Using an implementation science approach to build leader facilitation capability in healthcare: a novel approach for enhancing action learning set facilitation

PURPOSE

The study describes the implementation of a novel strategy, entitled the Action Learning Set Facilitation Model, to develop internal facilitation capability to lead change. The Model incorporated the Novice-Experienced-Expert pathway, a facilitation development approach underpinning the integrated-Promoting Action on Research Implementation in Health Services Implementation Framework, with action learning methodology.

DESIGN/METHODOLOGY/APPROACH

A mixed-methods descriptive approach reports the results of 22 interviews, 182 Action Learning Sets and 159 post program survey data sets to explore facilitator experiences, strengths and potential application of the Model.

FINDINGS

At program completion, five novice (of 174) and one experienced (of 27) facilitator transitioned to the next facilitation level. The three groups of facilitators described positive change in confidence and facilitation skill, and experience of action learning sets. Inconsistencies between self-report competence and observed practice amongst novices was reported. Novices had decreasing exposure to the Model due to factors related to ongoing organisational change. Internal facilitators were considered trusted and credible facilitators.

RESEARCH LIMITATIONS/IMPLICATIONS

There are practical and resource implications in investing in internal facilitation capability, noting proposed and real benefits of similar development programs may be compromised during, or as a consequence of organisational change. Further research describing application of the facilitation model, strategies to enhance multisystemic support for programs and evaluation support are suggested.

PRACTICAL IMPLICATIONS

The Action Learning Set Facilitation Model offers promise in developing internal facilitation capability supporting change in organisations. Critical success factors include building broad scale internal capability, stable leadership and longitudinal support to embed practice.

ORIGINALITY/VALUE

This is the first application of the facilitation component of the integrated-Promoting Action on Research Implementation in Health Services implementation framework embedded to action learning sets as an implementation science strategy for leader development supporting organisational change.

A Prescription for Resilience: Evaluating a Measure of Leader Resilience in Hospital Pharmacy Departments

OBJECTIVE

Globally, leaders require strategies to sustain the performance and well-being of themselves and their teams while managing and adapting to uncertainty, workplace turbulence, and high job demands. This study evaluates the Resilience at Work Leader 180 Scale assessing leader behaviors that either promote or detract from resilience in others.

METHOD

Study participants comprised Australian pharmacy employees (N = 80) in two groups made up of the senior leadership team (n = 10) and their direct report employees (n = 70). A mixed-methods design was employed using a directed content analysis.

RESULTS

Results indicate that the Resilience at Work Leader 180 Scale provides insight into leader behaviors that foster or detract from employee resilience.

CONCLUSION

This scale is of value to researchers and organizations interested in a measure of leader resilience.

Managing Complex Healthcare Change: A Qualitative Exploration of Current Practice in New South Wales, Australia

PURPOSE

As the cost of healthcare continues to rise, healthcare organizations internationally are seeking long-term solutions to eradicate inefficiency, achieve value-based healthcare, and minimize hospital inpatient services. This requires transformational change in healthcare organizations, and associated change management and leadership capability at multiple levels. Despite the critical need for effective change leadership and management in healthcare, limited evidence exists that this currently occurs in addition to the capability and capacity for managing change in health systems.

METHODS

Semi-structured interviews were undertaken with 16 healthcare managers and leaders at a range of levels in nine healthcare organizations across the public health system of one Australian state (New South Wales), including metropolitan, regional and rural geographical areas. Thematic content analysis was undertaken with the emergent data.

RESULTS

Four key themes emerged from the data: 1) lack of adoption of frameworks and methods for change management for any scope or scale of change, 2) inadequate resources for delivering, managing and leading change, 3) insufficient leadership, capacity and capability in managing change, and 4) the need for support and culture that supports change at all levels of the system.

CONCLUSION

Ensuring dedicated resources for change and sufficient capacity and capability amongst health professionals and managers at every level in a health system are required for effective management of change. An enabling culture for change, supported by adequate education and training in change leadership and management are critical in order for the benefits of health service and system changes to be realised.