THE IMPACT OF CLINICAL LEADERSHIP ON QUALITY AND ACCREDITATION STUDIES IN HEALTH SERVICES
Year 2021,
Volume: 5 Issue: 3, 221 - 232, 20.09.2021
Elif Özyurt
,
Keziban Avcı
,
Figen Çizmeci Şenel
Abstract
Aim:The provision of a safe, high-quality, and standardised service in healthcare facilities requires the involvement and collaboration of various stakeholders. Trust and collaboration between stakeholders are a critical element for designing and implementing the measures needed in order to effectively monitor patient care outcomes (61). Successful implementation and evaluation of these measures requires clinical leadership practices based on collaboration and mutual respect among healthcare providers. In this study, it is aimed to discuss the effect of clinical leadership model on improving the quality of health services.
Methods:Based on the idea of minimising patient safety concerns in general, clinical leadership is defined as a shared and distributed leadership model in the delivery of health services. This type of leadership promotes a leadership understanding not based on formal authority, but which all health professionals can develop associatively rather than formally. It is also a practice developed to create reliable health facilities that take non-technical skills and the human factor into consideration and to provide health services in accordance with quality and accreditation standards.
Results: Especially in today’s world where patient safety and quality of care are a source of concern, clinical leaders are at the forefront of ensuring the sustainability of quality and accreditation standards by guiding staff to continuously adopt and implement the quality improvement approaches.
References
- 1. Avcı E.Ö. ve Başer M., Klinik karar verme sürecinde Hemşirelerin Liderlik Özellikleri, Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 2019; 6 (2):1-5.
- 2. McSherry, R., & Pearce, P. what are the effective ways to translate clinical leadership into health care quality improvement? Journal of Healthcare Leadership, 2016; 8, 11,11-17.
- 3. Jeon, Y. H., Conway, J., Chenoweth, L., Weise, J., Thomas, T. H., & Williams, A. Validation of a clinical leadership qualities framework for managers in aged care: a Delphi study. Journal of Clinical Nursing, 2015; 24(7-8), 999-1010.
- 4. Gün, İ., & Aslan, Ö. Liderlik kuramları ve sağlık işletmelerinde liderlik. Journal of Health and Nursing Management, 2018; 5(3), 217-226.
- 5. Donald, D. U., Clinical Leadership as a Corollary for Professional Practice and Patient Safety, International Journal of Emergency Mental Health and Human Resilience, Vol. 17, No.1, pp. 2015; 262-266, ISSN 1522-4821.
- 6. Lawrence, N. & Richardson, J. To Explore and Understand the Leadership Experiences of Modern Matrons, Within an Acute NHS Trust. Journal of Nursing Management, 2014; 22(1), 70-79.
- 7. West, M. Developing Collective Leadership for Health Care. The King’s Fund, 2: London. 2014,http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/ leadership-for-engagement-improvement-nhs-final-review2012.pdf. ISBN: 9781909029316.
- 8. Daly, J., Jackson, D., Mannix, J., Davidson, P. M., & Hutchinson, M. The importance of clinical leadership in the hospital setting. Journal of Healthcare Leadership, 2014; 6, 75-83.
- 9. Poddar, R. Learning between Managers and Doctors. British Journal of Healthcare Management; 2013; 19 (4): 192-197.
- 10. Busari, J.O. Management and Leadership Development in Healthcare and The Challenges Facing Physician Managers in Clinical Practice. The International Journal of Clinical Leadership, 2013; 17(4), 211-216. Radcliffe Publishing Ltd.
- 11. Nath, V., & Clark, J. Medical Engagement: A Journey, not an Event. London: The King's Fund. 2014, ISBN: 9781909029088.
- 12. Garling P. Final Report of the Special Commission of Inquiry: Acute Care in NSW Public Hospitals, 2008 – Overview. Sydney, NSW: NSW Government; 2008., Available from: http://www.dpc.nsw. gov.au/__data/assets/pdf_file/0003/34194/Overview_-_Special_ Commission_Of_Inquiry_Into_Acute_Care_Services_In_New_South_ Wales_Public_Hospitals.pdf. Accessed April 9, 2014.
