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Purpose: The purpose of this paper is to review the literature on the response and adaption to change of allied health professionals. Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health-care environments are characterised by frequent and rapid change, often with unrealistic and challenging time frames. Individuals operate independently, but also as members of teams, professions and organisations. Therefore, having a sound understanding of individual response to change is important for change leaders. In the Australian context, allied health professionals represent a quarter of the health-care workforce. There is a significant gap in understanding how allied health professionals respond and adapt to change. Design/methodology/approach: A scoping review was designed to report on the nature and extent of the literature on the response and adaption to change in the context of allied health professionals. Change leaders in the health-care environment face a number of complex challenges when attempting to facilitate change. While this scoping review did not identify any specific literature on the response and adaption to change of allied health professionals, it did however provide information on change models and factors to take into consideration when implementing a change process. Findings: The results of this scoping review identified findings in two main areas with regard to response and adaptation of allied health to change: a review of change management literature at the organisation level and change management for allied health. Most of the literature described organisational level change management without providing a structural framework for change. At the professional individual level, the literature focused on specific clinical interventions, rather than on the response and adaption to change for allied health. Minimal literature was identified in regard to the response and adaption to change of allied health professionals. In an environment characterised by continuous change and policy reform, a greater understanding of the response and adaption to change by allied health is a priority for research, policy and practice. Research limitations/implications: This scoping review was undertaken to explore the response and adaption to change of allied health. It sought to identify the factors that may explain why certain disciplines within the allied health professional group responded to change differently. Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers. However, this scoping review provides a clear indication of the nature and extent of the literature in allied health. Practical implications: Social implications: This scoping review will assist change leaders to gain a better understanding of theoretical frameworks of individual, team and organisational change processes and the impacts these have individually and collectively on change processes. Originality/value: To the best of the authors' knowledge, this scoping review is the first of its kind to identify the minimal literature available on the way allied health professionals respond and adapt to change. [ABSTRACT FROM AUTHOR]

Purpose: This discursive paper presents a lived experience leadership model as developed as part of the Activating Lived Experience Leadership (ALEL) project to increase the recognition and understanding of lived experience leadership in mental health and social sectors. The model of lived experience leadership was formulated through a collaboration between the South Australian Lived Experience Leadership & Advocacy Network and the Mental Health and Suicide Prevention Research and Education Group. Design/methodology/approach: As one of the outcomes of the ALEL research project, this model incorporates findings from a two-year research project in South Australia using participatory action research methodology and cocreation methodology. Focus groups with lived experience leaders, interviews with sector leaders and a national survey of lived experience leaders provided the basis of qualitative data, which was interpreted via an iterative and shared analysis. This work identified intersecting lived experience values, actions, qualities and skills as characteristics of effective lived experience leadership and was visioned and led by lived experience leaders. Findings: The resulting model frames lived experience leadership as a social movement for recognition, inclusion and justice and is composed of six leadership actions: centres lived experience; stands up and speaks out; champions justice; nurtures connected and collective spaces; mobilises strategically; and leads change. Leadership is also guided by the values of integrity, authenticity, mutuality and intersectionality, and the key positionings of staying peer and sharing power. Originality/value: This model is based on innovative primary research, which has been developed to encourage understanding across mental health and social sectors on the work of lived experience leaders in seeking change and the value that they offer for systems transformation. It also offers unique insights to guide reflective learning for the lived experience and consumer movement, workers, clinicians, policymakers and communities. