Shared Leadership

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Implementation of Shared Leadership:
A Strategy to Improve Outcomes
Capstone Project Paper
Deb Colshan
Allen College

Implementation of Shared Leadership: A Strategy to Improve Outcomes Abstract
Healthcare has become complex and competitive forcing hospitals to find alternative methods to make care safer and more efficient. Because of overcrowding and workload, emergency departments often experience large staff turnover, low patient satisfaction scores, and a negative image within their community. Reversal of this trend may occur by implementing a shared leadership governing structure. Successful implementation of shared leadership empowers the front line staff to accept ownership of the department driving them to strive to make changes in the care environment that improve patient care. This article describes how one emergency department implemented a shared leadership governing structure to empower the staff to become problem solvers and change agents. Preliminary data collected supports the premise that shared leadership and decision making positively affects the care environment.

Implementation of Shared Leadership: A Strategy to Improve Outcomes Introduction
St. Luke’s emergency department has had an extended history of poor staff morale, large turnover rates (staff and management), low patient satisfaction scores, and a negative image within our hospital and the community. One strategy other successful hospitals are using to overcome these obstacles is to empower the staff to become problem solvers and change agents by implementation of a shared leadership governance structure. This structure allows many decisions to be made at the point of care by the staff members performing the care. Research suggests that implementation of shared leadership will improve the patient care environment and appears promising to re-vitalize the emergency department (Ellis & Gates, 2005). Implementation of shared leadership is a journey with many challenges. Complete implementation demonstrates promise to improve patient outcomes and satisfaction as well as retention of nursing personnel (Armstrong & Laschinger, 2006). This journey will be without challenge and difficulty, but by keeping the product within our line of vision, success will occur. Problem Statement with Rationale

The implementation of shared leadership and decision-making, a technique that places decision making at the front line staff level, allows for rapid changes and improvements to be made within the patient care environment. Implementation of changes that are staff driven will improve staff satisfaction by reducing redundancies and delays in care. The improvement in the care delivery environment will result in the emergency department being a desired place to work and receive care. Analyzing the results from this change in leadership style, I expect to see a reduction in staff turnover, improvement in patient satisfaction scores and an increased market share secondary to an improved image of the department. Literature Review

Shared leadership fosters a positive work environment that is vital to attract and retain nursing staff while improving patient outcomes (Upenieks, 2003; Brady-Schwartz, 2005: Golanowski, Beaudry, Kurz, Laffey, & Hook, 2007). Moore and Hutchison (2007) define shared leadership as staff having a voice and being involved in decision-making. By empowering staff, employees increase their feelings of respect and trust in management. All of these qualities lead to improvement in the work environment and that has a positive effect on patient outcomes. Engaged staff stay employed at an institution further elevating the positive effects on the care environment. Upenieks and Sitterding (2008) identify that challenges will occur within the shared leadership journey but will be “embraced by frontline nurses who are inspired to identify and make differences in their complex adaptive healthcare environment” (p. 427). Project Summary...
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