Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Building capacity for change: evaluation of an organisation-wide leadership development program

Tim Schultz A C , Jodie Shoobridge A , Gill Harvey A , Libby Carter B and Alison Kitson A
+ Author Affiliations
- Author Affiliations

A Adelaide Nursing School, Adelaide Health and Medical Sciences Building, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia. Email: jodie.shoobridge@adelaide.edu.au; gillian.harvey@adelaide.edu.au; alison.kitson@adelaide.edu.au

B Northern Adelaide Local Health Network, Lyell McEwen Hospital, Haydown Road, Elizabeth Vale, SA 5112, Australia. Email: libby.carter@sa.gov.au

C Corresponding author. Email: tim.schultz@adelaide.edu.au

Australian Health Review 43(3) 335-344 https://doi.org/10.1071/AH17158
Submitted: 6 July 2017  Accepted: 25 January 2018   Published: 23 May 2018

Abstract

Objective This study evaluated Leading 4 Change, a change leadership development program designed to support healthcare middle managers through a period of significant organisational change and enhance workplace resilience.

Methods A mixed methods evaluation was conducted within the program’s framework of a quality improvement activity. Quantitative measures were participant responses (n = 160) to online questionnaires, which were compared before and after the program, using an uncontrolled pre-post study design. Four questionnaires were used: Resilience @ Work, General Self-Efficacy, the 11-item Learning Organization Survey and organisational climate. Differences between the pre- and post-program periods were compared using linear mixed-effects models, incorporating repeated measures between ‘pre’ and ‘post’ periods. Qualitative data were obtained by interviewing four participants on three occasions during the program, and through text responses provided by participants during a presentation session after the program finished. Both interview data and textual data were subjected to thematic analysis.

Results Integration of data from quantitative and qualitative analyses generated three main findings: (1) participants were satisfied and engaged with the program, which met their learning objectives; (2) the program led to increased workplace resilience, in particular the ability to manage stress and self-efficacy for individuals; and (3) organisational learning perceptions were unchanged.

Conclusion Although conducted during a period of intense internal and external pressure, Leading 4 Change led to demonstrable effects. It effectively engaged middle managers across a health system. However, there was no evidence that the effect of the program extended beyond individual participants to their perceptions of their work environment as a learning organisation.

What is known about the topic? Although much has been written about change management and change leadership within healthcare, the failure to manage the ‘people’ element and engage employees hampers the success of that change. However, how to engage employees and enhance their resilience and self-efficacy (self-belief to proactively manage) during change has been little explored. Further, the concept of a learning organisation has been developed in private, non-healthcare fields and there is little known about it in other areas, such as healthcare, particularly during change.

What does this paper add? The paper describes the evaluation of a 16-week change leadership development program (Leading 4 Change) for middle managers of a public health system undergoing significant reform. It assesses how the program engaged employees, and how and to what extent their workplace resilience, self-efficacy and perceptions of their workplace as a learning organisation changed after the program. Based on the present study, individual development of staff does not necessarily translate directly to better staff perceptions of organisational outcomes.

What are the implications for practitioners? Despite being clearly engaged with Leading 4 Change, quantitative and qualitative measures suggested mixed effects of the program on participants. Participants’ self-rated workplace resilience, ability to manage stress and self-efficacy increased after the program. However, there was no evidence that the effect of the program improved staff perceptions of their work as a learning organisation. For complex public sector healthcare organisations to become learning organisations, other organisational factors, in addition to staff development and training, require consideration.


References

[1]  Viitala R. Leadership in transformation: a longitudinal study in a nursing organization. J Health Organ Manag 2014; 28 602–18.
Leadership in transformation: a longitudinal study in a nursing organization.Crossref | GoogleScholarGoogle Scholar |

[2]  SA Health. Delivering Transforming Health – proposals paper: meeting the clinical standard. Adelaide, SA, Australia: South Australian Government; 2014.

[3]  Dhensa-Kahlon R, Coyle-Shapiro J. Anticipatory (in)justice and organizational change: understanding employee reactions to change. In: Oreg S, Michel A, By RT, editors. The psychology of organizational change: viewing change from the employee’s perspective. Cambridge, UK: Cambridge University Press; 2013. pp. 173–94.

