Healthcare Managers/Executives/Administrators
OBJECTIVE The purpose of this study was to examine the impact of a program to develop shared leadership within a health care system.
METHODOLOGY The shared leadership concepts program (SLCP) was created by a team of staff nurses, managers and clinical nurse specialists working in the Aurora Health Care - Metro Region (Wisconsin). The SLCP had five content areas arranged in four 8-hour day modules and delivered over a two-month period to enable staff to practice concepts on the units and discuss their growth through the sessions. Nurses completed the individual contributor version of the Leadership Practices Inventory, and asked five colleagues to complete the observer's version of the instrument. Also completed were the Smola Assessment of Leadership Inventory (Smola, 1988) and the Nursing Activity Scale (Schutzenhofer, 1998).
KEY FINDINGS In the first study, a convenience sample of 30 proficient and expert nurses from one Aurora Metro hospital who participated in the SCLP in August 1995 and a convenience sample of 15 nurses from the same hospital who volunteered to be a wait-list control group were compared. Participants in the two groups were equivalent for such factors as age, years in nursing, education and previous leadership experience at time 1. No significant difference was found between the control group leadership scores between pre- and post-program but there were significant differences between preand post-program participants from the experimental group. The calculated effect size was .46. The control group change mean difference of -1.2 suggests a trend of little or no change as compared to the experimental group change mean difference of +5.3, which suggests use of more leadership behavior by the SCLP group.
The second study involved 412 nurses from more than 100 patient or ambulatory care units of the five hospitals, multiple off-site clinics, and community nursing programs of Aurora Health care who participated in the program between November 1995 and December 1997. Nurses showed statistically significant increases in all five leadership practices from pre- to 6- months post program. Observers' perceptions of nurses' use of all five leadership practices also significantly increased over this same time period.
The third study involved interviews with a panel of nurses at three, six, and twelve month's post-completion of the SCLP. Nurses reported increased personal self-growth over time after training. "They were more aware of how their leadership behavior had changed, how it affected how they acted, and areas to further improve over time. In general, nurses who completed the SCLP felt more confident, effective, organized, empowered and assertive, and these feelings continued to develop over time. They reported less stress, were able to participate in committees, and served as resources to other staff more effectively. They saw themselves as having more negotiation skills, better relating to others, and being more accountable for and aware of the health care system as a whole" (p. 51). "The third study documented improvements in patient outcomes and specifically linked those improvements to increased use of leadership behaviors" (p. 53).