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Can shared leadership enhance clinical team management? A systematic review

Lisa Aufegger (Department of Surgery and Cancer, Patient Safety Translational Research Centre, Imperial College London, London, UK)
Omair Shariq (Department of Surgery and Cancer, Patient Safety Translational Research Centre, Imperial College London, London, UK)
Colin Bicknell (Department of Surgery and Cancer, Patient Safety Translational Research Centre, Imperial College London, London, UK)
Hutan Ashrafian (Department of Surgery and Cancer, Patient Safety Translational Research Centre, Imperial College London, London, UK)
Ara Darzi (Department of Surgery and Cancer, Patient Safety Translational Research Centre, Imperial College London, London, UK)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 21 March 2019

Issue publication date: 4 April 2019

2786

Abstract

Purpose

Research in psychology or management science has shown that shared leadership (SL) enhances information sharing, fosters participation and empowers team members within the decision-making processes, ultimately improving the quality of performance outcomes. Little has been done and, thus, less is known of the value and use of SL in acute healthcare teams. The purpose of this study is to (1) explore, identify and critically assess patterns and behaviour of SL in acute healthcare teams; and (2) evaluate to what extent SL may benefit and accomplish safer care in acute patient treatment and healthcare delivery.

Design/methodology/approach

The authors conducted a review that followed the PRISMA-P reporting guidelines. A variety of sources were searched in April 2018 for studies containing primary research that focused on SL in acute healthcare teams. The outcome of interest was a well-specified assessment of SL, and an evaluation of the extent SL may enhance team performance, lead to safer patient care and healthcare delivery in acute healthcare teams.

Findings

After the study selection process, 11 out of 1,383 studies were included in the review. Studies used a qualitative, quantitative or mixed-methods approach. Emerging themes based on behavioural observations that contributed to SL were: shared mental model; social support and situational awareness; and psychological safety. High-performing teams showed more SL behaviour, teams with less seniority displayed more traditional leadership styles and SL was associated with increased team satisfaction.

Research limitations/implications

Evidence to date suggests that SL may be of benefit to improve performance outcomes in acute healthcare team settings. However, the discrepancy of SL assessments within existing studies and their small sample sizes highlights the need for a large, good quality randomized controlled trial to validate this indication.

Originality/value

Although studies have acknowledged the relevance of SL in healthcare service and delivery, a systematic, evidence-based and robust evaluation of behavioural patterns and the benefits of SL in this field is still missing.

Keywords

Acknowledgements

The work was funded by the NIHR Patient Safety Translational Research Centre. The authors declare that they have no other conflicts of interest to disclose.

Citation

Aufegger, L., Shariq, O., Bicknell, C., Ashrafian, H. and Darzi, A. (2019), "Can shared leadership enhance clinical team management? A systematic review", Leadership in Health Services, Vol. 32 No. 2, pp. 309-335. https://doi.org/10.1108/LHS-06-2018-0033

Publisher

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Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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