Leadership Matters

There is a growing body of research to show that the role of leadership is a critical factor in the achievement of evidence-based practice. A number of articles in Worldviews on Evidence-Based Nursing reflect this (e.g., Gifford et al. 2007; Sandstrom et al. 2011; Wilkinson et al. 2011; Gifford et al. 2012), as do some conceptual and theoretical frameworks (e.g., Rycroft-Malone et al. 2002; Damschroder et al. 2009). Whilst leadership has been receiving growing attention from the evidence-based practice community and has been the subject of an increasing number of research projects, many questions remain about what we mean by leadership, and about why and how leadership might be so important. Often leadership is conflated with the concept of management and the roles of leaders, with managers. Clearly these functions and roles are difficult to disentangle— managers may be good leaders for evidence-based practice change, and recognized leaders in evidence-based practice change, good managers. The important factor for designing, conducting, and reporting on leadership related research, whether in secondary or primary studies, is that there is clarity about how terms are being operationalized. This has not often been the case to date. However, what is clear from the evidence base, albeit relatively young and underdeveloped (Gifford et al. 2007; Sandstrom et al. 2011) is that that managerial support for improving the success of evidence-based practice is important (Wilkinson et al. 2011). The question about why and how leadership is important to the achievement of evidence-based practice is a fertile research ground as there are a limited number of research studies in this area. There is evidence to suggest that leaders have the potential to create the appropriate conditions and context for evidence-based practice. For example, Stetler et al. (2009) studied an organization in which evidence-based practice was considered to be institutionalized—that is, evidence-based practice had become the norm. One of the features of the context of this organization was a distributed model of leadership, in which evidence-based practice was an important feature at all levels of the organization. Whilst there will be further reporting from this study about leaders’ functional and strategic behaviors, data show that this distributed model of informal and formal leadership, which was spearheaded by the chief nursing officer, resulted in condi-