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From Followership to Shared Leadership: The Changing Role of the Patient in the Healthcare Team

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Abstract

This chapter explores the changing role of the patient in healthcare teams through the perspective of follower-centered and shared leadership theories, offering individual and team-context factors that influence this role. Healthcare practice increasingly supports patient proactivity in managing their own medical needs, shaped by factors within the team context and at the patient level that move the patient role from follower to leader through sharing complementary knowledge, authority, and responsibility for health service choices. The team context, encompassing broad economic and social realities, includes factors of increased healthcare system and medical complexity, trends in societal demographics, resource limitations, technology in healthcare, culture, and the informed patient. At the patient level, factors affecting participative roles in the healthcare team include a range of personal characteristics, health perceptions, knowledge and information access, relationship with medical professionals, and the informal support network. Through this overview, we aim to contribute to the paradigm shift needed to achieve an appropriate level of followership and shared leadership in healthcare, with the ultimate goal of improving patient well-being within a sustainable healthcare system.

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References

  • Anderson, J. G. (2007). Social, ethical and legal barriers to e-health. International Journal of Medical Informatics, 76(5), 480–483.

    Google Scholar 

  • Anderson, R. M., & Funnell, M. M. (2010). Patient empowerment: Myths and misconceptions. Patient Education and Counseling, 79(3), 277–282.

    Article  Google Scholar 

  • Aujoulat, I., d’Hoore, W., & Deccache, A. (2007). Patient empowerment in theory and practice: Polysemy or cacophony? Patient Education and Counseling, 66(1), 13–20.

    Article  Google Scholar 

  • Binder, L. (2013, December 11). The courage and triumph of the patient. Forbes.com. Retrieved April 5, 2017, from https://www.forbes.com/sites/leahbinder/2013/12/11/the-courage-and-triumph-of-the-patient/

  • Boeckxstaens, P., & De Graaf, P. (2011). Primary care and care for older persons: Position paper of the European forum for primary care. Quality in Primary Care, 19(6), 369–389.

    Google Scholar 

  • Campbell, J., Dussault, G., Buchan, J., Pozo-Martin, F., Guerra Arias, M., Leone, C., … Cometto, G. (2013). A universal truth: No health without a workforce, Forum report, third global forum on human resources for health, Recife, Brazil. Geneva, Switzerland: Global Health Workforce Alliance and World Health Organization.

    Google Scholar 

  • Carson, J. B., Tesluk, P. E., & Marrone, J. A. (2007). Shared leadership in teams: An investigation of antecedent conditions and performance. Academy of Management Journal, 50(5), 1217–1234.

    Article  Google Scholar 

  • Carsten, M. K., & Uhl-Bien, M. (2013). Ethical followership: An examination of followership beliefs and crimes of obedience. Journal of Leadership and Organizational Studies, 20(1), 49–61.

    Article  Google Scholar 

  • Carsten, M. K., Uhl-Bien, M., West, B. J., Patera, J. L., & McGregor, R. (2010). Exploring social constructions of followership: A qualitative study. Leadership Quarterly, 21, 543–562.

    Article  Google Scholar 

  • Cegala, D. J. (2011). An exploration of factors promoting patient participation in primary care medical interviews. Health Communication, 26(5), 427–436.

    Article  Google Scholar 

  • Cox, J. F., Pearce, C. L., & Perry, M. L. (2003). Toward a model of shared leadership and distributed influence in the innovation process: How shared leadership can enhance new product development team dynamics and effectiveness. In C. L. Pearce & J. A. Conger (Eds.), Shared leadership: Reframing the hows and whys of leadership (pp. 48–76). Thousand Oaks, CA: SAGE.

    Chapter  Google Scholar 

  • Davis, R. E., Jacklin, R., Sevdalis, N., & Vincent, C. A. (2007). Patient involvement in patient safety: What factors influence patient participation and engagement? Health Expectations, 10, 259–267.

    Article  Google Scholar 

  • DeChurch, L. A., & Marks, M. A. (2006). Leadership in multiteam systems. Journal of Applied Psychology, 91(2), 311–329.

    Article  Google Scholar 

  • Degner, L. F., & Sloan, J. A. (1992). Decision making during serious illness: What role do patients really want to play? Journal of Clinical Epidemiology, 45(9), 941–950.

    Article  Google Scholar 

  • Dinh, J. E., Lord, R. G., Gardner, W. L., Meuser, J. D., Liden, R. C., & Hu, J. (2014). Leadership theory and research in the new millennium: Current theoretical trends and changing perspectives. The Leadership Quarterly, 25, 36–62.

    Article  Google Scholar 

  • Dweck, C. S., Chiu, C.-Y., & Hong, Y.-Y. (1995). Implicit theories and their role in judgments and reactions: A world from two perspectives. Psychological Inquiry, 6(4), 267–285.

    Article  Google Scholar 

  • Ensley, M. D., Pearson, A., & Pearce, C. L. (2003). Top management team process, shared leadership, and new venture performance: A theoretical model and research agenda. Human Research Management Review, 13, 329–346.