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to extend the consideration of distributed leadership in health-care settings. Leadership is typically studied from the classical notion of the place of single leaders and continues to examine distributed leadership within small teams or horizontally. The purpose is to develop a practical understanding of how distributed leadership may occur vertically, between different layers of the health-care leadership hierarchy, examining its influence on health-care outcomes across two hospitals. Design/methodology/approach: Using semi-structured interviews, data were collected from 107 hospital employees (including executive leadership, clinical management and clinicians) from two hospitals in Australia and the USA. Using thematic content analysis, an iterative process was adopted characterized by alternating between social identity and distributed leadership literature and empirical themes to answer the question of how the practice of distributed leadership influences performance outcomes in hospitals? Findings: The perceived social identities of leadership groups shaped communication and performance both positively and negatively. In one hospital a moderating structure emerged as a leadership dyad, where leadership was distributed vertically between hospital hierarchal layers, observed to overcome communication limitations. Findings suggest dyad creation is an effective mechanism to overcome hospital hierarchy-based communication issues and ameliorate health-care outcomes. Originality/value: The study demonstrates how current leadership development practices that focus on leadership relational and social competencies can benefit from a structural approach to include leadership dyads that can foster these same competencies. This approach could help develop future hospital leaders and in doing so, improve hospital outcomes. [ABSTRACT FROM AUTHOR]

Purpose The paper aims to explore the beliefs of doctors in leadership roles of the concept of “the dark side”, using data collected from interviews carried out with 45 doctors in medical leadership roles across Australia. The paper looks at the beliefs from the perspectives of doctors who are already in leadership roles themselves; to identify potential barriers they might have encountered and to arrive at better-informed strategies to engage more doctors in the leadership of the Australian health system. The research question is: “What are the beliefs of medical leaders that form the key themes or dimensions of the negative perception of the ‘dark side’?”.Design/methodology/approach The paper analysed data from two similar qualitative studies examining medical leadership and engagement in Australia by the same author, in collaboration with other researchers, which used in-depth semi-structured interviews with 45 purposively sampled senior medical leaders in leadership roles across Australia in health services, private and public hospitals, professional associations and health departments. The data were analysed using deductive and inductive approaches through a coding framework based on the interview data and literature review, with all sections of coded data grouped into themes.Findings Medical leaders had four key beliefs about the “dark side” as perceived through the eyes of their own past clinical experience and/or their clinical colleagues. These four beliefs or dimensions of the negative perception colloquially known as “the dark side” are the belief that they lack both managerial and clinical credibility, they have confused identities, they may be in conflict with clinicians, their clinical colleagues lack insight into the complexities of medical leadership and, as a result, doctors are actively discouraged from making the transition from clinical practice to medical leadership roles in the first place.Research limitations/implications This research was conducted within the Western developed-nation setting of Australia and only involved interviews with doctors in medical leadership roles. The findings are therefore limited to the doctors’ own perceptions of themselves based on their past experiences and beliefs. Future research involving doctors who have not chosen to transition to leadership roles, or other health practitioners in other settings, may provide a broader perspective. Also, this research was exploratory and descriptive in nature using qualitative methods, and quantitative research can be carried out in the future to extend this research for statistical generalisation.Practical implications The paper includes implications for health organisations, training providers, medical employers and health departments and describes a multi-prong strategy to address this important issue.Originality/value This paper fulfils an identified need to study the concept of “moving to the dark side” as a negative perception of medical leadership and contributes to the evidence in this under-researched area. This paper has used data from two similar studies, combined together for the first time, with new analysis and coding, looking at the concept of the “dark side” to discover new emergent findings. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to call for strong medical co-leadership in transforming the Australian health system. The paper discusses how Health LEADS Australia, the Australian health leadership framework, offers an opportunity to engage medical clinicians and doctors in the leadership of health services. Design/methodology/approach -- The paper first discusses the nature of medical leadership and its associated challenges. The paper argues that medical leaders have a key role in the design, implementation and evaluation of healthcare reforms, and in translating these reforms for their colleagues. Second, this paper describes the origins and nature of Health LEADS Australia. Third, this paper discusses the importance of the goal of Health LEADS Australia and suggests the evidence-base underpinning the five foci in shaping medical leadership education and professional development. This paper concludes with suggestions on how Health LEADS Australia might be evaluated. Findings -- For the well-being of the Australian health system, doctors need to play an important role in the kind of leadership that makes measurable differences in the retention of clinical professions; improves organisational cultures; enhances the engagement of consumers and their careers; is associated with better patient and public health outcomes; effectively addresses health inequalities; balances cost effectiveness with improved quality and safety; and is sustainable. Originality/value -- This is the first article addressing Health LEADS Australia and medical leadership. Australia is actively engaging in a national approach to health leadership. Discussions about the mechanisms and intentions of this are valuable in both national and global health leadership discourses. [ABSTRACT FROM AUTHOR]

