Journal of Healthcare Leadership最新文献

The World Health Organization (WHO) recognizes the importance of Integrated Health Systems (IHS) in translating health information and its determinants into tangible outcomes. However, effective implementation of an IHS has not been realized due to the lack of a structured Health Information System (HIS) for centralized data analytics and accessibility. This is further exacerbated in developing nations because of the complex interplay between limited resources, inadequate infrastructure, and high disease burden. Therefore, the perspectives presented provide an enhanced engine in the form of a structured HIS to propel the IHS, such that the health system is driven by efficient health data management and analytics. The transformational IHS presented considers resource limitations within the context of the factors influencing political, structural, and economic reforms. This provides an adaptive and progressive approach to address multifaceted health challenges in developing nations. Importantly, the IHS framework presented provides a health system paradigm shift that integrates health practices and their determinants within an artificially intelligent-enabled data-driven architecture to achieve structured and seamless universal health coverage.

Purpose: Healthcare organizations face challenges in balancing efficiency and innovation, known as ambidexterity. Leadership plays an important role, with transformational leadership driving innovation and transactional leadership supporting efficiency. The dominant leadership framework is the Full-Range Leadership Theory (FRLT), which identifies three leadership behaviors: transformational, transactional, and passive avoidant. Organizational structures, following Mintzberg, Pugh and Galbraith, including span of control (SoC), unit grouping, and lateral linkages, significantly influence leadership dynamics. This study examines the impact of structural changes on perceived leadership styles in a Dutch radiotherapy center (RTc) following the implementation of proton therapy, a radical innovation.

Patients and methods: A mixed-method approach combined leadership surveys, with data collected at three time points, before and after structural changes in 2022. The multifactor leadership questionnaire (MLQ) was distributed among the employees in November 2021, March 2022, and March 2023. Three interventions were introduced: (1) appointing dedicated team leaders (TLs) to improve information flow and reduce management SoC; (2) integrating a Patient Care (PC) manager into the advisory board to facilitate direct communication within the governance structure, including other hierarchical layers; and (3) adding a proton therapy manager as a liaison to improve coordination. Leadership perceptions were measured using the Multifactor Leadership Questionnaire (MLQ) at three time points (T1, T2, T3). The Independent-Samples Mann-Whitney U-Test (p<0.05), was used to compare T1, T2, and T3, managers' self-ratings with employee ratings, and scores between photon and proton treatment employees.

Results: Transformational leadership significantly increased across all groups, with PC scores rising from 2.3 at T1/T2 to 2.5 at T3, and MT-PC scores from 1.8 at T1 to 2.4 at T3. Passive avoidant leadership significantly decreased (eg, MT-PC: 1.6 at T1 to 1.0 at T3). Transactional leadership showed less pronounced and non-significant changes. Photon therapy staff experienced earlier improvements in leadership perceptions, while proton therapy staff showed delayed but stronger shifts by T3.

Conclusion: In this study, structural changes positively influenced leadership perceptions, supporting ambidexterity. Significant increases in transformational leadership and decreases in passive avoidant leadership align leadership styles with the dual demands of innovation and operational efficiency, demonstrating the importance of organizational design in healthcare leadership. Our findings show that healthcare management could use organizational structure changes to promote transformational leadership.

Purpose: Effective leadership is one of the most important factors contributing to an organization's effectiveness and success. The objective of this study is to identify the leadership styles of primary healthcare managers and explore associated sociodemographic factors.

Methods: A cross-sectional study was conducted at Prince Sultan Military Medical City (PSMMC) in Riyadh, Saudi Arabia, among primary healthcare managers in different aspects of 6 primary healthcare centers (PHC). Data were collected using a self-assessment questionnaire composed of two main sections: sociodemographic characteristics of the participants and the emotional intelligence questionnaire to assess the various competencies of emotional intelligence of leadership style.

