Leadership in Health Services最新文献

{"title":"Crisis leadership and power dynamics in Portuguese hospitals: organisational learning from COVID-19.","authors":"Paula Cristina de Almeida Marques","doi":"10.1108/LHS-11-2025-0183","DOIUrl":"https://doi.org/10.1108/LHS-11-2025-0183","url":null,"abstract":"<p><strong>Purpose: </strong>This paper aims to examine how power struggles, competing leadership logics and governance failures shaped organisational learning and crisis response in Portuguese public hospitals during the COVID-19 pandemic. By analysing tensions between managerial, clinical and political actors, this study explores how fragmented authority and informal leadership networks conditioned hospitals' adaptive capacity under sustained systemic pressure.</p><p><strong>Design/methodology/approach: </strong>This study draws on 41 semi-structured interviews with hospital managers, clinical leaders and frontline coordinators across three major public hospitals, complemented by documentary analysis of contingency plans, internal communications and official reports. A deductive thematic analysis was conducted, supported by systematic triangulation, inter-coder validation and critical incident reconstruction.</p><p><strong>Findings: </strong>Three interrelated patterns emerged: strained relationships between hospital management and central and regional authorities undermined coordination and trust; informal leadership networks developed within clinical departments to address operational bottlenecks, frequently bypassing formal hierarchies; and political interference intensified power rivalries, reducing coherence, transparency and institutional learning. Although these dynamics often constrained organisational learning, they also enabled pockets of rapid local adaptation driven by autonomous clinical leadership.</p><p><strong>Research limitations/implications: </strong>This study is limited by its focus on three large hospitals in Northern Portugal, which restricts generalisation to other regions or smaller institutions. The qualitative design, although suitable for exploring governance dynamics, captures perceptions that may be influenced by hindsight bias and the exceptional pressures of the pandemic. The absence of quantitative performance indicators limits the ability to assess the measurable effects of governance tensions. Future research should incorporate mixed methods, include diverse organisational contexts and examine longitudinal integration of informal practices into formal governance and learning systems.</p><p><strong>Practical implications: </strong>Hospitals require governance arrangements that recognise and integrate informal leadership and frontline expertise during crises. Strengthening transparent communication channels, formalising multi-level coordination mechanisms and embedding learning processes within crisis governance frameworks are critical for enhancing resilience and leadership effectiveness.</p><p><strong>Social implications: </strong>This study highlights how governance tensions during the COVID-19 pandemic affected not only hospital functioning but also the broader social experience of healthcare. Unclear authority structures and delayed decisions contributed to public uncertainty, reduced confidence in health i","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"1-20"},"PeriodicalIF":1.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692896","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":"Development and psychometric validation of the distributed leadership scale for nurses.","authors":"Fatma Demirkaya, Ece Uysal Kasap","doi":"10.1108/LHS-11-2025-0177","DOIUrl":"https://doi.org/10.1108/LHS-11-2025-0177","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to develop a new scale to measure nurses' perceptions of distributed leadership and to test its psychometric properties. Distributed leadership remains an understudied concept in the context of nursing, and no distributed leadership scale specifically tailored for nurses has been identified.</p><p><strong>Design/methodology/approach: </strong>This is a cross-sectional, methodological, descriptive and correlational study. The development of this scale and the determination of its psychometric properties were carried out in three stages. First, a literature review was conducted. In the second stage, a preliminary evaluation of the items was performed. In the third stage, the psychometric properties were assessed. The study evaluated the scale's face, content and construct validity, as well as its internal consistency and test-retest reliability. The psychometric properties of the scale were evaluated in a sample of 550 nurses employed at a state hospital affiliated with the Ministry of Health in Turkey. Data were collected between December 2024 and April 2025.</p><p><strong>Findings: </strong>The content validity index of the scale was 0.86. According to the principal axis factor, the scale consisted of 26 items and three subdimensions, accounting for 62.20% of the total variance. The confirmatory factor analysis indicated that the fit indices were at an acceptable level for this structure. Reliability analysis demonstrated good internal consistency. The test-retest results indicated that the scale possesses temporal stability.</p><p><strong>Originality/value: </strong>The distributed leadership scale for nurses is a valid and reliable instrument for measuring nurses' perceptions of distributed leadership. It provides a comprehensive assessment through three subdimensions: collaborative management, leadership skills and collegial support.