Purpose -- This paper aims to describe the educational philosophy and practice underpinning the Royal Australasian College of Medical Administrators (RACMA) program and how it is aligned with the needs of the Australian and New Zealand health care systems. Preparing future doctors as medical leaders requires keeping pace with developments in medical education and increased sophistication on the part of teaching and supervising faculty. Design/methodology/approach -- This paper is a descriptive case study. The data are complemented by workforce data and excerpts from the RACMA Management and Leadership Curriculum. Findings -- The RACMA has developed a program informed by current best practices in medical education. The educational underpinnings and instructional practices of the RACMA emphasize leadership as a collaborative social process and the importance of relational leadership in successful modern day practice. The ongoing development of the program has a focus on setting of clear learning objectives, regular and continuous feedback to trainees and reflective practice facilitated by the close relationship between trainees and their preceptor. Research limitations/implications -- Although a site-specific case study, the application of relational models of teaching can be applied in other settings. Practical implications -- The application of relational models of teaching can be applied in other settings. Social implications -- This paper fulfils a social need to describe successful competency models used for medical leadership development. Originality/value -- This paper fulfils an identified need to define competency models used as a foundation for medical leadership development. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe a two-part study that has explored the organisational and leadership competencies required for successful service integration within a health consortia in Australia. Preliminary organisational and leadership competency frameworks were developed to serve as reference points as the consortia it expanded to cater for increased service demand in the midst of significant health reform. Design/methodology/approach – The study design is outlined, which involved literature reviews and semi-structured interviews with key stakeholders to ascertain the key determinants of successful service integration at both organisational and leadership levels. Findings – The literature reviews revealed little existing research specifically focused on the organisational and leadership competencies that underpin successful service integration. The themes from the literature reviews and semi-structured interviews informed the preliminary organisational and leadership competency frameworks. Both frameworks are outlined in the paper. Key determinants of successful service integration – at both an organisational and individual leadership level – are also presented. Research limitations/implications – This is a one-organisation case study and the competency frameworks presented are preliminary. However, the study findings provide a foundation for further research focusing on the longer-term success of service integration. Originality/value – Service integration in health is a new and emerging area, and there is little extant research exploring the organisational and leadership competencies underpinning its success. The competency frameworks presented in the paper may be of interest to other consortia and organisations engaged in service integration and other forms of merger and collaboration. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate to what extent an engaging or authentic leadership style is related to higher levels of patient safety performance. Design/methodology/approach – A survey and/or interview of 53 medical and dental staff on their perceptions of leadership style in their unit was conducted. Scores obtained from 51 responses were averaged for each question and overall performance was compared with unit specific hand hygiene (HH) compliance data. Interview material was transcribed and analysed independently by each member of the research team. Findings – A modest negative relationship between this leadership style and hand hygiene compliance rates (r=0.37) was found. Interview data revealed that environmental factors, role modelling by the leader and education to counter false beliefs about hand hygiene and infection control may be more important determinants of patient safety performance in this regard than actual overall leadership style. Research limitations/implications – The sample was relatively small, other attributes of leaders were not investigated. Practical implications – Leadership development for clinicians may need to focus on situational or adaptive capacity rather than a specific style. In the case of improving patient safety through increasing HH compliance, a more directive approach with clear statements backed up by role modelling appears likely to produce better rates. Originality/value – Little is known about patient safety and clinical leadership. Much of the current focus is on developing transformational, authentic or engaging style. This study provides some evidence that it should not be used exclusively. