Leading value-based health care: The role of leadership in integrated practice units

An important aspect of value-based health care is providing care in an integrated practice unit (IPU). In an IPU, the full cycle of care for a specific medical condition is delivered through collaboration among professionals with diverse functional backgrounds. Although the proposed functioning of an IPU in the literature on value-based health care is based on assumptions about leadership, the role of leadership in the context of IPUs is overlooked in empirical studies.

Drawing on previous studies on shared leadership in other organizational contexts, this paper explores the role of formal leadership in the emergence of shared leadership in IPUs.

To this end, we carried out a qualitative study in four IPUs in the Netherlands with differing formal leadership structures.

We found that, in an IPU, leadership is mainly exhibited by those in formal leadership positions. It also appeared that having one versus multiple formal leaders can influence the opportunities for other IPU members to demonstrate leadership and the extent to which IPU members feel the need to exercise leadership in IPUs.

We encourage staff managers and IPU members to define clear roles for leaders and establish a structured strategy for sharing information and resources, such as communication channels and regular feedback loops.