A couple of weeks ago, we wrote here about the role of leadership for quality improvement in healthcare. As a summary, we described that leaders have a particularly critical part to play in:
1 – Building the foundations of psychological safety that allow us to tolerate risk and embrace innovation
2 – Managing the emotion that can come with change
3 – Coordinating the knowledge flow that both healthcare and QI requires between individuals, professions and departments
But what exactly is it that the best leaders do – how do they behave – in order to have that impact?
I’d say that leadership is an art, rather than a science (maybe that’s why it’s been treated for so long as a subject matter separate from traditional improvement science – because it doesn’t fit neatly). So I don’t suggest that you can take a prescribed set of leadership behaviours, implement them, and expect to guarantee a particular outcome.
However, understanding patterns of how people respond to particular behaviours (which is a science – ‘behavioural science’!) and understanding our personal impact, is central to being a better leader. This is why we have recently been talking with some of our colleagues and our senior leaders about the type of leadership we need in order to nurture an improvement culture in our organisation.
Although we can learn from examples and research carried out elsewhere about specific leadership behaviours that facilitate quality improvement, we are really interested in what we can learn from our own experiences in our own organisation.
The diagram below explains a little about what we think we know already:
What do you think? Are these the types of leadership behaviours we should be focusing on if we want to build an improvement culture?
Please do take a minute to share your thoughts in the comments section below – they’re a pivotal part of the discussion, and as we know, leadership matters!
Thanks,
Rebecca – @Rebecca3005
Be the Change 
I really like the diagram and it sums up what we should be looking for when recruiting leaders. My only issue with it is what we do with the diagram and how do we translate it into every day life? We have all had managers who would fit into every one of the boxes but just seem to accept the unsupportive behaviours. My question back to you would be how do we ensure the leaders we recruit fit the behaviours we want and what do we do with those leaders who display the behaviours we don’t want? Do we make too many excuses for managers / leaders who are performing badly and do we actively seek those staff members with the behaviours we like and ensure they move into senior roles?
I wonder is there a way of asking questions based around these behaviours either at interview or even at the reference stage and be strong enough not to recruit if a staff member doesn’t have the behaviours we want. Ultimately we would not recruit a nurse who hasn’t got the clinical qualification to be a nurse so why should we recruit someone in a leadership position who hasn’t got the skills which we have deemed essential to the role?
Is it laziness, is it fear of not recruiting or is it that we don’t actually know what we want? Hopefully this diagram is the start of a piece of work to understand this.