- 13. Snelling, I., Brown, H., Hardy, L., Cockburn, S., and Somerset, L., An Evaluation Of The Health Education England South West Clinical Leadership Mentors Programme, NHS Health Education England, July 2020.
- 14. Olsen O, Husebo S, Qvindesland S, et al. Redefining clinical leadership for team course development. jhosp admin. 2015; 4: 52–60.
- 15. NHS, Clinical Leadership Competency Framework: Self Assessment Tool. NHS Leadership Academy: Leeds. 2012.
- 16. Stanley, D. Clinical leadership characteristics confirmed. Journal of Research in Nursing, 2014; 19, 118–128. https://doi.org/10.1177/1744987112464630.
- 17. Giles, M., Parker, V., Conway, J., & Mitchell, R. Knowing how to get things done. Nurse Consultants as Clinical Leaders. Journal of Clinical Nursing, 2018; 27(9-10), 1981–1993.https://doi.org/10.1111/jocn.14327.
- 18. Darzi, A. Healthcare for London: A Framework for Action, London: NHS Reports, 4 October, 2007.
- 19. Department of Health, NHS Next Stage Review: A High Quality Workforce, London: NHS, 2008 a.
- 20. Department of Health, NHS Next Stage Review Final Report: High Quality Care For All, London: NHS, 2008 b.
- 21. NHS, Clinical Leadership Competency Framework Project: Report on Findings, London: National Leadership Council, 2010.
- 22. Budak. F. Sağlık Yönetiminde Klinik Liderlik, Klinik Liderlik ölçeği, Ankara: Siyasal Kitapevi; 2018, s: 63.
- 23. NHS Leadership Academy. Clinical leadership competency framework: NHS institute for innovation and improvement. Coventry: Coventry House University of Warwick campus, 2011.
- 24. NHS, Clinical leadership a framework for action. NHS Improvement. IG 02/19 Erişim; 2019.https://improvement.nhs.uk/documents/3702/Clinical_leadership_-_framework_Jan2019.pdf, 25.12.2020.
- 25. Özkan, Ş., Klı̇nı̇k Lı̇derlı̇k ve Sağlık Kurumlarına Yansımaları, Uluslararası Liderlik Çalışmaları Dergisi: Kuram ve Uygulama (International Journal of Leadership Studies: Theory and Practice) 2021; 4 (1), 40-50.
- 26. NHS, Clinical Leadership Competency Framework, Leadership Academy, 2011.
- 27. Jacinta Nzinga, Gerry McGivern and Mike English, Examining clinical leadership in Kenyan public hospitals through the distributed leadership lens, Health Policy and Planning, 33, 2018, ii27–ii34 doi: 10.1093/heapol/czx167 Original Article.
- 28. Gauld, R. ve Horsburgh, S., Clinical Governance Assessment Project: Final Report on a National Health Professional Survey and Site Visits to 19 New Zealand DHBs, Dunedin: Centre for Health Systems, University of Otago, 2012.
- 29. VQC, (2005). Developing the Clinical Leadership Role in Clinical Governance: A Guide for Clinicians and Health Services, Victoria: Department of Human Services.
- 30. Hofmann, R., and Vermunt, J. D. Professional learning, organisational change and clinical leadership development outcomes. Medical Education, 2021;55:252-265.
- 31. Coyne, I., Comiskey, C. M., Lalor, J. G., Higgins, A., Elliott, N., & Begley, C. An exploration of clinical practice in sites with and with-out clinical nurse or midwife specialists or advanced nurse practi-tioners, in Ireland. BMC Health Services Research, 2016; 16(1), 151. https:// doi.org/10.1186/s1291 3-016-1412-8.
- 32. Elliott, N., Higgins, A., Begley, C., Lalor, J., Sheerin, F., Coyne, I., & Murphy, K.The identification of clinical and professional leadership activities of advanced practitioners: Findings from the Specialist Clinical and Advanced Practitioner Evaluation study in Ireland. Journal of Advanced Nursing, 2013; 69(5), 1037–1050. https://doi.org/10.1111/j.1365-2648.2012.06090.x.
