Leadership in Health Services最新文献

Purpose: This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles.

Design/methodology/approach: This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020.

Findings: Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses' intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout.

Originality/value: Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses' intentions to pursue formal leadership roles.

Purpose: This study aims to appraise and synthesize evidence examining the effects of toxic leadership on the nursing workforce and patient safety outcomes.

Design/methodology/approach: This is a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Five electronic databases (SCOPUS, PubMed, Web of Science, CINAHL and Psych INFO) were searched to identify relevant articles. Two independent researchers conducted the data extraction and appraisal. A content analysis was used to identify toxic leadership outcomes.

Findings: The initial literature search identified 376 articles, 16 of which were deemed relevant to the final review. Results of the content analysis identified 31 outcomes, which were clustered into five themes: satisfaction with work; relationship with organization; psychological state and well-being; productivity and performance; and patient safety outcomes. Seven mediators between toxic leadership and five outcomes were identified in the included studies.

Practical implications: Organizational strategies to improve outcomes in the nursing workforce should involve measures to build and develop positive leadership and prevent toxic behaviors among nurse managers through theory-driven strategies, human resource management efforts and relevant policy.

Originality/value: The review findings have provided modest evidence suggesting that working under a leader who exhibits toxic behaviors may have adverse consequences in the nursing workforce; however, more research examining if this leadership style influences patient safety and care outcomes is warranted.

Purpose: This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme's aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.

Design/methodology/approach: The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners' interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.

Findings: The authors' evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another's experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.

Research limitations/implications: Despite a small sample size, the authors' results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.

Practical implications: The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.

Originality/value: ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

Purpose: Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study aims to describe nurse leaders' perceptions of what future leadership in hospital settings in the post-pandemic era needs to be like.

Design/methodology/approach: A qualitative descriptive study was used. A total of 20 nurse leaders from the Finnish central hospital were interviewed from June to October 2021. The data were analysed using inductive content analysis.

Findings: The analysis revealed five main categories describing nurse leaders' perceptions of future leadership in hospital settings in the post-pandemic era: digitalisation and hybrid working culture, development of sustainable working conditions, moving smoothly to the post-pandemic era, dissolution of traditional regimes of organisation and flexibility in leadership.

Practical implications: In the post-pandemic era, the constantly changing demands and challenges currently facing healthcare systems have significantly increased the complexity of hospital organisations. This requires critical evaluation and change to traditional leadership. Enhancing flexibility and authenticity in leadership, strengthening competencies, implementing a wide range of digital resources and increasing the appeal of the nursing profession to build the next generation of nurses - all of these are needed to provide sustainability in future healthcare.

Originality/value: The results identify the critical points of leadership that need to be developed for future challenges and for maintaining a sufficient supply of qualified professionals. Acting on this information will enhance flexibility in organisations and lead to acceleration of changes and the development of new kinds of leadership in the future.

Purpose: This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.

Design/methodology/approach: Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.

Findings: Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.

Research limitations/implications: All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents' profiles, demographic variables were not analyzed.

Practical implications: This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.

Originality/value: This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

Purpose: Nurses are one the essential health-care providers within society, seeking the employment of authentic leadership approaches to reduce the burnout and stressors established within the emergency departments. Burnout has been vitally documented as a psychological impulse that emerges due to the prevalence of chronic job stressors. Authentic leadership approaches will act as an affirmative organizational resource that could help to minimize burnout in the work environments. Therefore, this study aims to evaluate the role of authentic leadership in stress and burnout among nurses in emergency departments.

Design/methodology/approach: This study used a quantitative, cross-sectional design. A package of surveys was distributed to nurses working in emergency departments using standardized questionnaires that measured the study variables. A total of 188 nurses participated in the study. SPSS was used to analyze data.

Findings: The study's results supported the hypotheses and found that authentic leadership significantly and negatively influenced nurses' job stress R = -0.169, p = 0.0205. Also, the results of this study found that the relationship between authentic leadership and burnout was significant and negative R = -0.245, F (1,186) = 11.8, p = 0.0007.

Originality/value: Nurse leaders can introduce flexible working hours and develop coordination and cooperation among nurses, and management of the hospitals needs to focus on improving the structure and enhancing nurses' outcomes that could affect patients' and organizations' outcomes.

Purpose: This study aims to examine to what extent the relationships between hospital workers' perceptions of lean leadership behaviour, their engagement and the hospital unit's perceived performance are mediated by job demands.

Design/methodology/approach: The data (n = 1,624) come from a lean implementation study in a Dutch hospital and are analysed using structural equation modelling in Mplus (v8.4).

Findings: The results confirm that lean leadership behaviour is related to employee engagement and hospital unit performance as perceived by employees, and these relationships are partially mediated through job demands. More specifically, the authors found that the type of job demand explains the direction of mediation effects. On the one hand, so-called challenging demands positively mediate the relationships between lean leadership behaviour and its outcomes. Conversely, hindering demands negatively mediates the relationship between lean leadership behaviour and perceived unit performance.

Practical implications: The authors recommend hospital organisations and human resources managers start by helping hospital leaders understand the underlying mechanisms that explain the effects of leadership on employees' perceptions and, second, support their frontline leaders by providing training, coaching and feedback on how to influence job demands in a way that creates an optimal work environment for hospital employees.

Originality/value: The authors contribute to the literature by building upon insights from the job demands-resources model to explain the effects of lean leadership behaviour and by investigating the relevance of lean leadership in a hospital context, given the phenomenon's strong roots in manufacturing.

Purpose: This study aims to examine the long-term impact of leader-member exchange (LMX) on employee safety behavior. It proposes a conceptual model that includes the mediating role of job satisfaction (JS) in the relationship between LMX and safety behaviors, regarding safety compliance behavior (SCB) and safety participation behavior (SPB).

Design/methodology/approach: Data were collected from 325 health-care workers across public hospitals in Algeria at three waves. Data were analyzed with partial least square structural equation modeling.

Findings: The findings revealed that LMX positively influenced employees' job satisfaction. However, the relationship between LMX and SCB was found to be mediated by job satisfaction. LMX was not directly related to both dimensions of safety behavior, whereas JS was positively associated with safety compliance and safety participation.

Originality/value: This is the first paper, to the best of the authors' knowledge, to report on the significant mediating role of JS on the reciprocal process used to exchange resources between leaders and subordinates and safety behaviors among health-care workers, thereby filling an important research gap in existing literature.

Purpose: This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors' leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle-income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

Design/methodology/approach: This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants' knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick's model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.

Findings: The workshop yielded positive results, as evidenced by participants' increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.

Originality/value: The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.