Results: A total of 50 primary healthcare managers were included in the study. Approximately half of them (52%) were aged between 35 and 44 years. The highest applied statement was "I know when I am happy (4.42±0.95)", whereas the lowest applied statement was "I rarely worry about work or life in general (3.20±1.26)". Self-awareness was considered a strength in most of the participants (78%), while, managing emotions needs attention in 52% of them. Intrinsic motivating, empathy, and social skill were considered strengths in most of the participants (70%, 74%, and 68%, respectively). Participants aged (25-34 years) were more likely than others to need attention in the component of "intrinsic motivating" (31.6%), p=0.053. Single participants were more likely than married participants to need attention in the component of "intrinsic motivating" (70% versus 18.4%). P=0.006. Nurses, pharmacists and radiologists were more likely to need attention in the component of "self-awareness" than doctors and directors, p = 0.041.

Conclusion: This study highlights the significance of emotional intelligence components, such as self-awareness, empathy, and social skills, as strengths among primary healthcare managers in Riyadh, Saudi Arabia. The findings emphasize that enhancing emotional intelligence is essential for fostering effective leadership within primary healthcare sitting.

Purpose: Planetary health is the idea that human health and the health of our planet are inextricably linked. The healthcare sector promotes human health but has a significant impact on our natural world. In Canada, some hospitals are leading the way towards promoting planetary health in an increasingly challenging context. The purpose of this study was to understand how Canadian hospitals support planetary health, specifically through green teams and sustainability offices.

Patients and methods: People working in Canadian hospitals, either in sustainability offices or green teams, were invited to participate in this study. Participants completed an online survey and indicated if they would like to take part in a semi-structured interview via Zoom. Twenty-nine participants were interviewed and asked about how they supported planetary health and how their teams were integrated into the hospital setting. Interview transcripts were analyzed and data were summarized using thematic analysis. Demographic information was collected through the survey.

Results: Three main themes were: 1) From grassroots to corporate: Green teams and sustainability offices. This theme defined, compared, and contrasted teams and offices; 2) Operationalizing this work: Five green team exemplars. The five teams were: 1) the single-person green team; 2) the health profession-specific green team; 3) the green team pilot project; 4) external partners supporting green teams; and 5) the "bottom up" meets "top down" green team; and 3) Paving the path forward and tracking success. This theme explored how teams used metrics and other broader indicators to understand success.

Conclusion: This study examined the work of Canadian sustainability offices and green teams in the hospital setting. The former promoted planetary health from a "top-down" perspective while the latter did so from a "bottom-up" perspective. Teams that integrated both approaches were the most effective in promoting planetary health.

Purpose: Health care leaders have a significant impact on workforce engagement, making investments in leadership development essential. At Weill Cornell Medicine, a faculty development offering exists for early career faculty called Leadership in Academic Medicine Program (LAMP). This study aimed to identify the leaderships skills that LAMP participants found most challenging and applied an evidence-based leadership model to address those challenges.

Methods: The authors analyzed pre- and post-program surveys of LAMP participants (2013-2023) to assess their agreement with statements regarding their leadership and other professional skills. Percent disagreement was compared pre- and post-program. Statements with disagreements at or above the pre-program median were classified as areas of leadership discomfort. Statements with disagreements at or above the post-program median were classified as areas of persistent leadership discomfort. These areas were cross referenced with a leadership model shown to positively influence constituent well-being to inform specific curricular additions to LAMP.

Results: A total of 328 paired responses were analyzed, identifying three areas of persistent leadership discomfort: (1) Negotiating (2) Managing Competing Demands and (3) Managing Conflict. All were successfully cross referenced to teachable behaviors in an established leadership model.

Conclusion: Leadership behaviors that positively impact health care workers and that address skill gaps articulated by early career leaders can be used to enhance a curriculum in a faculty development program.