- 33. Higgins, A., Begley, C., Lalor, J., Coyne, I., Murphy, K., & Elliott, N. Factors influencing advanced practitioners' ability to enact leadership: A case study within Irish healthcare. Journal of Nursing Management, 2014; 22(7), 894–905. https://doi.org/10.1111/ jonm.12057.
- 34. Santiano, N., Young, L., Baramy, L.-S., McDonnell, S., Page, K., Cabrera, R., & Chapman, A. How do CNCs construct their after hours support role in a major metropolitan hospital. Collegian (Royal College of Nursing, Australia), 2009; 16(2), 85–97. https://doi.org/10.1016/j. colegn.2009.03.003.
- 35. Walsh, K., Bothe, J., Edgar, D., Beaven, G., Burgess, B., Dickson, V., Dunn, S., Horning, L., Jensen, J., Kandl, B., Nonu, M., Owen, F., & Moss, C. Investigating the role of Clinical Nurse Consultants in one health district from multiple stakeholder perspectives: A cooper-ative inquiry. Contemporary Nurse, 2015; 51(2–3), 171–187. https://doi.org/10.1080/10376 178.2016.1169936.
- 36. Jamiu O, Busari, Huriye Yaldiz, Reinold OB Gans ve Ashley J Duits, Clinical Leadership As An Agent For Change: A Health System Improvement Intervention İn Curaçao, Journal of Multidisciplinary Healthcare, 2020; 13, 787–798.
- 37. Arensberg, M. B., D’Andrea, C., Khan, M., Clinical Leadership and Innovation Help Achieve Malnutrition Quality Improvement Initiative Success, by the Academy of Nutrition and Dietetics, 2019.
- 38. Husebø S. E., and Olsen, Q. E., Actual clinical leadership: a shadowing study of charge nurses and doctors on-call in the emergency department, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 27, Article number: 2, 2019.
- 39. Bridgman C., McGrady M.G., Clinical leadership and prevention in practice: is a needs led preventive approach to the delivery of care to improve quality, outcomes and value in primary dental care practice a realistic concept? BMC Oral Health 2015; 15 (Suppl 1): S2.
- 40. Begley, C., Elliott, N., Lalor, J., Coyne, I., Higgins, A., & Comiskey, C. M. Differences between clinical specialist and ad-vanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study). Journal of Advanced Nursing, 2013; 69(6), 1323–1337. https://doi.org/10.1111/j.1365-2648.2012.06124.x.
- 41. Van Boekholt TA, Duits AJ, Busari JO. Health care transformation in a resource-limited environment: exploring the determinants of a good climate for change. J Multidiscip Healthc, 2019; 12:173–182. doi:10.2147/JMDH.S194180.
- 42. Blumenthal, D. M., Bernard, K., Fraser, T. N., Bohnen, J., Zeidman, J., and Stone, V. E. Implementing a pilot leadership course for internal medicine residents: design considerations, participant impressions, and lessons learned, BMC Medical Education 2014; 14:257 http://www.biomedcentral.com/1472-6920/14/257.
- 43. Boamah, S. Linking nurses' clinical leadership to patient care quality: The role of transformational leadership and workplace empowerment. Canadian Journal of Nursing Research, 2018; 50(1), 9-19.
44. Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing outlook, 2018; 66(2), 180-189.
- 45. Mianda, S., & Voce, A. Developing and evaluating clinical lead-ership interventions for frontline healthcare providers: A review of the literature. BMC Health Services Research, 2018; 18(1), 747. https://doi.org/10.1186/s1291 3-018-3561-4.
- 46. Sarto, F., & Veronesi, G. Clinical leadership and hospital performance: assessing the evidence base. BMC health services research, 2016; 16(2), 169.
- 47. Downey, M., Parslow, S., & Smart, M. The hidden treasure in nursing leader- ship: Informal leaders. Journal of Nursing Management, 2011; 19 (4), 517-521.
- 48. George, V., Burke, L., Rodgers, B., Duthie, N., Hoffmann, M.L., Koceja, V., ... Gehring, L.L. Developing staff nurse shared leadership behavior in profes- sional nursing practice. Nursing Admini- stration Quarterly, 2002; 26(3), 44-59.