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677481","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":"Enhancing hospital logistics through service modularity.","authors":"Tengiz Verulava, Giorgi Kurtanidze","doi":"10.1108/LHS-10-2025-0173","DOIUrl":"https://doi.org/10.1108/LHS-10-2025-0173","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Health-care organizations face the dual challenge of reducing costs while improving service quality, making hospital logistics a key area for innovation. This study aims to examine how service modularity, originating in manufacturing and service operations, can be applied to hospital logistics to enhance efficiency, flexibility and staff experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;A qualitative multi-case study was conducted across eight hospitals in Georgia. Data were collected through 15 semi-structured interviews, 4 focus groups and document analysis. The data were analyzed using NVivo software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Three interrelated dimensions of modularity were identified: division and classification of services and materials; process differentiation, including automation and decoupling of support functions from clinical work; and organizational centralization and specialization. These arrangements were associated with improved efficiency, cost control and enhanced staff experience by reducing health-care workers' involvement in routine logistical tasks. Implementation challenges included communication gaps, resistance to standardization and outdated Information and Communication Technology systems. The effectiveness of modularity depended on organizational readiness, technological capacity and staff engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;This study has several limitations. First, it is based on a qualitative case study of eight hospitals in Georgia, which limits generalizability. Second, hospitals were selected based on their engagement in logistics innovation, potentially introducing selection bias. Third, findings rely on self-reported experiences rather than objective performance measures. Finally, the focus on logistics processes excludes direct analysis of clinical workflows and patient outcomes. Future research should address these limitations through mixed-method and comparative designs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical implications: &lt;/strong&gt;The findings indicate that modular logistics arrangements benefit a broad range of health-care workers, including nurses, physicians, pharmacists, logistics professionals and administrative staff. By clarifying interfaces and reallocating support tasks away from clinical workflows, modularity improves staff experience and operational transparency while generating efficiency gains. Hospital managers should view modular logistics as an organizational design choice rather than a purely technical intervention, ensuring alignment with digital infrastructure and staff engagement strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Social implications: &lt;/strong&gt;At the societal level, improved staff experience and operational efficiency may indirectly contribute to better patient outcomes and quality of care. By reducing unnecessary operational strain on health-care workers across professional groups, modular logistics supports a more sustainable ","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"1-17"},"PeriodicalIF":1.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677616","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":"Self-management and home-based HIV/AIDS care in Tanzania.","authors":"Randolph K Quaye","doi":"10.1108/LHS-03-2025-0054","DOIUrl":"10.1108/LHS-03-2025-0054","url":null,"abstract":"<p><strong>Purpose: </strong>Adherence to antiretroviral therapy (ART) is a major contributor to the success of treating people with HIV/AIDS. This study aims to explore the degree to which human immunodeficiency virus and acquired immune deficiency (HIV/AIDS) infected individuals, especially those who routinely visit antiretroviral clinics would prefer to receive their treatment at home rather than at the clinic.</p><p><strong>Design/methodology/approach: </strong>Fifty semistructured and in-depth interviews were used to collect data. Based upon systematic review of the literature on self-management of people living with HIV/AIDs, the authors developed specific questions that explored the respondents' views on self-management, adherence to ART, stigma and overall attitudes of their health-care providers.</p><p><strong>Findings: </strong>The majority of the respondents reported learning about their HIV/AIDS status through voluntary testing, and that a majority of them preferred accessing care through their clinic. About half of them have informed their spouses or relatives about their HIV/AIDS status. They overwhelmingly were satisfied with services provided by their health-care providers. To better scale-up antiretroviral services, several studies have suggested that the government should play a major role in providing resources and income-generating programs to assist patients financially.