    Google Scholar 

  • Epstein, N. E. (2014). Multidisciplinary in-hospital teams improve patient outcomes: A review. Surgical Neurology International, 5, 295–303.

    Article  Google Scholar 

  • Fraenkel, L., & McGraw, S. J. (2007). What are the essential elements to enable patient participation in medical decision making? Journal of General Internal Medicine, 22(5), 614–619.

    Article  Google Scholar 

  • Frosch, D. L. (2015). The patient is the most important member of the team. British Medical Journal, 350, g7767.

    Article  Google Scholar 

  • Gawande, A. (2007). Annals of medicine: The checklist. The New Yorker.

    Google Scholar 

  • Goldberg, C. B., Clark, M. A., & Henley, A. (2011). Speaking up: A conceptual model of voice responses following the unfair treatment of others in non-union settings. Human Resource Management, 50(1), 75–94.

    Article  Google Scholar 

  • Gottlieb, S. (2015, June 17). The quickening pace of medical progress and its discontents. Forbes.com. Retrieved September 18, 2016, from https://www.forbes.com/sites/scottgottlieb/2015/06/17/the-quickening-pace-of-medicalprogress-and-its-discontents/#374196097a5a

  • Greenfield, G., Ignatowicz, A. M., Belsi, A., Pappas, Y., Car, J., Majeed, A., & Harris, M. (2014). Wake up, wake up! It’s me! It’s my life! Patient narratives on person-centeredness in the integrated care context: A qualitative study. BMC Health Services Research, 14, 619.

    Article  Google Scholar 

  • Hofstede, G. (2001). Culture’s consequences: Comparing values, behaviors, institutions, and organizations across nations (2nd ed.). Thousand Oaks, CA: SAGE.

    Google Scholar 

  • Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–37.

    Article  Google Scholar 

  • Kanfer, R., Luciano, M., & Clark, M. A. (2015). Healthcare transformation in action: Powering change through governance and teamwork. Academy of Management Annual Meeting Proceedings, 2015, 14526–14526.

    Article  Google Scholar 

  • Kean, S., Haycock-Stuart, E., Baggaley, S., & Carson, M. (2011). Followers and the co-construction of leadership. Journal of Nursing Management, 19(4), 507–516.

    Article  Google Scholar 

  • Kena, G., Hussar, W., McFarland, J., de Brey, C., Musu-Gillette, L., Wang, X., … Dunlop Velez, E. (2016). The condition of education 2016, NCES 2016144 (mces.ed.gov).

    Google Scholar 

  • Koné Pefoyo, A. J., Bronskill, S. E., Gruneir, A., Calzavara, A., Thavorn, K., Petrosyan, Y., … Wodchis, W. P. (2015). The increasing burden and complexity of multimorbidity. BMC Public Health, 15, 415.

    Article  Google Scholar 

  • Lee, S. J. C., Clark, M. A., Cox, J., Needles, B. M., Seigel, C., Akpan, J. A., Balasubramanian, B. A. (2016, in press). Achieving coordinated care for complex cancer patients: A multi-team system approach. Journal of Oncology Practice 10.1200/JOP.2016.013664.

  • Longtin, Y., Sax, H., Leape, L. L., Sheridan, S. E., Donaldson, L., & Pittet, D. (2010). Patient participation: Current knowledge and applicability to patient safety. Mayo Clinic Proceedings, 85(1), 53–62.

    Article  Google Scholar 

  • Manser, T. (2009). Teamwork and patient safety in dynamic domains of healthcare: A review of the literature. Acta Anaesthesiologica Scandinavica, 53, 143–151.

    Article  Google Scholar 

  • Neuberger, J. (2000). The educated patient: New challenges for the medical profession (review). Journal of Internal Medicine, 247, 6–10.

    Article  Google Scholar 

  • Nye, J. L. (2002). The eye of the follower. Information processing effects on attributions regarding leaders of small groups. Small Group Research, 33(3), 337–360.

    Article  Google Scholar 

  • O’Leary, K. J., Sehgal, N. L., Terrell, G., & Williams, M. V. (2012). Interdisciplinary teamwork in hospitals: A review and practical recommendations for improvement. Journal of Hospital Medicine, 7, 48–54.

    Article  Google Scholar 

  • Okuyama, A., Wagner, C., & Bijnen, B. (2014). Speaking up for patient safety by hospital-based health care professionals: A literature review. BMC Health Services Research, 14(1), 1.

    Article  Google Scholar 

  • Osborne, R. H., Batterham, R. W., Elsworth, G. R., Hawkins, M., & Buchbinder, R. (2013). The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ). BMC Public Health, 13(1), 1.

    Article  Google Scholar 

  • Pearce, C. L., & Conger, J. A. (2003). All those years ago: The historical underpinnings of shared leadership. In C. L. Pearce & J. A. Conger (Eds.), Shared leadership: Reframing the hows and whys of leadership (pp. 1–18). Thousand Oaks, CA: SAGE.

