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Understanding Organisational Dynamics

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Leadership in Healthcare

Part of the book series: Organizational Behaviour in Healthcare ((OBHC))

Abstract

Setting objectives and crafting a strategy to achieve them are important facets of the roles of Senior Leaders. Using personal insight as the basis of leadership capability, a leadership identity to reflect on the most appropriate approach, and having professional credibility to ensure the engagement of colleagues in all disciplines and at all levels will provide a foundation on which the organisation’s strategy can be built. However, if strategic objectives are to be translated into practical success, then an understanding of the dynamics of the organisation will also be a factor for consideration. Being able to combine effectiveness in both tangible elements of strategy and operations and the intangibility of organisational culture and its associated complexities may be the difference between leadership success and failure. The many interpretations of the role of the leader and the nature of leadership are one consideration; but how leaders and leadership are impacted by organisational dynamics is another.

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References

  • Abor, P. A., Abekah-Nkrumah, G., & Joshua Abor, J. (2008). An Examination of Hospital Governance in Ghana. Leadership in Health Services, 21(1), 47–60. https://doi.org/10.1108/17511870810845905.

    Article  Google Scholar 

  • Alimpic, Z. (2013). New Growth Platform Framework for Swiss Acute Hospitals – An Empirical Study for the Development of Dynamic Capabilities. Serbian Journal of Management, 8(2), 185–199.

    Article  Google Scholar 

  • Aubry, M., Richer, M., & Lavoie-Tremblay, M. (2014). Governance Performance in Complex Environment: The Case of a Major Transformation in a University Hospital. International Journal of Project Management, 32(8), 1333–1345.

    Article  Google Scholar 

  • Basistic, S., Cerne, M., & Vogel, B. (2017). Just How Multi-Level Is Leadership Research? A Document Co-Citation Analysis 1980–2013 on Leadership Constructs and Outcomes. The Leadership Quarterly, 28(1), 86–103.

    Article  Google Scholar 

  • Baxter, K., Weiss, M., & Grand, J. L. (2008). The Dynamics of Commissioning Across Organisational and Clinical Boundaries. Journal of Health Organization and Management, 22(2), 111–128.

    Article  Google Scholar 

  • Beaulieu, S. A., & Pasquero, J. A. (2002). Reintroducing Stakeholder Dynamics in Stakeholder Thinking. The Journal of Corporate Citizenship, 2002(6), 53. https://doi.org/10.9774/Gleaf.4700.2002.Su.00007.

    Article  Google Scholar 

  • Bentley, M., Freeman, T., Baum, F., & Javanparast, S. (2018). Interprofessional Teamwork in Comprehensive Primary Healthcare Services: Findings from a Mixed Methods Study. Journal of Interprofessional Care, 32(3), 274–283. https://doi.org/10.1080/13561820.2017.1401986.

    Article  Google Scholar 

  • Bish, M., Kenny, A., & Nay, R. (2015). Factors That Influence the Approach to Leadership: Directors of Nursing Working in Rural Health Services. Journal of Nursing Management, 23(3), 380–389. https://doi.org/10.1111/jonm.12146.

    Article  Google Scholar 

  • Bowen, D. J. (2015). Becoming a Nimble Leader: Leading Teams Through Change Requires Agility and Masterful Execution. Healthcare Executive, 30(6), 8.

    Google Scholar 

  • Bowers, L., Nijman, H., Simpson, A., & Jones, J. (2011). The Relationship Between Leadership, Teamworking, Structure, Burnout and Attitude to Patients on Acute Psychiatric Wards. Social Psychiatry and Psychiatric Epidemiology, 46(2), 143–148. https://doi.org/10.1007/s00127-010-0180-8.

    Article  Google Scholar 

  • Bowie, N. (2000). A Kantian Theory of Leadership. The Leadership and Organisation Journal, 21(4), 185–193.

    Article  Google Scholar 

  • Bresnen, M. (2017). Managing Modern Healthcare: Knowledge, Networks and Practice. New York: Routledge.

    Book  Google Scholar 

  • Cacioppe, R. (1997). Leadership Moment by Moment. Leadership and Organisation Development Journal, 18(7), 335–345.

    Article  Google Scholar 

  • Chapman, A. N., Johnson, D., & Kilner, K. (2014). Leadership Styles Used by Senior Medical Leaders. Leadership in Health Services (1751–1879), 27(4), 283. https://doi.org/10.1108/LHS-03-2014-0022.