- 49. Nzinga, J., McGivern, G. and English, M., Examining clinical leadership in Kenyan public hospitals through the distributed leadership lens, Health Policy and Planning, 33, 2018; ii27–ii34 doi: 10.1093/heapol/czx167 Original Article.
- 50. Keogh, B. Review into the quality of care and treatment provided by 14 hospital trusts in England: Overview report. Department of Health, 2013, Retrieved from https://www.nhs.uk/nhsen gland/ bruce -keogh -revie w/docum ents/outco mes/keogh -revie w-final -report. pdf.
- 51. Kirkup, B. The Report of the Morecambe Bay Investigation: An in-dependent investigation into the management, delivery and outcomes of care provided by the maternity and neonatal services at the University Hospitals of Morecambe Bay NHS Foundation Trust from January 2004 to June 2013, 2015.
- 52. Jonas, S., McCay, L., & Keogh, B. The importance of clinical lead-ership. In ABC of clinical leadership. Wiley-Blackwell, BMJ Books, 2011.
- 53. Kakemam, E. And Goodall, A.H., Hospital performance and clinical leadership: New evidence from Iran. BMJ Leader, 2019; doi: 10.1136/leader-2019-000160.
54. Committee on Quality of Healthcare in America. Crossing the quality chasm. A new health system for the 21st century. Washington, DC: Institute of Medicine; 2001. Available from: http://www.iom.edu/ Reports/2001/Crossing-the-Quality-Chasm-A-New-Health-System- for-the-21st-Century.aspx. Accessed February 21, 2014.
- 55. Howieson B, and Thaigarajah T. What is clinical leadership? A journal- based meta-review. Int J Clin Leadersh. 2011; 17:7–18.
- 56. Mannix J, Wilkes L, Daly J. Attributes of clinical leadership in con- temporary nursing: an integrative review. Contemp Nurse. 2013; 45(1): 10–21.
- 57. Davidson P, Elliott D, Daly J. Clinical leadership in contemporary clinical practice: implications for nursing in Australia. J Nurs Manag. 2006;14(3):180–187.
- 58. Nicol, E.D., Mohanna, K. and Cowpe, J., Clinical Leadership Perspectives: A Qualitative Study Exploring the Views of Top Healthcare Leaders in the UK. Journal of the Royal Society of Medicine; 2014; Vol. 107(7) 277–286 doi: 10.1177/0141076814527274.
- 59. Martin J, McCormack B, Fitzsimons D, Spirig R. Evaluation of a clinical leadership programme for nurse leaders. J Nurs Manag. 2012; 20 (1):72–80.
- 60. David Stanley, Denise Blanchard, Amali Hohol, Marani Hutton & Anna McDonald (2017) To cite this article: Health professionals’ perceptions of clinical leadership. A pilot study, Cogent Medicine, 4:1, 1321193, DOI: 10.1080/2331205X.2017.1321193.
- 61. Busari JO, Moll FM, Duits AJ. Understanding the impact of inter- professional collaboration on the quality of care: a case report from a small-scale resource limited health care environment. 10, 227. J Multidiscip Healthc. 2017; 10(227):227–234. doi:10.2147/JMDH. S140042.
- 62. Van Hecke, A., Goemaes, R., Verhaeghe, S., Beyers, W., Decoene, E., & Beeckman, D. Leadership in nursing and midwifery: Activities and associated competencies of advanced practice nurses and mid-wives. Journal of Nursing Management, 2019; 27(6), 1261–1274. https://doi.org/10.1111/jonm.12808.
- 63. Tsai, T. C., Jha, A. K., Gawande, A. A., Huckman, R. S., Bloom, N. & Sadun, R. Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics. Health Affairs, 2015; Vol. 34, No. 8, pp. 1304-1311.
- 64. Lamb, A., Martin-Misener, R., Bryant-Lukosius, D., & Latimer, M. Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing Open, 2018; 5(3), 400–413. https://doi.org/10.1002/nop2.150.
- 65. Collinson, D. Rethinking followership: a Post-Structuralist Analysis of Follower Identities. The Leadership Quarterly, 2006; 17, 179-189.
