title: A Tale of Two Sites: Lessons on Leadership from the Implementation of a Long-term Care Delivery Model (CDM) in Western Canada.
abstract: Residential, long-term care serves vulnerable older adults in a facility-based environment. A new care delivery model (CDM) designed to promote more equitable care for residents was implemented in a health region in Western Canada. Leaders and managers faced challenges in implementing this model alongside other concurrent changes. This paper explores the question: How did leadership style influence team functioning with the implementation of the CDM? Qualitative data from interviews with leadership personnel (directors and managers, residential care coordinators and clinical nurse educators), and direct care staff (registered nurses, licensed practical nurses, health care aides, and allied health therapists), working in two different facilities comprise the main sources of data for this study. The findings reveal that leaders with a servant leadership style were better able to create and sustain the conditions to support successful model implementation and higher team functioning, compared to a facility in which the leadership style was less inclusive and proactive, and more resistant to the change. Consequently, staff at the second facility experienced a greater sense of overload with the implementation of the CDM. This study concludes that strong leadership is key to facilitating team work and job satisfaction in a context of change.
authors.affiliation: Department of Geography and Centre on Aging, University of Victoria, Victoria, BC V8W 2Y2, Canada. dcfisher@uvic.ca.
authors.forename: Denise
authors.initials: D
authors.lastname: Cloutier
authors.affiliation: Department of Sociology and Centre on Aging, University of Victoria, Victoria, BC V8W 3P5, Canada. amygc@uvic.ca.
authors.forename: Amy
authors.initials: A
authors.lastname: Cox
authors.affiliation: Department of Sociology and Centre on Aging, University of Victoria, Victoria, BC V8W 3P5, Canada. rkampen@uvic.ca.
authors.forename: Ruth
authors.initials: R
authors.lastname: Kampen
authors.affiliation: Department of Sociology and Centre on Aging, University of Victoria, Victoria, BC V8W 3P5, Canada. kmkobay@uvic.ca.
authors.forename: Karen
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Interior Health Authority, Kelowna, BC V1Y 4N7, Canada. Heather.Cook@interiorhealth.ca.
authors.forename: Heather
authors.initials: H
authors.lastname: Cook
authors.affiliation: Interior Health Authority, Kelowna, BC V1Y 4N7, Canada. Deanne.Taylor@interiorhealth.ca.
authors.forename: Deanne
authors.initials: D
authors.lastname: Taylor
authors.affiliation: First Nations Health Authority, Vancouver, BC V6C 1A1, Canada. Gina.Gaspard@fnha.ca.
authors.forename: Gina
authors.initials: G
authors.lastname: Gaspard
keywords: care delivery model; change management; direct care staff; leadership; long-term care; team work