Frontline leadership for implementing clinical guidelines in Norwegian mental health services: a qualitative study
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 8 March 2022
Issue publication date: 12 July 2022
Abstract
Purpose
The purpose of this study was to explore and interpret how frontline leaders define, experience and rationalise their approaches to the successful implementation of clinical guidelines in mental health care.
Design/methodology/approach
Employing an interpretative phenomenological design, the authors conducted and analysed individual interviews of frontline leaders at 14 psychiatric clinics involved in a national study of implementing evidence-based clinical guidelines in mental health.
Findings
The authors found a broad spectrum of attitudes and attributes, as well as a wide repertoire of strategies for frontline implementation leadership. Three main approaches were revealed, comprising “Curious and welcoming”, “Integrity and setting standards” and “Caring and collegial”.
Research limitations/implications
The study present what experienced frontline leaders emphasise to enable implementation of guidelines, not empirical pieces of evidences for what they in fact do or if these actions lead to implementation. The generalisability to other settings is unknown. Another sample profile, context or organisational level may have impacted the result. The concreteness of the frontline leaders’ considerations, approaches and actions gives important knowledge about frontline leaders leadership across traditional leadership theories.
Originality/value
Existing leadership theories describe different leadership styles, while this study reveals the need for a wide range of approaches to balance the many needs and demands. The complexity of leadership approaches this study found is in line with implementation theories; thus, the present study incorporates implementation science into the leadership literature.
Keywords
Acknowledgements
The authors would like to thank the frontline managers for their participation in this study.
Funding: This study was funded by South-Eastern Norway Regional Health Authority (Helse Sør-Øst HF) (grant number 2015106) and Stavanger University Hospital.
Previous presentation: Data have not been previously published and is not being submitted for publication elsewhere.
Trial registration: ClinicalTrials.gov Identifier: NCT03271242.
Disclosures: There are no competing interests.
Authors’ contribution: The analyses and interpretations were conducted by H.N., a clinical psychologist and psychotherapist with a background in the psychodynamic tradition, as well as several years as leader of the profession and manager of a psychiatric clinic; M.H., associated professor and researcher in a health trust, with a PhD in implementation science and quality improvement; K.R., associate professor and clinical nurse with several years of experience as a frontline leader in psychiatric wards; G.E.M., a clinical psychologist and professor with several years of experience as a manager in various positions in large organisations. H.N. collected the data, and together with M.H., K.R. and G.E.M. planned the study and contributed to the analyses and interpretations.
All authors contributed to the conception, and/or design/methods of the study, wrote and critically revised the article and gave final approval for its submission.
Conflict of interests: The authors have no conflict of interest to declare.
Citation
Nordin, H., Rørtveit, K., Mathisen, G.E., Joa, I., Johannessen, J.O., Ruud, T. and Hartveit, M. (2022), "Frontline leadership for implementing clinical guidelines in Norwegian mental health services: a qualitative study", Journal of Health Organization and Management, Vol. 36 No. 5, pp. 617-632. https://doi.org/10.1108/JHOM-08-2021-0286
Publisher
:Emerald Publishing Limited
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