Leadership Theories in Practice

Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization. Leadership Theories in Practice

To Prepare:

· Review the Resources and examine the leadership theories and behaviors introduced.

· Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

· Reflect on the leadership behaviors presented in the three resources that you selected for review.

· Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

READING RESOURCES

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

· Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)

· Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)

· Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194) Leadership Theories in Practice

ARTICLE

Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3 Leadership Theories in Practice

Abstract

Background

Administrative evidence based practices (A-EBPs) are agency level structures and activities positively associated with performance measures (e.g., achieving core public health functions, carrying out evidence-based interventions). The objectives of this study were to examine the contextual conditions and explore differences in local health department (LHD) characteristics that influence the implementation of A-EBPs.

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Methods

Qualitative case studies were conducted based on data from 35 practitioners in six LHDs across the United States. The sample was chosen using an A-EBP score from our 2012 national survey and was linked to secondary data from the National Public Health Performance Standards Program. Three LHDs that scored high and three LHDs that scored low on both measures were selected as case study sites. The 37-question interview guide explored LHD use of an evidence based decision making process, including A-EBPs and evidence-based programs and policies. Each interview took 30–60 min. Standard qualitative methodology was used for data coding and analysis using NVivo software. Leadership Theories in Practice

Results

As might be expected, high-capacity LHDs were more likely to have strong leadership, partnerships, financial flexibility, workforce development activities, and an organizational culture supportive of evidence based decision making and implementation of A-EBPs. They were also more likely to describe having strong or important relationships with universities and other educational resources, increasing their access to resources and allowing them to more easily share knowledge and expertise.

Conclusions

Differences between high- and low-capacity LHDs in A-EBP domains highlight the importance of investments in these areas and the potential those investments have to contribute to overall efficiency and performance. Further research may identify avenues to enhance resources in these domains to create an organizational culture supportive of A-EBPs. Leadership Theories in Practice

Peer Review reports

Background

The tenets of evidence-based decision making (EBDM) in public health have been formally developed over the past 15 years in several countries. Evidence-based decision making is a process that involves the integration of the best available research evidence, practitioner expertise, and the characteristics, needs, and preferences of the community [1–9]. In local health departments (LHDs), this process includes the implementation of administrative evidence based practices (A-EBPs) [9]. Administrative evidence based practices are agency level structures and activities positively associated with performance measures (e.g., achieving core public health functions, carrying out evidence-based interventions) [10]. There are five broad domains of A-EBPs: leadership, workforce development, partnerships, financial processes, and organizational culture and climate (Table 1). These domains were previously developed from a literature review of evidence reviews that aimed to identify administrative practices of varying priority, determined by the length of time needed to modify them or the strength of their research support [10]. The five broad domains, and their 11 subdomains, are described as both high-priority and locally modifiable in a short to medium timeframe [10]. Use of A-EBPs in LHDs is important because these practices have been shown to be effective in boosting performance, contributing to accreditation efforts, and may ultimately lead to improved health of the population [9, 10]. In addition, the Public Health Accreditation Board requires that LHDs use and contribute to the evidence base, and likewise requires effective administrative practices – thus use of A-EBPs may fulfill multiple domains within the LHD accreditation process [11]. Since LHDs in the United States are using A-EBPs to varying degrees [12, 13], it is important to examine the contextual conditions that influence the implementation of A-EBPs. The purpose of this study, then, is to explore differences in LHD characteristics that may in part explain the differences in implementation of A-EBPs. In particular, this study will focus on contextual differences between high- and low-capacity LHDs, further defined below. Leadership Theories in Practice

Table 1 Administrative evidence-based practices (A-EBPs)a in local health departments

Full size table

Methods

A mixed methods approach was utilized to expand upon quantitative findings from the LEAD Public

Health National Survey (LEAD survey) and further examine differences in LHD characteristics that influence the use of A-EBPs [12, 13]. Qualitative case studies were conducted among a select number of LHDs, in conjunction with a set of quantitative studies on the definition and use of A-EBPs in LHDs [9, 10, 12, 14–17]. The case study sample was selected using an A-EBP score from the LEAD survey (described elsewhere) [12] and secondary data from the National Public Health Performance Standards Program (NPHPSP). A set of A-EBP scores were derived from thirteen 7-point Likert scale questions from the LEAD survey and sum scores were then ranked into quartiles. Secondary data from the NPHPSP was linked to the LEAD survey; in concordance with NPHPSP scoring methodology, an overall performance score was computed as a simple average of the 10 Essential Public Health Services scores and then ranked into quartiles. “High-capacity” was defined as A-EBP scores in the top quartiles and “low-capacity” defined as scores in the bottom quartiles for both the LEAD survey and the NPHPSP. Leadership Theories in Practice

Three LHDs that were in the top quartile and three from the bottom quartile of both measures were used as case study sites. The 6 sites were selected to provide a variation in geographic dispersion, governance structure and jurisdiction size. A goal of 6–8 interviews was used to achieve content saturation. Previous research shows that meaningful themes can be developed after 6 interviews and saturation is often present with 12 interviews [18]. All of the LHDs that were selected and approached agreed to participate in this research Leadership Theories in Practice