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SBNH Presentations at the Canadian Health Workforce Virtual Conference

A summary and the full abstracts of three SBNH-related presentations given at the Canadian Health Workforce Conference 2020

Three oral presentations from research members of the study "Transforming Nurses' Work Environments Through a Strengths-Based Leadership and Management Training Program" were included in the , held virtually. Below is a brief summary of each presentation, followed by their abstracts.

The presentations were a success, and the conference facilitated networking in the virtual space, providing direct avenues of communication. Overall, the presentations lead to thoughtful discussion and promising connections with other healthcare leaders and researchers in attendance.

Thanks and congratulations to the presenters, Co-Investigator Pam Hubley, Training & Learning Consultant Michele Durrant, and Research Assistants Sonia Castiglione and Julie Fréchette!

Summaries:

  1. By Co-Investigator Pam Hubley and Training & Learning Consultant Michele Durrant, “Influencing Work Culture: A Strengths-Based Nursing Leadership Education Program”, describing the effectiveness of the SBNH-L training in “develop[ing] the leadership capacity of managers and interprofessional leaders to create environments that foster health and healing and advance[ing] the knowledge and skills of health leaders to lead with the business acumen required to lead efficient systems, effective teams and optimize system performance.”
  2. By Research Assistant Julie Fréchette, “Development of the Strengths-Based Nursing and Healthcare Leadership (SBNH-L) Scale”, describing the development and testing of the SBNH-L Scale to “allow for creating a psychometrically sound and feasible scale to measure the construct of SBNH-L.”
  3. By Research Assistant Sonia Castiglione, “Results of an integrative review of organizational factors influencing large-scale change (LSC) in healthcare: Considerations and reflections for nurse leaders”, describing “a review of organizational factors that influenced the successful implementation of LSC in healthcare literature” and the adaptation of “a practical and nurse-focused reflective tool… to support nurse leaders as drivers of LSC within their organization.”

Presentation Abstracts:

Influencing Work Culture: A Strengths-Based Nursing Leadership Education Program

By Co-Investigator Pam Hubley and Training & Learning Consultant Michele Durrant

Take-Home Messages:

  1. The piloted Strengths-Based Nursing Leadership (SBNH-L) Education Program was designed to foster a unique, value-driven embodied approach that guided leaders to create workplace cultures and environments that honour, develop, mobilize and capitalize on the strengths of their team.
  2. Participants reported a high level of satisfaction and program relevance. The intent to impact or change practice was also rated as high by participants.
  3. Mentorship provided for program participants was found to be instrumental in assisting learners to advance an action plan that enabled teams to provide knowledgeable, compassionate, safe, high quality patient and family centered care.

Background/Rationale: Little is understood about how to develop the capacity of healthcare leaders to influence work cultures promoting health and healing. A program was designed for leaders responsible to create Strengths-Based care environments, with the business acumen required to lead efficient systems, highly effective and resilient teams and optimized system performance.

Objectives: Develop the leadership capacity of managers and interprofessional leaders to create environments that foster health and healing. Advance the knowledge and skills of health leaders to lead with the business acumen required to lead efficient systems, effective teams and optimize system performance.

Methodology/Approach: A quality improvement PDSA methodology was used to guide the program evaluation. Using a modular format and multiple teaching methods for program delivery, an evaluation was undertaken to elicit the participants perceived overall satisfaction with the program, teaching methods used, faculty facilitation and mentorship; as well as, mentee and mentor accounts of participant progress. Descriptive data was collected from 15 participants of the 16 enrolled from two paediatric academic health science centers through surveys following each module delivery and program delivery. Mentorship accounts were collected through mentorship logs (n = 8), 3 months following the classroom program delivery.

Findings/Impact/Outcome: The majority of participants were nurses (n = 13) and the remaining were allied health leaders (n = 2). Surveys were completed eliciting descriptive data from Likert scales and open-ended questions. Participants reported a high level of satisfaction (4.6-4.9 M; median score 4.75). They also found the program to be highly relevant (4.5-5.0 M; median score 4.7). Their intent to impact or change their practice was rated as high (4.4-5.0 M). Participants described mentorship as an important aspect of the program as they were able to formulated goals and action planning and overcome barriers with a mentor that revealed an intentionality to apply course content to their leadership actions in the context of the work environment.

Conclusion: An education program grounded in Strengths-Based care provided encouraging results in developing leadership capabilities and momentum supporting practice change. Ideas for program improvement were generated to enable program refinement and scalability. Further research of the next iteration will result in an evidence-based leadership program.

