Implementing Clinical Guidelines for the Treatment of Psychosis: The Frontline Leaders' Point of View. A Qualitative Study.

Background: Despite the large amount of leadership and implementation theories and recommendations, healthcare services continue to struggle with efficiently incorporating new knowledge. The questioning of conventional leadership approaches in healthcare organizations prompted us to investigate how frontline leaders comprehend their own implementation intentions and actions, and how these intentions and actions may impact the implementation of clinical guidelines in mental healthcare in Norway. Methods: Employing a theory-driven qualitative design, we conducted nine semi-structured interviews with frontline leaders who had recently led implementation of clinical guidelines for the treatment of psychosis in mental health. We employed Systematic Text Condensation, informed by Normalization Process Theory, to structure and analyze the data and used fidelity scales to measure the degree of implementation and distinguish between leaders' levels of success in implementation. Results: Frontline leaders in units that achieved high success in implementation described their intentions and actions differently, from those with less success. The former group's actions aligned more closely with the constructs of the Normalization Process Theory compared to the latter group when describing their actions. Frontline leaders leading units with a high degree of implementation success describe relation-orientation, trust, and providing adaptive space for staff members to take initiative. In contrast, those leading units with less implementation success describe more control and guidance of co-operators and place more emphasize on information and knowledge. Conclusion: Differences in how frontline leaders describe their actions and intentions to achieve clinical guideline implementation suggest that the leadership approach of these frontline leaders is an important factor to consider when planning and conducting implementation. To better understand the implementation process, it is important to pay attention to how frontline leaders customize their leadership approaches to the dynamics of complex organizations, and how they interact with their team and superiors.

Safety voice climate: A psychometric evaluation and validation.

INTRODUCTION: Speaking up about safety issues, termed "safety voice," is a proactive response where people across all levels of the organization express their concerns to prevent physical hazards. An understanding of safety voice requires insight into its antecedents. A perceived need to fit in with the organization and fear of consequences can trump the courage to speak out about safety concerns. Safety voice climate can be seen as a manifestation of the social exchanges in an organization and functions as a roadmap of which speaking out behaviors are encouraged and which behaviors are not. This study conceptualizes safety voice climate, presents the Safety Voice Climate Scale (SVCS) as a measurement tool, and gathers initial evidence for its validity. The study also assesses the associations between the SVCS and safety voice behavior. METHOD: The SVCS and the measurement of safety voice behavior were derived from the Trends in Risk Level in the Norwegian Petroleum Activity questionnaire. The SVCS includes the two theoretical dimensions Work colleagues' encouragement of safety voice and Leaders' attitudes towards safety voice. Psychometric properties were tested with a representative sample from the Norwegian petroleum sector (n = 7,624). RESULTS: Confirmatory factor analyses supported the proposed two-factor model, and the internal consistency of the factors was good. Furthermore, a structural equation model including the SVCS as predictors of safety voice behavior showed a good fit, indicating acceptable criterion validity, although only the Work colleagues' encouragement of safety voice variable was significantly associated with safety voice behavior. Conclusion and practical application: The SVCS can be used as a tool to detect some of the barriers and supporting elements relating to safety voice and guidance on the efforts needed to foster work climates that promote communication of safety issues.

Psychosocial safety climate as a predictor of work engagement, creativity, innovation, and work performance: A case study of software engineers.

Introduction: Creativity is vital for competitive advantage within technological environments facing the fourth industrial revolution. However, existing research on creativity has rarely addressed how a climate beneficial for worker psychological health, a psychosocial safety climate (PSC), could additionally stimulate the growth of workplace creativity, innovation, and performance in digital environments. Method: To examine how individually perceived PSC influences subsequent work engagement promoting higher levels of computer-based radical and incremental creativity, innovation, and work performance, employees in a software engineering firm (N = 29, 86 observations) completed a weekly questionnaire for 4 consecutive weeks. Results: At the between-person level PSC was positively related to average future weekly individual fluctuations of creativity (radical and incremental), work engagement, and job performance. Additionally weekly work engagement was related to future creativity (radical and incremental). Work engagement also mediated the between-person relationship between PSC and future creativity (both radical and incremental). PSC did not predict innovation. Discussion: This study contributes to the theory on PSC, creativity, and work performance by elucidating the individual perceived PSC-creativity relationship and suggesting PSC systems as meaningful antecedents to digital work performance.

Frontline leadership for implementing clinical guidelines in Norwegian mental health services: a qualitative study.

PURPOSE: The purpose of this study was to explore and interpret how frontline leaders define, experience and rationalise their approaches to the successful implementation of clinical guidelines in mental health care. DESIGN/METHODOLOGY/APPROACH: Employing an interpretative phenomenological design, the authors conducted and analysed individual interviews of frontline leaders at 14 psychiatric clinics involved in a national study of implementing evidence-based clinical guidelines in mental health. FINDINGS: The authors found a broad spectrum of attitudes and attributes, as well as a wide repertoire of strategies for frontline implementation leadership. Three main approaches were revealed, comprising "Curious and welcoming", "Integrity and setting standards" and "Caring and collegial". RESEARCH LIMITATIONS/IMPLICATIONS: The study present what experienced frontline leaders emphasise to enable implementation of guidelines, not empirical pieces of evidences for what they in fact do or if these actions lead to implementation. The generalisability to other settings is unknown. Another sample profile, context or organisational level may have impacted the result. The concreteness of the frontline leaders' considerations, approaches and actions gives important knowledge about frontline leaders leadership across traditional leadership theories. ORIGINALITY/VALUE: Existing leadership theories describe different leadership styles, while this study reveals the need for a wide range of approaches to balance the many needs and demands. The complexity of leadership approaches this study found is in line with implementation theories; thus, the present study incorporates implementation science into the leadership literature.

The occurrences and correlates of bullying and harassment in the restaurant sector.

The aim of this study was to explore the occurrence of bullying in the restaurant sector and its potential consequences. The sample consisted of 207 superiors and employees in 70 restaurants. The findings indicated that bullying prevails in the restaurant industry, with apprentices as a risk group. Bullying was negatively related to job satisfaction, commitment, employees' perceptions of creative behavior, and external evaluations of restaurant creativity level, and positively related to burnout and intention to leave the job. Some support was found for a mediation hypothesis, where bullying was the predictor, job satisfaction, commitment and burnout were mediators, and intention to leave was dependent variable. One implication of this study is that there is a need to challenge the attitude, common in this sector, that aggression and bullying is a natural and even necessary part of the work environment.

Climate for work group creativity and innovation: Norwegian validation of the team climate inventory (TCI).

The present study assessed the psychometric properties and the validity of the Norwegian translation of the Team Climate Inventory (TCI). The TCI is a measure of climate for innovation within groups at work and is based on the four-factor theory of climate for innovation (West, 1990). Cronbach's alpha revealed satisfactory reliabilities and exploratory factor analysis successfully extracted the four original factors as well as a fifth factor that has also been reported in other studies (N = 195 teams from a wide range of professions). Results from confirmatory factor analysis, using a different sample (N = 106 teams from the Norwegian public postal service), suggested that the five-factor solution had the most parsimonious fit. Criterion validity was explored by correlating TCI scores from 92 post offices and 395 postal distribution teams with customer satisfaction scores. Significant positive relationships were found between three of four TCI scales and customer satisfaction.