Leadership in Health Services最新文献

Purpose: This paper presents a realist evaluation of leadership within an integrated care system (ICS) in England. This paper aims to examine which aspects of leadership are effective, for whom, how and under what circumstances.

Design/methodology/approach: Realist evaluation methodology was used, adopting prior realist review findings as the theoretical framework to refine explanations of how and why leadership within an ICS is effective. Between January and November 2023, 23 interviews with ICS leaders took place, alongside 7 meeting observations and documentary analysis. The Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) guidance informed the study design, conduct and reporting.

Findings: The findings highlight two overarching infrastructural contexts influencing leadership in ICSs: the impact of the post-COVID-19 pandemic legacy and the differences between health and social care regulatory and financial environments. Findings demonstrate that ICS leaders identified a strong sense of purpose as crucial for guiding decisions and creating a psychologically safe environment for open, honest discussions, fostering calculated risk-taking. Whilst a shared vision directed priority setting, financial pressures led to siloed thinking. Leadership visibility was linked to workforce morale, with supportive leadership boosting morale amidst evolving ICS landscapes and confidence in data-driven decisions supported prevention activities. However, financial constraints hindered responsiveness and innovation in addressing health inequalities.

Originality/value: By examining ICS leadership post-COVID-19 pandemic and amidst varying regulatory and financial environments, this study contributes to the emerging literature on systems leadership and offers practical guidance for leaders navigating the complexities of integrated care.

Purpose: The purpose of this study is to explore the impact of EL style on key variables in health-care settings. Very few studies investigate the impact and outcomes of EL on health-care organizations. Synthesis of evidence will assist health-care leaders in making informed decisions about the outcomes they can expect from practicing EL.

Design/methodology/approach: Arksey and O'Malley's five-stage framework is used for conducting the scoping review. The databases include Scopus, Emerald Insight and Web of Science.

Findings: A total of 22 studies were finally considered for scoping review. The data are presented in terms of years, sampling techniques, sample size, data collection methods, and the directional relationship of the variables with EL.

Practical implications: Managers should be trained in EL style as it promotes the sustainability of the environment and organizations. Furthermore, EL should be promoted in health-care organizations as it improves employee resilience and voicing behavior and reduces instances of adverse events and medication errors, thus making the hospital a better and safer place.

Originality/value: This is one of the studies investigating the EL implications for health-care managers.

Purpose: Healthcare workforce shortages, particularly in rural areas, present a global challenge. The purpose of this study is to explore the leadership dynamics within federally qualified health centers (FQHC) in rural Oklahoma, focusing on recruitment, retention, job satisfaction and development practices.

Design/methodology/approach: Eighteen managers with five or more years of tenure from Oklahoma FQHCs were interviewed. Leadership's role in influencing job satisfaction, recruitment, retention and development practices was analyzed using a multilevel ecological framework through qualitative content analysis with NVivo.

Findings: The analysis includes ten key themes including the critical role of leadership in addressing recruitment and retention challenges, the importance of aligning organizational culture, rural culture, access challenges, trainings and values with workforce development initiatives, and the impact of leadership practices on job satisfaction.

Originality/value: This study uniquely examines leadership strategies in rural FQHCs, integrating ecological considerations for cultural, logistical and community-specific factors. It emphasizes the pivotal role leadership plays in shaping workforce development. As rural healthcare evolves, refining these approaches is crucial for addressing workforce challenges, improving healthcare access and ensuring that rural FQHCs remain sustainable, driving positive outcomes for healthcare professionals and communities.

Purpose: This paper aims to assess the influence of nursing leadership style on error management culture (EMC).

Design/methodology/approach: This scoping review was conducted following the integrative review methodology of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, CINAHL, Scopus, Web of Science, Embase and EBSCO databases were systematically searched to identify studies on nursing leadership, error management and measurement, and error management culture. The studies' methodological quality was then assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies.

Findings: Thirteen manuscripts were included for review. The analysis confirmed that nursing leadership plays an important role in EMC and nurses' intention to report errors. Three emerging themes were identified: 1) leadership and EMC; 2) leadership and the intention to report errors; and 3) leadership and error rate.

Research limitations/implications: A major limitation of the studies is that errors are often analyzed in a transversal way and associated with patient safety, and not as a single concept.

Practical implications: Healthcare managers should promote training dedicated to head nurses and their leadership style, for creating a good work environment in which nurses feel free and empowered to report errors, learn from them and prevent their reoccurrence in the future.

Originality/value: There is a positive relationship between nursing leadership and error management in terms of reduced errors and increased benefits. Positive nursing leadership leads to improvements in the caring quality.

