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Ideas for Leaders #725

Spread Innovation Through Shared Leadership

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Key Concept

A new real-world study traces how shared leadership among managers and professionals can ensure that innovation diffuses more widely.

Idea Summary

Innovation can flourish in specific sections or units of an organization or system, but then fail to diffuse more widely. Two University of Warwick professors, Graeme Currie and Dimitrios Spyridonidis, studied the diffusion of 12 promising health care innovations from a citywide R&D unit to hospitals throughout the city. (The city is unnamed in the research.) The English National Health Service (NHS) tasked the R&D unit, called Metro Healthcare Innovation (MHI), to initiate and diffuse health care innovations into everyday practice. 

The results of MHI’s innovation diffusion efforts were mixed: one of the innovations was adopted by only 3 other hospitals; other innovations would be adopted by 4, 6, 9, or 12 other hospitals; in one particularly successful diffusion, the innovation was adopted by 15 other hospitals.

The least successful diffusion occurred with a mental health innovation project (introducing a new community clinic aimed at improving access to mental health). The most successful diffusion involved chronic obstructive pulmonary disease (COPD), for which MHI introduced a new pathway to improve the safe discharge of patients, and improved the patient experience.

Through four years of extensive interviews, observations of meetings and review of official documentation, the researchers observed and analysed the evolving shared leadership dynamics of the 12 diffusion efforts — focusing especially on the COPD innovation to understand how leaders involved with the innovation were able to diffuse it so widely.

With most health care initiatives, three categories of leaders are involved:

  • Doctors, who because of their expertise and knowledge tend to be the most powerful leaders in the system.
  • Nurses, subordinate to doctors and whose leadership influence is more limited to other nurses only — influence that is based on hierarchy.
  • Managers, who attempt to exert leadership influence over doctors and nurses through various mechanisms, such as human resource management and performance management systems as well as their involvement in organizational strategy, business plans, etc. 

In the diffusion of innovation, how does shared leadership among these three categories of leaders evolve? In previous research on innovation leadership, managers are often given an outsized role over professionals (here, the doctors and nurses). In a health care setting, however, doctors, as mentioned above, have the greatest influence. 

Conducted over the last four years of MHI’s program, this research revealed that managers are indeed the more important drivers of innovation diffusion, but only in the early part of the effort. Then the doctors take the lead through their professional influence.

Specifically, the study showed that in successful innovation diffusion occurred in three phases:

Phase 1 (year 1-2 of the study): Managers created the climate for innovation through their initial mandate from NHS; seeking and providing resources from commissions; and implementing educational programmes related to the innovation to get buy-in from hospital chief executives and doctors.

Phase 2 (year 3 of the study): Doctors then took the lead as they facilitated the diffusion of the innovations into other hospitals by promoting the innovations to the city commissioners (thus influencing funding) and presenting the evidence to and educating their peers in other hospitals. Doctors in other hospitals also took a leadership role as they began adapting the innovations to better fit the situation in their hospitals.

While nurses followed the lead of the doctors, they also helped to adapt the innovations to local conditions, and provided valuable help in engaging frontline personnel.

Phase 3 (year 4 of the study): The doctors, still in the lead, focused on building medical networks to diffuse evidence and best practices related to the COPD innovation. Managers sought to provide resources to sustain the innovation but in general ceded leadership to the doctors, and nurses increased their leadership role in the adaptation of the innovation and engagement of nurses and other support staff in their hospitals. 

The COPD innovation diffusion was a resounding success of shared leadership as all three types of leaders played their roles diligently. The researchers note, however, that some other factors beyond shared leadership also played a role in the varying success of the other initiatives, including financial challenges, disengaged nursing corps and less collaborative cultures, the latter which is key to the success of shared leadership.

Business Application

As revealed in this study, shared leadership among managers and professionals is different from hierarchical leadership in three ways:

  • The “who” of leadership: hierarchical leadership is not about the personal attributes and characteristics of senior leaders; shared leadership involves practices enacted by leaders at all levels, although the top leadership role may evolve (e.g., from managers to doctors). 
  • The “what” of leadership: rather than top-down control and command, shared leadership takes place through social interactions among all levels of leaders; followers have a role to play in influencing and creating leadership. 
  • The “how” of leadership: shared leadership works through the skills and abilities of leaders to enable and enhance collective learning. Educating others — commissioners, chief executives, and doctors and nurses in other hospitals – on the merits of the COPD innovation was key.

Innovators trying to diffuse innovations throughout their organization or beyond should look for the leaders with influence who are willing to take on non-hierarchical, multi-level and evolving shared leadership roles in the process. 

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Authors

Institutions

Source

Idea conceived

  • October 2018

Idea posted

  • January 2019

DOI number

10.13007/725

Subject

Real Time Analytics