Primary care workforce :
evaluation of ‘triumvirate leadership’ development and network programme

Leigh, JA; Warne, AR; Rosen, LC; Gillaspy, EE

Abstract

Executive Summary
Background
Staff who demonstrate effective leadership behaviours are at the forefront of any future primary care transformation. By empowering and engaging self and others to work differently within a changing clinical context, good leaders are better able to plan and provide a vision for the future of their organisations. However there is evidence of underinvestment in leadership development for staff working within the field of primary care.
Health Education West Midlands Triumvirate Leadership Programme
Triumvirate primary care leadership offers the potential to ‘unlock' the potential for the General Practitioner, General Practice Nurse and Practice Manager when working collaboratively to improve the outcomes for their patients and to transform primary care practice.
Aims and Objectives of the Programme Evaluation
1. To critically explore the experience of participating in the Triumvirate Leadership Development Programme from the perspective of key stakeholders participants (General Practitioners, General Practice Nurses, Practice Managers, programme and practice colleagues).
2. To provide evidenced-informed recommendations for primary care triumvirate healthcare leadership development.
Design
Kirkpatrick's Four/Five Levels of Evaluation Model provided the framework for the evaluation (Kirkpatrick 1983, Winfrey 1999).
The five levels of the model measure:
1. Reaction- students initial thoughts and feelings about the education and training experience
2. Learning - the resulting increase in knowledge or capability
3. Behaviour- extent of behaviour and capability improvement and implementation/application
4. Results - the effects on the business or environment resulting from the student’s performance
5. Return of Investment – often used to demonstrate monetary investment in education and training.

For the purpose of this study, it was not intended to demonstrate evidence at level 5 as this would be extremely difficult to evidence with any certainty therefore this study evaluated the programme using levels 1-4 only.

Methods
Face to face and telephone focus group interviews were undertaken with the following stakeholder groups:
• GPs
• Practice Managers
• General Practice Nurses
• Programme team
• General Practice administrative staff (non-triumvirate).
• Individual triumvirate participants forming 2 case study sites
Participants completed poster presentations as part of the programme requirements. The content of these was also analysed for evaluative data using Kirkpatrick’s levels.
Findings
Thematic analysis of the semi-structured focus group interviews and poster presentations identified themes and subthemes relating to the four levels of Kirkpatrick’s model. Evidence was found across all four levels, with the majority of changes in levels 3 and 4.
Conclusions
Findings show how adopting a primary care triumvirate leadership approach offers a promising platform for operationalising the contemporary collective and distributed approaches to leadership development (Storey and Holti, 2013; West et al, 2015). Future programmes could benefit further by adopting a multi-dimensional leadership development model (Leigh et al, 2015). This would expose the primary care triumvirate leader to the evidence based Six ‘E’s’ approach to leadership development (Leigh, 2016).
Summary of the evidence-informed recommendations for primary care triumvirate healthcare leadership development:
1. The triumvirate leadership development approach is the recommended method to operationalise collective and shared leadership within the primary care setting.
2. Operationalise future programmes within a multi-dimensional leadership development model to promote the best environment to implement the following five key concepts for effective primary care triumvirate leadership:

1. Bring the right people (not the available people) into the triumvirate from the outset and ensure these are people who are willing to challenge and transform their primary care practice
2. Adopt teaching and learning strategies that develop the resilient triumvirate leader so that they can motivate others and challenge the reluctant followers
3. Adopt teaching and learning strategies that promote the development of strategic management, communication, change and service improvement in order to spread the triumvirate philosophy across their primary care organisation for the benefit of patient care and improved patient outcomes
4. Promote leadership development within an empowered learning organisation (both educational and primary care practice).
5. Put in place strategies and systems at all levels of the primary care system to build and sustain a culture for lifelong leadership learning and development.

Citation

evaluation of ‘triumvirate leadership’ development and network programme

• Report Type: Project Report
• Publication Date: Nov 10, 2016
• Deposit Date: Nov 21, 2016
• Additional Information: Projects : PRIMARY CARE WORKFORCE