[4]  Cannon MD, Edmondson AC. Failing to learn and learning to fail (intelligently). Long Range Plann 2005; 38 299–319.
Failing to learn and learning to fail (intelligently).Crossref | GoogleScholarGoogle Scholar |

[5]  Senge PM. The fifth discipline: the art and practice of the learning organization. New York, NY, USA: Currency Doubleday; 2006.

[6]  Singer SJ, Moore SC, Meterko M, Williams S. Development of a short-form Learning Organization Survey: the LOS-27. Med Care Res Rev 2012; 69 432–59.
Development of a short-form Learning Organization Survey: the LOS-27.Crossref | GoogleScholarGoogle Scholar |

[7]  Winwood PC, Colon R, McEwen K. A practical measure of workplace resilience: developing the resilience at work scale. J Occup Environ Med 2013; 55 1205–12.
A practical measure of workplace resilience: developing the resilience at work scale.Crossref | GoogleScholarGoogle Scholar |

[8]  Robertson IT, Cooper CL, Sarkar M, Curran T. Resilience training in the workplace from 2003–2014: a systematic review. J Occup Organ Psychol 2015; 88 533–62.
Resilience training in the workplace from 2003–2014: a systematic review.Crossref | GoogleScholarGoogle Scholar |

[9]  Luszczynska A, Scholz U, Schwarzer R. The general self-efficacy scale: multicultural validation studies. J Psychol 2005; 139 439–57.
The general self-efficacy scale: multicultural validation studies.Crossref | GoogleScholarGoogle Scholar |

[10]  Schwarzer R, Jerusalem M. Generalized Self-Efficacy scale. In: Weinman J, Wright S, Johnston M, editors. Measures in health psychology: a user’s portfolio. Windsor: NFER-NELSON; 1995. pp. 35–7.

[11]  Vakola M. What’s in there for me? Individual readiness to change and the perceived impact of organizational change. Leadersh Organ Dev J 2014; 35 195–209.
What’s in there for me? Individual readiness to change and the perceived impact of organizational change.Crossref | GoogleScholarGoogle Scholar |

[12]  Rogerson S, Meir R, Crowley-McHattan Z, McEwen K, Pastoors R. A randomized controlled pilot trial investigating the impact of a workplace resilience program during a time of significant organizational change. J Occup Environ Med 2016; 58 329–34.
A randomized controlled pilot trial investigating the impact of a workplace resilience program during a time of significant organizational change.Crossref | GoogleScholarGoogle Scholar |

[13]  Government of South Australia. Fact sheet – Leading 4 Change. Department for Health and Ageing, Adelaide, SA, Australia: Government of South Australia; 2015.

[14]  Benning A, Ghaleb M, Soukas A, Dixon-Woods M, Dawson J, Barber N, Franklin BD, Girling A, Hemming K, Carmalt M, Rudge G, Naiker T, Nwulu U, Choudhury S, Lilford R. Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation. BMJ 2011; 342 d195
Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation.Crossref | GoogleScholarGoogle Scholar |

[15]  Cummings GG, Spiers JA, Sharlow J, Germann P, Yurtseven O, Bhatti A. Worklife improvement and leadership development study: a learning experience in leadership development and ‘planned’ organizational change. Health Care Manage Rev 2013; 38 81–93.
Worklife improvement and leadership development study: a learning experience in leadership development and ‘planned’ organizational change.Crossref | GoogleScholarGoogle Scholar |

[16]  Kirkpatrick DL, Kirkpatrick JD. Evaluating training programs: the four levels. San Francisco, CA, USA: Berrett-Koehler Publishers; 2006.

