Development of a leadership module to support quality improvement teams in nursing homes

Leadership is a critical lever for supporting implementation of practice change ideas intended to improve care. We need evidence-based leadership programmes to help front-line providers meaningfully implement practice change in complex care settings. Part of the SHIFT intervention, this paper describes the development of a leadership programme module (LeaderSHIFT) that provides training and implementation coaching to front-line leaders, as one of several integrated facilitated supports designed to help front-line care teams meaningfully enact practice change. The LeaderSHIFT programme module was developed based on empirical work, relevant facilitation and transformational leadership theories, and principles of co-design and feasible engagement. Early feasibility work, examining several of Proctor’s (2011) implementation outcomes, was conducted to address uncertainties pertaining to intervention acceptability and implementability. LeaderSHIFT includes four interactive workshops plus two one-on-one coaching sessions designed to develop capacity in four areas of implementation leadership: (1) Self-awareness , (2) Motivate and inspire , (3) Facilitate learning capacity , and (4) Support “team-oriented processes” . Feasibility work suggests it can be successfully implemented (it was acceptable, adopted, appropriate, feasible). Fidelity (LeaderSHIFT role enactment) varied across teams. With a strong theoretical and empirical base, LeaderSHIFT highlights important, often overlooked, relational and socio-cultural aspects of successful implementation leadership. As such, the LeaderSHIFT program module has the potential to improve implementation of practice change interventions in nursing homes and other institutional care settings.