Leadership in Health Services最新文献

Purpose: This study aims to demonstrate how service providers, service users and their families should be able to share the co-leadership, co-auspicing, co-ownership, and co-governance, of a the mental health-care ecosystem, at every level, as it develops upwards and wider, in a process of inclusivity, conviviality and polyphonic discourse, via the overlapping phases of co-creativity, codesign, co-production, co-delivery, co-evaluation, co-research and co-replication, to achieve outcomes of co-communal or organisational well-being.

Design/methodology/approach: "Co-design" is shorthand code for encouraging multiple pathways and trajectories toward forming and sustaining a sparkling web or vibrant network of inclusive opportunities for stakeholder participation and a collaborative partnership in organizational development, in these circumstances, for more effective mental health services (MHSs).

Findings: In a co-design framework, all partners should be entitled to expect and "to have and to hold" an ongoing equal stake, voice and power in the discourse from start to finish, in a bottom-up process which is fostered by an interdisciplinary leadership group, providing the strong foundation or nutrient-rich and well-watered soil and support from which a shared endeavor can grow, blossom and generate the desired fruit in ample quality and quantity.

Originality/value: The authors should be working toward co-design and co-production of contemporary MHSs in a mental health-care ecosystem.

Purpose: Being a novel public health crisis, the COVID-19 pandemic presented world leaders with difficult options and some serious dilemmas that must somehow be negotiated. Whilst these leaders had limited knowledge about the coronavirus and how the pandemic would potentially evolve, they were still expected to make high-staked judgements amidst a range of uncertainties. The purpose of this paper is to explore the response strategies used by various world leaders from the perspective of crisis leadership within the public health domain.

Design/methodology/approach: Secondary data was collected from research papers, policy reports and credible media outlets to examine the construct of crisis leadership within the context of the global pandemic.

Findings: The paper identified three cognitive antecedents to the COVID-19 crisis leadership failures, which helped to explain why certain policy decisions were successful and why others were less so. On this basis, a clear dichotomy was drawn between highly rated leaders and their less successful counterparts in relation to the management and governance of the coronavirus pandemic.

Originality/value: The uniqueness of this paper lies in its psycho-political approach, which offered insights into the cognitive undertones that underpin the three leadership failures that emerged from the distinct approaches used by world leaders to prepare for, respond to and recover from the COVID-19 pandemic. The practical recommendations proposed in this paper are hoped to aid better decision-making for leaders faced with the task of managing future public health crises.

Purpose: Leadership literature has identified that the servant leadership style can reduce employee negative work outcomes, even in challenging work environments like the health-care sector as nurses play an important role in the performance of a hospital. That is why, the efficiency and effectiveness of the nurses are believed to be directly linked to improved health benefits to the public. So, this study aims to investigate the inter-relationship between servant leadership, organizational justice and workplace deviance of nurses in public sector hospitals.

Design/methodology/approach: A self-administrated questionnaire using a drop-and-collect method was used for collecting the data from nurses working in the public sector hospitals of Pakistan using a convenient sampling technique. In total, 370 questionnaires were distributed among the nursing staff, of which 201 completed and usable questionnaires were returned and used for data analysis. Further, the partial least squares structural equation modeling approach is used in this study using SmartPLS version 3 software to test the hypothesized model and determine the direct and indirect effects.

Findings: Results showed a negative relationship between servant leadership and workplace deviance, positive relationship between servant leadership and organizational justice, negative relationship between organizational justice and workplace deviance and that organizational justice mediates in the relationship between servant leadership and workplace deviance.

Practical implications: This study provides valuable recommendations and practical implications to address the nurses' deviant workplace behaviors in the public sector hospitals of Pakistan.

Originality/value: This study is novel as it shows the significance of servant leadership behavior which has the ability to positively influence organizational justice perception leading to less likelihood of the emergence of nurses' deviant workplace behavior, specifically in the context of public sector hospitals of Pakistan.

Purpose: Following serious case review, the Transforming Care agenda (DH, 2015) highlights the need for adults with learning disabilities, autism, mental health issues or behaviors that challenge to be supported within communities rather than hospitals. Poor or absent leadership has been identified as contributing to serious cases of abuse in health-care settings [Department of Health (DH), 2012]. This paper aims to focus on identifying the elements required for good leadership and service delivery in community forensic services (CFS).

Design/methodology/approach: The perspectives of 12 support workers working in CFS were obtained through semi-structured interviews.

Findings: Thematic analysis identified two predominant themes, namely, authentic leadership and effective team practice. A culture of trust and learning occurs when teams are well led. This culture leads to consistent practice which benefits services users and reduces risk of poor practice. Analysis suggests a framework for service delivery which is complimented by aspects of the Total Attachment model.

Research limitations/implications: The data set was collected from the same organisation and views may have been aligned to existing organisational policy. However, the sample was taken across different teams and geographical locations to collate more generalised experiences of team dynamics. The lead researcher works for the organisation and this dual role may have affected the candour with which individuals shared information during interviews.

Practical implications: Using a model to understand the functional dynamics of teams within CFS may support leaders and practitioners to improve service delivery.

Social implications: Improving service delivery within CFS may increase opportunity to meet the Transforming Care Agenda.

Originality/value: This paper examines staff perspectives and the application of theoretical frameworks to propose a unique service delivery model for supported living within CFS.

