Journal of Healthcare Leadership最新文献

Background: Somalia's health system remains among the world's most fragile, with a Universal Health Coverage index of only 25% and a critical health workforce density of 0.11 clinicians per 1000 population. While previous national strategies such as NDP-9 and HSSP III provided broad frameworks, the National Transformation Plan (NTP) 2025-2029 represents a paradigm shift toward multi-stakeholder engagement and evidence-based priority-setting for health system transformation.

Aim: This roundtable aimed to identify priority areas and implementation strategies for the NTP health pillar through structured stakeholder consultation, moving beyond traditional top-down planning approaches to incorporate diverse perspectives from Somalia's fragmented health landscape.

Methods: A qualitative multi-stakeholder roundtable was conducted in Mogadishu with 30 purposively sampled participants representing federal and state ministries, universities, public and private providers, non-governmental organizations, and civil society. Ethical approval was waived, and informed consent was obtained. Audio-recorded discussions were transcribed, translated, and analyzed thematically according to the four NTP health domains.

Results: Thematic analysis identified four critical priorities. Participants emphasized that primary health care expansion should prioritize female community health workers and rural facility rehabilitation to increase service coverage beyond the current 25%. Participants emphasized that health workforce constraints, with only 0.11 clinicians per 1000 population, require regional training hubs and rural deployment incentives. Participants emphasized that regulation and governance through the newly established National Health Professionals Council need sustainable funding and federal-state accountability frameworks. Participants emphasized that public-private partnerships and digital health integration could leverage telemedicine and private sector capacity for underserved areas.

Conclusion: The roundtable produced actionable strategies linking community-centered primary care, workforce development, regulatory strengthening, and technology-enabled partnerships. However, implementation faces significant constraints, including limited domestic financing, weak governance coordination, and ongoing fragility. Success will require sustained political commitment and innovative approaches adapted to Somalia's unique post-conflict context.

Purpose: Sustainable leadership is essential for addressing workforce shortages, technological advancements, and increasing regulatory demands in Australian healthcare. Many healthcare leaders assume their roles based on clinical expertise rather than formal leadership training, highlighting the need for structured support. This study explores sustainable leadership in Australian healthcare, identifying key challenges, support mechanisms, and strategies for improvement.

Methods: A cross-sectional survey was conducted among 276 managers, leaders, and supervisors working in Australian healthcare organisations. Participants were recruited through professional networks, social media, and direct invitations. The survey, administered via Qualtrics, examined leadership training, characteristics of sustainable leadership, challenges, and available support systems. Quantitative data were analysed using IBM SPSS Statistics, while qualitative responses underwent thematic analysis.

Results: Leadership training was primarily informal, with limited access to structured programs due to time and financial constraints. Sustainable leadership was defined as balancing operational demands with long-term planning, ethical decision-making, and fostering a resilient workplace culture. Key challenges included staff retention, change management, and hierarchical structures limiting innovation. Support for leaders was inconsistent, with male leaders reporting higher perceived support. Systemic barriers, such as outdated leadership models and a focus on financial performance over workplace culture, restricted sustainable leadership implementation.

Conclusion: To enhance sustainable leadership, organisations must prioritize structured training, mentorship, and inclusive leadership pathways. Addressing systemic barriers and redefining leadership success beyond financial metrics will strengthen leadership resilience, reduce burnout, and improve healthcare outcomes.

Purpose: Studies show that women communicate and perceive communication from supervisors and colleagues differently than men. This is evident also in the healthcare sector and particularly among female doctors. The primary aim of this study is to explore the relationships between communication practices, leadership approaches, and the association with physicians' job satisfaction and overall well-being. Particular attention is paid to gender and its impact on the communication of physicians in hospitals.

Design/methodology/approach: We carried out a comprehensive survey of physicians working in hospitals across Switzerland in 2019 to investigate the role of gender on communication style and physicians' job satisfaction and well-being in hospitals. We collected 1565 responses and performed Mann-Whitney U-tests to test if the job satisfaction and well-being measures differ by gender. Furthermore, we used multiple-regression models to estimate the conditional relationship between the outcome measures and predictor variables.

