Shared leadership in interprofessional teams: beyond team characteristics to team conditions

ABSTRACT

Shared leadership has been shown to enhance processes, effectiveness, and performances in interprofessional teams. While earlier studies suggest the association of internal team environment (ITE) and transactive memory system (TMS) with shared leadership, the relative influence of these team conditions vis-a-vis team characteristics (such as team size, stability, and interprofessional roles) on shared leadership is not well understood. This study aims to examine the comparative influence of team characteristics versus team conditions of ITE and TMS on shared leadership during interprofessional team meetings (IPTMs). We compared interprofessional teams from two departments, namely larger and more diverse teams of Geriatric Medicine versus the smaller and more homogeneous Palliative Medicine. We administered a questionnaire survey to healthcare professionals who attended IPTMs in both departments (N = 133). Our results revealed significantly higher scores in shared leadership, ITE and TMS in Palliative Medicine (p < .05). Using hierarchical regression analysis adjusting for team conditions, department and number of IPTMs attended were not significant in the final model (both p > .05). Instead, TMS (β= 0.250, p < .01) and ITE (β= 0.584, p < .01) outperformed team characteristics as conditions that are highly associated with shared leadership, explaining an additional 29.8% and 19.0%, respectively, of model variance. Further analysis revealed a stronger correlation between shared leadership subdomains with TMS in Geriatric Medicine and with ITE in Palliative Medicine. Our results demonstrate how a positive working environment with a high level of shared memory engendered a perception of shared leadership, and how these team conditions can be tapped upon to circumvent differences in team characteristics to facilitate shared leadership. Identifying key conditions that are highly associated with shared leadership is critical for the teaching of dynamic leadership roles to junior clinicians which in turn, can enhance patient care.

KEYWORDS:

• Shared leadership
• team conditions
• team characteristics
• interprofessional
• hierarchical regression

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This project was supported by resources from the NHG-HOMER Grant (FY13/A15).

Notes on contributors

Yu Han Ong

Yu Han Ong is a Research Analyst of Health Outcomes & Medical Education Research (HOMER), National Healthcare Group. Her research interests are leadership in healthcare teams and collaborative healthcare practices, with a focus on complexity in shared leadership and team dynamics in interprofessional teams. Her other current research work includes team communication for collaborative decision making and evaluation of residency communication courses where she uses a range of methods in her research, from survey design to interviews and focus groups to draw out the various aspects of communication and learning in clinical contexts.

Mervyn Yong Hwang Koh

Mervyn Yong Hwang Koh is Head and Senior Consultant of the Department of Palliative Medicine at Tan Tock Seng Hospital. He was trained in both Palliative Care and Geriatric Medicine and is also an Adjunct Associate Professor at the Lee Kong Chian School of Medicine, Singapore. His areas of interest include Burnout and Health Services Development

Wee Shiong Lim

Wee Shiong Lim is faculty advisor to Health Outcomes & Medical Education Research (HOMER), National Healthcare Group; Senior Consultant at Department of Geriatric Medicine; and research track lead at the Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital. As a ground leader practitioner, he strives to conduct Pasteur quadrant research that informs the theory and practice of interprofessional collaborative practice and leadership.