Return on investment in healthcare leadership development programs

The Development of Leadership Communities of Practice: Utilizing the ADKAR Framework

This paper introduces the concept of leadership communities of practice (COP) as a strategy to enhance succession planning and leadership development within the Canadian healthcare context. Drawing upon Prosci's ADKAR methodology as a foundational change management framework, this paper explores the adaptation of COP, originally developed by Lave and Wenger in 1991, to foster collaborative learning. While COP have a long history in business and education sectors, their formal integration into healthcare, specifically leadership development is relatively recent. This paper highlights the necessity of a robust change management approach to effectively introduce COP as a mechanism to enhance leadership development in healthcare settings, highlighting their potential to facilitate knowledge exchange and support social learning among healthcare leaders.

Engaging the collective voice of physicians: Optimizing participation in research and policy development in the context of COVID-19 and physician burnout

Physicians and governments work collaboratively to determine optimal healthcare policy options. Physicians are also engaged by health researchers to participate in studies. Physician engagement can be impeded by limits on physician time and remuneration for engagement, and the impact of physician burnout (exacerbated by COVID-19). Doctors Nova Scotia engaged physicians on various research and policy items throughout the pandemic. Strategies included integrating physicians into research teams, remunerating engagement activities, and leveraging existing tools and networks. Health researchers and policy-makers can improve physician engagement through physician champions, reduction of research duplication, valuing of physician contributions, and integrating networks.

How is return on investment from quality improvement programmes conceptualised by mental healthcare leaders and why: a qualitative study

BACKGROUND

Return on Investment (ROI), whereby the ratio of costs to benefits is assessed, is encouraged in-order to justify the value of Quality Improvement (QI) programmes. We previously performed a literature review to develop a ROI conceptual framework for QI programmes. We concluded that, QI-ROI is conceptualised as any monetary and non-monetary benefit. In the current study, we explored if this finding is shared by mental healthcare leaders. We also investigated the stability of this conceptualisation against influencing factors and potential for disinvestment.

METHODS

We performed qualitative interviews with leaders in an NHS mental health organisation. There were 16 participants: nine board members and seven senior leaders. The interviews were held online via Microsoft Teams and lasted an hour on average. We performed deductive-inductive analysis to seek data from our initial ROI framework and any new data.

RESULTS

We found that in mental healthcare, QI-ROI is also conceptualised as any valued monetary and non-monetary benefits. There was a strong emphasis on benefits to external partners and a de-emphasis of benefit monetisation. This conceptualisation was influenced by the 1) perceived mandates to improve quality and manage scarce resources, 2) expectations from QI, 3) health and social care values, 4) ambiguity over expectations, and 5) uncertainty over outcomes. Uncertainty, ambiguity, and potential for disinvestment posed a threat to the stability of this conceptualisation but did not ultimately change it. Health and social care values supported maintaining the QI-ROI as any benefit, with a focus on patients and staff outcomes. Socio-political desires to improve quality were strong drivers for QI investment.

CONCLUSION

Mental healthcare leaders primarily conceptualise QI-ROI as any valued benefit. The inclusion of externalised outcomes which are hard to attribute may be challenging. However, mental healthcare services do collaborate with external partners. The de-emphases of benefit monetisation may also be controversial due to the need for financial accountability. Mental healthcare leaders recognise the importance of efficiency savings. However, they raised concerns over the legitimacy and utility of traditional ROI as a tool for assessing QI value. Further research is needed to bring more clarity on these aspects of the QI-ROI concept.

The evaluation of health care leadership development programmes: a scoping review of reviews

PURPOSE

The purpose of this paper is to report a scoping review of reviews which investigated HLDP evaluations to determine: how the conceptualisation of leadership development programmes (HLDPs), and despite growing calls for robust evaluations of their pedagogic design, delivery and effectiveness, there are concerns regarding the quality of data associated with their evaluation. This scoping review of reviews investigated the reporting of HLDP evaluations to determine: how the conceptualisation of leadership underpinning HLDPs influence their evaluation; how the pedagogical approaches within HLDPs influence their evaluation; and the evaluation designs and measures used to assess HLDPs.

DESIGN/METHODOLOGY/APPROACH

The scoping review was conducted on reviews of HLDPs. Searches were performed on four databases and on the grey literature. Data were extracted and a narrative synthesis was developed.

FINDINGS

Thirty-one papers were included in the scoping review of reviews. A great deal of heterogeneity in HLDPs was identified. Evaluations of HLDPs were affected by poor data quality, and there were limitations in the evidence about "what works". Leadership was conceptualised in different ways across HLDPs, and consequently, there was a lack of consistency as to what is being evaluated and the methods used to assess HLDPs.