Development of the Strengths-Based Nursing and Healthcare Leadership (SBNH-L) Scale

By Research Assistant Julie Fréchette

Take-home messages:

  1. Strengths-Based Nursing and Healthcare Leadership (SBNH-L) is a leadership approach that shows great potential in supporting healthy and productive workplaces
  2. An SBNH-L scale can be used to assess to what extent healthcare leaders embody SBNH-L
  3. Evaluating an SBNH-L scale provides strong grounds for developing the SBNH-L approach within healthcare settings

Background/Rationale: Strengths-Based Nursing and Healthcare Leadership (SBNH-L) is a unique, value-driven, embodied approach that guides leaders to create workplace cultures and environments that honour, develop, mobilize, and capitalize on the strengths of their team. Although this leadership approach shows great promise for improving workplace culture and supporting health workforce, no scale to date captures this unique construct.

Objectives: The current study aims to develop and test a scale to measure SBNH-L. Research results will contribute to understanding SBNH-L, as well as creating new knowledge in the field of healthcare leadership.

Methodology/Approach: Three independent samples will be used to evaluate the SBNH-L scale. The first sample, comprised of general managers (n=250-350), will complete a survey including the SBNH-L scale (V1). Reliability testing and construct validation will be assessed to further refine the scale (reduce number of items, and possibly reword a number of items). This refined SBNH-L scale (V2) will then be included in a survey for the second and third samples of healthcare leaders (n=250-350 and n=100-125 respectively), and further tested. This will allow for creating a psychometrically sound and feasible scale to measure the construct of SBNH-L.

Findings/Impact/Outcome: Currently, the SBNH-L scale is undergoing multiple phases of content validation and item reduction in preparation of administration to the first sample of participants. The original scale was 150 items generated from theory, research results (SBNH-L pilot study), and documents developed by SBNH-L experts. Sample items include: I create opportunities for team members to develop supportive relationships at work, I mobilize my team’s strengths to overcome the challenges we face, etc. This study will be beneficial to society since we need to create the right conditions to improve the healthcare system and SBNH-L shows great potential in being one of these conditions. Measuring SBNH-L is the first step in being able to recognize this construct in healthcare settings and jumpstart improvement.

Conclusion: In conclusion, this study will allow developing and testing a scale to measure the construct of SBNH-L. SBNH-L is a leadership approach that shows great potential in contributing to creating healthy and productive workplaces for all, including health workforce.

Results of an integrative review of organizational factors influencing large-scale change (LSC) in healthcare: Considerations and reflections for nurse leaders

By Research Assistant Sonia Castiglione

Background: Large-scale changes (LSCs) are promoted to achieve sustained and meaningful quality healthcare. Despite their potential, LSCs often fail, impacting the health and wellbeing of patients and the nursing workforce. To facilitate LSC, nurse leaders can reflect on and address organizational readiness for change. Therefore, nurse leaders warrant an updated review of organizational factors influencing LSC.

Objectives: This presentation will describe a review of organizational factors that influenced the successful implementation of LSC in healthcare literature. As a result of this review, a practical and nurse-focused reflective tool was adapted to support nurse leaders as drivers of LSC within their organization.

Methodology/Approach: An integrative review methodology was used to understand the organizational factors influencing LSC. Two healthcare databases were searched for articles published between 2009-2018. A total of 20 articles met the inclusion criteria and were subjectively appraised for their authenticity and information value. No major methodological issues arose, and all 20 articles were included in the review. Key information, including organizational factors that appeared to act as barriers or facilitators to influence the implementation of LSC were extracted. The findings were synthesized and interpreted deductively and inductively using a thematic approach. Data was synthesized narratively and through tables.

Findings/Impact/Outcome: In 20 peer-reviewed articles, 19 unique LSCs were described using a diversity of study designs. LSCs were implemented in large organizations, across multiple healthcare establishments within a health system, or in entire health systems within a specific jurisdiction mostly in North America. Various health settings were implicated, including hospitals and acute care, ambulatory or community care, primary care and nursing homes. Reforms target practice changes across health disciplines and with administrators. Seven organizational factors were consistently described as facilitators or barriers to successful LSC in healthcare. These factors included 1) infrastructure support, 2) organizational culture, 3) leadership, 4) change management approach, 5) roles and responsibilities, 6) networks, and 7) measurement and feedback.

Conclusion: The factors described are consistent with concepts of implementation and highlight learning organizations in successful LSC. The results were adapted in a reflective tool for nurse leaders. As calls for changes in healthcare delivery of this magnitude continue, nurses are well-positioned to take an active role in organizational preparedness.

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