    Article  Google Scholar 

  • Chelliah, J., Boersma, M., & Klettner, A. (2016). Governance Challenges for Not-for-Profit Organisations: Empirical Evidence in Support of a Contingency Approach. Contemporary Management Research, 12(1), 3–23. https://doi.org/10.7903/Cmr.14538.

    Article  Google Scholar 

  • Donnelly, T. (2017). Leadership: Briefing and Debriefing in the Operating Room. Journal of Perioperative Practice, 27(7), 154–157.

    Article  Google Scholar 

  • Drucker, P. (2006). What Executives Should Remember. Harvard Business Review, 84(2), 144–152.

    Google Scholar 

  • Emslie, S., Oliver, C., & Bruce, J. (2006). Getting Governance Right at Board Level: The Policy Governance Approach to Building Better National Health Service Boards. Clinician in Management, 14(2), 69–77.

    Google Scholar 

  • Ezziane, Z. (2012). The Importance of Clinical Leadership in Twenty First Century Health Care. International Journal of Health Promotion and Education, 50(5), 261–269.

    Article  Google Scholar 

  • Goeschel, C. A., Wachter, R. M., & Pronovost, P. J. (2010). Medical Ethics: Responsibility for Quality Improvement and Patient Safety. Hospital Board and Medical Staff Leadership Challenges. Chest, 138, 171–178. https://doi.org/10.1378/chest.09-2051.

    Article  Google Scholar 

  • Gokce, B., Guney, S., & Katrinli, A. (2014). Does Doctors’ Perception of Hospital Leadership Style and Organizational Culture Influence Their Organizational Commitment? Social Behavior & Personality: An International Journal, 42(9), 1549–1561.

    Article  Google Scholar 

  • Graber, D. R., & Kilpatrick, A. O. (2008). Establishing Values-Based Leadership and Value Systems in Healthcare Organizations. Journal of Health & Human Services Administration, 31(2), 179–197.

    Google Scholar 

  • Grint, K. (2005). Leadership: Limits and Possibilities. Basingstoke: Palgrave Macmillan.

    Book  Google Scholar 

  • Harvey, G., Boaden, R., Kislov, R., Kislov, R., Harvey, G., Boaden, R., et al. (2014). Rethinking Capacity Building for Knowledge Mobilisation: Developing Multilevel Capabilities in Healthcare Organisations. Implementation Science, 9, 166.

    Article  Google Scholar 

  • Heskestad, R. N., Aase, K., & Storm, M. (2016). Inter-Organisational Learning Among Health Care Professionals: A Learning Arena to Address Transitional Care of the Elderly. International Journal of Integrated Care (IJIC), 16(6), 1–3. https://doi.org/10.5334/ijic.2778.

    Article  Google Scholar 

  • Hunt, C. S., Landry, R. T., & Kerr, B. J. (2016). Formal Leaders’ Perceptions of Informal Leaders. Radiology Management, 38(4), 51–57.

    Google Scholar 

  • Jones, A., Lankshear, A., & Kelly, D. (2016). Giving Voice to Quality and Safety Matters at Board Level: A Qualitative Study of the Experiences of Executive Nurses Working in England and Wales. International Journal of Nursing Studies, 59, 169–176. https://doi.org/10.1016/j.ijnurstu.2016.04.007.

    Article  Google Scholar 

  • Jumaa, M. (2008). The ‘F.E.E.L.’ Good Factors in Nursing Leadership at Board Level Through Work-Based Learning. Journal of Nursing Management, 16(8), 992–999. https://doi.org/10.1111/J.1365-2834.2008.00953.X.

    Article  Google Scholar 

  • Kaplan, R. S., & Norton, D. P. (2006). How to Implement a New Strategy Without Disrupting Your Organisation. Harvard Business Review, 84(3), 100–109.

    Google Scholar 

  • Kennedy, N., Armstrong, C., Woodward, O., & Cullen, W. (2015). Primary Care Team Working in Ireland: A Qualitative Exploration of Team Members’ Experiences in a New Primary Care Service. Health & Social Care in the Community, 23(4), 362–370. https://doi.org/10.1111/Hsc.12150.

    Article  Google Scholar 

  • Kilburg, R. R., & Donohue, M. D. (2011). Toward a ‘Grand Unifying Theory’ of Leadership: Implications for Consulting Psychology. Consulting Psychology Journal: Practice and Research, 63(1), 6–25. https://doi.org/10.1037/A0023053.