</p><p><strong>Research limitations/implications: </strong>The findings lend credence to the impact of ART programs in improving and prolonging the lives of Tanzanian individuals living with HIV/AIDS. It is the hope that the global effort in this campaign, especially through the U.S. Presidential Emergency Fund for AIDS Relief will continue. The current proposal to defund this program should be reconsidered for the sake of millions of individuals living with HIV/AIDS globally.</p><p><strong>Practical implications: </strong>This is a call to action by governments, nongovernmental organizations and the larger international community to harness resources to scale-up treatment for individuals living with HIV/AIDS.</p><p><strong>Social implications: </strong>The burden of HIV/AIDS has complicated the current plight of patients. Expanding antiretroviral services will help reduce the excess death facing many developing and developed nations.</p><p><strong>Originality/value: </strong>The knowledge gained in this study may benefit society by accessing how clinic and home-based care can be an effective tool of extending antiretroviral services to patients seeking care. While the geographically limited ample size makes generalizations to all of Tanzanian society impossible, nevertheless, the findings lend credence to the impact of ART programs in improving and prolonging the lives of Tanzanian. It is the hope that the global effort in this campaign will continue.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"169-186"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365749","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":"Evaluating community perceptions of leadership in decentralized governance during public health crisis: a case study from Thrissur district, Kerala (India).","authors":"Kiran Prakash Vattamparambil, Suhita Chopra Chatterjee","doi":"10.1108/LHS-04-2025-0062","DOIUrl":"10.1108/LHS-04-2025-0062","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate how demographic variables - specifically age, gender and income - influenced community perceptions of decentralized governance leadership during the COVID-19 crisis in Elavally Panchayat, Kerala. It explores residents' varied experiences with local service delivery and support mechanisms, revealing disparities in satisfaction and access. The findings underscore the importance of inclusive, adaptive and crisis-responsive local leadership during public health emergencies.</p><p><strong>Design/methodology/approach: </strong>Adopting a mixed-methods approach, this study combined unstructured interviews with elected local self-government leaders and primary health centre staff with a structured household survey. The survey included first 100 household respondents drawn from confirmed COVID-19 cases across all 16 wards. Six dimensions of governance performance were assessed using a three-point Likert scale (Satisfied, Neutral and Dissatisfied). Descriptive statistics and chi-square tests (p < 0.05) were applied to examine demographic variations in satisfaction levels. Qualitative insights from interviews further contextualized and deepened the findings.</p><p><strong>Findings: </strong>The results indicate significant demographic disparities in perceived leadership effectiveness. Younger adults appreciated digital welfare schemes but felt excluded from local decision-making. Middle-aged residents experienced severe healthcare and livelihood disruptions, while elderly individuals struggled with digital health systems. Women expressed higher satisfaction due to targeted welfare schemes, whereas men cited unmet mental health and economic needs. Lower-income groups reported barriers to accessing essential services. Nonetheless, decentralized governance grounded in trust, equity and participatory approaches enabled an effective, context-specific crisis response.</p><p><strong>Originality/value: </strong>Unlike studies that treat communities as homogeneous, this research disaggregates perceptions, offering policy insights to strengthen equity and resilience in local health governance.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"226-246"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913358","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":"Empowering adaptive leadership: a dynamic adaptive approach.","authors":"Anke Aarninkhof-Kamphuis, Hans Voordijk, Geert Dewulf","doi":"10.1108/LHS-07-2025-0121","DOIUrl":"10.1108/LHS-07-2025-0121","url":null,"abstract":"<p><strong>Purpose: </strong>Adaptive leadership and dynamic adaptive approaches to decision-making are becoming increasingly important for organizations operating in complex and uncertain environments. This study aims to examine how the utilization of a dynamic adaptive approach influences adaptive leadership within strategic processes. Adaptive leadership enables organizations to navigate unpredictable challenges by fostering resilience, learning and change, while the applied dynamic adaptive approach supports strategic decision-making under deep uncertainty.</p><p><strong>Design/methodology/approach: </strong>A qualitative multiple-case study design was used, involving four Dutch healthcare organizations - two elder care organizations and two disability care organizations. Each organization participated in a strategic decision-making workshop in which a dynamic adaptive approach was applied. Data were collected through workshop observations, interviews and supporting documentation.