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to identify the domains of performance needed by leaders in aged and community care not-for-profit organisations. Design/methodology/approach – Focus groups and individual interviews were conducted with senior managers employed by faith-based aged and community care not-for-profit organisations, academics in ageing and business fields and senior government employees from aged services departments and agencies in Australia. Results were content transcribed and analysed thematically in order to identify the major themes that emerged. Findings – A total of 37 people participated in the study. The domains of performance identified by participants as required of leaders in aged and community care were: professionalism; collaboration and teamwork; judgement and decision making; communication; scholarship and teaching; management; advocacy; and leadership. The performance requirements that were identified for leaders in aged and community care not-for-profit organisations were broader than just leadership per se. Research limitations/implications – The findings of this study suggest that the aged and community care not-for-profit sector has specific requirements for the performance of its leaders. Leadership is one of a number of performance attributes desirable in leaders in this sector. Practical implications – The aged and community care not-for-profit sector has distinctive needs and specific requirements of its leaders. Originality/value – It is recommended that a broad range of performance attributes are taken into account by aged and community care not-for-profit organisations when recruiting and training staff in leadership positions. [ABSTRACT FROM AUTHOR]

Purpose: The themes that emerged from the qualitative data of a mixed methods study that explored the effects of leadership style on the job satisfaction of aged care workers. Design/methodology/approach: The study is a mixed methods study with the qualitative approach informing the interpretative phenomenological analysis from the transcripts of semi-structured interviews. Findings: Three themes related to the effects of leadership style on job satisfaction of aged care employees emerged from the IPA. These themes were, The Context of Aged Care, Employee Engagement and Voice and Leader Behaviour. Job burnout and organisational disengagement were prevalent in participants of the qualitative study. Research limitations/implications: The research deployed quantitative measurements to determine the differences between aged care leaders and their followers and used these to explore participants' lived experiences and how they made sense of their personal and social worlds at work. In the quantitative study, there may be an overstatement of the strength of the relationship between variables among those motivated to participate in the study. The qualitative study requires the researcher to be thorough in describing the research context, and it may be that those who wish to transfer the results of this study to a different one are responsible for making the judgement on the suitability of the transferability of findings. Practical implications: Decreasing job disengagement and burnout will positively impact reducing attrition and turnover and, thus, the availability of the aged care workforce. It will inform leadership development programs and training in aged care and other health and social care sectors. Social implications: The workforce is a primary consideration for aged care in Australia and globally. Reducing burnout and disengagement will reduce workforce attrition, thus, improving the care for some of the most vulnerable in the population. Originality/value: This report is from original research with ethical clearance from a university human research ethics committee contributing to the knowledge of leadership practice in aged care in Australia. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to demonstrate how service providers, service users and their families should be able to share the co-leadership, co-auspicing, co-ownership, and co-governance, of a the mental health-care ecosystem, at every level, as it develops upwards and wider, in a process of inclusivity, conviviality and polyphonic discourse, via the overlapping phases of co-creativity, codesign, co-production, co-delivery, co-evaluation, co-research and co-replication, to achieve outcomes of co-communal or organisational well-being. Design/methodology/approach: "Co-design" is shorthand code for encouraging multiple pathways and trajectories toward forming and sustaining a sparkling web or vibrant network of inclusive opportunities for stakeholder participation and a collaborative partnership in organizational development, in these circumstances, for more effective mental health services (MHSs). Findings: In a co-design framework, all partners should be entitled to expect and "to have and to hold" an ongoing equal stake, voice and power in the discourse from start to finish, in a bottom-up process which is fostered by an interdisciplinary leadership group, providing the strong foundation or nutrient-rich and well-watered soil and support from which a shared endeavor can grow, blossom and generate the desired fruit in ample quality and quantity. Originality/value: The authors should be working toward co-design and co-production of contemporary MHSs in a mental health-care ecosystem. [ABSTRACT FROM AUTHOR]