Purpose: This study aims to investigate the conceptual relationship between full-range leadership theory (FRLT) and patient safety culture in primary care settings, aiming to understand how leadership styles influence the development and sustainability of a culture prioritizing patient safety.

Design/methodology/approach: Using a conceptual analysis approach, the study builds a theoretical framework that integrates FRLT - which includes transformational, transactional and laissez-faire leadership styles - with the elements of patient safety culture. This framework serves as the basis for a comprehensive literature review, allowing for the formulation of hypotheses regarding the impact of each leadership style on patient safety culture.

Findings: The analysis demonstrates that transformational leadership bolsters patient safety culture by fostering open communication, encouraging error reporting and facilitating continuous improvement. Transactional leadership yields mixed effects, effectively supporting compliance and operational outcomes but showing limitations in promoting a proactive safety culture. Conversely, laissez-faire leadership is associated with negative outcomes for patient safety culture, mainly due to its passive and detached approach.

Originality/value: The originality of this study is rooted in its focused examination of FRLT's impact on patient safety culture within primary care settings, the development of a unique conceptual framework and its contribution of actionable insights for health-care leadership. These elements collectively advance the understanding of how leadership can enhance patient safety culture, providing a solid foundation for future research and practical application in primary care environments.

Purpose: This study aims to investigate the mediating roles of servant leadership and employee vitality in the relationship between psychological ownership and employee creativity among healthcare workers in Ghana.

Design/methodology/approach: A sample of 736 public and private healthcare respondents was selected using a convenience sampling technique. Data collected using a self-reported questionnaire was analyzed via partial least square structural equation modeling.

Findings: The findings reveal that psychological ownership directly improves employee creativity, while servant leadership and employee vitality mediate the relationship between psychological ownership and employee creativity separately and complementarily.

Research limitations/implications: The research used self-reported data, increasing the potential for common method variance. However, sufficient care was taken to minimize these limitations.

Practical implications: This research makes valuable contributions to the field of healthcare practice literature. The findings suggest that management of health care entities should focus on creating a workplace culture that cultivates psychological ownership among employees and policies that enhance employee vitality and promote servant behavior to foster employee creativity.

Originality/value: This study represents one of the earliest attempts to examine a theoretical framework that connects servant leadership, employee vitality, employee creativity and psychological ownership within the context of the health service industry.

Purpose: In this case study, the authors aimed to investigate the usefulness of five interactive workshops on leadership skills relevant to academic physicians for their professional fulfillment. Workshops were led by experts in finance, negotiation, business administration and digital tools and enhanced a practical understanding of skills in 1) financial investment; 2) growing clout on social media; 3) negotiation; 4) navigating institutional culture as a woman; and 5) conflict management.

Design/methodology/approach: Workshops were deployed to faculty in the departments of Radiology and Psychiatry. Attendance at seminars was captured, categorized as in-person (when offered), virtual-live or virtual-recording views post hoc. The authors also collected responses to a brief, 5-question survey which assessed faculty familiarity with the topic pre-and post-seminar and evaluated the perceived relevance of the topic to professional fulfillment.

Findings: The highest attendance was for the seminar on financial investments, and the lowest attendance was for that on conflict management. The seminar that the highest proportion of respondents deemed important as a leadership skill was on the topic of navigating institutional culture as a woman in the workplace. The seminar that focused on cultivating clout on social media was the seminar that the highest proportion of respondents deemed worth attending.

Originality/value: From this case study, the authors learned that financial literacy, discerning institutional culture, managing conflicts, negotiating and using digital tools are topics which have relevance to physician professional fulfillment. Such topics could be valuable as the building blocks for future programs which provide leadership training to physicians.

Purpose: Strategic leadership plays an important role in achieving organizational success in surviving and growing in a challenging business environment. This study aims to examine the role of strategic leadership in responding to a rare moment in the health industry, which is the combination of government regulations that tend to continue to change and the emergence of COVID-19 pandemic.

Design/methodology/approach: A total of 358 respondents from 141 type C and D hospitals in Indonesia participated in this research. This study used six latent variables and 27 dimensions, processed using structural equation modeling.

Findings: The results of this study confirmed that resilient leaders will not seek new partners by developing network capabilities; but rather choose to save the hospital first, by resources reconfiguration as response to the unanticipated adversity caused by fusing the government regulation and emergence of the COVID-19 pandemic.

Originality/value: This study makes an important contribution that enables hospital management to develop action plans in response to national health-care regulations coupled with the emergence and extension of the COVID-19 pandemic; as well as the results of the investigation into organizational resources, and to implement strategic resilience capability more effectively.