- 66. Colla, C. H., Lewis, V. A., Shortell, S. M. & Fisher, E. S. First National Survey Of Acos Finds That Clinicals Are Playing Strong Leadership And Ownership Roles. Health Affairs, Vol. 2014; 33, No. 6, pp. 964-971.
- 67. West, M. (2014). Developing Collective Leadership for Health Care. The King’s Fund, 2:London.http://www.kingsfund.org.uk/ sites/ files/ kf/ field/ field publication file/ leadership-for-engagement-improvement-nhs-final-review2012.pdf. ISBN: 9781909029316.
- 68. Stratejik plan 2019-2023, Türkiye Sağlık Enstitüleri Başkanlığı.
Year 2021,
Volume: 5 Issue: 3, 221 - 232, 20.09.2021
Elif Özyurt
,
Keziban Avcı
,
Figen Çizmeci Şenel
References
- 1. Avcı E.Ö. ve Başer M., Klinik karar verme sürecinde Hemşirelerin Liderlik Özellikleri, Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 2019; 6 (2):1-5.
- 2. McSherry, R., & Pearce, P. what are the effective ways to translate clinical leadership into health care quality improvement? Journal of Healthcare Leadership, 2016; 8, 11,11-17.
- 3. Jeon, Y. H., Conway, J., Chenoweth, L., Weise, J., Thomas, T. H., & Williams, A. Validation of a clinical leadership qualities framework for managers in aged care: a Delphi study. Journal of Clinical Nursing, 2015; 24(7-8), 999-1010.
- 4. Gün, İ., & Aslan, Ö. Liderlik kuramları ve sağlık işletmelerinde liderlik. Journal of Health and Nursing Management, 2018; 5(3), 217-226.
- 5. Donald, D. U., Clinical Leadership as a Corollary for Professional Practice and Patient Safety, International Journal of Emergency Mental Health and Human Resilience, Vol. 17, No.1, pp. 2015; 262-266, ISSN 1522-4821.
- 6. Lawrence, N. & Richardson, J. To Explore and Understand the Leadership Experiences of Modern Matrons, Within an Acute NHS Trust. Journal of Nursing Management, 2014; 22(1), 70-79.
- 7. West, M. Developing Collective Leadership for Health Care. The King’s Fund, 2: London. 2014,http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/ leadership-for-engagement-improvement-nhs-final-review2012.pdf. ISBN: 9781909029316.
- 8. Daly, J., Jackson, D., Mannix, J., Davidson, P. M., & Hutchinson, M. The importance of clinical leadership in the hospital setting. Journal of Healthcare Leadership, 2014; 6, 75-83.
- 9. Poddar, R. Learning between Managers and Doctors. British Journal of Healthcare Management; 2013; 19 (4): 192-197.
- 10. Busari, J.O. Management and Leadership Development in Healthcare and The Challenges Facing Physician Managers in Clinical Practice. The International Journal of Clinical Leadership, 2013; 17(4), 211-216. Radcliffe Publishing Ltd.
- 11. Nath, V., & Clark, J. Medical Engagement: A Journey, not an Event. London: The King's Fund. 2014, ISBN: 9781909029088.
- 12. Garling P. Final Report of the Special Commission of Inquiry: Acute Care in NSW Public Hospitals, 2008 – Overview. Sydney, NSW: NSW Government; 2008., Available from: http://www.dpc.nsw. gov.au/__data/assets/pdf_file/0003/34194/Overview_-_Special_ Commission_Of_Inquiry_Into_Acute_Care_Services_In_New_South_ Wales_Public_Hospitals.pdf. Accessed April 9, 2014.
- 13. Snelling, I., Brown, H., Hardy, L., Cockburn, S., and Somerset, L., An Evaluation Of The Health Education England South West Clinical Leadership Mentors Programme, NHS Health Education England, July 2020.
- 14. Olsen O, Husebo S, Qvindesland S, et al. Redefining clinical leadership for team course development. jhosp admin. 2015; 4: 52–60.
- 15. NHS, Clinical Leadership Competency Framework: Self Assessment Tool. NHS Leadership Academy: Leeds. 2012.
- 16. Stanley, D. Clinical leadership characteristics confirmed. Journal of Research in Nursing, 2014; 19, 118–128. https://doi.org/10.1177/1744987112464630.
