Post on 31-Dec-2015
description
The Influence of AuthenticLeadership and Empowerment onNew-Graduate Nurses’ Perceptionsof Interprofessional Collaboration
Heather K. Spence Laschinger, RN, PhD, FAAN, FCAHSThe University of Western Ontario
Leslie Marie Smith, MScN, RNThe University of Western Ontario
Collaborating Across Borders (CAB IV)Vancouver, British Columbia
June 12-14, 2013
Background Related literature
Authentic Leadership Empowerment Interprofessional Collaboration
Hypothesized model Aims of the current study Methods Results Conclusions
PRESENTATION OVERVIEW
BACKGROUND
Lack of proper communication and collaboration between healthcare workers is responsible for a high percentage of adverse events (~70%)
New graduate nurses require support from their leaders as they transition to their nurse role
Empowering leadership practices play an important role in establishing work environments that encourage greater teamwork and that empower workers to optimize their practice
The influence of leadership and empowerment on interprofessional collaboration in healthcare has not yet been examined
AUTHENTIC LEADERSHIP(AVOLIO ET AL., 2004))
“…a pattern of transparent and ethical leader behaviour that encourages openness in sharing
information needed to make decisions while accepting input from those who follow.”
(Avolio et al., 2009)
Authentic leadership is linked to empowerment (Laschinger et al., 2012; Zhu et al., 2004)
Authentic leadership consists of: Self-Awareness Relational Transparency Moral/Ethical Behaviour Balanced Information Processing
COMPONENT EXAMPLE BEHAVIOURS
(1) Relational Transparency Says exactly what she/he meansEncourages others to speak-up about
their concerns(2) Moral/Ethical Conduct Acts in accordance with her/his stated beliefs
Uses core values to make decisions(3) Balanced Processing Seeks out opinions that challenge personal views
Takes multiple points of view into consideration (4) Self-Awareness Asks for feedback to improve interpersonal interactions
Understands how her/his actions affect others
AUTHENTIC LEADERSHIP BEHAVIOURS(AVOLIO ET AL., 2004)
STRUCTURAL EMPOWERMENT THEORY(KANTER 1977; 1993)
“…access to organizational structures that enable employees to accomplish their work in meaningful ways…” (Kanter, 1979).
Kanter describes four organizational empowerment structures: Access to information Access to support Access to resources needed to do the job Opportunities to learn and grow
Structural empowerment is linked to: Supportive professional practice environments (Upeneiks, 2003) Co-worker respect (Laschinger, 2004) Nurse-physician collaboration (Faulkner & Laschinger, 2008) Work effectiveness (Laschinger, Wong, McMahon & Kaufmann, 1999)
IPC is a “collaborative practice whereby healthcare workers from different professional backgrounds work together with patients, families, carers, and communities, to deliver the
highest quality of care” (WHO, 2010)
IPC is viewed as critical to patient safety (Zwarrenstein & Bryant, 2000)
IPC has been linked to: Increased job satisfaction, decreased job turnover intent and burnout
(Rafferty et al., 2001)
Greater trust in team members, reduced co-worker conflict and increased knowledge sharing (Gaboury et al., 2011)
INTERPROFESSIONAL COLLABORATION (IPC)
Challenges associated with IPC (Delva et al., 2008; Kenaszchuck et al., 2010; Reeves et al., 2009):
Lack of understanding/valuing of members roles Differing views on collaboration Hierarchical imbalances Poor communication
INTERPROFESSIONAL COLLABORATION (IPC)
AIM OF THE CURRENT STUDY
To test the relationships between leaders’ authentic leadership practices, the degree of structural
empowerment in their work settings and new-graduate nurses’ perceptions of the quality
of IPC on their units.
METHODS AND ANALYSIS
Sample: Data from second wave of longitudinal study: Time 2
= 194Random sample of acute care new graduates (< 2
years)Original sample obtained from provincial
registration database
Data Collection:
Mail survey Modified Dillman Total Design Method (2000) Data were collected in 2010
Data Analysis:
Descriptive and Hierarchical Multiple Regression analyses using SPSS 20.0
• AUTHENTIC LEADERSHIP• The Authentic Leadership Questionnaire (ALQ) (Avolio, Gardner, & Walumbwa,
2007)
• STRUCTURAL EMPOWERMENT• Conditions of Work Effectiveness Questionnaire (CWEQ-11) (Laschinger,
2000)
• INTERPROFESSIONAL COLLABORATION• 6 item newly created scale based on previous research (Kenaszchuck et al.,
2010; Orchard et al., 2005)
MEASURES
Moderate levels of authentic leadership and structural empowerment
High perceptions of overall IPC on work units
DESCRIPTIVE RESULTS
TEST OF HYPOTHESIS
INTERPROFESSIONALCOLLABORATION
AUTHENTIC LEADERSHIP
STRUCTURAL EMPOWERMENT
.29
.29
• Both authentic leadership and empowerment were sig. independent predictors of IPC
Authentic leadership and empowerment explained 9-29% of the variance in 4 out of 5 components of IPC (personal belief that IPC improved patient care = ns)
Both authentic leadership and empowerment are important and may be fundamental organizational resources that positively influence new-graduate nurses’ experiences of IPC on their units
Authentic leaders are well positioned to ensure that new graduates are integrated into interprofessional teams and are seen as valued contributors in the delivery of care
Positive experiences on interprofessional teams are vitally important for new graduates’ future inclinations to collaborate
Experiences of IPC may help ensure that patients benefit from higher quality, less fragmented care
CONCLUSIONS