title: Distributed leadership to mobilise capacity for accreditation research.
abstract: OBJECTIVE
  Inquiries into healthcare organisations have highlighted organisational or system failure, attributed to poor responses to early warning signs. One response, and challenge, is for professionals and academics to build capacity for quality and safety research to provide evidence for improved systems. However, such collaborations and capacity building do not occur easily as there are many stakeholders. Leadership is necessary to unite differences into a common goal. The lessons learned and principles arising from the experience of providing distributed leadership to mobilise capacity for quality and safety research when researching health care accreditation in Australia are presented.
  
  
  METHODS
  A case study structured by temporal bracketing that presents a narrative account of multi-stakeholder perspectives. Data are collected using in-depth informal interviews with key informants and ethno-document analysis.
  
  
  RESULTS
  Distributed leadership enabled a collaborative research partnership to be realised. The leadership harnessed the relative strengths of partners and accounted for, and balanced, the interests of stakeholder participants involved. Across three phases, leadership and the research partnership was enacted: identifying partnerships, bottom-up engagement and enacting the research collaboration.
  
  
  CONCLUSIONS
  Two principles to maximise opportunities to mobilise capacity for quality and safety research have been identified. First, successful collaborations, particularly multi-faceted inter-related partnerships, require distributed leadership. Second, the leadership-stakeholder enactment can promote reciprocity so that the collaboration becomes mutually reinforcing and beneficial to partners.
  
  
  CONCLUSIONS
  The paper addresses the need to understand the practice and challenges of distributed leadership and how to replicate positive practices to implement patient safety research.
authors.affiliation: Centre for Clinical Governance Research, University of New South Wales, Kensington, Australia. d.greenfield@unsw.edu.au
authors.forename: David
authors.initials: D
authors.lastname: Greenfield
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
authors.forename: Marjorie
authors.initials: M
authors.lastname: Pawsey
authors.forename: Brian
authors.initials: B
authors.lastname: Johnson
authors.forename: Maureen
authors.initials: M
authors.lastname: Robinson
mesh_terms: D000068:Accreditation; D001315:Australia; D003299:Cooperative Behavior; D006302:Health Services Research / Q000379:methods*; D006739:Hospital Administration; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D007857:Leadership; D036301:Qualitative Research; D011787:Quality of Health Care / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration*