We advance a comprehensive theory of tailoring leadership development that subsumes the plethora of insights on the tailoring of leadership development programs fragmented across multiple disciplines under a unified framework. In doing so, we answer an over 30-year continuous call for a deeper understanding of the tailoring of leadership development. Based on a close reading of the leadership development literature, we derive six elements generic to all leadership development programs and use these as a basis for outlining a multidimensional conceptualization of tailoring leadership development. Subsequently, we use this enhanced conceptualization to explain how the dimensions of tailoring leadership development combine to inform transfer of training over time. Our theoretical framework offers researchers a much-needed conceptual foundation for studying tailoring leadership development, thus enabling generation, dissemination and synthesis of knowledge in this important research area. Our framework also serves as a guide for enhanced application of leadership development for scholars and practitioners alike.

In this article, we extend the understanding of enabling leadership in complexity leadership theory by showing what enables and stifles organizational adaptability. By drawing on a case study of an organizational change related to competence supply in health and care services, we explore what (enabling) leaders do, in the different (i.e. ideation and scaling) stages of an adaptive process, to engage the two complexity (i.e. the tension and the linking up) dynamics that are essential for nurturing and sustaining adaptive processes in organizations. The results show that, in both stages, the way a complexity challenge is framed can determine the type of process it will trigger: if the challenge is framed as a technical one, while trying to eliminate tensions, the likely response is an order one; if the challenge is framed as a complex one, while trying to sustain tensions, the likely response is an adaptive one. Ideation can be held back by not only 'external' pressures but also 'internally' perceived scaling barriers. In scaling, dividing the implementation of a solution into phases can 'buy time' for the organization to 'mature' and, accordingly, to be better prepared for its implementation. Involving operational leadership early in the adaptive process, so that they assume certain ownership, can foster connecting and can contribute to navigating the linking up dynamic and thus reduce the risk of ideas "hitting the brick wall". The support from managers at the 'top' of the system is essential for scaling adaptive processes and thus implementing systems change.

This study explores co-production - as a form of co-design - as a collaborative process where stakeholders and professionals co-create change through 'doing with', emphasising that transformative practices demand advanced meaning-making, a dimension often underexplored in understanding how such collaborative forms are facilitated. The investigation revealed that experienced leaders utilise two distinct meaning-making approaches to co-production that influence their roles and process dynamics. Both cultivate a collaborative environment wherein every stakeholder's voice is valued. Approach 1 is grounded in equality, consensus, and a sense of responsibility for others. Approach 2 emphasises shared learning, self-care for the leader, and process responsibility while viewing co-production as an emergent, experimental practice. As complexity increases, conflict evolves into a less personal, more fluid element that is crucial for learning and growth. Moreover, power transitions from a hierarchical commodity to a shared, collective experience, thereby leading to a shift in leadership from a controlling to a more adaptive, 'light touch' approach. The study underscores the importance of recognising these meaning-making strategies to cultivate more mindful, inclusive co-production and co-design practices. The findings advocate for a reflective journey towards understanding co-production, oneself, and the collective to lead to practices that resonate with stakeholders' diverse perspectives.

IntroductionImprovement science emphasizes the need to understand and enhance quality in complex service systems. While the field primarily has developed within healthcare, its expansion into social care requires deeper engagement with how quality is understood and enacted in practice. This study addresses this need by exploring how child welfare professionals in Sweden understand and enact “quality” in their everyday work with implications for improvement science in complex human service systems.MethodsThe study employed a qualitative, practice-oriented, and interactive research design. The data consisted of 28 semi-structured interviews with professionals in child welfare, an analysis seminar, and documents (such as a quality management system and quality reports). An inductive content analysis was conducted, constructing themes through systematic interpretation rather than predefined frameworks.ResultsThe analysis identified two coexisting logics of quality: one emphasizing uniformity, the other emphasizing responsiveness to uniqueness. The findings show how professionals move between these logics as tensions become salient in daily practice.DiscussionBy conceptualizing quality as a paradoxical construct, the study highlights how quality in child welfare is enacted through the ongoing negotiation of multiple logics, with implication for improvement science. The findings align with previous research suggesting that sustainable improvement involves the interplay of generalizable and contextual knowledge, and that paradoxes in organizational life shape conditions for learning and improvement.ConclusionQuality in child welfare is not a fixed attribute but a negotiated phenomenon, shaped by persistent tensions between uniformity and responsiveness. Recognizing these paradoxes invites reflection on how improvement science engages with quality in complex human service systems, particularly in relation to the interplay between codified standards and professional judgment.

