Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

International Journal of Health Policy and Management, Vol. 5(8), Pp. 477–486, 2016

10 Pages Posted: 20 Jul 2016

See all articles by Malin Tistad

Malin Tistad

School of Education, Health and Social Studies, Dalarna University, Falun, Sweden

Susanne Palmcrantz

Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden

Lars Wallin

Dalarna University

Anna Ehrenberg

School of Education, Health and Social Studies, Dalarna University, Falun, Sweden

Christina B. Olsson

Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden

Göran Tomson

Karolinska Institutet

Lotta Widén Holmqvist

Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden

Wendy Gifford

Faculty of Health Sciences, School of Nursing, University of Ottawa

Ann Catrine Eldh

School of Education, Health and Social Studies, Dalarna University, Falun, Sweden

Date Written: April 11, 2016

Abstract

Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a fourmonth leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations.

Keywords: Evidence-Based Practice (EBP), Facilitation, Implementation, Leadership, Management, Stroke Rehabilitation

Suggested Citation

Tistad, Malin and Palmcrantz, Susanne and Wallin, Lars and Ehrenberg, Anna and Olsson, Christina B. and Tomson, Göran and Holmqvist, Lotta Widén and Gifford, Wendy and Eldh, Ann Catrine, Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness (April 11, 2016). International Journal of Health Policy and Management, Vol. 5(8), Pp. 477–486, 2016, Available at SSRN: https://ssrn.com/abstract=2811498

Malin Tistad (Contact Author)

School of Education, Health and Social Studies, Dalarna University, Falun, Sweden ( email )

SE-788 81 Borlange
United States

Susanne Palmcrantz

Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ( email )

Granits väg 4
Section for Integrative Physiology
Solna, Stockholm 17171
Sweden

Lars Wallin

Dalarna University ( email )

SE-788 81 Borlange
United States

Anna Ehrenberg

School of Education, Health and Social Studies, Dalarna University, Falun, Sweden ( email )

SE-788 81 Borlange
United States

Christina B. Olsson

Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ( email )

Granits väg 4
Section for Integrative Physiology
Solna, Stockholm 17171
Sweden

Göran Tomson

Karolinska Institutet ( email )

Granits väg 4
Section for Integrative Physiology
Solna, Stockholm 17171
Sweden

Lotta Widén Holmqvist

Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ( email )

Granits väg 4
Section for Integrative Physiology
Solna, Stockholm 17171
Sweden

Wendy Gifford

Faculty of Health Sciences, School of Nursing, University of Ottawa ( email )

2292 Edwin Crescent
Ottawa, Ontario K2C 1H7
Canada

Ann Catrine Eldh

School of Education, Health and Social Studies, Dalarna University, Falun, Sweden ( email )

SE-788 81 Borlange
United States

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