Impact of clinical leadership development on the clinical leader, nursing team and care-giving process: a case study

J Nurs Manag. 2008 Sep;16(6):753-63. doi: 10.1111/j.1365-2834.2008.00930.x.


Aim: This study explored the dynamics related to a leadership development programme and their impact on the clinical leader, the nursing team and the care-giving process.

Background: While there is a growing conviction about the need to invest in transformational leadership in nursing, further insight into the true complexity of leadership development and, more specifically, how leadership can make a difference in nursing and patient outcomes is essential.

Method: A single instrumental case study was conducted in a unit of a large academic hospital where a Clinical Leadership development Project (CLP) was implemented successfully. We used mixed methods with multiple sources of data to capture the complexity of leadership development. Data were collected through individual interviews, focus groups and observation of participants. A purposive sample of 17 participants representing a wide variety of team members has permitted data saturation. The data were categorized and conceptualized and finally organized into a framework describing leadership development on the unit and its impact on the leader, the nursing team and the care-giving process.

Results: Leadership development is an ongoing, interactive process between the clinical leader and the co-workers. The head nurse became more effective in areas of self-awareness, communication skills, performance and vision. The nursing team benefited because more effective leadership promoted effective communication, greater responsibility, empowerment and job clarity. Improved clinical leadership seemed also to influence patient-centred communication, continuity of care and interdisciplinary collaboration.

Conclusions: The results of the study give more insight into the processes underlying the leader's progress towards attaining a transformational leadership style and its impact on the team members. The impact of leadership on the care-giving process, however, remains difficult to describe.

Implications for nursing management: The interactive nature of leadership development makes CLP a challenge for the leader as well for the team members. Through its impact on the leader and the nursing team, CLP is a valuable instrument for improving work environments of nurses, contributing positively to patient-centred care.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Belgium
  • Clinical Competence* / standards
  • Communication
  • Education, Nursing, Continuing / organization & administration*
  • Focus Groups
  • Health Facility Environment / organization & administration
  • Humans
  • Interprofessional Relations
  • Leadership*
  • Nurse Administrators* / education
  • Nurse Administrators* / psychology
  • Nurse's Role / psychology
  • Nursing Education Research
  • Nursing Methodology Research
  • Nursing Staff, Hospital / psychology*
  • Outcome Assessment, Health Care
  • Personnel Turnover
  • Program Evaluation
  • Quality of Health Care / organization & administration
  • Self Efficacy
  • Staff Development / organization & administration*
  • Surveys and Questionnaires