• Belinda Dewar and Fiona Cook.
• Institute of Care and Practice Improvement, University of West of Scotland, Faculty of Health Education and Social Sciences, School of Health, Nursing and Midwifery, Caird Building, Hamilton Campus, Almada Street, Hamilton ML3 OBA, United Kingdom. Electronic address: Belinda.dewar@uws.ac.uk.
• Nurse Educ Today. 2014 Sep 1; 34 (9): 1258-64.

BackgroundRecent attention in health care focuses on how to develop effective leaders for the future. Effective leadership is embodied in relationships and should be developed in and with staff and patients. This paper describes development, implementation and evaluation of an appreciative and relationship centred leadership programme carried out with 86 nursing staff covering 24 in-patient areas within one acute NHS Board in Scotland.Aim Of Leadership ProgrammeThe aim of the programme was to support staff to work together to develop a culture of inquiry that would enhance delivery of compassionate care.Theoretical UnderpinningsThe 12 month Leadership Programme used the principles of appreciative relationship centred leadership. Within this framework participants were supported to explore relationships with self, patients and families, and with teams and the wider organisation using caring conversations.Structure Of ProgrammeParticipants worked within communities of practice and action learning sets. They were supported to use a range of structured tools to learn about the experience of others and to identify caring practices that worked well and then explore ways in which these could happen more of the time.MethodsA range of methods were used to evaluate impact of the programme including a culture questionnaire and semi structured interviews. Immersion crystallisation technique and descriptive statistics were used to analyse the data.FindingsKey themes included; enhanced self-awareness, better relationships, greater ability to reflect on practice, different conversations in the workplace that were more compassionate and respectful, and an ethos of continuing learning and improvement.ConclusionsThe programme supported participants to think in different ways and to be reflective and engaged participants rather than passive actors in shaping the cultural climate in which compassionate relationship centred care can flourish. Multidisciplinary programmes where the process and outcomes are explicitly linked to organisational objectives need to be considered in future programmes.Copyright © 2014 Elsevier Ltd. All rights reserved.

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