Background: Second Victim Syndrome (SVS) refers to the significant emotional and psychological distress experienced by healthcare professionals following adverse patient events. While numerous interventions have been developed to support second victims, their effectiveness remains poorly understood. This systematic review aimed to synthesize the evidence on the outcomes of available interventions targeting SVS.

Methods: We systematically searched MEDLINE, Embase, and the Cochrane Library databases, covering all records up to July 7, 2024. We included studies that evaluated the impact of SVS interventions on psychological, professional, and institutional outcomes. We assessed the quality of the included studies using the Joanna Briggs Institute (JBI) critical appraisal tool and evaluated the certainty of evidence using the GRADE framework. Due to heterogeneity in study designs and outcome measures, we opted for a narrative synthesis.

Results: Fifteen studies were included, predominantly of moderate quality. Peer support programs were the most commonly implemented interventions, often structured around the Scott Three-Tiered Model. These programs demonstrated consistent short-term benefits, such as reduced emotional distress and perceived isolation. However, evidence for long-term outcomes-including professional resilience, burnout reduction, and retention-was mixed and generally of low certainty. Structured psychological interventions, including cognitive behavioral therapy (CBT) and mindfulness-based programs, showed more promising long-term results but remain underexplored. Standardized outcome measures, such as the Second Victim Experience and Support Tool (SVEST), were infrequently used, limiting comparability across studies.

Conclusion: SVS interventions, particularly peer support, offer short-term relief but limited long-term impact. There is a critical need for longitudinal research using standardized outcome measures to better evaluate effectiveness. This review highlights the need for system-wide, evidence-based interventions and standardized evaluation metrics to support healthcare professionals effectively.

Introduction: Primary care has strategic importance in Australia's complex health system, attracting one-third of the country's health budget. Primary Health Networks (PHNs), established in 2015 to act as commissioners for non-hospital health and social care across Australia, enable a more comprehensive health planning approach to identify and prioritise service gaps and commission appropriate health services. Hence, building PHNs' capability in health commissioning is critical to maximising health outcomes of the Australian population.

Objective: This study was conducted to identify the skill development needs of PHNs employees to lead and manage commissioning, and strategies to build commissioning capabilities across PHNs.

Methods: A multiphase mixed-method approach was used, including an anonymous online survey and two focus group discussions.

Results: The health commissioning practices of PHNs directly affect PHN staff's confidence (Pearson's r=0.484, p<0.001) and self-perceived competence in their commissioning practices (Pearson's r=0.335, p<0.001). This study confirms that systematic upskilling commissioning among PHN employees, focusing on the commissioning cycle, complex healthcare environments, and data management, is required to improve their capabilities. This highlights the importance of organisational support in strengthening the six key factors for effective commissioning.

Discussion: The enhancement of PHNs' capability in health commissioning should be centered around employees' capability building guided by the proposed PHN health commissioning capability building model. Organisation investment in performance monitoring and enhancement, organisations' multi-strategy approach towards internal support and development, and external learning and development opportunities are the three key pillars.

Conclusion: Enhancing robust commissioning processes and strengthening leadership capabilities in health commissioning are essential for PHNs to meet the evolving healthcare needs of the population. Effective commissioning requires skilled and confident teams, systematic upskilling, organisational support, and strategic approaches to address challenges, deliver high-quality primary care, and improve population health outcomes. Building PHNs' commissioning capability requires a systematic and progressive skill development approach that prioritises a staff-centred model.

Introduction: The ongoing evolution of Health Information Technology has provided professionals with major challenges in maintaining the safety and quality of care provided to patients, especially when it comes to hyper-technological environments in hospital. This has driven the need to develop specific competencies and maintain a balance between ethical aspects, social and legal challenges related to privacy and data security, as well as the challenge of ensuring person-centered care practice. Then it will be important to understand what competences nurses are developing, based on what models and what instruments exist to assess them.

Purpose: Identify and map information technologies and measurement instruments used to assess nurses' competencies in technological environments in hospital.

Methods: A scoping review was carried out using the methodology presented by The Joanna Briggs Institute.