Findings: Effective leadership communication is positively associated with the job satisfaction of all physicians, regardless of functions, generations, languages, genders, hospital types, and specializations. The results of the study indicate that there are gender differences between men and women physicians in Swiss hospitals regarding the effect of leadership communication on job satisfaction, satisfaction with leadership communication and well-being.

Originality: While there are valid studies that provide valuable insights into leadership styles, gender disparities in leadership, and the impact of gender bias on leadership, this study fills the lack of direct evidence addressing the effect of leadership communication skills on the job satisfaction and the well-being of female physicians and the need for different types of leadership communication skills for female physicians in hospitals.

Purpose: To understand how institutions can support faculty during crises in biomedical research, this study examined early career researchers (ECRs) experiences with institutional supports during the COVID-19 pandemic and their perspectives on how institutions can support professional recovery.

Subjects and methods: This national, cross-sectional study evaluated professional and personal-related institutional supports offered to ECRs during the COVID-19 pandemic, the impact of these supports, and additional supports needed for professional recovery. An online survey was distributed electronically in fall 2021 to all individuals with F32 or K-level awards through the National Institutes of Health in 2020. Descriptive statistics, chi square tests, and thematic analysis summarized findings.

Results: Among 4,440 ECRs contacted, 1,587 ECRs (35.7%) responded to the survey, and 1,527 (34.4%) met inclusion criteria. Most respondents reported their institutions offered programs or services during the COVID-19 pandemic (81.3%, n=1241), including professional support(s) (76.8%, n=1172) and personal support(s) (43.6%, n=666). The most impactful support was mentoring programs, with 49.9% (n=402/806) reporting that it had positive impact, followed by personal assistants (48.4%, n=60/123) and bridge funding (for research: 42.4%, n=156/358; for salary: 41.7%, n=115/276). For coaching programs, bridge funding for salary, and elder care services, respondents indicated significant differences in the impact between expanded or new supports versus continued existing supports. Regarding institutional supports needed to support professional recovery, responses fell into six themes: caregiving support, mental health support, financial support, work support, career development support, and employment support.

Conclusion: This study provides novel insights into ECRs' perspectives on the supports offered by institutions during the COVID-19 pandemic and additional areas of need for professional recovery. Institutions must invest in relevant, effective, and accessible supports for ECRs to help them persist in scientific careers, particularly during periods of disruption and uncertainty.

Introduction: Clinical Engineering Departments (CEDs) face growing challenges in managing rapidly evolving medical technologies and increasing equipment inventories under constrained budgets and limited human resources. These pressures often result in strained staffing capacity and imbalanced workload distribution. This study aimed to develop and validate a metrics-driven hybrid staffing model to optimize workforce allocation and improve workload efficiency across National Guard Health Affairs (NGHA) hospitals in Saudi Arabia.

Methods: Five years of maintenance data were extracted from the Computerized Maintenance Management System (CMMS) and Oracle E-Business Suite. These data were analyzed to construct a hybrid staffing model that combined quantitative workload metrics with qualitative input from clinical engineering staff across 11 NGHA hospitals. Model validation included a detailed case study at King Abdullah Specialized Children's Hospital (KASCH), with comparisons to existing staffing models, including the Ottawa Hospital approach.

Results: The case study revealed that the current staffing of 14 full-time equivalents (FTEs) at KASCH was insufficient, with the model projecting a requirement of 17 FTEs, indicating a 7.8% shortfall. Workload analysis showed highly uneven staff utilization rates, ranging from 20.8% to 71.5%. High-maintenance equipment, such as MRI machines, required up to 42.1 hours per device annually. The proposed hybrid model achieved more balanced staffing, predictive maintenance scheduling, and dynamic task assignments. Compared to traditional models, it demonstrated an estimated 25% cost savings, equipment uptime exceeding 95%, and improved workload distribution.

Discussion: The hybrid staffing model provides a data-driven framework that integrates preventive and corrective maintenance requirements with staff input to support risk-based decisions. While validated within the NGHA system, the model is adaptable for healthcare facilities with different device profiles, regulatory pressures, and financial constraints. Successful implementation depends on strong institutional leadership, continuous data collection, and comprehensive staff training to ensure long-term sustainability and scalability.