ABSTRACT Human resource development increasingly emphasizes strategic training and development activities to support the growth of leaders and their leadership skills. This underscores the growing importance of human resource (HR) practitioners, who are often responsible for overseeing leadership development (LD). Despite their central role, research on HR practitioners' experiences and perspectives on LD design and delivery remains limited. This study explores how HR practitioners organize and refine LD in various organizational settings. This qualitative study employes an exploratory design and uses inductive thematic analysis of 24 semistructured interviews conducted across diverse organizational settings in Sweden. HR practitioners use three main strategies to organize LD: (1) tailoring LD to the organizational context, (2) tailoring LD to leaders' personal needs and growth expectations and (3) tailoring LD activities to context and leaders. The effectiveness of these strategies, however, depends on the practitioners' organizational support and work conditions, which can enable or constrain HR efforts. HR practitioners play a multifaceted role in shaping LD, balancing organizational goals with individual growth. Successful implementation of tailored LD strategies requires not only professional expertise, but also adequate resources, organizational support and strategic involvement.

Coproduction is an inclusive approach for improving health and social care services, and coproduction research mostly focuses on participating stakeholders who are not researchers. Programme theories are important for designing, evaluating and disseminating change initiatives; however, few empirical studies on quality improvement initiatives or coproduction projects include explicit programme theories. This study addresses these knowledge gaps by describing new researchers’ initial implicit programme theories of coproduction from three different system perspectives. This is a cross-sectional interview substudy that includes 12 respondents. The respondents are new researchers (doctoral students) in Samskapa, an international research programme. The respondents conduct their studies in their own national contexts: Western Europe and North America. The interviews focus on their thoughts and experiences of coproduction, and the data are analysed using directed content analysis based on central concepts of programme theory. Coded statements are additionally coded for the system perspective they refer to. To describe programme theories of coproduction from micro-, meso- and macrosystem perspectives, a latent interpretation of the data is carried out. The consolidated criteria for reporting qualitative research (COREQ) checklist for qualitative studies was used to assure quality standards. A generic programme theory of coproduction is suggested: If microsystem actors collaborate, facilitated by mesosystem mediators and supported by macrosystem managements’ feedback and engagement, then coproduction will occur and health and welfare systems will improve. Coproduction projects are complex interventions that exhibit equifinality – a principle from open systems theory which posits that similar outcomes can be achieved through multiple, distinct pathways. Programme theories of coproduction from several system perspectives can be merged into a generic programme theory, which in turn can capture the interventions’ complexity.

INTRODUCTION: To address communication barriers, minimise social isolation, prevent psychosocial illness and increase the independence of Deaf older adults, a mobile care team consisting of Deaf assistant nurses using sign language was initiated and developed by a nongovernmental organisation in a region in southern Sweden. AIM: To describe Deaf older adults’ experiences receiving support from an NGO-initiated mobile old-age care team for Deaf and sign language-speaking older adults in Sweden. METHODS: A series of 15 individual interviews with four Deaf older adults were analysed via content analysis. RESULTS: Support from the mobile care team was appreciated, as illustrated by the following categories: support in everyday activities, communication supported and enabled and support for psychosocial well-being. The care team facilitated communication using sign language. For example, they enabled in-depth communication and information sharing and supported older adults in expressing opinions and thoughts to authorities and regular care staff. Increased communication supported psychosocial well-being, independence, and feelings of safety. CONCLUSION: A sign language mobile care team that is well familiar with Deafness as a culture rather than a hearing disability is highly valued by Deaf older adults in need of home or residential care later in life. It also shows that access to a sign language mobile care team leads to increased psychological wellbeing and happiness among Deaf older adults, as well as to their increased participation in decision-making concerning various aspects of their lives.

The significance of leadership for organizational success is widely recognized; however, there are numerous perspectives on the best way to develop leadership. The aim of this study was to explore the factors that professionals collectively identify as crucial for enhancing leadership development in organizations. The research questions addressed are: What key principles guide well-informed decisions in organizing leadership development practices? What generic aspects are related to these principles? Employing a participatory research approach, we collected and analyzed data in collaboration with professionals working with leadership development in 17 municipalities and 10 regions in Sweden. The data were gathered by recording collaborative work during workshops, analyzed using reflexive thematic analysis and interpreted using paradox theory. Our main theoretical contribution consists of nine key principles that guide well-informed decisions in organizing leadership development practices. These principles are structured within key questions that go beyond perspectives on the best way to develop leadership, addressing inevitable paradoxical tensions. Additionally, we identify three generic aspects for managing these tensions and enhancing leadership development practices in organizations: systematic deliberation, integration and continuous improvement. Based on these findings, we present two practical tools to help professionals strengthen leadership development as a cohesive support system. Rather than seeking a single best curriculum or framework, professionals can be supported by aligning the responses to Why? What? How and when? Who? and What works?, always related to Where? and by continuously applying systematic deliberation, integrating leadership development with business strategies and HR activities and pursuing continuous improvement.

