title: Making time for learning-oriented leadership in multidisciplinary hospital management groups.
abstract: BACKGROUND
  Although the clinical requirements of health care delivery imply the need for interdisciplinary management teams to work together to promote frontline learning, such interdisciplinary, learning-oriented leadership is atypical.
  
  
  OBJECTIVE
  We designed this study to identify behaviors enabling groups of diverse managers to perform as learning-oriented leadership teams on behalf of quality and safety.
  
  
  METHODS
  We randomly selected 12 of 24 intact groups of hospital managers from one hospital to participate in a Safety Leadership Team Training program. We collected primary data from March 2008 to February 2010 including pre- and post-staff surveys, multiple interviews, observations, and archival data from management groups. We examined the level and trend in frontline perceptions of managers' learning-oriented leadership following the intervention and ability of management groups to achieve objectives on targeted improvement projects. Among the 12 intervention groups, we identified higher- and lower-performing intervention groups and behaviors that enabled higher performers to work together more successfully.
  
  
  RESULTS
  Management groups that achieved more of their performance goals and whose staff perceived more and greater improvement in their learning-oriented leadership after participation in Safety Leadership Team Training invested in structures that created learning capacity and conscientiously practiced prescribed learning-oriented management and problem-solving behaviors. They made the time to do these things because they envisioned the benefits of learning, valued the opportunity to learn, and maintained an environment of mutual respect and psychological safety within their group.
  
  
  CONCLUSIONS
  Learning in management groups requires vision of what learning can accomplish; will to explore, practice, and build learning capacity; and mutual respect that sustains a learning environment.
authors.affiliation: Sara J. Singer, MBA, PhD, is Associate Professor of Health Care Management and Policy, Harvard School of Public Health/Harvard Medical School, Boston, Massachusetts. E-mail: ssinger@hsph.harvard.edu. Jennifer E. Hayes, EdM, was Qualitative Research Analyst, Massachusetts General Hospital and Center for Organization, Leadership and Management Research, VA Boston Healthcare System, Massachusetts; currently, Health Systems Specialist, Office of Academic Affiliations, Veterans Health Administration, Washington, D.C. Garry C. Gray, PhD, is Assistant Professor of Sociology, University of Victoria, British Columbia, Canada; and a Network Fellow, Edmond J. Safra Center for Ethics, Harvard University, Cambridge, Massachusetts. Mathew V. Kiang, MPH, is Doctoral Candidate, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Singer
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Hayes
authors.forename: Garry C
authors.initials: GC
authors.lastname: Gray
authors.forename: Mathew V
authors.initials: MV
authors.lastname: Kiang
mesh_terms: D007324:Institutional Management Teams; D007857:Leadership; D007858:Learning; D009937:Organizational Objectives; D017751:Safety Management