Objective: Explore possible associations between healthcare personnel's work-related factors, mental well-being, and health literacy sensitivity. Few studies have investigated these factors. Thus, knowledge about their relationships may enhance healthcare personnel's ability to meet patients' health literacy needs, ultimately improving patient care.

Methods: This cross-sectional survey included interdisciplinary healthcare personnel (N = 288, 75% female, mean age 44 (SD = 11.8)) working in direct patient care at a medium-sized general hospital in Norway. Participants were recruited from May to June 2022 and asked to answer questions regarding work-related factors, mental well-being, and how they follow up on patients' health literacy needs. Data were analyzed using hierarchical multiple regression.

Results: Greater health literacy sensitivity among healthcare personnel is associated with fewer work-related and mental well-being challenges. The work-related factors, teamwork (β = 0.138-0.236, p < 0.05 - p < 0.001) and staffing (β = 0.178, p < 0.01), as well as the mental well-being variables, work engagement (β = 0.179-0.288, p < 0.01 - < 0.001) and depression (β = 0.154, p < 0.05), show statistically significant associations with one or more of the nine health literacy domains.

Conclusion: Work-related factors and mental well-being, particularly work engagement, are associated with healthcare personnel's health literacy sensitivity.

Practice implications: Healthcare organizations should actively enhance healthcare personnel's health literacy resources while ensuring that their efforts to follow up on patients' health literacy needs do not adversely impact the healthcare personnel's work-related factors or mental well-being.

Background: Effective leadership is essential for high-performing healthcare systems, yet many leadership training programs lack contextual and cultural adaptability. In Oman, leadership development has historically focused on clinical expertise rather than strategic competencies. This study describes the development and implementation of a culturally adapted leadership training program tailored to the needs of Omani healthcare professionals.

Methods: A multiphase project-based learning approach was used to design and assess the program. A needs assessment survey was conducted among healthcare leaders to identify competency gaps. The program was then developed based on international best practices and customized to the Omani healthcare system. A rigorous selection process involved psychometric testing, personal leadership statements, and structured interviews. The eight-month program incorporated evidence-based leadership training, mentorship, and project-based labs. Evaluation was guided by the Kirkpatrick model, assessing knowledge, skills, and behavioral change. Post-program qualitative interviews explored participant experience.

Results: The needs assessment (n = 16 senior hospital managers) identified gaps in strategic decision-making, crisis management, and interdisciplinary collaboration. The program addressed these needs through eight structured modules. Of 177 applicants, 38 were selected via a multilevel assessment process. Post-program interviews with a purposive sample revealed improvements in self-awareness, strategic capabilities, team collaboration, and leadership accountability. Participants emphasized the program's contextual relevance and its value in bridging theory and real-world practice.

Conclusion: This study demonstrates the feasibility and impact of a culturally tailored leadership development program in a healthcare setting. By integrating context-specific training with global leadership principles, the program addresses critical competency gaps and strengthens leadership capacity in Oman's healthcare system. Post-program feedback provided insights into the program's transformative potential. Future studies should examine the long-term impact of such programs on healthcare performance and patient outcomes.

Introduction: Despite achieving gender parity among medical and graduate students, women remain underrepresented in academic medical center leadership. This highlights a need for inclusive leadership development programs which impact both individuals and the organization. In response, we developed and evaluated a novel, comprehensive, and collaborative training designed for both mid-career to senior faculty and administrative leaders which addresses leader development and institutional culture.

Methods: A novel 18-month program for faculty and administrative leaders which includes 14 days of immersive workshops, a 360° assessment, personalized executive coaching, and an institutional group project was implemented and evaluated. Pre- and post-program assessments were analyzed using factor analysis to create seven composite scales defining various aspects of leadership competencies. Analysis of survey data used a t-test to determine significantly different scores pre- and post-test for each composite measure.