A leadership development system (LDS) encompasses all methods and practices used in an organisation to train and develop effective leadership. However, the underlying assumptions upon which such a system is based are often overlooked, and the workplace as a learning site is generally under-investigated, which may cause an unreflected LDS. Using a social representations theory approach, this study explores such underlying assumptions, i.e. social representations of leadership and leadership development, among 19 employees of an organisation with a non-hierarchical business structure. To collect data, the free association method was used to reveal underlying social representations shaping the company's current LDS. Through a transdisciplinary framing and customised design of work-integrated learning (WIL) among the employees (N = 57), the study also develops an exploratory model for facilitating the development of a deliberate LDS. The results show that uncovering social representations supports professional learning in work, which helps create an LDS that is based on articulated awareness. The study further shows that the process of uncovering hidden values, ideas, and perspectives can support a context-relevant and customised WIL curriculum for professional learning and cultivate a deliberate and purposeful approach to leadership development.

Leadership development (LD) plays a significant role in achieving high-quality performance and business results, but there is little research on how leadership development itself evolves as the organization develops. This study explores how a leadership development system evolved over 30 years, during a time when the organization became increasingly high performing. Through reflexive thematic analysis of organizational documents and interviews with top managers and practitioners, the study provides a rich longitudinal description of the evolvement. The results revealed three pervasive changes of the leadership development system: 1) from a system for business-specific learning to one for system-wide learning; 2) from a system for personal development to one for customer-oriented quality development; and 3) from a leadership development system consisting of leadership development programs to one that is integrated into regular meetings and uses simple rules. These changes supported the gradual transformation of the leadership development from being independent to becoming integrated in the wider system, supporting the business system. The findings offer a unique insight into how an organization transitioned from individual leader development towards promoting collective aspects of leadership development. The study provides two main theoretical contributions that support the perspective of viewing leadership development as integrated within organizational development. Firstly, we present a more multifaceted way of understanding leadership development, wherein managers and employees, customer outcomes, and business advancement are seen as mutually developing. Secondly, we introduce two new critical points that complement previous descriptions of an advanced leadership development system: It is system wide (not only business specific) and customer oriented (not only leader/participant oriented).

Recent years have seen a dramatic growth in interest in the nature and extent of co-production in the health and social care sectors. Due to the proliferation of work on co-production, there is variation in practice in how co-production is defined, understood, and used in practice. We conducted a narrative review to explore, and provide an overview of, which models of health and social care co-production have been developed, applied, and critiqued over recent decades. Seventy-three peer-reviewed articles met our inclusion criteria. In this set of articles, we identified three broad types of models: conceptual/theoretical, practice-oriented, and presenting a typology. We found that practice-oriented models, predominantly from the Health Services Research and Quality Improvement literature, had largely not drawn on conceptual/theoretical models from the disciplinary fields of Public Administration & Management and Sociology. In particular, they have largely neglected theoretical perspectives on relationships and power and agency in co-production work. The concepts of Service-Dominant Logic and Public Service-Dominant Logic as ways to think about the joint, collaborative process of producing new value, particularly in the context of the use of a service, have also been neglected. Our review has identified distinct literatures which have contributed a variety of models of health and social care co-production. Our findings highlight under-explored dimensions of co-production that merit greater attention in the health and social care contexts. The overview of models of co-production we provide aims to offer a useful platform for the integration of different perspectives on co-production in future research and practice in health and social care.