    Article  Google Scholar 

  • Kim, R. H., Gaukler, G. M., & Lee, C. W. (2016). Improving Healthcare Quality: A Technological and Managerial Innovation Perspective. Technological Forecasting and Social Change, 113(Part B), 373–378. https://doi.org/10.1016/j.techfore.2016.09.012.

    Article  Google Scholar 

  • Klarare, A., Lundh, H. C., Fürst, C. J., & Fossum, B. (2013). Team Interactions in Specialized Palliative Care Teams: A Qualitative Study. Journal of Palliative Medicine, 16(9), 1062. https://doi.org/10.1089/jpm.2012.0622.

    Article  Google Scholar 

  • Kok, M. C., Dieleman, M., Broerse, J. W., Kea, A. Z., Datiko, D. G., Taegtmeyer, M., et al. (2015). A Qualitative Assessment of Health Extension Workers’ Relationships with the Community and Health Sector in Ethiopia: Opportunities for Enhancing Maternal Health Performance. Human Resources for Health, 13, 80.

    Article  Google Scholar 

  • Kotter, J. P. (1996). Leading Change. Boston, MA: Harvard Business Review Press.

    Google Scholar 

  • Kumar, S., Deshmukh, V., & Adhish, V. S. (2014). Building and Leading Teams. Indian Journal of Community Medicine, 39(4), 208–213. https://doi.org/10.4103/0970-0218.143020.

    Article  Google Scholar 

  • Larkin, H. (2015). The New Health Care CEO: In a Rapidly Changing Field, Effective Leaders Require ‘Learning Agility’ and ‘Emotional Intelligence’ as Much–or More–Than Traditional Skills. H&HN Hospitals & Health Networks, 22(6).

    Google Scholar 

  • LeBrasseur, R., Whissell, R., & Ojha, A. (2002). Organisational Learning, Transformational Leadership and Implementation of Continuous Quality Improvement in Canadian Hospitals. Australian Journal of Management (University of New South Wales), 27(2), 141.

    Google Scholar 

  • Lewis, A. (2012). Organisations Adjusting to Change: A Discussion of the Impact of an Improving Access to Psychological Therapies (IAPT) Service on the Organisational Dynamics of an Existing Psychological Therapies Department. Counselling Psychology Review, 27(1), 22–29.

    Google Scholar 

  • Lingard, L., Vanstone, M., Fleming-Carroll, B., Lowe, M., Sinclair, L., Rashotte, J., et al. (2012). Conflicting Messages: Examining the Dynamics of Leadership on Interprofessional Teams. Academic Medicine, 87(12), 1762–1767.

    Article  Google Scholar 

  • Lv, C., & Zhang, L. (2017). Original Article: How Can Collective Leadership Influence the Implementation of Change in Health Care? Chinese Nursing Research, 4, 182–185. https://doi.org/10.1016/j.cnre.2017.10.005.

    Article  Google Scholar 

  • Makan, A., Fekadu, A., Murhar, V., Luitel, N., Kathree, T., Ssebunya, J., et al. (2015). Stakeholder Analysis of the Programme for Improving Mental Health Care (PRIME): Baseline Findings. International Journal of Mental Health Systems, 9(1), 1–12. https://doi.org/10.1186/s13033-015-0020-z.

    Article  Google Scholar 

  • Malik, N., Dhar, R. L., & Handa, S. C. (2016). Authentic Leadership and Its Impact on Creativity of Nursing Staff: A Cross Sectional Questionnaire Survey of Indian Nurses and Their Supervisors. International Journal of Nursing Studies, 63, 28–36.

    Article  Google Scholar 

  • Mannion, R., Davies, H., Jacobs, R., Kasteridis, P., Millar, R., & Freeman, T. (2017). Do Hospital Boards Matter for Better, Safer, Patient Care? Social Science & Medicine, 177, 278–287. https://doi.org/10.1016/j.socscimed.2017.01.045.

    Article  Google Scholar 

  • Martins, F. A., Ferreira-da-Silva, A., & Machado-Santos, C. (2014). Gestão dos Stakeholders na Captação de Recursos nos Hospitais Filantrópicos e Religiosos. RAC – Revista De Administração Contemporânea, 18, 65–85. https://doi.org/10.1590/1982-7849rac20141527.

    Article  Google Scholar 

  • Mastrangelo, A., Eddy, E. R., & Lorenzst, S. J. (2004). The Importance of Personal and Professional Leadership. The Leadership and Organisational Development Journal, 25(5), 435–451.

