Journal of Healthcare Leadership最新文献

{"title":"Organizational Culture and Effective Leadership in Academic Medical Institutions.","authors":"Anish Bhardwaj","doi":"10.2147/JHL.S358414","DOIUrl":"10.2147/JHL.S358414","url":null,"abstract":"<p><p>In the US, a heterogeneity in archetypes of leadership augments the success of an Academic Medical Institution (AMI) in fulfilling its key missions of clinical service, teaching, training, mentoring, research and scholarship, community engagement, inclusion, and diversity. Effective leadership is profoundly influenced by organizational culture with its dominant foundations in shared attitudes, beliefs, mores, behaviors-scripted and unscripted, as well as explicit and tacit rules and policies that become entrenched in the operational repertoire over time. Modulating organizational culture are an AMI's mission, vision, core and affirmed values, formal governance and its complexity, informal influencers, historical precedent, the rapidly evolving landscape of healthcare, regional and institutional socioeconomics, and faculty prototypes. It is paramount that AMIs endeavor to recruit and position leaders whose values align with those of the institution (\"cultural fit\"). This treatise highlights the crucial influences that affect organizational culture and its interface with AMI leadership and ensure the success of the organization and its leaders.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43845561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Organizational Commitment and Organizational Justice Among Health Care Workers in Ethiopian Jimma Zone Public Health Facilities.","authors":"Beshea Deressa,&nbsp;Kebebe Adugna,&nbsp;Bezawit Bezane,&nbsp;Matebu Jabessa,&nbsp;Gemechis Wayessa,&nbsp;Alemi Kebede,&nbsp;Gelila Tefera,&nbsp;Yisalemush Demissie","doi":"10.2147/JHL.S345528","DOIUrl":"https://doi.org/10.2147/JHL.S345528","url":null,"abstract":"Background The healthcare service sector is confronting a global labor shortage. Despite this fact, health care professionals are still highly vulnerable to organizational injustice, which negatively influence organizational commitment, putting an additional burden on the health sector. Thus, this study aimed to investigate the correlation between organizational commitment and organizational justice among health care workers. Methods Facility-based cross-sectional study design was conducted among 395 health care professionals in the Jimma zone. Four Hospitals and 10 health centers were involved in the study randomly. The sample was distributed proportionally based on the number of health care workers. To select individuals, a systematic random sampling method was employed. Data were collected through self-report questionnaire using modified Alan and Mayer scale to measure organizational commitment and Niehoff and Moorman scale to measure organizational justice. The validity of the tools was checked using the reliability coefficient alpha and it was >0.7. The collected data were cleaned and entered into EpiData software version 3.1 and exported to SPSS version 20 for analysis. Descriptive and inferential statistics were done. Results This study revealed that 212 (53.7%) of the respondents scored a low level of organizational commitment. About half of the participants, 202 (52.2%), judged organizational justice were fair. All organizational justice dimensions showed a positive and significant correlation with all organizational commitment dimensions. Thus, the finding revealed that overall organizational commitment and organizational justice had a strong and positive correlation (r = 0.695**, P < 0.01). From the regression analysis distributive justice (B = 0.382, 95% CI: 0.31–0.45), and procedural justice (B = 0.17, 95% CI: 0.06–0.283) were among the factors affecting organizational commitment. Conclusion and Recommendation This study showed a strong link between organizational commitment and organizational justice. This suggests that organizational justice has been recognized as a motivator and factor influencing health care workers’ organizational commitment. As a result, enhancing organizational justice can help to maintain the commitment of healthcare workers and the facility’s capabilities.","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/99/jhl-14-5.PMC8820756.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Physician on a Board of Directors: Bane or Benefit?","authors":"M. Borow, Baruch Levi, Benny Avissar, L. Wapner","doi":"10.2147/JHL.S344510","DOIUrl":"https://doi.org/10.2147/JHL.S344510","url":null,"abstract":"Abstract With the accelerated development of innovative domains such as artificial intelligence, big data, and personalized healthcare, the continuing growth of health-tech and bio-tech industries is to be expected. Concurrently, the question of the extent and nature of physicians’ involvement in these rapidly evolving industries arises, especially in management and leadership capacities such as directors or chief executive officers of such companies. Against this backdrop, the Israeli Medical Association recently launched a first-of-its-kind course designed to train senior physicians as directors in health-tech companies by providing them with vast relevant financial, legislative, and professional proficiencies. Due to their medical knowledge and clinical experience, physicians bring a substantial added value to these industries. However, considering the inherent tensions and potential conflicts between adhering to the logic of a profit-making, competitive market on one hand and maintaining the doctor’s oath on the other, it is inevitable that dilemmas and difficulties will emerge. Much has been written about the roles