Leadership in Health Services最新文献

Purpose: This study aims to make visible the dynamic nature of leader-member exchange (LMX) in the changing realm of health-care leadership.

Design/methodology/approach: The qualitative study used an open questionnaire, which was distributed amongst nursing staff and managers at a Finnish public university hospital.

Findings: The participants described partly LMX theory, but the leader-member relationship was also influenced by the organizational culture and the existing management practices. Nursing staff were found to have a more variable and dynamic role in the LMX relationship than has previously been reported. The research therefore provided novel information for the field of health-care research.

Research limitations/implications: The presented research was limited by the content of the data, as the collected single narratives were rather short; however, the fact that a large number of narratives were collected from diverse participants strengthened the ability to reliably answer the research questions.

Practical implications: Although the participants described partly LMX theory, the leader-member relationship is also influenced by the organizational culture and existing management practices; the finding that nurses have more variable roles in LMX relationships in the health-care context was new insight in this field. Therefore, the presented findings can help decision-makers change the current, perhaps antiquated, leadership practices at health-care organizations.

Originality/value: This study provides new insight into the field of LMX research in terms of the important role of nursing staff, the organizational factors that influence the LMX relationship and the dynamic nature of LMX relationships.

Purpose: The purpose of this paper is to report a scoping review of reviews which investigated HLDP evaluations to determine: how the conceptualisation of leadership development programmes (HLDPs), and despite growing calls for robust evaluations of their pedagogic design, delivery and effectiveness, there are concerns regarding the quality of data associated with their evaluation. This scoping review of reviews investigated the reporting of HLDP evaluations to determine: how the conceptualisation of leadership underpinning HLDPs influence their evaluation; how the pedagogical approaches within HLDPs influence their evaluation; and the evaluation designs and measures used to assess HLDPs.

Design/methodology/approach: The scoping review was conducted on reviews of HLDPs. Searches were performed on four databases and on the grey literature. Data were extracted and a narrative synthesis was developed.

Findings: Thirty-one papers were included in the scoping review of reviews. A great deal of heterogeneity in HLDPs was identified. Evaluations of HLDPs were affected by poor data quality, and there were limitations in the evidence about "what works". Leadership was conceptualised in different ways across HLDPs, and consequently, there was a lack of consistency as to what is being evaluated and the methods used to assess HLDPs.

Originality/value: This review of reviews summarises the current evidence on the evaluation of HLDPs. Evaluations of HLDPs need to explicitly account for the complexity of health systems, how this complexity impacts on the development and articulation of leadership practice, and how the underlying conceptualisation of leadership and the associated theory of change articulate a set of assumptions about how HLDPs support leaders to affect change within complex systems.

Purpose: This paper aims to explore users' perceptions of whether the Leadership Development Impact Assessment (LDI) Toolkit is valid, reliable, simple to use and cost-effective as a guide to its quality improvement.

Design/methodology/approach: The Canadian Health Leadership Network codesigned and codeveloped the LDI Toolkit as a theory-driven and evidence-informed resource that aims to assist health-care organizational development practitioners to evaluate various programs at five levels of impact: reaction, learning, application, impact and return on investment (ROI) and intangible benefits. A comparative evaluative case study was conducted using online questionnaires and semistructured telephone interviews with three health organizations where robust leadership development programs were in place. A total of seven leadership consultants and specialists participated from three Canadian provinces. Data were analyzed sequentially in two stages involving descriptive statistical analysis augmented with a qualitative content analysis of key themes.

Findings: Users perceived the toolkit as cost-effective in terms of direct costs, indirect costs and intangibles; they found it easy-to-use in terms of clarity, logic and structure, ease of navigation with a coherent layout; and they assessed the sources of the evidence-informed tools and guides as appropriate. Users rated the toolkit highly on their perceptions of its validity and reliability. The analysis also informed the refinement of the toolkit.

Originality/value: The refined LDI Toolkit is a comprehensive online collection of various tools to support health organizations to evaluate the leadership development investments effectively and efficiently at five impact levels including ROI.

Purpose: This study aims to explore nursing home and home care managers' strategies in handling the COVID-19 pandemic.

Design/methodology/approach: This study has a qualitative design with semistructured individual interviews conducted digitally by videophone (Zoom). Eight managers from nursing homes and five managers from home care services located in a large urban municipality in eastern Norway participated. Systematic text condensation methodology was used for the analysis.

Findings: The managers used several strategies to handle challenges related to the COVID-19 pandemic, including being proactive and thinking ahead in terms of possible scenarios that might occur, continuously training of staff in new procedures and routines and systematic information sharing at all levels, as well as providing different ways of disseminating information for staff, service users and next-of-kins. To handle staffing challenges, managers used strategies such as hiring short-term staff that were temporary laid off from other industries and bringing in students.

Originality/value: The COVID-19 pandemic heavily affected health-care systems worldwide, which has led to many health-care studies. The situation in nursing homes and home care services, which were strongly impacted by the pandemic and in charge of a vulnerable group of people, has not yet received enough attention in research. This study, therefore, seeks to contribute to this research gap by investigating how managers in nursing homes and home care services used different strategies to handle the COVID-19 pandemic.

Purpose: This paper aims to explore what is known in the literature about leadership and burnout within mental health clinicians (MHC).

