Transforming community services through the use of a multidimensional model of clinical leadership.

AIMS AND OBJECTIVES: To evaluate the application of a Multidimensional Model of Clinical Leadership on the community healthcare leader and on transforming community services. BACKGROUND: Healthcare policy advocates clinical leadership as the vehicle to transform community and healthcare services. Few studies have identified the key components of an effective clinical leadership development model. DESIGN: The first two stages of Kirkpatrick's (Personnel Administrator 28, 1983, 62) Four/Five Levels of Evaluation were used to evaluate the application of the multidimensional model of clinical leadership. METHODS: Eighty community healthcare leaders were exposed to this multidimensional clinical leadership development model through attendance of a community clinical leadership development programme. Twenty five leaders participated in focus group interviews. Data from the interviews were analysed utilising thematic content analysis. RESULTS: Three key themes emerged that influenced the development of best practice principles for clinical leadership development: 1. Personal leadership development 2. Organisational leadership 3. The importance of multiprofessional action learning/reflective groups CONCLUSIONS: Emergent best practice principles for clinical leadership development include adopting a multidimensional development approach. This approach encompasses: preparing the individual leader in the role and seeking organisational leadership development that promotes the vision and corporate values of the organisation and delivers on service improvement and innovation. Moreover, application of the Multidimensional Model of Clinical Leadership could offer the best platform for embedding the Six C's of Nursing (Compassion in Practice - Our Culture of Compassionate Care, Department of Health, Crown Copyright, 2012) within the culture of the healthcare organisation: care, compassion, courage, commitment, communication, and competency. This is achieved in part through the application of emotional intelligence to understand self and to develop the personal integrity of the healthcare leader and through supporting a culture of lifelong leadership learning. RELEVANCE TO CLINICAL PRACTICE: Embedding the best practice principles of clinical leadership development within a multidimensional model of clinical leadership provides a promising approach to: equipping the healthcare leader with those transferable leadership skills required to help them embark on a journey of lifelong leadership learning; and producing the healthcare leader who is caring, compassionate and can confidently and effectively transform community services.

Creating an organizational infrastructure to develop and support new nursing roles--a framework for debate.

AIM: This paper offers for debate a framework that will promote an effective organizational infrastructure when developing and supporting new nursing roles. The framework identifies key systems that need to work effectively in isolation but also clearly integrate to ensure a joined up approach to organizational thinking and working. A working example of how the infrastructure could be initiated in practice utilizing the concept of developing an Advanced Practitioner role is offered. BACKGROUND: The National Health Service has set out a modernization agenda to deliver consistent and high quality care to patients. However, often underpinning government vision and philosophy is the need for trust strategies to make real and operationalize recommendations made. It is against this background of government targets and change in the National Health Service that new nursing roles are created, which require an effective organizational infrastructure if they are to survive, let alone succeed. The government seems to be recognizing that lessons could be learned when developing new roles in the National Health Service by acknowledging the key themes identified from the earlier literature on the development and impact of new roles in nursing. KEY ISSUES: In reality, each of the key systems identified as part of the framework is very complex, particularly in large organizations. However, the framework proposed offers a simplified and user-friendly approach to this complex subject. There is no suggestion that organizations do not have the systems in place but what is often missing is the underpinning communications to link the systems together. Although, this paper relates to nursing roles the framework is transferable to all health care practitioners and organizations. CONCLUSION: Whilst supporting new roles, the framework presented offers a wider dimension for enhancing organizational thinking and working practices. It is open to debate, which would be welcomed by the authors, yet provides a challenge to health care organizations in assessing how integrated their systems are in meeting its business, aspirations and new targets.

What is the future of the lecturer practitioner role-a decade on?

Collaboration between the Greater Manchester Workforce Development Confederation, the University of Salford and nine NHS Trusts, in the implementation of the Fitness for Practice and Making a Difference recommendations, identified the need for a wider co nsultation on the future of education and practice links. Lessons learned from this initiative included a realization of the importance of partnering arrangements between higher education and practice. To achieve a collaborative model for the future a wo rking party was established to determine how effective partnership and collaboration between the NHS Trusts, Confederation and Higher Education could be developed, maintained and disseminated for the future. Five sub groups were formed from the main work ing party all charged with examining education and practice links. Each sub group reported back and presented evidence to the main working party. It was recognized that a whole repertoire of roles spanning education and practice would be required, includ ing the role of lecturer practitioner and joint appointments. The aim of this paper is to report on the work of the lecturer practitioner and joint appointment roles sub group, its evaluation of the evidence to support the role within the collaborative m odel and offer proposed actions for future practice.