    Article  Google Scholar 

  • McBride, A. B. (2017). Serving on a Hospital Board: A Case Study. Nursing Outlook, 65, 372–379. https://doi.org/10.1016/j.outlook.2016.12.006.

    Article  Google Scholar 

  • McKimm, J., & Phillips, K. (2009). Leadership and Management in Integrated Services. Exeter: Learning Matters.

    Google Scholar 

  • Meier, N. (2015). Configurations of Leadership Practices in Hospital Units. Journal of Health Organization and Management, 29(7), 1115–1130. https://doi.org/10.1108/JHOM-01-2014-0009.

    Article  Google Scholar 

  • Millar, R., Mannion, R., Freeman, T., & Davies, H. T. (2013). Hospital Board Oversight of Quality and Patient Safety: A Narrative Review and Synthesis of Recent Empirical Research. Milbank Quarterly, 91(4), 738–770. https://doi.org/10.1111/1468-0009.1203.

    Article  Google Scholar 

  • Mishra, A. (2014). ‘Trust and Teamwork Matter’: Community Health Workers’ Experiences in Integrated Service Delivery in India. Global Public Health, 9(8), 960–974. https://doi.org/10.1080/17441692.2014.934877.

    Article  Google Scholar 

  • Mitleton-Kelly, E. (2011). A Complexity Theory Approach to Sustainability: A Longitudinal Study in Two London NHS Hospitals. Learning Organization, 18(1), 45–53.

    Article  Google Scholar 

  • Northouse, P. G. (2016). Leadership, Theory and Practice (7th ed.). Thousand Oaks, CA: Sage Publications Inc.

    Google Scholar 

  • Opollo, J. G., Lloyd-Busby, A., Foreman, K., & Richardson, D. (2014). Nursing Administrative Officer: Transforming Nursing Leadership in Acute-Care Hospitals. Nurse Leader, 12, 84–90. https://doi.org/10.1016/j.mnl.2014.04.005.

    Article  Google Scholar 

  • Pencheon, D. (2015). Mini-Symposium: Making Health Care More Sustainable: The Case of the English NHS. Public Health, 129, 1335–1343. https://doi.org/10.1016/j.puhe.2015.08.010.

    Article  Google Scholar 

  • Pidgeon, K. (2017). The Keys for Success: Leadership Core Competencies. Journal of Trauma Nursing, 24(6), 338–341. https://doi.org/10.1097/JTN.0000000000000322.

    Article  Google Scholar 

  • Porter, M. E., & Teisberg, E. (2006). Redefining Health Care. Boston, MA: Harvard Business School Press.

    Google Scholar 

  • Reichenpfader, U., Carlfjord, S., & Nilsen, P. (2015). Leadership in Evidence-Based Practice: A Systematic Review. Leadership in Health Services, 28(4), 298–316.

    Article  Google Scholar 

  • Rumelt, R. (2011). Good Strategy, Bad Strategy. London: Profile Books.

    Google Scholar 

  • Senge, P. M., Lichtenstein, B. B., Kaeufer, K., Bradbury, H., & Carroll, J. S. (2007). Collaborating for Systemic Change. MIT Sloan Management Review, 48(2), 44–53.

    Google Scholar 

  • Shah, G. H., Sotnikov, S., Leep, C. J., Jiali, Y., & Van Wave, T. W. (2017). Creating a Taxonomy of Local Boards of Health Based on Local Health Departments’ Perspectives. American Journal of Public Health, 107(1), 72–80.

    Article  Google Scholar 

  • Shukri, N. M., & Ramli, A. (2015). Organizational Structure and Performances of Responsible Malaysian Healthcare Providers: A Balanced Scorecard Perspective. Procedia Economics and Finance, 28, 202–212. https://doi.org/10.1016/S2212-5671(15)01101-6.

    Article  Google Scholar 

  • Smits, S. J., Bowden, D., Falconer, J. A., & Strasser, D. C. (2014). Improving Medical Leadership and Teamwork: An Iterative Process. Leadership in Health Services (1751–1879), 27(4), 299–315. https://doi.org/10.1108/LHS-02-2014-0010.

    Article  Google Scholar 

  • Stacey, R. D. (2011). Strategic Management and Organisational Dynamics: The Challenge of Complexity to Ways of Thinking About Organisations. Harlow: Financial Times Prentice Hall.