Results: Participants in this intensive program reported increased agreement with skill development across all competencies except for personal growth, where there was no statistically significant increase, and increased expectations about the program's ability to enhance recognition, visibility, and opportunities to impress institutional leadership. Over 80% of participants in a five-year follow-up survey found the program beneficial for leadership development, and half of the participants felt the program influenced their decision to stay at their institution long-term. Ninety-four percent of faculty received promotions or new leadership roles within eight years.

Discussion: Determining the impact of leadership programming is difficult but institutional immersive leadership programs have demonstrated significant impact through the advancement of core leadership competencies, faculty and administrative staff promotion, and long-lasting collaborations across the academic medical center. Future comparative studies are needed to look across institutions to determine which elements of the program are most effective.

Purpose: To examine the sustained impact of a faculty leadership program at an academic health center (AHC) on participants' perceived effectiveness in leadership skills and leadership attainment compared to faculty controls.

Methods: The sample included 95 faculty members who participated in the year-long Faculty Leadership Institute (FLI). We compared FLI participants to 156 unmatched faculty controls. Participants completed online surveys self-reporting on perceived effectiveness in leadership skills, and leadership positions attained an average of 7 years after program completion. Background information, such as demographic characteristics and academic rank, was obtained from the faculty affairs office.

Results: The sample of participants was 47% female, 76% White, with an average age of 52.39 years. Academic ranks were higher in the FLI group; 62% of FLI graduates and 44% of controls were Full Professors (p < 0.001). FLI participants reported moderate-to-high effectiveness in overall leadership skills, which was significantly greater than controls (p < 0.001; d = 0.62). FLI participants had higher self-reports of effectiveness on 25 of 26 (96%) leadership skills and these differences were significant in 16 of 26 areas (62%), (p < 0.034 to 0.001) with small to moderate effect sizes (ds = 0.34 to 0.57). FLI participants attained a greater number of leadership positions. However, after correcting for multiple comparisons, the difference was not significant (p = 0.1). FLI participants were more likely to have held a leadership position in clinical operations (p = 0.018). Group differences in perceived effectiveness in leadership skills and leadership attainment did not vary by gender or race.

Conclusion: Findings support sustained benefits of the FLI program, particularly in perceived effectiveness of leadership skills, regardless of gender or race. Although additional research is needed to demonstrate how the positive effects translate to system-level outcomes (eg, research funding, patient care), continued efforts to develop talented faculty members are important to ensure a succession of well-prepared leaders at AHCs.

Background: Nursing leadership competency is important for staff empowerment, quality improvement, and patient safety, yet inadequate investment in its development hinders its development. This highlights the urgent need for strategic leadership competency building in nursing management.

Purpose: This study aims to examine the importance of self-assessing leadership competency in guiding Nursing Directors' leadership development and the relationship between nursing directors' leadership quality and nursing staff empowerment.

Methods: The cross-sectional quantitative study included two online surveys completed by 21 Nursing Directors and 260 nursing staff from two hospitals with >90% response rate. Two surveys were conducted: Survey for Nursing Directors adapting items from Management Competency Assessment Project to self-assess competency on leadership and professionalism; Survey for nursing staff using Leadership Behavioral Scales to reflect on Nursing Directors' leadership behaviors as observed by nursing staff. Descriptive statistical analysis (mean, frequencies and percentages) of the 21 behavioral items self-assessed by Nursing Directors and 19 leadership behaviors assessed by nursing staff were performed and reported Pearson correlation test was performed to test corrections of different variables.

Results: Nursing Directors' self-assessment on competencies of leadership and professionalism yielded a combined mean score of 4.63 and 4.85 respectively. Between 35% and 60% of staff recognized Nursing Directors' positive leadership behavior which were significantly and positively correlated with four dimensions of psychological empowerment scale used. The study also found consistent differences in the results of the assessment by Nursing Directors and nursing staff between two targeted hospitals.

Conclusion: The study confirmed that leadership demonstrated by Nursing Directors are important to empower nursing staff and organizational context plays an important role in developing nursing leadership and improving nursing management effectiveness. The study supports the value of management competency self-assessment in identifying competency gaps and competency development needs amongst Nursing Directors.