在经理中培养领导力，以促进国家指南建议的实施：一项关于可行性和有用性的过程评估。
Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness.
机构信息
School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
出版信息
Int J Health Policy Manag. 2016 Aug 1;5(8):477-486. doi: 10.15171/ijhpm.2016.35.
BACKGROUND
Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers' leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention's potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation.
METHODS
Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention.
RESULTS
Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation.
CONCLUSION
Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers' behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations.
背景
先前的研究支持这样一种观点，即管理者是实施临床实践指南（CPG）的重要参与者，但对于旨在培养管理者在促进实施方面领导力的干预措施却知之甚少。在这项试点研究中，通过探索干预措施在支持管理者实施国家指南建议用于门诊康复中风护理方面的潜力，采用过程评估来研究领导力干预的可行性和有用性。
方法
来自五个门诊中风康复中心的 11 名高级和一线管理人员参加了为期四个月的领导力干预，包括研讨会、研讨会和电话会议。重点是培养知识和技能，以增强 CPG 建议的实施，特别关注领导行为。每个管理者二人组被分配制定一个领导力计划，其中包括实施三项康复建议的具体目标和领导行为。在干预之前、干预之后一个月和一年，通过对管理者和工作人员的观察和访谈来探索可行性和有用性。
结果
管理者认为干预措施有益，特别是高级和一线管理人员的参与，以及专注于领导知识和技能以实施 CPG 建议。所有管理者都制定了领导力计划，但只有两个单位确定了具体实施三项中风康复建议的目标。其中，只有一个确定了支持实施的领导行为。
结论
管理者发现干预措施以可行的方式进行，并赞赏关注领导力以促进实施。然而，干预措施似乎对管理者的行为或单位的临床实践影响有限。未来针对管理者的干预措施应更加注重培养领导技能和行为，以制定实施计划并支持 CPG 建议的实施。
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