Clinical Leadership @ Nursing Homes

Role models in residential care homes?

Working in a WZC requires driven and punishing caregivers with a lot of expertise! Some carers are truly role models in this, they make a substantial difference in residential care centres for the residents and their colleagues. We also call them 'clinical leaders'. In hospitals, the concept of 'clinical leadership' is already well known and well-established, but in elderly care, let alone residential care centres (WZC), it is not at all. With this study, we want to change that!

Clinical leaders are care providers who, with their knowledge and skills, can make the difference and go that extra mile. Although they have no formal mandate to be leaders, some care providers really are key figures or role models. They sense very well what residents need and respond appropriately to difficult situations. They can influence, motivate and inspire others with their drive. They are 'clinical leaders' who promote the quality of care for residents and increase job satisfaction among their colleagues.

Definition and characteristics of a clinical leader

By talking to many caregivers, we found out how 'clinical leadership' is recognised in a WZC. We listened to caregivers talk about the team they work in and about their colleagues. It became clear that - just as in hospitals - healthcare providers recognise each other as clinical leaders in that setting too. By analysing those stories, we defined clinical leaders as inspired healthcare providers who translate their knowledge and expertise into attention to good, person-centred care. They are connected to the vision of the CHS and the team, and have communication skills with all stakeholders. These caregivers are also flexible, have a sense of responsibility and, above all, are very people-oriented with a warm heart for residents. 

We present the eight characteristics of a clinical leader in a CHC in a flower model (see figure below). A flower, because caregivers can grow in their role as clinical leaders. They possess a "core" of people orientation and team competence and their petals illustrate their other traits. Environmental factors such as professional identity, work environment, leadership style of the manager and team dynamics may or may not make clinical leaders grow more or less.

A clinical leader possesses every trait. Sometimes he possesses one trait more than another, or is stronger in one trait than another. So it is not necessary for a clinical leader to be equally good in every trait. But the fact that a clinical leader excels in one or more traits sets him apart from other healthcare providers. Because healthcare providers can grow in their role as clinical leaders, the traits of a clinical leader in the model of clinical leadership in nursing homes are represented as petals a flower.

Impact of clinical leadership on corona crisis

The physically and emotionally taxing working conditions during the corona crisis went against their ability to continue providing good, warm and person-centred care. This prevented them from functioning optimally, causing them to experience insecurity and risk losing their engagement. Yet it turned out that skilled, agile, team-oriented and communicatively strong caregivers managed to deal resiliently with the corona crisis. Caregivers with many clinical leadership traits sharpened team spirit, pursued creative solutions and, despite the crisis, experienced a pride in what they were able to achieve. In contrast, healthcare providers who had few CL traits functioned more laboriously, showed little agility to cope with the corona crisis and struggled to continue to strive for quality, people-centred care.   

Clinical leaders succeed in taking the quality of care in an ASC to the next level. Their presence makes a multidisciplinary team stronger. And despite the fact that the corona crisis put pressure on the WZC, clinical leaders managed to continue to ensure quality care as much as possible. Commitment to clinical leadership by supporting inspired caregivers seems crucial and promising in elderly care that is developing rapidly.