Lessons learned in promoting evidence-based public health: Perspectives from managers in state public health departments

Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders\u27 role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners

Challenges in the implementation of measurement feedback systems

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Liderazgo Ético en la Toma de Decisiones Administrativas: Impacto en la Cultura Organizacional y en la Satisfacción de los Empleados

Globalization and the current social and economic crisis have impacted companies, leading some to close due to inadequate management. Ethical success is essential for a sustainable organization, as management decisions influence strategic direction, organizational culture and employee perceptions. Ethical leaders set the standards of conduct in the organization and their decisions have an impact on society. The purpose of this research was to conduct a systematic study on ethical leadership in managerial decision making. The corresponding bibliographic information was searched in indexed databases such as Scopus Science Direct and Scielo, both of which provide a high level of research quality. Subsequently, six (6) research papers detailing the importance of ethical leadership as a significant factor in employee satisfaction were selected. The results indicate that organizations can benefit from cultivating leadership that prioritizes ethical values, which in turn can contribute to greater job satisfaction and improved organizational performance. It is concluded that ethical companies have competitive advantages and distinct areas to achieve success and competitiveness, with diverse personnel in personality and values.La globalización y la actual crisis social y económica han impactado en las empresas, llevando a algunas a cerrar debido a una inadecuada gestión. El éxito ético es esencial para una organización sostenible, ya que las decisiones administrativas influyen en la dirección estratégica, la cultura organizacional y la percepción de los empleados. Los líderes éticos fundamentan los estándares de conducta en la organización y sus decisiones tienen impactos en la sociedad. Mediante la presente investigación se buscó realizar un estudio sistemático sobre el liderazgo ético en la toma de decisiones administrativas. Se hizo una búsqueda de información bibliográfica correspondiente en bases de datos indexadas como Scopus Science Direct y Scielo, las mismas que prevalecen un alto nivel de calidad a la investigación. Posteriormente, se seleccionaron seis (6) trabajos investigativos que detallan la importancia del liderazgo ético como un factor significativo en la satisfacción de los empleados. Los resultados indican que las organizaciones pueden beneficiarse al cultivar un liderazgo que priorice los valores éticos, lo que a su vez puede contribuir a una mayor satisfacción laboral y un mejor desempeño organizacional. Se concluye que las empresas éticas tienen ventajas competitivas y áreas distintas para lograr éxito y competitividad, con personal diverso en personalidad y valores

Testing of the Nursing Evidence‐Based Practice Survey

BackgroundClinicians’ knowledge and skills for evidence‐based practice (EBP) and organizational climate are important for science‐based care. There is scant literature regarding aligning organizational culture with EBP implementation and even less for unit and organizational culture. The Nursing EBP Survey examines individual, unit, and organizational factors to better understand registered nurses’ (RN) self‐reported EBP.AimsEstablish and confirm factor loading, reliability, and discriminant validity for the untested Nursing EBP Survey.MethodsThe study employed a descriptive cross‐sectional survey design and was targeted for RNs. The setting included 14 hospitals and 680 medical offices in Southern California. The 1999 instrument consisted of 22 items; 7 items were added in 2005 for 29 items. The questionnaire used a 5 point, Likert‐type scale. The survey website opened in November 2016 and closed after 23 weeks. Psychometric testing and factor determination used parallel analysis, exploratory factor analysis, confirmatory factor analysis (CFA), and ANOVA post hoc comparisons.ResultsOne thousand one hundred and eighty‐one RNs completed the survey. All factor loadings in the CFA model were positive and significant (p < .001). All standardized loadings ranged from .70 to .94. The covariance estimate between Factor 1 and Factor 2 was marginally significant (p = .07). All other covariances and error variances were significant (p < .001). Final factor names were Practice Climate (Factor 1), Data Collection (Factor 2), Evidence Appraisal (Factor 3), Implementation (Factor 4), and Access to Evidence (Factor 5). Four of 5 factors showed significant differences between education levels (p < .05 level). All factors showed significant differences (p < .05) between inpatient and ambulatory staff, with higher scores for inpatient settings.Linking Evidence to ActionNurses’ knowledge, attitudes, and skills for EBP vary. The 2019 Nursing EBP survey offers RNs direction to plan and support improvement in evidence‐based outcomes and tailors future EBP initiatives.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154968/1/wvn12432.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154968/2/wvn12432_am.pd

