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Introduction
The purpose of this paper is to examine the challenges that face health care organizations, the need for associated culture change, the centrality of leadership in that process, the importance of collective leadership specifically in this context and the need for strategic approaches to nurturing collective leadership cultures that deliver high-quality patient care. In summary, the paper aims to outline an approach to nurturing and sustaining cultures in health care organizations that ensure continually improving, high quality and compassionate care for patients and service users. The core propositions of this paper, building on theory and research, are therefore that:
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Organizational culture exerts a profound influence on the behavior of all who work in or interact with an organization. It is defined as “[…] the values and beliefs that characterize organizations, as transmitted by socialization processes that newcomers have, the decisions made by management, and the stories and myths people tell and retell about their organizations” (Schneider and Barbera, 2014, p. 10). Attempts to change culture to ensure high performance, particularly when the environment is highly dynamic, are complex, challenging and can have unpredictable outcomes. It is therefore important to understand and specify the core cultural characteristics needed to deliver high performance in the specific context of health care.
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The single most malleable and powerful influence on the culture of modern organizations is leadership, which includes leadership from the strategic apex through to the front line, informal as well as formal leadership, and which reflects leadership processes as well as the qualities of the individuals who occupy leadership positions.
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Within the specific context of health care, collective leadership is necessary to ensure that continually improving, high quality and compassionate care is given to patients and other service users.
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Nurturing high-performance cultures therefore requires having leaders, leadership behaviors and leadership collaboration aligned around reinforcing the values, behaviors and practices that are core to the desired culture. To achieve this, a collective leadership strategy must be developed and implemented that ensures the organization has the leaders needed, displaying and modeling the desired behaviors and working collectively to nurture the culture required for high performance.
Health services internationally are facing new challenges that will require major change in strategies, structures and cultures. The two main challenges of contemporary...