Leading Innovative Practice: Leadership Attributes in LEAP Practices

Area of Science:

• Healthcare Management
• Organizational Leadership
• Primary Care Systems

Background:

• The US healthcare system is rapidly evolving, with primary care seen as key to achieving the Quadruple Aim.
• Effective practice-level leadership is vital for primary care to adapt to these changes and meet the Quadruple Aim.
• Complex adaptive systems theory provides a framework for understanding essential leadership attributes in dynamic healthcare environments.

Purpose of the Study:

• To identify and evaluate leadership attributes critical for primary care practices undergoing change and innovation.
• To explore how these leadership attributes manifest in high-performing primary care settings.
• To inform the development of leadership training programs for primary care.

Main Methods:

• Literature review on leadership from a complex adaptive systems perspective to identify key attributes.
• Secondary qualitative analysis of data from the Learning from Effective Ambulatory Practice (LEAP) project.
• Application of identified leadership attributes to nine high-performing primary care practices.

Main Results:

• All nine hypothesized leadership attributes (e.g., psychological safety, collective mind, boundary spanning) were evident in innovative practices.
• Two additional attributes, anticipating the future and developing formal processes, were also found to be important.
• A developmental model suggests some leadership attributes are foundational for others.

Conclusions:

• Successful primary care practices demonstrate diverse and strong local leadership.
• Current leadership training for primary care is often insufficient, needing to expand beyond basic team-building.
• Comprehensive leadership development is necessary to equip primary care leaders for a changing healthcare landscape.