ORIGINALITY/VALUE

This review of reviews summarises the current evidence on the evaluation of HLDPs. Evaluations of HLDPs need to explicitly account for the complexity of health systems, how this complexity impacts on the development and articulation of leadership practice, and how the underlying conceptualisation of leadership and the associated theory of change articulate a set of assumptions about how HLDPs support leaders to affect change within complex systems.

Evaluation of a leadership development impact assessment toolkit: a comparative case study of experts' perspectives in three Canadian provinces

PURPOSE

This paper aims to explore users' perceptions of whether the Leadership Development Impact Assessment (LDI) Toolkit is valid, reliable, simple to use and cost-effective as a guide to its quality improvement.

DESIGN/METHODOLOGY/APPROACH

The Canadian Health Leadership Network codesigned and codeveloped the LDI Toolkit as a theory-driven and evidence-informed resource that aims to assist health-care organizational development practitioners to evaluate various programs at five levels of impact: reaction, learning, application, impact and return on investment (ROI) and intangible benefits. A comparative evaluative case study was conducted using online questionnaires and semistructured telephone interviews with three health organizations where robust leadership development programs were in place. A total of seven leadership consultants and specialists participated from three Canadian provinces. Data were analyzed sequentially in two stages involving descriptive statistical analysis augmented with a qualitative content analysis of key themes.

FINDINGS

Users perceived the toolkit as cost-effective in terms of direct costs, indirect costs and intangibles; they found it easy-to-use in terms of clarity, logic and structure, ease of navigation with a coherent layout; and they assessed the sources of the evidence-informed tools and guides as appropriate. Users rated the toolkit highly on their perceptions of its validity and reliability. The analysis also informed the refinement of the toolkit.

ORIGINALITY/VALUE

The refined LDI Toolkit is a comprehensive online collection of various tools to support health organizations to evaluate the leadership development investments effectively and efficiently at five impact levels including ROI.

Attitudes and Perceptions of Health Leaders for the Quality Enhancement of Workforce in Saudi Arabia

BACKGROUND AND AIM

Besides the unique exposure and experience of health leaders in facing challenges and overcoming them, and the relatively fewer articles relating to the perception of health leaders in workforce quality enhancement, health leadership plays a crucial role in redirecting the workforce, increasing job satisfaction, professional development, and burnout prevention. Thus, this study aimed to understand the current healthcare workforce quality and future expectations from the attitudes and perceptions of health leaders.

METHODS

A qualitative research was carried out using semi-structured interviews consisting of 24 different questions. Participants of the study were healthcare leaders from different backgrounds and governmental institutions. All interviews were recorded, transcribed, and then analyzed using thematic analysis via the N-Vivo program.

RESULTS

Eleven participants were involved in the study, with one female and ten males. A thematic analysis and N-Vivo program yielded 5 main themes: (1) workforce competency, (2) health transformation, (3) leadership, (4) workforce planning, and (5) healthcare quality, with 22 emerging sub-themes. Moreover, participants responded with different attitudes and perceptions.

CONCLUSION

Health leaders are satisfied with the current direction of workforce competency and planning, yet fragmentation of the system and poor accessibility may need further enhancement. Furthermore, misutilization of services and the uncertainty of the future and talent pool are potential barriers for capability building. Moreover, with the existing gap in the workforce, health leaders believe that privatization and corporatization may have a positive effect. Aside from that, Saudization with the current plan of having a minimum standard of accepting non-Saudis in certain areas might benefit in maintaining competition and enriching experience. However, catching up with further research in healthcare quality in Saudi Arabia is needed because of the ongoing health transformation.

If philosophers went on a leadership course: A (serious) farce in three Acts

Leadership development is big business, with business schools and private providers offering leadership development programmes claimed to help turn managers into wise, good and able leaders. Leadership development originated in philosophy and, in the Western tradition, dates back at least as far as Socrates. This article asks: how would philosophers qua wisdom-lovers [philo-sophes] respond to contemporary programmes? We use the dramatic licence offered by theatre to imagine Foucault, Butler, Kant, Hume and others participating in a leadership training course. As our play opens, we find them critiquing a 360-degree psychometric assessment instrument they have been asked to complete. Our highly select group argue it solicits docile, servile supplicants to the interests of neoliberal capitalism. They offer an alternative containing key questions putative leaders should explore. The script includes other dramatis personnae and a Chorus (the authors of this paper). Speeches and programme notes provide the necessary bones of an academic paper, such as literature reviews and philosophical contexts. We ask colleagues to join with us in reconnecting leadership development to its philosophical roots in an effort to foster wiser and more ethical leadership.