    Google Scholar 

  • Peikes, D., Chen, A., Schore, J., & Brown, R. (2009). Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials. JAMA: The Journal of the American Medical Association, 301, 603–618.

    Article  Google Scholar 

  • Pronovost, P. J., Berenholtz, S. M., Goeschel, C. A., Needham, D. M., Sexton, J. B., Thompson, D. A., … Hunt, E. (2006). Creating high reliability in health care organizations. Health Service Research, 41, 1599–1617.

    Article  Google Scholar 

  • Schillinger, D., Bindman, A., Wang, F., Stewart, A., & Piette, J. (2004). Functional health literacy and the quality of physician–patient communication among diabetes patients. Patient Education and Counseling, 52(3), 315–323.

    Article  Google Scholar 

  • Scott, A., & Vick, S. (1999). Patients, doctors and contracts: An application of principal-agent theory to the doctor-patient relationship. Scottish Journal of Political Economy, 46(2), 111–134.

    Article  Google Scholar 

  • Scott, L., & Caress, A. (2005). Shared governance and shared leadership: Meeting the challenges of implementation. Journal of Nursing Management, 13(1), 4–12.

    Article  Google Scholar 

  • Spencer, B. (2016, August 22). Death rates from heart attacks and strokes plummet in a decade – Thanks to medical advances and better drugs. Daily Mail Online. Retrieved September 18, 2016, from http://www.dailymail.co.uk/health/article-3753134/Death-rates-heart-attacks-strokes-plummet-decade-thanksmedical-advances-better-drugs.html

  • Spooner, S. H., Keenan, R., & Card, M. (1997). Determining if shared leadership is being practiced: Evaluation methodology. Nursing Administration Quarterly, 22(1), 47–56.

    Article  Google Scholar 

  • Steinert, T., Goebel, R., & Rieger, W. (2006). A nurse-physician co-leadership model in psychiatric hospitals: Results of a survey among leading staff members in three sites. International Journal of Mental Health Nursing, 15(4), 251–258.

    Article  Google Scholar 

  • Stokken, R. (2009). The patient educated patient: A health-care asset or problem? Social Theory & Health, 7, 81–99.

    Article  Google Scholar 

  • Street Jr., R. L. (2003). Communication in medical encounters: An ecological perspective. In T. L. Thompson, A. M. Dorsey, K. I. Miller, & R. Parrott (Eds.), Handbook of health communication (pp. 63–89). Mahwah, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Street Jr., R. L., Gordon, H. S., & Haidet, P. (2007). Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor? Social Science & Medicine, 65(3), 586–598.

    Article  Google Scholar 

  • Street Jr., R. L., Gordon, H. S., Ward, M. M., Krupat, E., & Kravitz, R. L. (2005). Patient participation in medical consultations: Why some patients are more involved than others. Medical Care, 43(10), 960–969.

    Article  Google Scholar 

  • Thompson, A. G. (2007). The meaning of patient involvement and participation in health care consultations: A taxonomy. Social Science & Medicine, 64(6), 1297–1310.

    Article  Google Scholar 

  • Uhl-Bien, M., Riggio, R. E., Lowe, K. B., & Carsten, M. K. (2014). Followership theory: A review and research agenda. Leadership Quarterly, 25, 83–104.

    Article  Google Scholar 

  • UNESCO. (2016). Education for people and planet: Creating sustainable futures for all. Global Education Monitoring Report.

    Google Scholar 

  • United Nations. (2015). Department of Economic and Social Affairs, population division, world population ageing 2015 (ST/ESA/SER.A/390).

    Google Scholar 

  • Weaver, S. J., Dy, S. M., & Rosen, M. A. (2014). Team-training in healthcare: A narrative synthesis of the literature. BMJ Quality & Safety, 23, 359–372.

    Article  Google Scholar 

  • Weaver, S. J., Feitosa, J., Salas, E., Seddon, R., & Vozenilek, J. A. (2013). The theoretical drivers and models of team performance and effectiveness for patient safety. In E. Salas & K. Frush (Eds.), Improving patient safety through teamwork and team training. New York: Oxford Press.

    Google Scholar 

  • World Health Organization. (1998). Health promotion glossary. Health Promotion International, 13(4), 349–364.

    Article  Google Scholar 

  • Wyskiel, R. M., Weeks, K., & Marsteller, J. A. (2015). Inviting families to participate in care: A family involvement menu. Joint Commission Journal of Quality and Patient Safety, 41(1), 43–46.

    Article  Google Scholar 

  • Zaccaro, S. J. (2001). The nature of executive leadership: A conceptual and empirical analysis of success. Washington, DC: American Psychological Association.

    Book  Google Scholar 

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Clark, M.A., Buljac-Samardžić, M. (2018). From Followership to Shared Leadership: The Changing Role of the Patient in the Healthcare Team. In: Chatwani, N. (eds) Distributed Leadership. Palgrave Studies in Leadership and Followership. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-59581-8_4

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