and responsibilities of boards of directors, but to date, little has focused on the unique position of physicians who serve in these roles. This article aims to examine the ways in which conflicts or dualities of interest manifest themselves for physicians who assume roles as directors and whether effective remedial strategies are available, based on the authors’ own experience in the initiation of the IMA physician-directors course.","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49176327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Gaining Affective Commitment the Missing Strategy for Successful Change Management in Healthcare?","authors":"Reema Harrison,&nbsp;Ashfaq Chauhan,&nbsp;Amirali Minbashian,&nbsp;Ryan McMullan,&nbsp;Gavin Schwarz","doi":"10.2147/JHL.S347987","DOIUrl":"https://doi.org/10.2147/JHL.S347987","url":null,"abstract":"<p><p>Despite the requirement for continual change and development, change failure is omnipresent in health care, ranging from small technical errors within new systems, processes or technologies, through to breakdowns and large-scale disaster. Despite decades of research investment, consultancy and initiatives, creating a healthcare context that promotes clinician engagement with change remains elusive, with limited demonstrated progress. Affective commitment to change refers to commitment that is driven by a desire to support change based on its perceived benefits or value, as opposed to commitment that is based on a sense of obligation or the minimization of costs. Recent evidence from health-care contexts indicates that affective commitment to change drives change readiness more so than the individual's self-efficacy for dealing with the change. Considering evidence regarding the effect of affective commitment to change on individual and collective change readiness among health-care staff, we may need to reorient our current strategies for managing change. We explore the opportunities to enhance affective commitment to change and, in turn, change readiness through adopting values-based approaches to designing and executing change proposals with clinicians and service users.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/ef/jhl-14-1.PMC8784667.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Regional Health System Journey from Volume to Value: Roadmap to the Recognition as a 15 Top Health System in the USA for Quality Excellence.","authors":"Nidal H Harb,&nbsp;Patricia A Said,&nbsp;Shirley L Gusta,&nbsp;Amanda M Wesson,&nbsp;Jordan D Brautigam,&nbsp;Jon H Lemke,&nbsp;Stephen T DeLessio,&nbsp;Douglas P Cropper,&nbsp;Nicolas W Shammas","doi":"10.2147/JHL.S378664","DOIUrl":"https://doi.org/10.2147/JHL.S378664","url":null,"abstract":"<p><p>The 15 Top Health System program, an IBM Watson study, objectively measures health systems' performance overall on an annual basis using publicly reported data available from the Center for Medicare and Medicaid Services (CMS) and state data banks. Genesis Health System was recognized as an IBM Watson Health 15 Top Health System for two consecutive years in 2020 and 2021. A system-based approach with a \"physician-lead, professionally-managed\" framework, led to accomplishing the 15 Top Health System. The steps needed included adoption of the IBM Watson database to determine current status of certain key performance indicators, establishing a clinical effectiveness program and governance structure, and adopting Lean methodologies to analyze and determine appropriate interventions with long-term solution. The desire and willingness to accomplish this ambitious goal start with adoption by the Board and the administration of the health system while supplying appropriate financial and human resources that are dedicated to the success of the journey. In this manuscript, we describe the journey and steps implemented to accomplish the outcomes that led to the recognition as a 15 Top Health System for quality excellence.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/6b/jhl-14-203.PMC9733692.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10337333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value, Support, and Advancement: An Organization's Role in Faculty Career Intentions in Academic Medicine.","authors":"Fátima Sancheznieto,&nbsp;Angela Byars-Winston","doi":"10.2147/JHL.S334838","DOIUrl":"https://doi.org/10.2147/JHL.S334838","url":null,"abstract":"<p><strong>Purpose: </strong>Faculty engagement in academic medical centers is essential to advancing efficient healthcare delivery, research productivity, and organizational quality. The authors used turnover theory to empirically examine factors that influence faculty engagement, including both aspirational and attrition-related career intentions.</p><p><strong>Methods: </strong>Using a convergent, mixed methods design, the authors surveyed 284 faculty at a large Midwestern public university's school of medicine in Fall 2015, Fall 2016, and Spring 2017. The study's questionnaire included a series of scales which informed three outcome variables (promotion aspirations, leadership aspirations, and intent to leave the organization) and four groups (role strain, work-family conflict, organizational commitment and support, and departmental commitment and support) of predictor variables, all of which have been previously validated with medical faculty populations. The scales were followed by open-ended questions which allowed respondents to further elaborate on their experiences in their organization related to each outcome variable. The authors used a hierarchical multiple regression model to assess the effect of each of the four groups of predictor variables on the outcome variables and then employed an iterative thematic analysis of open-ended responses to further elucidate faculty's reported experiences.