</p><p><strong>Findings: </strong>The findings show that the applied dynamic adaptive approach strengthens a supportive environment and contributes to sensemaking necessary, helping participants engage with long-term uncertainties and strategic complexity. This, in turn, encouraged behaviors and mindsets associated with adaptive leadership. However, the study also reveals limitations: a single workshop is not sufficient to fully design an intervention for an organization and develop adaptive leadership capabilities. Iterative, ongoing engagement is necessary to build strategic resilience and adaptive capacity.</p><p><strong>Originality/value: </strong>This research complements recent calls for more empirical research on adaptive leadership and foresight approaches. The study reveals how the dynamic adaptive approach in strategic decision-making processes empowers adaptive leadership. This is especially important in today's complex organizations facing deep uncertainties in a rapidly changing environment.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"247-265"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999398","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":"Examining the relationship between transformational leadership, organizational culture and organizational change perception in a hospital setting: a structural equation modeling approach.","authors":"Mustafa Orhan, Yasemin Akbulut","doi":"10.1108/LHS-10-2025-0167","DOIUrl":"10.1108/LHS-10-2025-0167","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to examine how transformational leadership influences organizational change perception in accredited and digital hospitals, and whether organizational culture subdimensions mediate this relationship.</p><p><strong>Design/methodology/approach: </strong>This cross-sectional and explanatory study was conducted in two public hospitals in Izmir, Türkiye, both accredited and holding digital hospital certificates. Using stratified sampling to ensure professional representation, data were collected from 527 employees. Structural equation modeling was used to analyze the relationships among variables.</p><p><strong>Findings: </strong>Transformational leadership was found to have a significant effect on organizational change perception (β = 0.614). When organizational culture subdimensions were included as mediators, the effect size decreased to β = 0.179, indicating a partial mediating effect. Among the mediators, adhocracy culture, clan culture, hierarchy culture and market culture showed differing indirect effects in this relationship. The findings highlight the importance of organizational culture in shaping change perceptions in hospital settings.</p><p><strong>Practical implications: </strong>The study highlights that strengthening transformational leadership practices and fostering an adhocracy-oriented culture can improve hospitals' readiness for organizational change, such as accreditation and digital transformation, while also supporting employee engagement and successful change initiatives.</p><p><strong>Originality/value: </strong>By focusing on hospitals undergoing both accreditation and digitalization, this study contributes to understanding how leadership and culture interact in complex healthcare environments. The results offer practical insights for health managers aiming to foster successful change through cultural development and transformational leadership.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"266-278"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133250","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":"Comprehensive unit-based safety program in practice: high reliability organising, patient safety and organisational human factors in Victoria's public healthcare system - a qualitative study.","authors":"Clare McCarthy, Bill Shearer, Katharine See, Elizabeth Austin, Robyn Clay-Williams","doi":"10.1108/LHS-03-2025-0044","DOIUrl":"10.1108/LHS-03-2025-0044","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to explore organisational human factors in implementing and evaluating the Comprehensive Unit-based Safety Program (CUSP) as part of a high reliability organisations (HROs) framework for improving patient safety in a public hospital setting in Victoria, Australia.</p><p><strong>Design/methodology/approach: </strong>A qualitative study using semi-structured interviews with 15 participants from seven CUSPs was conducted. Participants represented diverse clinical and non-clinical roles, selected based on program maturity and availability. Data were collected between August 2022 and March 2023, with thematic analysis using deductive and inductive coding. Reflexive practices, including transcript verification and peer debriefing, ensured rigour.</p><p><strong>Findings: </strong>CUSP emerged as vital for fostering leadership, accountability, teamwork and psychological safety - pillars of a robust safety culture. Thematic analysis revealed three core themes: HRO Principles, Organisational Human Factors and Quality and Safety. CUSP's integration of timely, actionable safety data enhanced teamwork, flattened hierarchies and drove collaborative improvements in patient safety. By blending technical and adaptive elements, the program cultivated a proactive safety culture. These findings emphasise embedding human factors and leadership into safety programs while identifying a need for further research into CUSP's scalability and long-term impact.