Worklife Improvement and Leadership Development study: a learning experience in leadership development and "planned" organizational change.

BACKGROUND: In response to increasing recognition of the importance of quality health care work environments, the Alberta Cancer Board initiated a province-wide leadership development program to plan for organizational change through a series of stages. In 2004, the Leadership Development Initiative (LDI) was implemented to facilitate organizational learning using a cohort-based leadership intervention based on a communities of practice framework. PURPOSES: The aim of the Worklife Improvement and Leadership Development study was to examine both the outcomes and experiences of participants of the LDI program to better understand leadership development, implementation, and its impact on worklife quality among 5 cohorts of health care managers and staff at the Alberta Cancer Board. METHODOLOGY/APPROACH: This study used both structured survey and interview methods, using a pretest-intervention-posttest quasi-experiment without a control group design, to assess the effects of LDI on worklife of leaders and staff. Surveys included the Leadership Practices Inventory and Areas of Worklife Scale, which looked at meaningfulness of work and organizational engagement. Interviews and focus group data provided a more detailed description of the experience of leadership development and perceptions of organizational worklife. FINDINGS: The study revealed layers of information about the complexity of individual and collective leadership in a cohort-based design, perceptions of leadership initiatives, organizational worklife, and planned organizational change. Our findings suggest that early changes in how leaders reflected on their own skills and practices (Leading Self) were positive; however, growing disengagement as the LDI continued was evident in the focus group data, particularly when change in behavior of others was not perceived to be evident. PRACTICE IMPLICATIONS: To support the effectiveness and success of a leadership initiative, managers and administrators need to implement strategies designed to help leaders grow and cope with ongoing flux of organizational change and stagnation.

Impact of leadership development on emotional health in healthcare managers.

AIM: To examine the effects of a Leadership Development Initiative (LDI) on the emotional health and well-being among five levels of healthcare managers. BACKGROUND: Increasingly dynamic, demanding healthcare environments result in highly stressful work atmospheres. METHODS: Using quasi-experimental and mixed methods, we used regression on pre- and post-LDI survey data with 86 managers, and individual/focus group interview data for focused ethnographic analysis. RESULTS: An increasing trend was observed in self-assessed leadership practices after the LDI with a significant increase in 'inspiring a shared vision' (P<0.01). However, a non-significant decreasing trend in areas of work life and a non-significant increase in cynicism (P=0.14) was observed. Before the LDI, participants' self-assessment of their practice to 'enable others to act' was negatively related to emotional exhaustion (P<0.01). Both before and after the LDI, 'modelling the way' was significantly related to professional efficacy (P<0.01 pre; P<0.05 post). Post-LDI, 'inspiring a shared vision' was negatively (P<0.01) and 'enabling others to act' was positively (P<0.05) related to cynicism. CONCLUSION: The LDI provided opportunities for healthcare managers to connect, strengthen leadership and social support networks and manage burnout. IMPLICATIONS FOR NURSING MANAGEMENT: Transformational leadership practices may influence managers' emotional health. Senior administrative support and communicating the structure and vision of developmental initiatives may help to achieve realistic expectations.

Psychotherapy and pharmacotherapy randomized controlled trials are equally likely to report a positive outcome.

A very high proportion of controlled trials of psychotropic drugs report a positive outcome. To determine if the population of positive outcome in psychotherapy trials is as high as reported, a cohort of consecutive randomized controlled trials published in four internal psychiatry journals over a five-year period were analyzed. Chi square test and descriptive analysis were conducted. A total of 237 trials were included. Out of 188 pharmacotherapy trials, 164 (88%) reported a positive outcome. Out of 49 psychotherapy trials, 44 (90%) reported a positive outcome. The difference between above reported population was not statistically significant on chi-square test (p=0.626). It was concluded that positive outcome reports in published psychotherapy trials are as common as in pharmacotherapy trials.