</p><p><strong>Results: </strong>Organizational commitment and support were significantly associated with faculty's promotion aspirations, leadership aspirations, and intentions to leave the organization. Thematic analysis of participant responses to open-ended questions further revealed the specific career development support faculty desired, mainly, streamlined and transparent promotion and leadership processes; clear guidance to maneuver these processes; holistic professional development opportunities; feeling valued; and supports for clinical and administrative tasks.</p><p><strong>Conclusion: </strong>Advancing organizational policy that supports infrastructure for evidence-based interventions and programming for the intentional career development of faculty is an important aspect of a proactive talent development and retention model in academic medical centers.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/0c/jhl-13-267.PMC8610756.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39660436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospects of Integrating Gig Economy in the Saudi Arabian Health-care System from the Perspectives of Health-care Decision-makers and Practitioners.","authors":"Turki Alanzi","doi":"10.2147/JHL.S323729","DOIUrl":"https://doi.org/10.2147/JHL.S323729","url":null,"abstract":"<p><strong>Background: </strong>Gig economy is an approach in the labor market which is characterized by the prevalence of short-term contracts or freelance work in contrast to permanent jobs. The gig workers are independent workers or temporary contract workers who enter into formal/informal agreements with on-demand companies to provide their services. Rather than employing full-time/permanent employees companies may utilize gig workers as per the demand and work burden, which can minimize the costs incurred in managing permanent employees. However, there is a lack of research on using gig economy in health care, its prospects and the issues involved.</p><p><strong>Purpose: </strong>The purpose of this study is to identify and evaluate various prospects in integrating gig economy with the Saudi health-care system.</p><p><strong>Methods: </strong>An online survey questionnaire instrument including 22 prospects under three categories including organizational competitiveness, resource management, and sustainable development was used for collecting data from 712 health-care decision-makers and practitioners in Saudi Arabia. Findings were analyzed using the statistical means and standard deviations for each item in the questionnaire for analyzing the role of each factor in depth, and <i>t</i>-tests were used for comparing the responses between the groups.</p><p><strong>Results: </strong><i>T</i>-tests revealed no significant differences among the experts and health-care workers in relation to organizational competitiveness and resource management; however, significant differences in opinions were identified in relation to sustainable development. Individual factors including motivation for Saudization program (mean=4.5, SD=1.15) and creating employment opportunities in rural areas (mean=4.5, SD=1.08), growth in economy (mean=4.4, SD=1.43), increased opportunities for women and disabled (mean=4.4, SD=1.28), and growth in employment (mean=4.3, SD=1.68) were the major prospects identified in relation to the use of gig economy in the Saudi Arabian health-care system.</p><p><strong>Conclusion: </strong>Gig economy may offer a wide range of benefits in health care, especially sustainable development, effective resource management, and organizational competitiveness.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/9d/jhl-13-255.PMC8526949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39560472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organizational Culture, Quality of Care and Leadership Style in Government General Hospitals in Kuwait: A Multimethod Study.","authors":"Talal ALFadhalah,&nbsp;Hossam Elamir","doi":"10.2147/JHL.S333933","DOIUrl":"https://doi.org/10.2147/JHL.S333933","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the organizational culture, assess the quality of care, and measure their association with a transformational/transactional leadership style in six hospitals.</p><p><strong>Materials and methods: </strong>We used cross-sectional and retrospective quantitative approaches in government-sponsored secondary-care hospitals. A sample of 1626 was drawn from a frame of 9863 healthcare workers in six hospitals. Followers were surveyed using the Multifactor Leadership Questionnaire and the Organizational Description Questionnaire. We reviewed and analyzed one year (2012) of quarterly and annual quality indicators from the hospitals. Data were analyzed using suitable statistical analyses.</p><p><strong>Results: </strong>We collected 1626 responses from six hospitals. 66.4% to 87.1% of participants in each hospital identified their hospital's organizational culture as transformational, whereas 41 out of 48 departments were identified as having a transformational culture. The percentage of participants at each hospital rating their leader and organizational culture as transformational ranged from 60.5% to 80.4%. The differences between leadership style and organizational culture were statistically significant for four of the hospitals. For most of the quality indicators, there was a positive, but nonsignificant, correlation with leadership style.