Abstract
Background The current literature and
Department
of Health (DH) policies suggest change
should be implemented by frontline
clinicians using
a transformational leadership approach
(Alimo-
Metcalf and Alban-Metcalf, 2008; Darzi,
2008; DH,
2009, 2010; Govier and Nash, 2009).
Despite this,
change is still often led by senior managers
utilising
a ‘top down’, transactional approach
(Edmonstone,
2009; Muha and Manion, 2010; NHS
Institute of
Innovation and Improvement, 2005). It
could be
argued that this is primarily due to an
absence of
clinical leadership due to a paucity of
leadership
development opportunities for clinicians. In
order
to encourage frontline clinicians to lead
change we
firstly need to understand how change is
implemented
on the frontline and to ascertain their
development needs.
Aims This paper explores how frontline
clinical
leaders, specifically ward nurse managers
(WNMs),
implement change and why they choose a
particular
strategy. The aim is to explore the change
process,
through investigating change management
from
the perspective of those leading change.
Methods A case study methodology was
adopted
(Cohen et al, 2000; Yin, 2009). The case
study
comprised 18WNMs from one acute NHS
hospital
within the UK. The data were collected via
semistructured
3 / 7
questionnaires and interviews.
Results The case study demonstrates the
WNM’s
soft approach to change management,
based on
transformational principles, is in contrast
to senior
managers who focus on managerial
leadership
(Edmonstone, 2009). This point is not
explicit in
the previous literature and two new
models are
offered to explain this conclusion.
Originality/value This study provides new
insight
into theWNM’s approach to managing
change and
their development needs. This is an
important
perspective that so far has been neglected.
Conclusion WNMs appear to be intuitively
adopting
change models and using a pragmatic,
experiential
approach to implement change. However,
their
progression from change novice to expert
is stifled
by their poor theoretical evidence base
and their
lack of experience of leading change. A
bespoke
‘Leading Change’ development
programme for
WNMs is recommended
Original language | English |
---|---|
Pages (from-to) | 251-259 |
Journal | The International Journal of Clinical Leadership |
Volume | 17 |
Issue number | 4 |
Publication status | Published - 1 Sept 2012 |
Keywords
- clinical leadership
- change management
- leadership
- transformational leadership
- ward nurse managers