Abstract Background Innovations in coproduction are shaping public service reform in diverse contexts around the world. Although many innovations are local, others have expanded and evolved over time. We know very little, however, about the process of implementation and evolution of coproduction. The purpose of this study was to explore the adoption, implementation and assimilation of three approaches to the coproduction of public services with structurally vulnerable groups. Methods We conducted a 4 year longitudinal multiple case study (2019–2023) of three coproduced public service innovations involving vulnerable populations: ESTHER in Jönköping Region, Sweden involving people with multiple complex needs (Case 1); Making Recovery Real in Dundee, Scotland with people who have serious mental illness (Case 2); and Learning Centres in Manitoba, Canada (Case 3), also involving people with serious mental illness. Data sources included 14 interviews with strategic decision-makers and a document analysis to understand the history and contextual factors relating to each case. Three frameworks informed the case study protocol, semi-structured interview guides, data extraction, deductive coding and analysis: the Consolidated Framework for Implementation Research, the Diffusion of Innovation model and Lozeau’s Compatibility Gaps to understand assimilation. Results The adoption of coproduction involving structurally vulnerable populations was a notable evolution of existing improvement efforts in Cases 1 and 3, while impetus by an external change agency, existing collaborative efforts among community organizations, and the opportunity to inform a new municipal mental health policy sparked adoption in Case 2. In all cases, coproduced innovation centred around a central philosophy that valued lived experience on an equal basis with professional knowledge in coproduction processes. This philosophical orientation offered flexibility and adaptability to local contexts, thereby facilitating implementation when compared with more defined programming. According to the informants, efforts to avoid co-optation risks were successful, resulting in the assimilation of new mindsets and coproduction processes, with examples of how this had led to transformative change. Conclusions In exploring innovations in coproduction with structurally vulnerable groups, our findings suggest several additional considerations when applying existing theoretical frameworks. These include the philosophical nature of the innovation, the need to study the evolution of the innovation itself as it emerges over time, greater attention to partnered processes as disruptors to existing power structures and an emphasis on driving transformational change in organizational cultures.

Abstract Objectives Analyse reported processes of co-design and co-production in the context of health and social care to explore the underlying mechanisms that enable inclusive and reciprocal engagement. Search strategy Peer review research was obtained from a prior scoping review searching eight databases consisting of all methodologies relevant to co-design or co-production in the context of health and social care services and involving service-users. Methods of selection Articles were included for synthesis if they reported a process of dialogue, with mutuality, insight and clarification in their engagement process. Ninety-three peer-review articles informed our programme theory development. Analysis Data relating to co-design and co-production processes were extracted and analysed through inductive, abductive, and deductive analysis leading to the development of an initial programme theory. Main results This realist synthesis finds that co-design and co-production can occur at different times, in part or all of the research and participatory process. There is an over reliance on the term ‘co-design’ or ‘co-production’ to convey complex engagement or participatory processes. We identified six mechanisms (intention, assets, dialogue, documentation, interpretation and understanding). Interaction between these six identified mechanisms in context, even if only brief, is important for supporting meaningful engagement, alignment and agreement within a co-design or co-production process. Implications for practice The initial programme theory presented in this article provides clarity by identifying essential mechanisms which can guide the design and implementation of a range of participatory approaches. Rather than relying on a single label to convey complex participatory methods or processes, the values and principles of co-design or co-production, in combination with this programme theory, could be applied to guide implementation and reporting of specific activities within a range of research or participatory methods. Patient and public contribution The initial programme theory was presented and piloted in a series of collaborative workshops between May 2023 and March 2024 with patient and public contributors, health professionals and researchers. This engagement process is currently underway to refine the programme theory and it is anticipated that this next phase will be completed in September 2024.

Background As coproduction in public services increases, understanding the role of leadership in this context is essential to the tasks of establishing relational partnerships and addressing power differentials among groups. The aims of this review are to explore models of coproduction leadership and the processes involved in leading coproduction as well as, based on that exploration, to develop a guiding framework for coproduction practices. Methods A systematic review that synthesizes the evidence reported by 73 papers related to coproduction of health and welfare. Results Despite the fact that models of coleadership and collective leadership exhibit a better fit with the relational character of coproduction, the majority of the articles included in this review employed a leader-centric underlying theory. The practice of coproduction leadership is a complex activity pertaining to interactions among people, encompassing nine essential practices: initiating, power-sharing, training, supporting, establishing trust, communicating, networking, orchestration, and implementation. Conclusions This paper proposes a novel framework for coproduction leadership practices based on a systematic review of the literature and a set of reflective questions. This framework aims to help coproduction leaders and participants understand the complexity, diversity, and flexibility of coproduction leadership and to challenge and enhance their capacity to collaborate effectively.