Results: Of the 101 articles extracted, 4 articles were selected where 5 instruments were identified that evaluate: (1) Informatics Competency in Nursing Leaders; (2) Technological Competence as Nursing Care - Perception and Practice dimension; (3) Self-Assessment of Nursing Informatics Skills; (4) Clinical Decision Making in Nursing, and (5) Self-Assessment Questionnaire that Assesses Nurses' Informatics Skills, for nursing informatics.

Conclusion: The development and enhancement of technological skills in nursing care provide an innovative and crucial perspective for managing and organizing healthcare delivery. This perspective is of great importance, reinforced by the reality in which nurses find themselves, with highly technological nursing practice environments that are increasingly developed. Knowledge and use of IT equipment, areas of basic IT knowledge, information literacy, wireless device skills, the role of clinical IT, and applied IT skills are some of the skills identified by this study. The use of various support tools as instruments for clinical decision-making in nursing is also fundamental to the quality of nursing care.

Purpose: Although authentic leadership is known to improve caregivers' functioning, health, and quality of care, information is lacking about whether the authentic leadership subdimensions may be distinguished from an overarching authentic leadership global construct, and how these global and specific factors can combine within various profiles to explain outcomes over time. Relying on an integration of person- and variable-centered perspectives, this study aims to provide a deeper understanding of the dimensionality of the authentic leadership construct. Specifically, it aims to examine the profiles taken by authentic leadership dimensions, document their stability over time, and explore the associations between these profiles and outcomes (need satisfaction, anhedonia, and safety of care).

Methods: A questionnaire was completed twice over a one-year period by 750 healthcare professionals. Latent transition analysis was the primary method of analysis.

Results: Our results showed that employees' perceptions of authentic leadership behaviors reflected an overarching construct simultaneously coexisting with four specific dimensions (self-awareness, internalized moral perspective, relational transparency, and balanced processing). We identified four profiles highly stable over time: Low Global Authentic, Normative, Low Specific Self-Awareness, and High Specific Balanced Processing. Finally, employees' global and specific (relatedness, competence, and autonomy) levels of need satisfaction as well as perceptions of safety of care and anhedonia differed as a function of their profile, with the most positive outcomes associated with the Normative profile.

Conclusion: In addition to confirming that authentic leadership may be studied as a global construct, this study highlights the importance of considering the combinations of global and specific factors in explaining variations in caregivers' need satisfaction, anhedonia, and quality of care over a one year-period. Our findings suggest that managers should strive to implement a complete array of authentic leadership behaviors at a balanced level to ensure positive outcomes.

Background and aim: This study explores the key challenges affecting the healthcare system in Saudi Arabia as it strives to achieve the objectives of Vision 2030. Unlike previous research, which has primarily focused on policy and structural reforms, this study provides empirical insights from healthcare workers, offering a frontline perspective on the barriers to effective healthcare transformation.

Methods: A cross-sectional survey was conducted among 383 healthcare professionals from public and private hospitals. The questionnaire covered challenges related to capacity and infrastructure, workforce shortages, digital transformation, preventive healthcare, coordination and integration, healthcare financing, public awareness, quality of care, and disease prevention. Data were analyzed using descriptive statistics, t-tests, and ANOVA to assess variations in perceptions based on professional roles, work experience, gender, and hospital type.

Results: The findings reveal workforce shortages, infrastructure limitations, and digital transformation gaps as the most pressing concerns. Notable differences in perceptions highlight the need for tailored interventions across different healthcare roles and settings. Addressing these challenges requires strategic workforce planning, investment in infrastructure, digital innovation, and sustainable financing models.

Conclusion: This study contributes to the literature by offering evidence-based recommendations for policymakers and healthcare administrators, aligning healthcare system improvements with Vision 2030 objectives. The insights provided can help shape targeted strategies to enhance healthcare efficiency, accessibility, and resilience in Saudi Arabia.