Collaborative and Shared Leadership Dynamics in Healthcare Action Teams: A Systematic Literature Review.

Area of Science:

• Healthcare Management
• Team Leadership
• Organizational Behavior

Background:

• Healthcare Action Teams (HATs) face high-pressure environments demanding effective collaboration for optimal patient outcomes.
• Existing literature on collaborative leadership in HATs is fragmented, lacking consistent terminology and integrated findings.

Purpose of the Study:

• To systematically review the conceptualization, operationalization, and evaluation of collaborative leadership within HATs.
• To identify forms of collaborative leadership, supporting/constraining mechanisms, organizational factors, and impact on team performance and patient care.

Main Methods:

• A systematic literature review adhering to PRISMA guidelines.
• Searches conducted in Web of Science and EBSCOhost, selecting 56 peer-reviewed articles published up to September 2025.
• Analysis guided by research questions and integrated using functional leadership theory and social differentiation models.

Main Results:

• Identified two leadership forms: vertical differentiation (hierarchical) and horizontal differentiation (distributed).
• Collaborative leadership improves team adaptability, shared mental models, psychological safety, and communication.
• Effectiveness is influenced by organizational hierarchy, professional identity, task complexity, and team familiarity.

Conclusions:

• Collaborative leadership in HATs is a dynamic, context-dependent process crucial for adaptive coordination in clinical settings.
• Appropriate organizational structures and team conditions enhance communication, trust, and patient safety.
• Rigid hierarchies or unclear roles can diminish collaborative leadership effectiveness; a functional lens is proposed for understanding and future research.