Design/methodology/approach: The Arksey and O'Malley (2005) framework was used to conduct a systematised scoping review of three databases: PsycInfo, PubMed and CINAHL. To ensure a broad scope of the literature, Google, Google Scholar and three sources of grey literature were also searched.

Findings: In total 1,087 articles were identified and 36 were included in the final review, 23 of which were cross-sectional and correlational studies. There is a lack of experimental studies, longitudinal research and qualitative approaches. The literature repeatedly demonstrated an association between leadership and burnout; transformational-leadership style, good quality supervision, supportive relationships, positive communication and fostering autonomy are areas of interest.

Research limitations/implications: Future research activity should aim to follow the recommendations made in the literature; more experimental and longitudinal approaches are needed to support practical application of the findings.

Originality/value: To the best of the author's knowledge there is no other review which maps out the research pertaining to leadership and burnout among MHC. These findings can be used to guide future research to ensure that efforts are directed toward original, meaningful and practical ventures that will add to the evidence base and benefit clinical practice.

Purpose: Formal structured leadership training is increasingly incorporated as a regular fixture in developed nations to produce competent leaders to ensure the provision of quality patient care. However, most low- and middle-income countries (LMICs) rely on one-off external training opportunities for selected individuals as they lack the necessary resources to implement long-term training for a wider pool of potential health care leaders. This case study shares the establishment process of the Talent Grooming Programme for technical health care professionals (TGP), a three-year in-house leadership training programme specially targeted at potential health care leaders in Malaysia.

Design/methodology/approach: This case study aims to share a comprehensive overview of the ideation, conceptualisation and implementation of TGP. The authors also outlined its impact from the individual and organisational perspectives, besides highlighting the lessons learned and recommendations for the way forward.

Findings: TGP set out to deliver experiential learning focusing on formal training, workplace experiences, practical reflection and mentoring by supervisors and other esteemed leaders to fulfil the five competency domains of leadership, organisational governance, communication and relationship, professional values and personal values. The successes and challenges in TGP programme delivery, post-training assessment, outcome evaluation and programme sustainability were outlined.

Practical implications: The authors' experience in setting up TGP provided valuable learning points for other leadership development programme providers. As for any development programme, a continuous evaluation is vital to ensure its relevance and sustainability.

Originality/value: Certain aspects of TGP establishment can be referenced and modified to adapt to country-specific settings for others to develop similar leadership programme, especially those in LMICs.

Purpose: This study aims to enhance understanding of the collaboration between chairs of nurse councils (CNCs) and members of executive hospital boards (BM) from a relational leadership perspective.

Design/methodology/approach: The authors used a qualitative and interpretive methodology. The authors study the daily interactions of BM and CNCs of seven Dutch hospitals through a relational leadership lens. The authors used a combination of observations, interviews and document analysis. The author's qualitative analysis was used to grasp the process of collaborating between BM and CNCs.

Findings: Knowing each other, relating with and relating to are distinct but intertwined processes that influence the collaboration between BM and CNC. The absence of conflict is also regarded as a finding in this paper. Combined together, they show the importance of a relational process perspective to understand the complexity of collaboration in hospitals.

Originality/value: Collaboration between professional groups in hospitals is becoming more important due to increasing interdependence. This is a consequence of the complexity in organizing qualitative care. Nevertheless, research on the process of collaborating between nurse councils (NCs) and executive hospital boards is scarce. Furthermore, the understanding of the workings of boards, in general, is limited. The relational process perspective and the combination of observations, interviewing and document analysis proved valuable in this study and is underrepresented in leadership research. This process perspective is a valuable addition to skills- and competencies-focused leadership literature.

Purpose: The purpose of this study is to describe primary health-care managers' perceptions of management competencies at different management levels in digital health services using the management competency assessment program as a framework.

Design/methodology/approach: A secondary analysis study involving 21 semi-structured individual interviews was conducted among Finnish primary health-care managers at different management levels (frontline, middle and senior). The deductive framework method was used to analyze the data.

Findings: Similarities and differences were found in management competencies between different levels of management. Competencies related to the use of digitalization were highlighted by managers at all management levels. Managers at all management levels were involved in developing digital solutions and supporting employees in using digital solutions in their work. Frontline and middle managers emphasized more issues related to day-to-day management and communication with employees, whereas senior managers highlighted the management of large entities.

Research limitations/implications: In the secondary analysis, data were used for purposes other than originally intended. Therefore, the data are subject to limitations of the methodology applied and should be transferred to other contexts with caution.

Practical implications: Identifying the management competencies needed to manage digital health services is important to target managers' training according to needs in the future.

Social implications: The results could be used to develop the management of digital health services, as well as improve digital health services and their deployment.

Originality/value: Previous literature mostly examined managers' informatics competencies and paid little attention to other management competencies. This study discusses more broadly the management competencies that digital health services require from managers at different levels of management.

Purpose: Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager's job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers' perceptions of, prerequisites for and experiences from the implementation of changes in their manager's work conditions.

Design/methodology/approach: A grounded theory-based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis.

Findings: Three thematic areas were identified: engagement, facilitation and achievement. The second-line managers' descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process.

Originality/value: This study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up.