- 17. Giles, M., Parker, V., Conway, J., & Mitchell, R. Knowing how to get things done. Nurse Consultants as Clinical Leaders. Journal of Clinical Nursing, 2018; 27(9-10), 1981–1993.https://doi.org/10.1111/jocn.14327.
- 18. Darzi, A. Healthcare for London: A Framework for Action, London: NHS Reports, 4 October, 2007.
- 19. Department of Health, NHS Next Stage Review: A High Quality Workforce, London: NHS, 2008 a.
- 20. Department of Health, NHS Next Stage Review Final Report: High Quality Care For All, London: NHS, 2008 b.
- 21. NHS, Clinical Leadership Competency Framework Project: Report on Findings, London: National Leadership Council, 2010.
- 22. Budak. F. Sağlık Yönetiminde Klinik Liderlik, Klinik Liderlik ölçeği, Ankara: Siyasal Kitapevi; 2018, s: 63.
- 23. NHS Leadership Academy. Clinical leadership competency framework: NHS institute for innovation and improvement. Coventry: Coventry House University of Warwick campus, 2011.
- 24. NHS, Clinical leadership a framework for action. NHS Improvement. IG 02/19 Erişim; 2019.https://improvement.nhs.uk/documents/3702/Clinical_leadership_-_framework_Jan2019.pdf, 25.12.2020.
- 25. Özkan, Ş., Klı̇nı̇k Lı̇derlı̇k ve Sağlık Kurumlarına Yansımaları, Uluslararası Liderlik Çalışmaları Dergisi: Kuram ve Uygulama (International Journal of Leadership Studies: Theory and Practice) 2021; 4 (1), 40-50.
- 26. NHS, Clinical Leadership Competency Framework, Leadership Academy, 2011.
- 27. Jacinta Nzinga, Gerry McGivern and Mike English, Examining clinical leadership in Kenyan public hospitals through the distributed leadership lens, Health Policy and Planning, 33, 2018, ii27–ii34 doi: 10.1093/heapol/czx167 Original Article.
- 28. Gauld, R. ve Horsburgh, S., Clinical Governance Assessment Project: Final Report on a National Health Professional Survey and Site Visits to 19 New Zealand DHBs, Dunedin: Centre for Health Systems, University of Otago, 2012.
- 29. VQC, (2005). Developing the Clinical Leadership Role in Clinical Governance: A Guide for Clinicians and Health Services, Victoria: Department of Human Services.
- 30. Hofmann, R., and Vermunt, J. D. Professional learning, organisational change and clinical leadership development outcomes. Medical Education, 2021;55:252-265.
- 31. Coyne, I., Comiskey, C. M., Lalor, J. G., Higgins, A., Elliott, N., & Begley, C. An exploration of clinical practice in sites with and with-out clinical nurse or midwife specialists or advanced nurse practi-tioners, in Ireland. BMC Health Services Research, 2016; 16(1), 151. https:// doi.org/10.1186/s1291 3-016-1412-8.
- 32. Elliott, N., Higgins, A., Begley, C., Lalor, J., Sheerin, F., Coyne, I., & Murphy, K.The identification of clinical and professional leadership activities of advanced practitioners: Findings from the Specialist Clinical and Advanced Practitioner Evaluation study in Ireland. Journal of Advanced Nursing, 2013; 69(5), 1037–1050. https://doi.org/10.1111/j.1365-2648.2012.06090.x.
- 33. Higgins, A., Begley, C., Lalor, J., Coyne, I., Murphy, K., & Elliott, N. Factors influencing advanced practitioners' ability to enact leadership: A case study within Irish healthcare. Journal of Nursing Management, 2014; 22(7), 894–905. https://doi.org/10.1111/ jonm.12057.
- 34. Santiano, N., Young, L., Baramy, L.-S., McDonnell, S., Page, K., Cabrera, R., & Chapman, A. How do CNCs construct their after hours support role in a major metropolitan hospital. Collegian (Royal College of Nursing, Australia), 2009; 16(2), 85–97. https://doi.org/10.1016/j. colegn.2009.03.003.
