Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2026

Collective leadership in healthcare: what is the evidence for safer patient care? A systematic review (#79)

Helen Phuong 1 2 , Sumitha Bhaskaran 3 , Alicia James 4 , Cassandra Gorton 5 , Amelia Crabtree 6 7
  1. Aged and Rehabilitation Division, Monash Health , Melbourne
  2. Geriatric Medicine , Alfred Health , Melbourne
  3. General Medicine, Aged, Rehabilitation Division, Monash Health , Melbourne
  4. Allied Health , Monash Health , Melbourne
  5. Library Services, Monash Health , Melbourne
  6. School of Clinical Sciences, Monash University, Melbourne
  7. Continuing Care Division, Epworth Healthcare, Melbourne

Collective leadership involves distribution of leadership roles and responsibilities across various team members and has been proposed to replace traditional hierarchical leadership structures in healthcare (1-4).

 

Aims

To determine the relationship between collective leadership and 1) clinical outcomes 2) patient and healthcare worker experiences 3) healthcare performance

 

Methods

A systematic review of published and grey literature, utilising Medline and Emcare (Ovid) was conducted. Multidisciplinary collective leadership models in healthcare settings were included.  Screening was undertaken in Covidence and study quality was assessed using the Joanna Briggs Institute tool. A narrative synthesis was completed.

 

Results

From 3004 records, six studies were included. All studies were published in the past ten years and half (n=3) were conducted in acute hospital settings. Designs were commonly quantitative (n=4); two studies met all quality criteria. Shared leadership was the most frequently evaluated subtype of collective leadership (n=3). There were no concrete clinical outcomes reported however participants in one study perceived positive impacts due to increased holistic care. Two studies reported positive impacts on patient experience through improved safety. Five studies explored healthcare worker experiences which included positive outcomes at the team level (teamwork and innovation) and lower stress for individuals. No studies evaluated healthcare performance.

 

Conclusions

Collective leadership appears to positively influence perceived clinical care, patient experience, and healthcare worker wellbeing. However, evidence base is limited, with an absence of objective outcomes. Robust research is required to evaluate impacts across diverse healthcare contexts, including subacute settings, and on measurable effects on patient outcomes.

  1. De Brún A, Anjara S, Cunningham U, Khurshid Z, Macdonald S, O’Donovan R, et al. The Collective Leadership for Safety Culture (Co-Lead) Team Intervention to Promote Teamwork and Patient Safety. Int J Environ Res Public Health. 2020 Nov 22;17(22):8673.
  2. De Brún A, O’Donovan R, McAuliffe E. Interventions to develop collectivistic leadership in healthcare settings: a systematic review. BMC Health Serv Res. 2019 Jan 25;19(1):72.
  3. Hunter ST, Bedell-Avers KE, Mumford MD. The typical leadership study: Assumptions, implications, and potential remedies. Leadersh Q. 2007 Oct 1;18(5):435–46.
  4. Silva JAM, Mininel VA, Agreli HF, Peduzzi M, Harrison R, Xyrichis A. Collective leadership to improve professional practice, healthcare outcomes and staff well-being. 2022;(10).