The cognitive-behavioral system of leadership: cognitive antecedents of active and passive leadership behaviors

Teamwork in Health Care Services Delivery in Nigeria: A Mixed Methods Assessment of Perceptions and Lived Experiences of Pharmacists in a Tertiary Hospital

Background

Lack of teamwork is the bane of weak and ineffective health care systems in many countries. This study examined the perceptions and lived experiences of pharmacists working in a Nigerian government-owned (public) multispecialty tertiary hospital regarding teamwork in their workplace.

Methods

A sequential explanatory mixed methods study using phenomenological approach of inquiry, was conducted among pharmacists with experience in multidisciplinary health care provision in a public tertiary hospital in Nigeria. Questionnaires with 16 close-ended questions based on a Likert scale, which scored from strongly disagree (1) to strongly agree (5), were administered. The mean (M) scores were determined using SPSS Version 20; M ≥ 3.00 indicated agree, while M < 3.00 disagree. Subsequently, focus group discussions were conducted, and the audio recorded responses transcribed and subjected to thematic analysis using NVivo 11.

Results

Some participants (50%) had worked for 5–10 years in the hospital’s Department of Pharmacy, 25% (11–20 years), and 16.7% (21–30 years). Participants agreed that effective teamwork leads to positive patient outcomes (M = 3.67) and is in the public’s interest (M = 4.25). However, they disagreed that their workplace supports teamwork (M = 2.33), effective interprofessional collaborative practices exist in the hospital (M = 1.08), and their remuneration reflects their worth to the organization (M = 2.33). Doctors’ dominance and claim of ownership of patients, allied professionals’ attitudes and ignorance of pharmacists’ roles, salary disparity, poor communication, and defective leadership style among others were identified as impediments to teamwork.

Conclusion

The hospital pharmacists demonstrated positive disposition towards teamwork, and agreed that effective teamwork would improve health care delivery. However, they identified some factors that hinder interprofessional teamwork in the hospital. Principles and practices of teamwork should be incorporated into the curriculum of each discipline; interdisciplinary collaborative practices, health system structure, institutional policies and leadership should be strengthened to enhance teamwork.

How Servant Leadership Leads to Employees' Customer-Oriented Behavior in the Service Industry? A Dual-Mechanism Model

Although servant leadership has been acknowledged as an important predictor of employees’ behavioral outcomes in the service industry, there is still no cohesive understanding of the positive association between servant leadership and employees’ customer-oriented behavior (COB). This research, drawing on cognitive affective processing system theory (CAPS), empirically investigates the influence of servant leadership on employees’ COB by exploring two mediators (i.e., organizational identification and vitality). We conducted two studies in China, using a cross-sectional design to survey employees in service-oriented technical organizations (Study 1) and a time-lagged design to survey hospitality employees with frontline service jobs in star-level hotels (Study 2). Across both samples, we found that servant leadership enhanced employees’ COB by simultaneously increasing their organizational identification and vitality. We discuss the implications of these results for future research and practice.

How do iLead? Validation of a scale measuring active and passive implementation leadership in Swedish healthcare

OBJECTIVES

This study aims to describe the creation of a scale-the iLead scale-through adaptations of existing domain-specific scales that measure active and passive implementation leadership, and to describe the psychometric properties of this scale.

METHODS

Data collected from a leadership intervention were used in this validation study. Respondents were 336 healthcare professionals (90% female and 10% male; mean age 47 years) whose first-line and second-line managers participated in the intervention. The data were collected in the Stockholm regional healthcare organisation that offer primary, psychiatric, rehabilitation and acute hospital care, among other areas. The items for measuring implementation leadership were based on existent research and the full-range leadership model. Confirmatory factor analysis was performed to evaluate the dimensionality of the scale, followed by tests for reliability and convergent, discriminant and criterion-related validity using correlations and multilevel regression analyses.

RESULTS

The final scale consists of 16 items clustered into four subscales representing active implementation leadership, and one scale signifying passive implementation leadership. Findings showed that the hypothesised model had an acceptable model fit (χ²₍₉₉₎=382.864**, Comparative Fit Index=0.935, Tucker-Lewis Index=0.911, root mean square error of approximation=0.059). The internal consistency and convergent, discriminant and criterion-related validity were all satisfactory.

CONCLUSIONS

The iLead scale is a valid measure of implementation leadership and is a tool for understanding how active and passive leader behaviours influence an implementation process. This brief scale may be particularly valuable to apply in training focusing on facilitating implementation, and in evaluating leader training. Moreover, the scale can be useful in evaluating various leader behaviours associated with implementation success or failure.