    Google Scholar 

  • Taplin, S. H., Foster, M. K., & Shortell, S. M. (2013). Organizational Leadership for Building Effective Health Care Teams. Annals of Family Medicine, 11(3), 279–281. https://doi.org/10.1370/afm.1506.

    Article  Google Scholar 

  • Thorpe, R., Gold, J., & Lawler, J. (2011). Locating Distributed Leadership. International Journal of Management Reviews, 13, 239–250. https://doi.org/10.1111/j.1468-2370.2011.00303x.

    Article  Google Scholar 

  • Top, M., Akdere, M., & Tarcan, M. (2015). Examining Transformational Leadership, Job Satisfaction, Organizational Commitment and Organizational Trust in Turkish Hospitals: Public Servants Versus Private Sector Employees. International Journal of Human Resource Management, 26(9), 1259–1282. https://doi.org/10.1080/09585192.2014.939987.

    Article  Google Scholar 

  • Tran, V., & Voyer, B. (2015). Fostering Innovation: An Organisational Perspective. British Journal of Healthcare Management, 21(3), 141.

    Article  Google Scholar 

  • Tsai, Y. (2011). Relationship Between Organizational Culture, Leadership Behavior and Job Satisfaction. BMC Health Services Research, 11, 98.

    Article  Google Scholar 

  • Tsai, T. C., Jha, A. K., Gawande, A. A., Huckman, R. S., Bloom, N., & Sadun, R. (2015). Hospital Board and Management Practices Are Strongly Related to Hospital Performance on Clinical Quality Metrics. Health Affairs, 34(8), 1304–1311.

    Article  Google Scholar 

  • Tuan, L. T. (2012). Clinical Governance: A Lever for Change in Nhan Dan Gia Dinh Hospital in Vietnam. Clinical Governance: An International Journal, 17(3), 223–247. https://doi.org/10.1108/14777271211251345.

    Article  Google Scholar 

  • Uhl-Bien, M., & Arena, M. (2017). Complexity Leadership: Enabling People and Organizations for Adaptability. Organizational Dynamics, 46, 9–20.

    Article  Google Scholar 

  • Valentijn, P. P., Ruwaard, D., Vrijhoef, H. M., de Bont, A., Arends, R. Y., & Bruijnzeels, M. A. (2015). Collaboration Processes and Perceived Effectiveness of Integrated Care Projects in Primary Care: A Longitudinal Mixed-Methods Study. BMC Health Services Research, 15(1), 1–12. https://doi.org/10.1186/s12913-015-1125-4.

    Article  Google Scholar 

  • Valsecchi, R., Wise, S., Mueller, F., & Smith, C. (2012). The Practice of Teamwork in Health Industry Call Centres. Employee Relations, 34(3), 288–305.

    Article  Google Scholar 

  • Vinot, D. (2014). Transforming Hospital Management à la Francaise: The New Role of Clinical Managers in French Public Hospitals. International Journal of Public Sector Management, 27(5), 406–416. https://doi.org/10.1108/IJPSM-06-2012-0067.

    Article  Google Scholar 

  • Walton, A. L., & Mullinix, C. (2016). Increasing the Number of Oncology Nurses Serving on Boards. Clinical Journal of Oncology Nursing, 20(4), 440–442. https://doi.org/10.1188/16.CJON.440-442.

    Article  Google Scholar 

  • Waring, J., & Bishop, S. (2013). McDonaldization or Commercial Re-stratification: Corporatization and the Multimodal Organisation of English Doctors. Social Science & Medicine, 82, 147–155. https://doi.org/10.1016/j.socscimed.2012.12.023.

    Article  Google Scholar 

  • Williams, J. (2016). Effective Team Working to Improve Diabetes Care in Older People. Journal of Diabetes Nursing, 20, 137–141.

    Google Scholar 

  • Wilson Pecci, A. (2014). No Nurses on Your Hospital Board? Why Not? Healthcare Leadership Review, 33(11), 8–9.

    Google Scholar 

  • Yang, J., Liu, Y., Chen, Y., & Pan, X. (2014). Original Article: The Effect of Structural Empowerment and Organizational Commitment on Chinese Nurses’ Job Satisfaction. Applied Nursing Research, 27, 186–191. https://doi.org/10.1016/j.apnr.2013.12.001.

    Article  Google Scholar 

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  1. Leeds Business School, Leeds Beckett University, Leeds, UK

    Paul Turner

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Turner, P. (2019). Understanding Organisational Dynamics. In: Leadership in Healthcare. Organizational Behaviour in Healthcare. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-04387-2_8

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