The making and sustaining of leaders in health care.

PURPOSE

Many nations are focussing on health care's Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools.

DESIGN/METHODOLOGY/APPROACH: This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development.

FINDINGS

This paper makes "frugal innovation" recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages.

RESEARCH LIMITATIONS/IMPLICATIONS: The study centred primarily on one Canadian community health care services' organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community.

PRACTICAL IMPLICATIONS

The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles.

ORIGINALITY/VALUE: This paper demonstrates how health care leadership can be developed and sustained.