of leadership and management in the NHS. No more heroes. 2011. https://tinyurl.com/yakyju8b (accessed 25 May 2018 ) Google Scholar- Patterns of aggressive behaviour in experimentally created ‘social climates’. J Soc Psychol. 1939 [available online from 2010]; 10(2):269–299. https://doi.org/https://doi.org/10.1080/00224545.1939.9713366 Crossref, Google Scholar
- The Examination of factors relating to the leadership style of nursing leaders in hospitals. Our Economy. 2015; 62(1):27–36. https://doi.org/https://doi.org/10.1515/ngoe-2016-0003 Google Scholar
- Power and leadership: an influence process. International Journal of Management. Bus Adm (Lond). 2012; 15(1): 1–9. https://tinyurl.com/pgz2ldb (
accessed 25 May 2018 ) Google Scholar - Leadership, ethics and integrity. In: Storey J, ed. Leadership in organizations: current issues and key trends. 2nd edn. Abingdon: Routledge; 2011 Google Scholar
- Power and empowerment in nursing: looking backward to inform the future. Online J Issues Nurs. 2007; 12(1):2. Medline, Google Scholar
- The importance of teaching and learning resilience in the health disciplines: a critical review of the literature. Nurse Educ Today. 2009; 29(4): 371–379. https://doi.org/https://doi.org/10.1016/j.nedt.2008.10.011 Crossref, Medline, Google Scholar
- Understanding organizational behaviour. 3rd edn. Mason, OH: South-Western/Cengage Learning; 2007 Google Scholar
NHS Improvement . Developing people, improving care together. One year on. 2017. https://tinyurl.com/y943t697 (accessed 25 May 2018 ) Google ScholarNHS Leadership Academy . Case studies. 2018. www.leadershipacademy.nhs.uk/case-studies (accessed 25 May 2018 ) Google ScholarNursing and Midwifery Council . The Code. Professional standards of practice and behaviour for nurses and midwives. 2015. https://tinyurl.com/nmc-code (accessed 25 May 2018 ) Google Scholar- Clore Social Leadership Programme. The importance of resilience in leadership. 2010. https://tinyurl.com/yde3x9gc (
accessed 25 May 2018 ) Google Scholar - The contemporary construction of nurse empowerment. J Nurs Scholarsh. 2012; 44(4): 396–402. https://doi.org/https://doi.org/10.1111/j.1547-5069.2012.01473.x Crossref, Medline, Google Scholar
- Developing effective leadership in the NHS to maximise the quality of patient care. London: King's Fund; 2011. https://tinyurl.com/y7ahnftu (
accessed 25May 2018 ). Google Scholar - Social distance and charisma: theoretical notes and an exploratory study. Leadership Quarterly. 1995; 6(1):19–47. https://doi.org/https://doi.org/10.1016/1048-9843(95)90003-9 Crossref, Google Scholar
- Are leaders' well-being, behaviours and style associated with the affective well-being of their employees? A systematic review of three decades of research. Work Stress. 2010; 24(2): 107–139. https://doi.org/https://doi.org/10.1080/02678373.2010.495262 Crossref, Google Scholar
- The destructiveness of laissez-faire leadership behavior. J Occup Health Psychol. 2007; 12(1): 80–92. https://doi.org/https://doi.org/10.1037/1076-8998.12.1.80 Crossref, Medline, Google Scholar
- Practical leadership and management in healthcare: For nurses and allied health professionals. 2nd edn. Harlow: Pearson; 2013 Google Scholar
- Leadership in context. Lessons from new leadership theory and current leadership development practice. London: King's Fund; 2011. https://tinyurl.com/y7umvdhb (
accessed 25 May 2018 ) Google Scholar - . Nurse managers' perceptions and experiences regarding staff nurse empowerment: a qualitative study. Front Psychol. 2015; 6:1585. https://doi.org/https://doi.org/10.3389/fpsyg.2015.01585 Crossref, Medline, Google Scholar
- . Staff nurses' perceptions and experiences about structural empowerment: a qualitative phenomenological study. PLoS One. 2016; 11(4): e0152654. https://doi.org/https://doi.org/10.1371/journal.pone.0152654 Crossref, Medline, Google Scholar
- The Protestant ethic and the spirit of capitalism: and other writings. New York, NY: Penguin; 1905 Google Scholar
- Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev. 2015; (8):CD007798. https://doi.org/https://doi.org/10.1002/14651858.CD007798.pub4 Medline, Google Scholar
- Leadership and leadership development in health care: the evidence base. London: King's Fund; 2015. https://tinyurl.com/y7v3fojx (
accessed 25 May 2018 ) Google Scholar - NHS staff management and health service quality. Results from the NHS staff survey and related data. 2011. https://tinyurl.com/ya9okq82 (
accessed 25 May 2018 ) Google Scholar - Developing collective leadership for health care. London: King's Fund; 2014. https://tinyurl.com/ycpljfgn (
accessed 25 May 2018 ) Google Scholar - Authentic leadership and nurses' voice behaviour and perceptions of care quality. J Nurs Manag. 2010; 18(8): 889–900. https://doi.org/https://doi.org/10.1111/j.1365-2834.2010.01113.x Crossref, Medline, Google Scholar
- Authentic leadership and nurse-assessed adverse patient outcomes. J Nurs Manag. 2013; 21(5): 740–752. https://doi.org/https://doi.org/10.1111/jonm.12075 Crossref, Medline, Google Scholar
- Leadership in organisations. 8th edn. Upper Saddle River, NJ: Pearson; 2012 Google Scholar



