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Despite hospitals’ efforts to reduce health care-associated infections (HAIs), success rates vary. We studied how leadership practices might impact these efforts.

We conducted eight case studies at hospitals pursuing central line-associated blood stream infection (CLABSI)-prevention initiatives. At each hospital, we interviewed senior leaders, clinical leaders, and line clinicians (n=194) using a semi-structured interview protocol. All interviews were transcribed and iteratively analyzed.

We found that the presence of local clinical champions was perceived across organizations and interviewees as a key factor contributing to HAI-prevention efforts, with champions playing important roles as coordinators, cheerleaders, and advocates for the initiatives. Top-level support was also critical, with elements such as visibility, commitment, and clear expectations valued across interviewees.

Results suggest that leadership plays an important role in the successful implementation of HAI-prevention interventions. Improving our understanding of nonclinical differences across health systems may contribute to efforts to eliminate HAIs.

The importance of culture is often emphasized for continuous learning and quality improvement within health care organizations. Limited empirical evidence for cultivating a culture that supports continuous learning and quality improvement in health care settings is currently available.

The purpose of this report is to characterize the evolution of a large division of physical therapists and occupational therapists in a pediatric hospital setting from 2005 to 2018 to identify key facilitators and barriers for cultivating a culture empowered to engage in continuous learning and improvement.

An ethnographic methodology was used including participant observation, document review, and stakeholder interviews to acquire a deep understanding and develop a theoretical model to depict insights gained from the investigation.

A variety of individual, social, and structural enablers and motivators emerged as key influences toward a culture empowered to support continuous learning and improvement. Features of the system that helped create sustainable, positive momentum (e.g., systems thinking, leaders with grit, and mindful design) and factors that hindered momentum (e.g., system uncertainty, staff turnover, slow barrier resolution, and competing priorities) were also identified.

Individual-level, social-level, and structural-level elements all influenced the culture that emerged over a 12-year period. Several cultural catalysts and deterrents emerged as factors that supported and hindered progress and sustainability of the emergent culture.

Cultivating a culture of continuous learning and improvement is possible. Purposeful consideration of the proposed model and identified factors from this report may yield important insights to advance understanding of how to cultivate a culture that facilitates continuous learning and improvement within a health care setting.

Organization development is focused on implementing a planned process of positive humanistic change in organizations through the use of social science theory, action research, and data-based feedback methods. The role of personality in that change process, however, has historically been ignored or relegated to a limited set of interventions. The purpose of this chapter is to provide a conceptual overview of the linkages between personality and OD, discuss the current state of personality in the field including key trends in talent management, and offer a new multi-level framework for conceptualizing applications of personality for different types of OD efforts. The chapter concludes with implications for research and practice.

This research explored the literature regarding successful leadership practices and how these practices form the organizational context that leads to success in the biotechnology industry. Dominate themes emerged in general leadership strategies, leading research and development scientists, moving ideas from research to the consumer and the culture of research versus practice. Themes include leaders must be adaptable and able to lead effectively in a dynamic environment. Leaders need to consistently articulate the vision throughout the organization. Leaders need to be strategic decision-makers and flexible enough to allow the vision to adjust to the culture and the environment. Leaders need to communicate effectively and create an organization where communication flows efficiently at all levels. Leaders need to recognize clear cultural differences between functional groups, and they need to empower employees at all levels to make strategic decisions. Leaders need to know which decisions must be retained as his or her sole responsibility.

We link counterproductive work behavior (CWB) (particularly workplace bullying) and organizational citizenship behavior to individual narcissism and organizational culture. We link counterproductive work culture in turn to organizations' leader(s), enumerating multiple roles an executive may play: actor, target, ignorer, enabler, rewarder, or, ultimately, champion of change. Both positive (citizenship) and negative (counterproductive) behaviors are associated with narcissism, a complex, multifaceted set of personality characteristics, primarily based on the individual's cognitive interpretation of self and the world. Theoretical interpretations of reactive CWB (stressor-emotion-control theory) and instrumental CWB (theory of planned behavior) support the development of coaching and counseling interventions. Cognitive behavioral theory (CBT)-based prescriptive executive coaching is proposed as a promising mechanism for redirecting narcissistic organizational players from counterproductive to citizenship schemas and behaviors.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

Women remain under-represented in leadership positions in both clinical medicine and medical education, despite a rapid increase in the proportion of women in the medical profession. This chapter explores potential reasons for this under-representation and how it can be ameliorated, drawing on a range of international literatures, theories and practices. We consider both the ‘demand’ for and ‘supply’ of women as leaders, by examining: how evolving theories of leadership help to explain women’s’ leadership roles and opportunities, how employment patterns theory and gender schemas help to explain women’s career choices, how women aspiring to leadership can be affected by the ‘glass ceiling’ and the ‘glass cliff’ and the importance of professional development and mentoring initiatives. We conclude that high-level national strategies will need to be reinforced by real shifts in culture and structures before women and men are equally valued for their leadership and followership contributions in medicine and medical education.

The COVID-19 pandemic and its related economic meltdown and social unrest severely challenged most countries, their societies, economies, organizations, and individual citizens. Focusing on both more and less successful country-specific initiatives to fight the pandemic and its multitude of related consequences, this chapter explores implications for leadership and effective action at the individual, organizational, and societal levels. As international management scholars and consultants, the authors document actions taken and their wide-ranging consequences in a diverse set of countries, including countries that have been more or less successful in fighting the pandemic, are geographically larger and smaller, are located in each region of the world, are economically advanced and economically developing, and that chose unique strategies versus strategies more similar to those of their neighbors. Cultural influences on leadership, strategy, and outcomes are described for 19 countries. Informed by a cross-cultural lens, the authors explore such urgent questions as: What is most important for leaders, scholars, and organizations to learn from critical, life-threatening, society-encompassing crises and grand challenges? How do leaders build and maintain trust? What types of communication are most effective at various stages of a crisis? How can we accelerate learning processes globally? How does cultural resilience emerge within rapidly changing environments of fear, shifting cultural norms, and profound challenges to core identity and meaning? This chapter invites readers and authors alike to learn from each other and to begin to discover novel and more successful approaches to tackling grand challenges. It is not definitive; we are all still learning.