Background Co-production is promoted as an effective way of improving the quality of health and social care but the diversity of measures used in individual studies makes their outcomes difficult to interpret. Objective The objective is to explore how empirical studies in health and social care have described the outcomes of co-production projects and how those outcomes were measured. Design and methods A scoping review forms the basis for this systematic review. Search terms for the concepts (co-produc* OR coproduc* OR co-design* OR codesign*) and contexts (health OR ‘public service* OR “public sector”) were used in: CINAHL with Full Text (EBSCOHost), Cochrane Central Register of Controlled trials (Wiley), MEDLINE (EBSCOHost), PsycINFO (ProQuest), PubMed (legacy) and Scopus (Elsevier). There was no date limit. Papers describing the process, original data and outcomes of co-production were included. Protocols, reviews and theoretical, conceptual and psychometric papers were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The Mixed Methods Appraisal Tool underpinned the quality of included papers. Results 43 empirical studies were included. They were conducted in 12 countries, with the UK representing >50% of all papers. No paper was excluded due to the Mixed Methods Quality Appraisal screening and 60% of included papers were mixed methods studies. The extensive use of self-developed study-specific measures hampered comparisons and cumulative knowledge-building. Overall, the studies reported positive outcomes. Co-production was reported to be positively experienced and provided important learning. Conclusions The lack of common approaches to measuring co-production is more problematic than the plurality of measurements itself. Co-production should be measured from three perspectives: outputs of co-production processes, the experiences of participating in co-production processes and outcomes of co-production. Both self-developed study-specific measures and established measures should be used. The maturity of this research field would benefit from the development and use of reporting guidelines.

First-line managers (FLMs) have a vital role in developing stable output and organizational competitiveness through their ability to manage front-line operations in daily work. It is also well known that FLMs are strong determinants of good ergonomics and well-being for front-line staff. However, research focusing on how FLMs deal with their important role is lacking particularly regarding empirical studies. The focus here is how they deal with uncertainties and disruptive interruptions and develop more resilient performance in daily work - intro-duced in this article as resilient action strategies. This research uses two conceptual frameworks on resilient engineering for analysis of FLM's actions in daily work in two manufacturing companies, to explore how resilient action strategies can be organizationally sup-ported. The study combines analysis of front-line activities with multilevel organizational support based on 30 semi-structured in-depth interviews with FLMs and support functions, 21 workshops as well as policy documents of the two companies. The analysis exemplifies how resilience engineering was enabled in practice in the organizations.The study contributes to the empirical understanding of how resilience can be organizationally supported in daily front-line work. Our results show that a developed and consistent infrastructure in companies promotes the emergence of resilient action strategies in front-line work. We propose an extended model for resilient front-line performance enhancement by including coordination as a linking aspect between the earlier suggested resilient potentials - anticipate, monitor, respond and learn. This highlights the importance of both organizational sup-port and coordination between system levels to enable the development of resilient action strategies by FLMs.

Abstract Background Innovations in coproduction are shaping public service reform in diverse contexts around the world. Although many innovations are local, others have expanded and evolved over time. We know very little, however, about the process of implementation and evolution of coproduction. The purpose of this study was to explore the adoption, implementation, and assimilation of three approaches to the coproduction of public services with structurally vulnerable groups. Methods We conducted a four-year longitudinal multiple case study of three coproduced public service innovations involving vulnerable populations: ESTHER in Jönköping region, Sweden involving people with multiple complex needs (Case 1); Making Recovery Real in Dundee, Scotland with people who have serious mental illness (Case 2); and Learning Centres in Manitoba, Canada (Case 3), also involving people with serious mental illness. Data sources included 14 interviews with strategic decision makers and a document analysis to understand the history and contextual factors relating to each case. Three frameworks informed the case study protocol, semi-structured interview guides, data extraction, deductive coding, and analysis: the Consolidated Framework for Implementation Research, the Diffusion of Innovation model, and Lozeau’s Compatibility Gaps to understand assimilation. Results The adoption of coproduction involving structurally vulnerable populations was a notable evolution of existing improvement efforts in Cases 1 and 3, while impetus by an external change agency, existing collaborative efforts among community organisations, and the opportunity to inform a new municipal mental health policy sparked adoption in Case 2. In all cases, coproduced innovation centred around a central philosophy that valued lived experience on an equal basis with professional knowledge in coproduction processes. This philosophical orientation offered flexibility and adaptability to local contexts, thereby facilitating implementation when compared with more defined programming. According to the informants, efforts to avoid co-optation risks were successful, resulting in the assimilation of new mindsets and coproduction processes, leading to transformative change. Conclusions To augment existing frameworks, careful study of the evolution of coproduction processes involving structurally vulnerable populations and the partnered processes that disrupt existing power structures and drive transformational cultural change is needed.