- 35. Walsh, K., Bothe, J., Edgar, D., Beaven, G., Burgess, B., Dickson, V., Dunn, S., Horning, L., Jensen, J., Kandl, B., Nonu, M., Owen, F., & Moss, C. Investigating the role of Clinical Nurse Consultants in one health district from multiple stakeholder perspectives: A cooper-ative inquiry. Contemporary Nurse, 2015; 51(2–3), 171–187. https://doi.org/10.1080/10376 178.2016.1169936.
- 36. Jamiu O, Busari, Huriye Yaldiz, Reinold OB Gans ve Ashley J Duits, Clinical Leadership As An Agent For Change: A Health System Improvement Intervention İn Curaçao, Journal of Multidisciplinary Healthcare, 2020; 13, 787–798.
- 37. Arensberg, M. B., D’Andrea, C., Khan, M., Clinical Leadership and Innovation Help Achieve Malnutrition Quality Improvement Initiative Success, by the Academy of Nutrition and Dietetics, 2019.
- 38. Husebø S. E., and Olsen, Q. E., Actual clinical leadership: a shadowing study of charge nurses and doctors on-call in the emergency department, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 27, Article number: 2, 2019.
- 39. Bridgman C., McGrady M.G., Clinical leadership and prevention in practice: is a needs led preventive approach to the delivery of care to improve quality, outcomes and value in primary dental care practice a realistic concept? BMC Oral Health 2015; 15 (Suppl 1): S2.
- 40. Begley, C., Elliott, N., Lalor, J., Coyne, I., Higgins, A., & Comiskey, C. M. Differences between clinical specialist and ad-vanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study). Journal of Advanced Nursing, 2013; 69(6), 1323–1337. https://doi.org/10.1111/j.1365-2648.2012.06124.x.
- 41. Van Boekholt TA, Duits AJ, Busari JO. Health care transformation in a resource-limited environment: exploring the determinants of a good climate for change. J Multidiscip Healthc, 2019; 12:173–182. doi:10.2147/JMDH.S194180.
- 42. Blumenthal, D. M., Bernard, K., Fraser, T. N., Bohnen, J., Zeidman, J., and Stone, V. E. Implementing a pilot leadership course for internal medicine residents: design considerations, participant impressions, and lessons learned, BMC Medical Education 2014; 14:257 http://www.biomedcentral.com/1472-6920/14/257.
- 43. Boamah, S. Linking nurses' clinical leadership to patient care quality: The role of transformational leadership and workplace empowerment. Canadian Journal of Nursing Research, 2018; 50(1), 9-19.
44. Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing outlook, 2018; 66(2), 180-189.
- 45. Mianda, S., & Voce, A. Developing and evaluating clinical lead-ership interventions for frontline healthcare providers: A review of the literature. BMC Health Services Research, 2018; 18(1), 747. https://doi.org/10.1186/s1291 3-018-3561-4.
- 46. Sarto, F., & Veronesi, G. Clinical leadership and hospital performance: assessing the evidence base. BMC health services research, 2016; 16(2), 169.
- 47. Downey, M., Parslow, S., & Smart, M. The hidden treasure in nursing leader- ship: Informal leaders. Journal of Nursing Management, 2011; 19 (4), 517-521.
- 48. George, V., Burke, L., Rodgers, B., Duthie, N., Hoffmann, M.L., Koceja, V., ... Gehring, L.L. Developing staff nurse shared leadership behavior in profes- sional nursing practice. Nursing Admini- stration Quarterly, 2002; 26(3), 44-59.
- 49. Nzinga, J., McGivern, G. and English, M., Examining clinical leadership in Kenyan public hospitals through the distributed leadership lens, Health Policy and Planning, 33, 2018; ii27–ii34 doi: 10.1093/heapol/czx167 Original Article.
- 50. Keogh, B. Review into the quality of care and treatment provided by 14 hospital trusts in England: Overview report. Department of Health, 2013, Retrieved from https://www.nhs.uk/nhsen gland/ bruce -keogh -revie w/docum ents/outco mes/keogh -revie w-final -report. pdf.