</p><p><strong>Practical implications: </strong>CUSP's adaptable, data-driven approach can embed patient safety into organisational practices. Healthcare organisations can leverage this study's insights to prioritise leadership, promote psychological safety and ensure data accessibility for staff.</p><p><strong>Originality/value: </strong>To the best of the authors' knowledge, this is the first Australian study to examine CUSP within a HRO context, highlighting how leadership and teamwork underpin safety program success in public healthcare.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"187-201"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890467","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":"A conceptual framework for health-promoting leadership in healthcare inspired by the Okanagan Charter.","authors":"Victor Do, Kordan Harvey, Jerry M Maniate","doi":"10.1108/LHS-07-2025-0116","DOIUrl":"10.1108/LHS-07-2025-0116","url":null,"abstract":"<p><strong>Purpose: </strong>The wellbeing of healthcare workers is increasingly recognized as foundational to high-quality care and sustainable health systems. While various leadership frameworks promote wellbeing, there remains a gap in system-wide strategies that integrate equity, psychological safety and health promotion into leadership practice. This paper aims to address that gap by adapting the Okanagan Charter, originally developed for health-promoting universities, into a novel framework for health-promoting leadership in healthcare.</p><p><strong>Design/methodology/approach: </strong>This conceptual paper reinterprets the principles of the Okanagan Charter through the lens of inclusive, distributed and compassionate leadership. The authors adapt an established six-domain model to the health leadership context: embed health in all policies, adapt spaces to promote wellbeing, create thriving communities and cultures, support meaningful personal and professional development, promote engagement with health services and collaborate in continuous improvement and evaluation. For each domain, they provide theoretical rationale, leadership strategies and practice-based illustrations.</p><p><strong>Findings: </strong>This paper critically examines the applicability of the Okanagan Charter within healthcare leadership, highlights practical implementation challenges and presents a revised leadership case study grounded in real-world complexity. The findings demonstrate the utility of the six-domain model in guiding leaders to embed wellbeing into everyday practice.</p><p><strong>Originality/value: </strong>This paper advances existing scholarship by explicitly extending Okanagan Charter-aligned work into the domain of healthcare leadership. It offers a clear, theory-informed roadmap for leaders to integrate wellbeing, equity and health promotion into the fabric of organizational life, positioning health-promoting leadership as a strategic imperative for resilient, inclusive and high-performing health systems.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"298-308"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126677","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":"The shaky terrain of patient quality and safety: the potential of leadership to improve patient and staff experiences.","authors":"Rishika Selvakumar, Farinaz Havaei, David Birnbaum","doi":"10.1108/LHS-11-2024-0133","DOIUrl":"10.1108/LHS-11-2024-0133","url":null,"abstract":"<p><strong>Purpose: </strong>Patient safety's inconsistent progress remains a prominent concern. Influential advocates recently identified faltering leadership in stalled initiatives. This study aims to identify how patient care quality and safety can be improved by analyzing leadership and organizational frameworks.</p><p><strong>Design/methodology/approach: </strong>This multimethod study began with narrative review of existing literature on leadership for organizational frameworks in the context of patient-care quality and safety. The review informed development of scripted questions followed by semi-structured interviews with a purposeful sample of 11 healthcare leaders across Canada and the USA.</p><p><strong>Findings: </strong>Key findings include consistent themes, along with indication by cited authors that important yet widely unfamiliar historical lessons from leading innovators along the past 100 years seem lost to institutional memory. Three themes emerged from the literature review: organizational ideology, the right leadership and organizational resilience. Several unique practical methods were discovered to be associated with consistent success. Additional interview themes include: a clear organizational mission, values and vision; personal values driving passion; all leaders and teams should collaborate; importance of a role model figure; importance of transparency; and flexibility to lead differently.</p><p><strong>Originality/value: </strong>Important achievements and innovations exist in isolated examples. Now is the time to rethink leadership for organizations to widely steady a continuous evolution of patient care quality and safety progress. This manuscript identifies methods for improvement that have not been considered from business literature and recognizes current perspectives of healthcare leaders, for application in the realm of patient safety.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"216-225"},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764269","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}