Getting Things Done, Virtually! - The Role of Virtual Team Leadership in Virtual Team Effectiveness

A virtual team’s success depends on the team's effectiveness. Accomplishing such a team’s effectiveness is far more difficult when compared with traditional work teams. This article is a result of an exploratory study of the role of leadership in virtual teams. Virtual teams’ leadership is seemingly situational and supervisory, depending on the task. This study reveals that (1) individual virtual team members act as leaders based on the specific requirements for getting things done, (2) classifies virtual team leadership under supervisory and facilitating leadership, (3) suggests that both leadership roles are essential for virtual team effectiveness and functioning and (4) recommends exploration of leadership-oriented communication competency, shared understanding and virtual team citizenship behaviour as these are required for the effective performance of a virtual team

Components of impactful dementia training for general hospital staff: a collective case study

Background and objectives: People with dementia occupy around one quarter of general hospital beds, with concerns consistently raised about care quality. Improving workforce knowledge, skills and attitudes is a mechanism for addressing this. However little is known about effective ways of training healthcare staff about dementia. This study aimed to understand models of dementia training most likely to lead to improved practice and better care experiences for people with dementia, and to understand barriers and facilitators to implementation. Method: A collective case study was conducted in three National Health Service Acute Hospital Trusts in England. Multiple data sources were used including interviews with training leads/facilitators, ward managers and staff who had attended training; satisfaction surveys with patients with dementia and/or carers; and observations of care using Dementia Care Mapping. Results: Interactive face-to-face training designed for general hospital staff was valued. Simulation and experiential learning methods were felt to be beneficial by some staff and stressful and distressing by others. Skilled delivery by an experienced and enthusiastic facilitator was identified as important. Staff identified learning and practice changes made following their training. However, observations revealed not all staff had the knowledge, attitudes and skills needed to deliver good care. Patient and carer satisfaction with care was mixed. A major barrier to training implementation was lack of resources. Supportive managers, organisational culture and strong leadership were key facilitators. Conclusion: Dementia training can lead to improved care practices. There are a range of key barriers and facilitators to implementation that must be considered

Leading implementation in health and social care : the line manager in the spotlight

Background: Health and social care organizations are frequently undergoing changes intended to improve quality of care and are expected to implement practices based on the best available evidence. However, about two-thirds of all implementation efforts fail. This has resulted in the well-known evidence-practice gap that means patients and clients may not receive the best possible care. Leadership is critical for implementation success. Implementation science and leadership research suggest that implementation is a structured process that requires certain leadership actions, which should be performed in an active and engaging way to increase the likelihood of implementation success. Line managers’ play a key role in facilitating implementation processes because they are usually responsible for implementing and directly overseeing implementation efforts. Yet what line managers’ do and how they can lead implementation is not well understood. Aim: The overall aim of this thesis is to increase the knowledge of line managers’ leadership during implementation. More specifically, this thesis explores leadership from the line manager perspective (Study I and Study III) and from the employee perspective (Study III), and validates a scale used to measure implementation leadership from line managers’ and employees’ perspective (Study IV). This thesis also investigates how context influences line managers in leading implementation (Study II). Methods: Multiple designs and data collection methods were used in this thesis. Study I and Study II, which were conducted in social care, used a cross-sectional qualitative design in which data were collected using semi-structured interviews. These studies explored how line managers’ describe their actions when leading implementation (Study I) and how context influences them in this process (Study II). Study I uses the “Phases of an Implementation” and Study II the “Consolidated Framework for Implementation Research” frameworks from implementation science to analyse the data. Study III and Study IV were conducted in health care. Study III used a longitudinal design and data were collected using web-based questionnaires administered to line managers and employees at three time points (at pre-, and post-intervention, and at a six-month follow-up). This study investigated agreement between line managers and their employees’ for general leadership behaviours. Study IV was a validation study that used a cross-sectional design. Data were collected from web-based questionnaires distributed to employees. The leadership theory, “Full-Range Leadership Model”, was used in both Study III and Study IV to measure leadership. Findings: Study I found that line managers described their implementation leadership as a rather ad hoc, unstructured process in which they were active in some phases while passive in others. They were most active in informing and preparing their employees for an implementation when a decision had been made on which effort to implement. The line managers’ were most passive in performing an analysis of needs prior to an implementation decision and in following up the process in the later phases of an implementation. Study II found that many factors in the inner and outer context influenced line managers’ implementation leadership. These contextual factors include support from the closest manager and senior management, social interactions (networks and internal communications), opportunities to improve knowledge and skills, and opportunities to apply for project funding. However, not all factors, when available, had an impact on the managers’ implementation leadership. One explanation for this was that an interaction between factors was often needed to have a positive impact (e.g., project funding from actors in the outer context only had an impact if a positive and supportive climate existed in the inner context). Study III found a disagreement between line managers’ self-ratings and their employees’ ratings of the managers’ leadership. The managers rated their leadership either more positive (higher) or less positive (lower) than their employees. A leadership intervention aimed at improving implementation leadership led to greater agreement at unit level. Study IV found that the iLead scale showed good psychometric properties and can be used to measure active and passive implementation leadership. Conclusions: Line managers could benefit from being cognizant of implementation as a structured process that requires strategic thinking. Training interventions that develop managers’ knowledge and skills may be supportive in how to most effectively lead implementation. It should be acknowledged, however, that line managers’ task in leading implementation need to align with all other challenging managerial activities that they perform daily. Furthermore, feedback on line managers’ leadership behaviours that includes their employees’ perspective can help managers become more aware of their leadership behaviours and thus become more effective leaders. The iLead scale is a valid scale that can be used to measure managers’ active and passive implementation leadership from both their own and employees’ perspective. Finally, line managers need support in leading implementation and are influenced by various contextual factors. Yet the contextual factors that provide support are complex, various, and often overlapping. A one-size-fits-all support does not exist. Each line manager’s situation should be considered in its entirety when tailoring individual manager support