</p><p><strong>Conclusion: </strong>Leaders define and influence organizational culture. The prevailing transformational leadership style creates and maintains a transformational organizational culture. The effect of transformational leadership on the quality of care delivered by the organization was measured in this study, and showed a positive and nonsignificant relationship between generic quality indicators and the transformational style.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/c0/jhl-13-243.PMC8528408.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39560471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Diffusion of Home-Based Reablement in Norwegian Municipalities.","authors":"Trond Bliksvær,&nbsp;Tilde Marie Bertelsen,&nbsp;Merete Kvamme Fabritius,&nbsp;Morten Balle Hansen,&nbsp;Bente Vibecke Lunde,&nbsp;Ragnhild Holmen Waldahl","doi":"10.2147/JHL.S326663","DOIUrl":"10.2147/JHL.S326663","url":null,"abstract":"<p><strong>Introduction: </strong>Home-based reablement (HBR) has achieved significant international prominence in recent years. In the Nordic countries, HBR has been introduced as an innovative care model within the municipal health care sector that answers the need for better and more effective service delivery. But knowledge about how innovations can be spread in the municipal health care sector is scarce. We also know little about what role first-line managers (FLMs) may play for the diffusion of innovations.</p><p><strong>Purpose: </strong>To describe and explain adoption of HBR in municipalities in Norway and to explore if there is a relationship between early/late adoption and the FLM's perception of innovativeness in their organization. Such knowledge is valuable for the understanding of the role of FLM for the diffusion of innovations in the health care sector.</p><p><strong>Methods: </strong>A cross-sectional national online survey was carried out among FLM in the eldercare sector in 422 Norwegian municipalities. The response rate was 64%. The analysis was based on univariate and bivariate techniques, factor analysis, and multiple linear regression.</p><p><strong>Results: </strong>A bivariate analysis revealed that early adoption is associated with a high score on perception of innovativeness among FLMs. Innovators and early adopters scored highest (5.65) on perception of innovativeness, followed by early majority (5.31) and late majority (5.18). The lowest score was found among Laggards. A multiple regression analysis revealed that a substantial part of the positive relationship between early adoption and perception of innovativeness can be explained by FLMs' length of service in the organization and their educational level. Wealth of the municipality does not have an effect on innovativeness.</p><p><strong>Conclusion: </strong>An implication of the results is that mature and stable personnel in key positions in the organization, and personnel with higher education, can be positive for innovativeness in the municipal health care sector.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2021-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/04/jhl-13-231.PMC8520449.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39538899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Differences in Experiences Among Multi-Level Healthcare Leaders, Between the First and the Second Wave of the COVID-19 Pandemic: Two Cross-Sectional Studies Compared.","authors":"Bibi Hølge-Hazelton, Line Zacho Borre, Mette Kjerholt, Brendan McCormack, Elizabeth Rosted","doi":"10.2147/JHL.S326019","DOIUrl":"10.2147/JHL.S326019","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the differences in experiences during wave I and II of the COVID-19 pandemic among healthcare leaders.</p><p><strong>Background: </strong>It is expected, that working conditions for COVID-19-pandemic frontline staff will change, as health care organizations have gained experience with handling the consequences of the disease.</p><p><strong>Methods: </strong>An online survey was sent out to Danish health care leaders during the first and the second pandemic wave. Comparative analyses were performed in relation to three key characteristics: management level, management education and experiences as a leader.</p><p><strong>Results: </strong>Eighty-nine health care leaders completed both surveys. Significant differences were found within the entire group across the key characteristics as they felt more prepared for each stage of the situation, they had more influence on the decisions taken, and they felt more concerned about the quality of treatment and care and their own health. Further significant results related to the three key characteristics were found at 1) Management level: The heads of department experienced being better informed, having more overview of their tasks and that these were meaningful. The ward managers experienced being more able to work in consistency with own beliefs and values, though they felt more overloaded. 2) Level of management education: Leaders, without a formal management education, experienced being more supported by staff. 3) Years of experiences as leader: Leaders with more than five years of experience, experienced being more prepared and informed, had more influence on decision-making, and were more worried about their own health.</p><p><strong>Conclusion: </strong>The learning from experience that happens naturally in crisis situations is the reason why the leaders feel more prepared. However, there is a need for further leadership and practice development, to create contexts where leaders feel more ready for all aspects of their role.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/eb/jhl-13-209.PMC8445098.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39430709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}