The Influence of Authentic Leadership and Empowerment on New-Graduate Nurses’ Perceptions

1. The Influence of Authentic Leadership and Empowerment on New-Graduate Nurses’ Perceptions of Interprofessional Collaboration Heather K. Spence Laschinger, RN, PhD, FAAN, FCAHS The University of Western Ontario Leslie Marie Smith, MScN, RN The University of Western Ontario Collaborating Across Borders (CAB IV) Vancouver, British Columbia June 12-14, 2013

2. PRESENTATION OVERVIEW • Background • Related literature • Authentic Leadership • Empowerment • Interprofessional Collaboration • Hypothesized model • Aims of the current study • Methods • Results • Conclusions

3. BACKGROUND • Lack of proper communication and collaboration between healthcare workers is responsible for a high percentage of adverse events (~70%) • New graduate nurses require support from their leaders as they transition to their nurse role • Empowering leadership practices play an important role in establishing work environments that encourage greater teamwork and that empower workers to optimize their practice • The influence of leadership and empowerment on interprofessional collaboration in healthcare has not yet been examined

4. Authentic Leadership(Avolio et al., 2004)) • “…a pattern of transparent and ethical leader behaviour that encourages openness in sharing information needed to make decisions while accepting input from those who follow.” (Avolioet al., 2009) • Authentic leadership is linked to empowerment (Laschinger et al., 2012; Zhu et al., 2004) • Authentic leadership consists of: • Self-Awareness • Relational Transparency • Moral/Ethical Behaviour • Balanced Information Processing

5. Authentic Leadership Behaviours(Avolio et al., 2004) COMPONENTEXAMPLE BEHAVIOURS (1) Relational Transparency Says exactly what she/he means Encourages others to speak-up about their concerns (2) Moral/Ethical Conduct Acts in accordance with her/his stated beliefs Uses core values to make decisions (3) Balanced Processing Seeks out opinions that challenge personal views Takes multiple points of view into consideration (4) Self-Awareness Asks for feedback to improve interpersonal interactions Understands how her/his actions affect others

6. STRUCTURAL EMPOWERMENT THEORY(KANTER 1977; 1993) “…access to organizational structures that enable employees to accomplish their work in meaningful ways…” (Kanter, 1979). Kanter describes four organizational empowerment structures: • Access to information • Access to support • Access to resources needed to do the job • Opportunities to learn and grow Structural empowerment is linked to: • Supportive professional practice environments (Upeneiks, 2003) • Co-worker respect (Laschinger, 2004) • Nurse-physician collaboration (Faulkner & Laschinger, 2008) • Work effectiveness (Laschinger, Wong, McMahon & Kaufmann, 1999)

7. INTERPROFESSIONAL COLLABORATION (IPC) IPC is a “collaborative practice whereby healthcare workers from different professional backgrounds work together with patients, families, carers, and communities, to deliver the highest quality of care” (WHO, 2010) IPC is viewed as critical to patient safety (Zwarrenstein & Bryant, 2000) IPC has been linked to: Increased job satisfaction, decreased job turnover intent and burnout (Rafferty et al., 2001) Greater trust in team members, reduced co-worker conflict and increased knowledge sharing (Gaboury et al., 2011)

8. INTERPROFESSIONAL COLLABORATION (IPC) Challenges associated with IPC(Delvaet al., 2008; Kenaszchuck et al., 2010; Reeves et al., 2009): Lack of understanding/valuing of members roles Differing views on collaboration Hierarchical imbalances Poor communication

9. HYPOTHESIZED MODEL Authentic leadership + Interprofessional Collaboration Structural empowerment +

10. AIM OF THE CURRENT STUDY • To test the relationships between leaders’ authentic leadership practices, the degree of structural empowerment in their work settings and new-graduate nurses’ perceptions of the quality • of IPC on their units.

11. Methods and Analysis Sample: Data from second wave of longitudinal study: Time 2 = 194 Random sample of acute care new graduates (< 2 years) Original sample obtained from provincial registration database Data Collection: • Mail survey • Modified Dillman Total Design Method (2000) • Data were collected in 2010 Data Analysis: • Descriptive and Hierarchical Multiple Regression analyses using SPSS 20.0

12. Measures • AUTHENTIC LEADERSHIP • The Authentic Leadership Questionnaire (ALQ) (Avolio, Gardner, & Walumbwa, 2007) • STRUCTURAL EMPOWERMENT • Conditions of Work Effectiveness Questionnaire (CWEQ-11) (Laschinger, 2000) • INTERPROFESSIONAL COLLABORATION • 6 item newly created scale based on previous research (Kenaszchuck et al., 2010; Orchard et al., 2005)

13. DESCRIPTIVE RESULTS Moderate levels of authentic leadership and structural empowerment High perceptions of overall IPC on work units

14. TEST OF HYPOTHESIS Authentic leadership .29 Interprofessional Collaboration Structural empowerment .29 • Both authentic leadership and empowerment were sig. independent predictors of IPC • Authentic leadership and empowerment explained 9-29% of the variance in 4 out of 5 components of IPC (personal belief that IPC improved patient care = ns)

15. CONCLUSIONS Both authentic leadership and empowerment are important and may be fundamental organizational resources that positively influence new-graduate nurses’ experiences of IPC on their units Authentic leaders are well positioned to ensure that new graduates are integrated into interprofessional teams and are seen as valued contributors in the delivery of care Positive experiences on interprofessionalteams are vitally important for new graduates’ future inclinations to collaborate Experiences of IPC may help ensure that patients benefit from higher quality, less fragmented care

16. Questions?(hkl@uwo.ca)