Purpose: The agglomeration of specialist health-care facilities has often been restricted to metropolitan areas. This study aims to understand how health-care professionals with transformational leadership behaviors and entrepreneurial aims with a similar vision and expertise play pertinent roles in providing essential specialized health care in rural and semi-urban areas and achieving the United Nations Sustainable Development Goals (UNSDGs).

Design/methodology/approach: Qualitative synthesis using focused-group discussions and interviews was conducted in a phased manner. For this, this study has used stakeholder-theory, and dynamic-capabilities approaches.

Findings: This study explores the intricacies of collaborative entrepreneurship (CE)-based health-care ventures in developing regions and reveals five pertinent attributes: strategic control, synergy, commitment, empathy and satisfaction. This study recommends that entrepreneurial collaboration, especially by transformational health-care leaders, can significantly contribute to creating an endogenous health-care ecosystem with advanced facilities and technology-enabled modern infrastructure and augmenting regional development.

Research limitations/implications: This study was conducted in semi-urban settings in India. Future research should include other sectors and regions to generalize the findings.

Practical implications: This study benefits health-care professionals having an analogous vision, skills and entrepreneurial aims.

Social implications: Collaboration of health-care professionals and using transformational leadership behaviors can considerably contribute to providing specialist health care in developing areas and enhance patient satisfaction.

Originality/value: To the best of the authors' knowledge, this is the first study to discuss the importance of CE in health care in developing areas. In addition, it discusses the benefits of the CE model in achieving the UNSDGs and offers valuable suggestions for health-care professionals and administrators.

Purpose: Many academic leaders have little formal leadership training, which can result in challenges to effective leadership, succession planning and burnout. This paper aims to explore the leadership skills needed to be an effective senior academic leader in a Canadian medical faculty.

Design/methodology/approach: An anonymous voluntary survey of needed leadership skills and supports was sent to 60 senior academic leaders at the University of Alberta. This was followed by interviewing a purposive sample, using open-ended questions based on a multimodal needs assessment of senior academic leaders. The authors used an iterative process to analyze the data; anonymized transcripts were coded and categorized separately by two researchers, and themes were created.

Findings: The "ability to influence" was the highest rated needed leadership skill in the survey. The interviewed leaders (n = 12) were unanimous that they felt unprepared at the start of the leadership role. The survey and interviews identified five major themes for leadership skills: Mentoring, Finances, Human Resources, Building Relationships and Protected Time. Networking and leadership courses were identified as major sources of support.

Research limitations/implications: Although a single site study, the results were similar to another large Canadian medical faculty (University of Toronto, Lieff et al., 2013). While the survey had a 42% response rate (25/60), the survey responses were echoed in the interviews. Although the purposive sample was small, the interviewed leaders were a representative sample of the larger leadership group.

Originality/value: Academic leaders may benefit from a mentorship team/community of leaders and specific university governance knowledge which may help their ability to influence and advance their strategic initiatives.

Purpose: Accountability within distributed leadership (DL) is critical for DL to drive positive outcomes in health services organizations. Despite this, how accountability emerges in DL is less clear. This study aims to understand how accountability emerges in DL so that distributed leaders can drive improvements in healthcare access - an increasingly important outcome in today's health services environment.

Design/methodology/approach: The authors use an instrumental case study of a dental institution in the USA, "Environ," as it underwent a strategic change to improve healthcare access to rural populations. The authors focused on DL occurring within the strategic change and collected interview, observation and archival data.

Findings: The findings demonstrate accountability in DL emerged as shared accountability and has three elements: personal ownership, agentic actions and a shared belief system. Each of these was necessary for DL to advance the strategic change for improved healthcare access.

Practical implications: Top managers should be cognizant of the emergence processes driven by DL. This includes enabling pockets of employees to connect, align and link up so that ideas, processes and practices can emerge and allow for shared accountability in DL.

Originality/value: The overarching contribution of this research is identifying shared accountability in DL and its three elements: personal ownership, agentic actions and a shared belief system. These elements serve as a platform to demonstrate "how DL works" in a healthcare organization.

Purpose: This discursive paper presents a lived experience leadership model as developed as part of the Activating Lived Experience Leadership (ALEL) project project to increase the recognition and understanding of lived experience leadership in mental health and social sectors. The model of lived experience leadership was formulated through a collaboration between the South Australian Lived Experience Leadership & Advocacy Network and the Mental Health and Suicide Prevention Research and Education Group.

Design/methodology/approach: As one of the outcomes of the ALEL research project, this model incorporates findings from a two-year research project in South Australia using participatory action research methodology and cocreation methodology. Focus groups with lived experience leaders, interviews with sector leaders and a national survey of lived experience leaders provided the basis of qualitative data, which was interpreted via an iterative and shared analysis. This work identified intersecting lived experience values, actions, qualities and skills as characteristics of effective lived experience leadership and was visioned and led by lived experience leaders.

Findings: The resulting model frames lived experience leadership as a social movement for recognition, inclusion and justice and is composed of six leadership actions: centres lived experience; stands up and speaks out; champions justice; nurtures connected and collective spaces; mobilises strategically; and leads change. Leadership is also guided by the values of integrity, authenticity, mutuality and intersectionality, and the key positionings of staying peer and sharing power.

Originality/value: This model is based on innovative primary research, which has been developed to encourage understanding across mental health and social sectors on the work of lived experience leaders in seeking change and the value that they offer for systems transformation. It also offers unique insights to guide reflective learning for the lived experience and consumer movement, workers, clinicians, policymakers and communities.