학술논문

Exploring the implementation and evaluation of a distributed leadership model within a Scottish, integrated health and care context.
Document Type
Academic Journal
Author
Leask CF; Strategy & Transformation, Aberdeen City Health & Social Care Partnership, Aberdeen, UK calum.leask@nhs.scot.; Health Intelligence, NHS Grampian, Aberdeen, UK.; Macleod S; Strategy & Transformation, Aberdeen City Health & Social Care Partnership, Aberdeen, UK.
Source
Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101757339 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2398-631X (Electronic) Linking ISSN: 2398631X NLM ISO Abbreviation: BMJ Lead Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Health and care systems are facing unprecedented challenges, exacerbated by wicked issues that have no single solution and are complex to solve. It has recently been suggested that how such systems are structured (ie, in hierarchies) may not be the most effective approach to tackling these issues. Increasing calls have been made for senior leaders within these systems to adopt structures that emphasise leadership as a distributed endeavour as an approach to foster greater collaboration and enhance innovation. Here, the implementation and evaluation of a distributed leadership model within a Scottish, integrated health and care context is described.
Methods: Aberdeen City Health & Social Care Partnership's leadership team (N=17 as of time in 2021) have been operating in a flat, distributed leadership model since 2019. The model is characterised by a 4P approach (professional; performance; personal development and peer support). The evaluation approach was a national healthcare survey administered at three time points and a further evaluation questionnaire specifically assessing constructs associated with high-performing teams.
Results: Results indicated that staff satisfaction increased 3 years into the flat structure (mean score=7.7/10) compared with the traditional, hierarchal structure (mean score=5.18/10). Respondents were agreeable that the model had increased autonomy (67% agreeableness); collaboration (81% agreeableness) and creativity (67% agreeableness) CONCLUSIONS: Overall, results suggest that a flat, distributed leadership model is preferable to a traditional, hierarchal leadership model within this context. Future work should aim to explore the impact that this model has on the effectiveness of planning and delivering integrated care services.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)