A research priority for transforming nursing leadership is identifying the personal and professional characteristics most critical to leadership in health care organizations. One way this priority can be addressed is by examining the literature on nursing leadership and its relationship to patient outcomes. Although an abundance of research exists on the topic of leadership in healthcare, little exists that was conducted to a high level of academic standards (Kim & Newby-Bennett, 2012). There are however some relevant findings drawn from the literature. For example, in their systematic review of the literature, Wong, Cummings and Ducharme (2013) examined nursing leadership and its relationship to patient outcomes.
Of the 20 identified articles, Wong, Cummings, and Ducharme (2013) found only nine studies based on an explicit leadership theory and the researchers also note that leader member exchange (LMX) theory is not represented well in the general leadership literature, suggesting a reluctance to acknowledge that health care leaders create in groups and out groups, which the LMX theory identifies. The researchers further note that the majority of studies examined transformational leadership as a theoretical perspective consideration. In this way, the theory of transformational leadership has the most influence in terms of guiding health care leadership research.
In another system review of the literature, Wong and Gillonardo (2013), discovered that six of the nine articles selected for their review explicitly identified transformational leadership theory. Other theories identified in Wong and Giallonardo’s (2013) review were LMX theory, servant leadership theory and authentic leadership theory.
Transformational leadership has demonstrated a positive relationship with employee well-being, increased work-life balance, positive nursing and patient safety outcomes as well as patient and staff satisfaction (Munir, Nielsen, Garde, Albertsen & Carneiro, 2012). A few studies have examined the relationship between authentic leadership in healthcare. The authentic leadership theory places an emphasis on building relationships with followers through ethical behavior and transparency. This trust building leads to employee engagement and improved team and individual performance. For example, Laschinger and Cummings (2010) discovered that nurses who perceived their managers as demonstrating high levels of authentic leadership, reported higher levels of trust, engagement and improved quality of care.
Authentic leadership has also been associated with improved working life, trust in management and improved patient outcomes (Wong &Giallonardo, 2013). Also, authentic leadership has been associated with nurse empowerment, which results in improved job performance. In conclusion, leadership is important to study as the evidence clearly demonstrates the positive impact of transformational and authentic leadership in predicting quality outcomes in health care settings.
- Kim, Y. & Newby-Bennett, D. (2012). The role of leadership in learning culture and patient safety. International Journal of Organization Theory and Behavior, 15 (1), 151–175.
- Munir, F., Nielsen, K., Garde, H., Albertsen, K., & Carneiro, G. (2012). Mediating the effects of work-life conflict between transformational leadership and health-care workers’ job satisfaction and psychological wellbeing. Journal of Nursing Management, 20 (4), 512.
- Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21 (5), 709–24.
- Wong, C. A. & Giallonardo, L.M. (2013). Authentic leadership and nurse-assessed adverse patient outcomes. Journal of Nursing Management, 21 (5), 740–52.
