Health care is a complex and dynamic sector that requires effective and collaborative leadership across different organisations, professions, and levels. Systems leadership is a type of leadership that focuses on creating a shared vision, building relationships, and influencing change across boundaries and systems. Systems leadership is essential for improving the quality, safety, and efficiency of health care services, as well as the outcomes and experiences of patients and staff.
That’s why ONE Dorset Vanguard has developed a systems leadership work stream for health care leaders working in the Dorset region. The systems leadership work stream is a one-year programme that aims to support health care leaders to develop their systems leadership skills, knowledge, and networks, and to undertake a collaborative project relevant to their practice.
The systems leadership work stream is based on the Arbinger Institute model, which focuses on developing and implementing an outward mindset. The programme also combines a facilitated element, action learning sets, coaching, and online resources. The programme also provides access to academic and health care networks, and opportunities for dissemination and publication.
The programme has been evaluated by an independent research team from Bournemouth University, who collected data and feedback from the programme participants, facilitators, and stakeholders about their experiences and views of the systems leadership work stream. The evaluation report provides a detailed analysis of the impact and effectiveness of the systems leadership work stream, as well as recommendations for future development.
The evaluation report highlights some of the positive aspects of the systems leadership work stream, such as:
- The systems leadership work stream aligns with the Developing One NHS in Dorset Principles, which aim to create a culture change to achieve the Vanguard vision, positive working relationships and system leadership capability, mind set shift of shared leadership identity beyond organisational form, and engaged and motivated workforce from all participating organisations.
- The systems leadership work stream results in increased understanding of, and engagement in, effective communication and organisational challenges. The process can be described as transformative in relation to mind-set facilitating participants to develop a greater sense of shared identify and gain additional insight into the challenges faced by other teams and organisations.
- The systems leadership work stream supports inter-organisational working by allowing participants to address difficult conversations and issues more pro-actively with greater appreciation of the perspectives and motives of others. The decision to expand the programme beyond the three acute trusts was key to ensure a whole systems approach and that the benefits of a shared language and collaborative mind set can be fully realised.
- The systems leadership work stream has a personal impact on the participants, who report increased confidence, self-awareness, resilience, motivation, and skills in relation to systems leadership. Participants also report changes in their behaviour and attitude towards their colleagues, teams, organisations, and patients.
- The Arbinger Institute approach and model are considered a particular strength of the programme due to their reflective and interactive nature. Participants value the opportunity to learn from each other’s experiences and challenges, as well as from external facilitators.
The evaluation report also identifies some of the challenges and areas for development of the systems leadership work stream, such as:
- The systems leadership work stream is time and resource intensive, which may limit its scalability and sustainability. If investment is made for further cohorts, consistency should be considered in regards to attendees.
- The systems leadership work stream requires organisational support and commitment for the maximum benefit of the process to be achieved. Participants may face barriers or resistance from their managers or colleagues who are not involved in or supportive of the programme.
- The systems leadership work stream could be further supported by ensuring greater consistency in respect to attendance and organisational or strategic aims. Participants may experience disengagement or frustration if there are changes or conflicts in their organisational priorities or expectations.
- The systems leadership work stream could be enhanced by providing more feedback, support, and guidance to the participants throughout the programme. Participants may benefit from more clarity on the objectives, outcomes, and assessment criteria of the programme.
- The long-term impact of the systems leadership work stream should be evaluated to understand how the behaviours translate to individual teams and organisations, and the degree to which mind-set changes become embedded in practice and on a strategic level. The evaluation report also acknowledges some limitations of the research, such as the small sample size, the use of self-report data, and the need for further research to explore the impact of workforce development initiatives.
