Human-centred leadership in health care: A contemporary nursing leadership theory generated via constructivist grounded theory.

AIM: To generate a unique and contemporary leadership theory reflecting the essence of nursing within a complex health care environment. BACKGROUND: As health care faces unprecedented change and increasing complexity, a nursing leadership theory embedded within complexity science is vital for teams to be innovative, nimble and focused on human-centred care. METHODS: Constructivist grounded theory framed exploration of human issues embedded in nursing leadership. The constructivist approach sought thematic and theoretical sensitivity through the rich co-creative experience of participants, researchers, literature and data. Focus groups were convened over 18 months with 39 nurse leaders from bedside to boardroom. RESULTS: Constant comparative methods resulted in 15 attributes. Advanced coding positioned the 15 attributes into constructs: Awakener, Connector and Upholder. Definitions emerged through the constructivist process organically connecting attributes and constructs to the potential outcomes identified in the theory as cultures of excellence, trust and caring. CONCLUSIONS: The final constructivist process revealed a nursing-specific theory: human-centred leadership in health care uniquely suited to assist leaders in addressing structure, process and outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Efforts by nurse leaders to test the theory with metrics related to nursing excellence will result in validation of the theory and validation of the proposed sustained culture change.

Human-Centered Leadership in Health Care: An Idea That's Time Has Come.

The Human-Centered Leadership model, which is relevant for leaders at all levels in a complex health care system, embraces change from the inside out. The Human-Centered Leader (HCL) is embedded in the organization, rather than positioned above it, and recognizes the expertise and value of those who serve at the point of care. The HCL starts with a focus on self-awareness, self-compassion, self-care, and mindfulness while focusing on others through demonstration of the characteristics of an Awakener, a Connector, and an Upholder. As an Awakener, the HCL grows and cultivates the team through the development of individual growth plans and staff empowerment in decision making. The result is a professionally prepared workforce that delivers market-leading patient outcomes. The HCL, as a Connector, builds the community in the microsystem by creating a healthy work environment. Finally, as an Upholder, the HCL recognizes the humanity in others and brings out the best in them. Demonstration of sincere care for those who care for patients results in improved staff satisfaction and, in turn, exceptional patient experience. The sustainable changes resulting from Human-Centered Leadership are realized through development of Cultures of Excellence, Trust, and Caring.

Clinical Nurse Leader Knowledge Production to Quality Improvement in a Seamless Trajectory: A Participatory Research Approach.

BACKGROUND: Health systems are actively implementing Clinical Nurse Leader (CNL)-integrated care delivery across the United States. PROBLEM: However, the CNL model is a complex health care intervention, making it difficult to generate evidence of effectiveness using traditional research frameworks. APPROACH: Participatory research is a growing alternative to traditional research frameworks, emphasizing partnership with target community members in all phases of research activities. This article describes a system-based participatory study that leveraged academic and practice knowledge to conduct research that was feasible and relevant, and which produced findings that were easily translated into systematic action by the health system. OUTCOMES: Study data were used to produce improvements in the health system's CNL onboarding process, role differentiation, performance, recruitment, and growth plus development. CONCLUSIONS: A participatory approach can be used in future CNL studies, providing a framework for research efforts and potentially speeding up CNL evidence generation and utilization in practice.