[17]  Cunningham CE, Woodward CA, Shannon HS, MacIntosh J, Lendrum B, Rosenbloom D, Brown J. Readiness for organizational change: a longitudinal study of workplace, psychological and behvaioural correlates. J Occup Organ Psychol 2002; 75 377–92.
Readiness for organizational change: a longitudinal study of workplace, psychological and behvaioural correlates.Crossref | GoogleScholarGoogle Scholar |

[18]  Langford P. Measuring organisational climate and employee engagement: evidence for a 7 Ps model of work practices and outcomes. Aust J Psychol 2009; 61 185–98.
Measuring organisational climate and employee engagement: evidence for a 7 Ps model of work practices and outcomes.Crossref | GoogleScholarGoogle Scholar |

[19]  Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3 77–101.
Using thematic analysis in psychology.Crossref | GoogleScholarGoogle Scholar |

[20]  Moran-Ellis J, Alexander VD, Cronin A, Dickinson M, Fielding J, Sleney J, Thomas H. Triangulation and integration: processes, claims and implications. Qual Res 2006; 6 45–59.
Triangulation and integration: processes, claims and implications.Crossref | GoogleScholarGoogle Scholar |

[21]  O’Cathain A, Murphy E, Nicholl J. Three techniques for integrating data in mixed methods studies. BMJ 2010; 341 c4587
Three techniques for integrating data in mixed methods studies.Crossref | GoogleScholarGoogle Scholar |

[22]  Vanhove AJ, Herian MN, Perez ALU, Harms PD, Lester PB. Can resilience be developed at work? A meta-analytic review of resilience-building programme effectiveness. J Occup Organ Psychol 2016; 89 278–307.
Can resilience be developed at work? A meta-analytic review of resilience-building programme effectiveness.Crossref | GoogleScholarGoogle Scholar |

[23]  Reed J, Vakola M. What role can a training-needs analysis play in organisational change? J Organ Change Manage 2006; 19 393–407.
What role can a training-needs analysis play in organisational change?Crossref | GoogleScholarGoogle Scholar |

[24]  Schwarzer R, Warner LM. Perceived self-efficacy and its relationship to resilience. In: Prince-Embury S, Saklofske DH, editors. Resilience in children, adolescents, and adults: translating research into practice. New York, NY, USA: Springer; 2013. pp. 139–50.

[25]  Schwarzer R, Renner B. Health specific self-efficacy scales. 2009. Available at https://userpage.fu-berlin.de/health/healself.pdf [Verified 2 May 2018].

[26]  Gully S, Chen G. Individual differences, attribute–treatment interactions, and training outcomes. In: Kozlowski SWJ, Salas E, editors. Learning, training and development in organisations. Organizational Frontiers Series. New York, NY, USA: Routledge, Taylor & Francis; 2010. pp. 3–64.

[27]  Sheaff R, Pilgrim D. Can learning organizations survive in the newer NHS? Implement Sci 2006; 1 27
Can learning organizations survive in the newer NHS?Crossref | GoogleScholarGoogle Scholar |

[28]  Snell RS. The learning organization, sense-giving and psychological contracts: a Hong Kong case. Organ Stud 2002; 23 549–69.
The learning organization, sense-giving and psychological contracts: a Hong Kong case.Crossref | GoogleScholarGoogle Scholar |

[29]  Akhnif E, Macq J, Idrissi Fakhreddine MO, Meessen B. Scoping literature review on the learning organisation concept as applied to the health system. Health Res Policy Syst 2017; 15 16
Scoping literature review on the learning organisation concept as applied to the health system.Crossref | GoogleScholarGoogle Scholar |

[30]  Rashman L, Withers E, Hartley J. Organizational learning and knowledge in public service organizations: a systematic review of the literature. Int J Manag Rev 2009; 11 463–94.
Organizational learning and knowledge in public service organizations: a systematic review of the literature.Crossref | GoogleScholarGoogle Scholar |

[31]  Singer SJ, Benzer JK, Hamdan SU. Improving health care quality and safety: the role of collective learning. J Healthc Leadersh 2015; 7 91–107.
Improving health care quality and safety: the role of collective learning.Crossref | GoogleScholarGoogle Scholar |

[32]  Government of South Australia. Central Adelaide Local Health Network Annual Report 2015–16. Adelaide, SA, Australia: Government of South Australia; 2016.

[33]  Harvey G, Kitson AL. PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice. Implement Sci 2016; 11 33
PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice.Crossref | GoogleScholarGoogle Scholar |

[34]  Doyle L. Action learning: developing leaders and supporting change in a health care context. Action Learn Res Pract 2014; 11 64–71.
Action learning: developing leaders and supporting change in a health care context.Crossref | GoogleScholarGoogle Scholar |