Predicting Implementation Citizenship Behavior Rating Discrepancies Between Supervisor-Subordinate Dyads

Organizational citizenship behavior (OCB), defined as behavior that is discretionary and not directly or explicitly recognized by the formal reward system, has gained significant interest in the literature over the past few decades. Recent OCB research has begun to address more specialized facets of citizenship behavior that target behaviors that support specific strategic goals in the organization. One form of OCB encompasses those behaviors that assist with the implementation of new practices or innovations in the organization, above and beyond typical implementation. This study extends both the general OCB literature and the newer literature on implementation citizenship by examining factors that predict the agreement between employee self-ratings and their supervisor\u27s ratings of their implementation citizenship behavior. Demographic and contextual variables were examined as possible predictors of more or less agreement. Based on data from 400 substance use treatment providers under 70 supervisors, the results did not find support for the hypotheses. However, supplemental results did provide some new insights, such as the tendency for ratings to become more or less variable as a result of the study predictors. Implications and directions for future research are discussed

Private Hospital’s Analysis Based on Physician and Non-Physician Differences in Leadership

Hospital performance metrics are an indicator of leadership performance. However, there is inadequate research on whether physician or nonphysician chief executive officers (CEOs) perform better in the private hospitals of Pakistan. The purpose of this study was to examine which type of leaders is better. Leadership trait, situational leadership, and leadership behavior theories constituted the theoretical foundation. The key research question examined the relationship between a hospital’s outcomes, which in this study, included hospital net income, patient experience ratings, and mortality rates, and the type of CEO in that hospital: physician or non-physician. A quantitative, causal comparative design was used to answer this question. Three hypotheses were tested using multivariate analysis of variance. The dependent variable was hospital outcomes: hospital net income, patient experience ratings, and mortality rates. The independent variable was the type of hospital CEO: physician and nonphysician. A sample of 60 private hospitals was drawn from private hospitals based on number of staffed beds (n = 60). No significant differences were found between nonphysician and physician CEOs on hospitals’ net income (p = .911), patient experience ratings (p = .166), or mortality rates (p = .636). Thus, the null hypotheses were retained. Findings suggest that physician and non-physician CEOs may produce similar outcomes in the hospitals they lead. Based on these findings, hospital boards can view CEO applicants equally when considering whom to hire and understanding private hospital leadership