Purpose: Globally, private and public organisations invest ever increasing amounts of money, time and effort to develop leadership capabilities in current and future leaders. Whilst such investment results in benefits for some, the full value of developmental strategies on offer is not always realised. Challenges inhibiting achievement of full value include struggling to identify learning programs that best fit with the organisational structure, culture, mission and vision and difficulties in maximising engagement of personnel at multiple levels of the management structure. Design/methodology/approach: The purpose of this study is to introduce a pathway for health services to develop and embed simulation-based educational strategies that provide targeted learning for leaders and teams. Aligning this approach to leadership development through presentation of case studies in which the model has been applied illustrates the pathway for application in the health-care sector. Findings: The findings of the approach to leadership development are presented through the presentation of a case study illustrating application of the ADELIS model to simulation-based learning. Practical implications: The ADELIS model, outlined in this study, provides a guide for creating customised and flexible learning designs that apply simulation-based learning, enabling organisations to develop and provide leadership training for individuals, units and teams that is appropriately fit for purpose. Originality/value: The key contribution to health-care leadership development offered in this study is the rationale for using simulation-based learning accompanied by a model and pathway for creating such a pedagogical approach, which embraces the reality of workplace circumstances. [ABSTRACT FROM AUTHOR]

Purpose – Crisis-prone organizations are reactive and unprepared, and are characterized by deficiencies in damage containment mechanisms (DCMs), which are tools and processes intended to prevent and/or manage crises. In the literature, DCMs are usually studied piecemeal and have not been studied in health organizations in a broader organizational context. Thus, this study aims to identify the use of DCMs and the frequency with which they are inspected, maintained and reviewed for design flaws. Design/methodology/approach – Data were obtained by questionnaire from decision-making executives in hospitals, medical centers, aged care, pharmacies, dental clinics and practices in physiotherapy, chiropractic and podiatry. Findings – Heavy reliance was placed on planning and technological DCMs while human and social methods were typically not considered. Organizations considered limited crisis types and there was a disconnect between the types of DCMs and the crises they targeted. Over half the organizations reviewed DCMs annually or more frequently. Backup DCMs mostly consisted of on-call staff and first responders with some auxiliary communications systems. Interviewees stated that these were designed to prevent financial, equipment breakdown, human resource and occupational safety crises. Originality/value – Most organizations had inadequate DCMs due to a lack of top-down support, planning and foresight. Furthermore, these health organizations demonstrated a lack of understanding of what DCMs are and how they function. The conclusion is that most of the health organizations surveyed are crisis-prone and health leaders need to put more effort into looking broadly at DCMs to improve organizational preparedness. [ABSTRACT FROM AUTHOR]

Purpose Leadership, and leadership development, in health and human services is essential. This review aims to draw conclusions from practice within the Australian context.Design/methodology/approach This review is an overview of health leadership development in Australia, with a particular focus on the implementation of the national health leadership framework, Health LEADS Australia (HLA).Findings Since its inception, the HLA has influenced the development of health leadership frameworks across the Australian states and territories. Both the National Health Leadership Collaboration and individuals with “boundary-spanning” roles across state government and the university sector have contributed to the development of collaborative online communities of practice and professional networks. Innovation has also been evident as the HLA has been incorporated into existing academic curricula and new professional development offerings. Ideas associated with distributed leadership, integral to the HLA, underpin both sets of actions.Practical implications The concept of a national health leadership framework has been implemented in different ways across jurisdictions. The range of alternative strategies (both collaborative and innovative) undertaken by Australian practitioners provide lessons for practice elsewhere.Originality/value This article adds to the body of knowledge associated with policy implementation and provides practical recommendations for the development and promotion of health leadership development programmes. [ABSTRACT FROM AUTHOR]

Purpose – Corporate culture is a product of managerial mindset and it consists of obscured, undisclosed and unconditionally accepted assumptions that underlie corporate behaviour. This study seeks to investigate the extent of corporate mindset since it is a causal factor in crises. Design/methodology/approach – Data were obtained by questionnaire from decision-making executives in hospitals, medical centres, aged care, pharmacies, dental clinics and practices in physiotherapy, chiropractic and podiatry. Findings – Organizations were judged to be in a state of medium disavowal concerning their belief that the impact of any crisis would be small. Around two thirds of participants indicated that the general mind-set of organizations contributes to effective crisis management, and that a welcoming attitude would prevail in the event of the implementation of a organization-wide, systems-wide, crisis management program. With regard to denial mechanisms or beliefs that hinder effective crisis management, two-thirds indicated inactive/passive resistance and one-third indicated active/aggressive resistance. The reasons for resistance were apathy, anti-change, and concern about cost. Originality/value – Cultural opposition to crisis preparedness varies significantly between organizations and poses a major barrier to effective crisis management. This study empowers health leaders by identifying several mindset changes that are required to create crisis-resilient health organisations. [ABSTRACT FROM AUTHOR]