- 51. Kirkup, B. The Report of the Morecambe Bay Investigation: An in-dependent investigation into the management, delivery and outcomes of care provided by the maternity and neonatal services at the University Hospitals of Morecambe Bay NHS Foundation Trust from January 2004 to June 2013, 2015.
- 52. Jonas, S., McCay, L., & Keogh, B. The importance of clinical lead-ership. In ABC of clinical leadership. Wiley-Blackwell, BMJ Books, 2011.
- 53. Kakemam, E. And Goodall, A.H., Hospital performance and clinical leadership: New evidence from Iran. BMJ Leader, 2019; doi: 10.1136/leader-2019-000160.
54. Committee on Quality of Healthcare in America. Crossing the quality chasm. A new health system for the 21st century. Washington, DC: Institute of Medicine; 2001. Available from: http://www.iom.edu/ Reports/2001/Crossing-the-Quality-Chasm-A-New-Health-System- for-the-21st-Century.aspx. Accessed February 21, 2014.
- 55. Howieson B, and Thaigarajah T. What is clinical leadership? A journal- based meta-review. Int J Clin Leadersh. 2011; 17:7–18.
- 56. Mannix J, Wilkes L, Daly J. Attributes of clinical leadership in con- temporary nursing: an integrative review. Contemp Nurse. 2013; 45(1): 10–21.
- 57. Davidson P, Elliott D, Daly J. Clinical leadership in contemporary clinical practice: implications for nursing in Australia. J Nurs Manag. 2006;14(3):180–187.
- 58. Nicol, E.D., Mohanna, K. and Cowpe, J., Clinical Leadership Perspectives: A Qualitative Study Exploring the Views of Top Healthcare Leaders in the UK. Journal of the Royal Society of Medicine; 2014; Vol. 107(7) 277–286 doi: 10.1177/0141076814527274.
- 59. Martin J, McCormack B, Fitzsimons D, Spirig R. Evaluation of a clinical leadership programme for nurse leaders. J Nurs Manag. 2012; 20 (1):72–80.
- 60. David Stanley, Denise Blanchard, Amali Hohol, Marani Hutton & Anna McDonald (2017) To cite this article: Health professionals’ perceptions of clinical leadership. A pilot study, Cogent Medicine, 4:1, 1321193, DOI: 10.1080/2331205X.2017.1321193.
- 61. Busari JO, Moll FM, Duits AJ. Understanding the impact of inter- professional collaboration on the quality of care: a case report from a small-scale resource limited health care environment. 10, 227. J Multidiscip Healthc. 2017; 10(227):227–234. doi:10.2147/JMDH. S140042.
- 62. Van Hecke, A., Goemaes, R., Verhaeghe, S., Beyers, W., Decoene, E., & Beeckman, D. Leadership in nursing and midwifery: Activities and associated competencies of advanced practice nurses and mid-wives. Journal of Nursing Management, 2019; 27(6), 1261–1274. https://doi.org/10.1111/jonm.12808.
- 63. Tsai, T. C., Jha, A. K., Gawande, A. A., Huckman, R. S., Bloom, N. & Sadun, R. Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics. Health Affairs, 2015; Vol. 34, No. 8, pp. 1304-1311.
- 64. Lamb, A., Martin-Misener, R., Bryant-Lukosius, D., & Latimer, M. Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing Open, 2018; 5(3), 400–413. https://doi.org/10.1002/nop2.150.
- 65. Collinson, D. Rethinking followership: a Post-Structuralist Analysis of Follower Identities. The Leadership Quarterly, 2006; 17, 179-189.
- 66. Colla, C. H., Lewis, V. A., Shortell, S. M. & Fisher, E. S. First National Survey Of Acos Finds That Clinicals Are Playing Strong Leadership And Ownership Roles. Health Affairs, Vol. 2014; 33, No. 6, pp. 964-971.
- 67. West, M. (2014). Developing Collective Leadership for Health Care. The King’s Fund, 2:London.http://www.kingsfund.org.uk/ sites/ files/ kf/ field/ field publication file/ leadership-for-engagement-improvement-nhs-final-review2012.pdf. ISBN: 9781909029316.
- 68. Stratejik plan 2019-2023, Türkiye Sağlık Enstitüleri Başkanlığı.