Grant: Travel Awards - Institute Community Support

Providing care for populations that are increasing in medical and social complexity is a well-recognized challenge that necessitates coordinating services across multiple sectors and organizations. There is a need to re-organize how care is delivered to align with coordination efforts, in the form of inter-organizational networks. However, substantial gaps remain in our understanding of how to effectively implement these networks, and what leadership approaches facilitate successful implementation. Drawing on distributed leadership theory, we examine how leadership is enacted in Health Links networks, a care coordination initiative in Ontario, Canada. We conducted a qualitative multiple case study of three Health Links. 30 participants participated in hour-long, semi-structured interviews. We find that distributed leadership was enacted across all cases, and ranged from strong distributed models with numerous strategic partners, to 'weaker' distributed approaches that were primarily directed by the lead organization's vision and leadership. In all cases, the lead organization's influence was critical to the network's perceived successful implementation. When effectively leveraging their role, the lead organization empowered partners to enact distributed leadership across their network. However, strong variability was seen in the capacity of each lead organization to harness their power and position, resulting in mixed experiences of implementation.