The Influence of AuthenticLeadership and Empowerment onNew-Graduate Nurses’ Perceptionsof Interprofessional Collaboration

Heather K. Spence Laschinger, RN, PhD, FAAN, FCAHSThe University of Western Ontario

Leslie Marie Smith, MScN, RNThe University of Western Ontario

Collaborating Across Borders (CAB IV)Vancouver, British Columbia

June 12-14, 2013

Background Related literature

Authentic Leadership Empowerment Interprofessional Collaboration

Hypothesized model Aims of the current study Methods Results Conclusions

PRESENTATION OVERVIEW

BACKGROUND

Lack of proper communication and collaboration between healthcare workers is responsible for a high percentage of adverse events (~70%)

New graduate nurses require support from their leaders as they transition to their nurse role

Empowering leadership practices play an important role in establishing work environments that encourage greater teamwork and that empower workers to optimize their practice

The influence of leadership and empowerment on interprofessional collaboration in healthcare has not yet been examined

AUTHENTIC LEADERSHIP(AVOLIO ET AL., 2004))

“…a pattern of transparent and ethical leader behaviour that encourages openness in sharing

information needed to make decisions while accepting input from those who follow.”

(Avolio et al., 2009)

Authentic leadership is linked to empowerment (Laschinger et al., 2012; Zhu et al., 2004)

Authentic leadership consists of: Self-Awareness Relational Transparency Moral/Ethical Behaviour Balanced Information Processing

COMPONENT EXAMPLE BEHAVIOURS

(1) Relational Transparency Says exactly what she/he meansEncourages others to speak-up about

their concerns(2) Moral/Ethical Conduct Acts in accordance with her/his stated beliefs

Uses core values to make decisions(3) Balanced Processing Seeks out opinions that challenge personal views

Takes multiple points of view into consideration (4) Self-Awareness Asks for feedback to improve interpersonal interactions

Understands how her/his actions affect others

AUTHENTIC LEADERSHIP BEHAVIOURS(AVOLIO ET AL., 2004)

STRUCTURAL EMPOWERMENT THEORY(KANTER 1977; 1993)

“…access to organizational structures that enable employees to accomplish their work in meaningful ways…” (Kanter, 1979).

Kanter describes four organizational empowerment structures: Access to information Access to support Access to resources needed to do the job Opportunities to learn and grow

Structural empowerment is linked to: Supportive professional practice environments (Upeneiks, 2003) Co-worker respect (Laschinger, 2004) Nurse-physician collaboration (Faulkner & Laschinger, 2008) Work effectiveness (Laschinger, Wong, McMahon & Kaufmann, 1999)

IPC is a “collaborative practice whereby healthcare workers from different professional backgrounds work together with patients, families, carers, and communities, to deliver the

highest quality of care” (WHO, 2010)

IPC is viewed as critical to patient safety (Zwarrenstein & Bryant, 2000)

IPC has been linked to: Increased job satisfaction, decreased job turnover intent and burnout

(Rafferty et al., 2001)

Greater trust in team members, reduced co-worker conflict and increased knowledge sharing (Gaboury et al., 2011)

INTERPROFESSIONAL COLLABORATION (IPC)

Challenges associated with IPC (Delva et al., 2008; Kenaszchuck et al., 2010; Reeves et al., 2009):

Lack of understanding/valuing of members roles Differing views on collaboration Hierarchical imbalances Poor communication

INTERPROFESSIONAL COLLABORATION (IPC)

HYPOTHESIZED MODEL

INTERPROFESSIONALCOLLABORATION

AUTHENTIC LEADERSHIP

STRUCTURAL EMPOWERMENT

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AIM OF THE CURRENT STUDY

To test the relationships between leaders’ authentic leadership practices, the degree of structural

empowerment in their work settings and new-graduate nurses’ perceptions of the quality

of IPC on their units.

METHODS AND ANALYSIS

Sample: Data from second wave of longitudinal study: Time 2

= 194Random sample of acute care new graduates (< 2

years)Original sample obtained from provincial

registration database

Data Collection:

Mail survey Modified Dillman Total Design Method (2000) Data were collected in 2010

Data Analysis:

Descriptive and Hierarchical Multiple Regression analyses using SPSS 20.0

• AUTHENTIC LEADERSHIP• The Authentic Leadership Questionnaire (ALQ) (Avolio, Gardner, & Walumbwa,

2007)

• STRUCTURAL EMPOWERMENT• Conditions of Work Effectiveness Questionnaire (CWEQ-11) (Laschinger,

2000)

• INTERPROFESSIONAL COLLABORATION• 6 item newly created scale based on previous research (Kenaszchuck et al.,

2010; Orchard et al., 2005)

MEASURES

Moderate levels of authentic leadership and structural empowerment

High perceptions of overall IPC on work units

DESCRIPTIVE RESULTS

TEST OF HYPOTHESIS

INTERPROFESSIONALCOLLABORATION

AUTHENTIC LEADERSHIP

STRUCTURAL EMPOWERMENT

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• Both authentic leadership and empowerment were sig. independent predictors of IPC

Authentic leadership and empowerment explained 9-29% of the variance in 4 out of 5 components of IPC (personal belief that IPC improved patient care = ns)

Both authentic leadership and empowerment are important and may be fundamental organizational resources that positively influence new-graduate nurses’ experiences of IPC on their units

Authentic leaders are well positioned to ensure that new graduates are integrated into interprofessional teams and are seen as valued contributors in the delivery of care

Positive experiences on interprofessional teams are vitally important for new graduates’ future inclinations to collaborate

Experiences of IPC may help ensure that patients benefit from higher quality, less fragmented care

CONCLUSIONS

QUESTIONS?(HKL@UWO.CA)