Leadership in Health Services最新文献

{"title":"Contexts and complexities: a realist evaluation of integrated care system leadership.","authors":"Lisa Knight, Rafaela Neiva Ganga, Matthew Tucker, Adam P Shore, Steve Nolan","doi":"10.1108/LHS-06-2024-0051","DOIUrl":"10.1108/LHS-06-2024-0051","url":null,"abstract":"<p><strong>Purpose: </strong>This paper presents a realist evaluation of leadership within an integrated care system (ICS) in England. This paper aims to examine which aspects of leadership are effective, for whom, how and under what circumstances.</p><p><strong>Design/methodology/approach: </strong>Realist evaluation methodology was used, adopting prior realist review findings as the theoretical framework to refine explanations of how and why leadership within an ICS is effective. Between January and November 2023, 23 interviews with ICS leaders took place, alongside 7 meeting observations and documentary analysis. The Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) guidance informed the study design, conduct and reporting.</p><p><strong>Findings: </strong>The findings highlight two overarching infrastructural contexts influencing leadership in ICSs: the impact of the post-COVID-19 pandemic legacy and the differences between health and social care regulatory and financial environments. Findings demonstrate that ICS leaders identified a strong sense of purpose as crucial for guiding decisions and creating a psychologically safe environment for open, honest discussions, fostering calculated risk-taking. Whilst a shared vision directed priority setting, financial pressures led to siloed thinking. Leadership visibility was linked to workforce morale, with supportive leadership boosting morale amidst evolving ICS landscapes and confidence in data-driven decisions supported prevention activities. However, financial constraints hindered responsiveness and innovation in addressing health inequalities.</p><p><strong>Originality/value: </strong>By examining ICS leadership post-COVID-19 pandemic and amidst varying regulatory and financial environments, this study contributes to the emerging literature on systems leadership and offers practical guidance for leaders navigating the complexities of integrated care.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591385","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":"Ethical leadership in health-care organizations - a scoping review.","authors":"Ankit Singh, Harshitha Vashist","doi":"10.1108/LHS-04-2024-0035","DOIUrl":"https://doi.org/10.1108/LHS-04-2024-0035","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to explore the impact of EL style on key variables in health-care settings. Very few studies investigate the impact and outcomes of EL on health-care organizations. Synthesis of evidence will assist health-care leaders in making informed decisions about the outcomes they can expect from practicing EL.</p><p><strong>Design/methodology/approach: </strong>Arksey and O'Malley's five-stage framework is used for conducting the scoping review. The databases include Scopus, Emerald Insight and Web of Science.</p><p><strong>Findings: </strong>A total of 22 studies were finally considered for scoping review. The data are presented in terms of years, sampling techniques, sample size, data collection methods, and the directional relationship of the variables with EL.</p><p><strong>Practical implications: </strong>Managers should be trained in EL style as it promotes the sustainability of the environment and organizations. Furthermore, EL should be promoted in health-care organizations as it improves employee resilience and voicing behavior and reduces instances of adverse events and medication errors, thus making the hospital a better and safer place.</p><p><strong>Originality/value: </strong>This is one of the studies investigating the EL implications for health-care managers.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510157","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":"Leadership in federally qualified health centers: examining recruitment and retention in rural Oklahoma.","authors":"Courtney Hamby, Carissa R Smock","doi":"10.1108/LHS-06-2024-0054","DOIUrl":"https://doi.org/10.1108/LHS-06-2024-0054","url":null,"abstract":"<p><strong>Purpose: </strong>Healthcare workforce shortages, particularly in rural areas, present a global challenge. The purpose of this study is to explore the leadership dynamics within federally qualified health centers (FQHC) in rural Oklahoma, focusing on recruitment, retention, job satisfaction and development practices.</p><p><strong>Design/methodology/approach: </strong>Eighteen managers with five or more years of tenure from Oklahoma FQHCs were interviewed. Leadership's role in influencing job satisfaction, recruitment, retention and development practices was analyzed using a multilevel ecological framework through qualitative content analysis with NVivo.</p><p><strong>Findings: </strong>The analysis includes ten key themes including the critical role of leadership in addressing recruitment and retention challenges, the importance of aligning organizational culture, rural culture, access challenges, trainings and values with workforce development initiatives, and the impact of leadership practices on job satisfaction.</p><p><strong>Originality/value: </strong>This study uniquely examines leadership strategies in rural FQHCs, integrating ecological considerations for cultural, logistical and community-specific factors. It emphasizes the pivotal role leadership plays in shaping workforce development. As rural healthcare evolves, refining these approaches is crucial for addressing workforce challenges, improving healthcare access and ensuring that rural FQHCs remain sustainable, driving positive outcomes for healthcare professionals and communities.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477396","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":"Nursing leadership style and error management culture: a scoping review.","authors":"Eleonora Moraca, Francesco Zaghini, Jacopo Fiorini, Alessandro Sili","doi":"10.1108/LHS-12-2023-0099","DOIUrl":"https://doi.org/10.1108/LHS-12-2023-0099","url":null,"abstract":"<p><strong>Purpose: </strong>This paper aims to assess the influence of nursing leadership style on error management culture (EMC).</p><p><strong>Design/methodology/approach: </strong>This scoping review was conducted following the integrative review methodology of the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed, CINAHL, Scopus, Web of Science, Embase and EBSCO databases were systematically searched to identify studies on nursing leadership, error management and measurement, and error management culture. The studies' methodological quality was then assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies.</p><p><strong>Findings: </strong>Thirteen manuscripts were included for review. The analysis confirmed that nursing leadership plays an important role in EMC and nurses' intention to report errors. Three emerging themes were identified: 1) leadership and EMC; 2) leadership and the intention to report errors; and 3) leadership and error rate.</p><p><strong>Research limitations/implications: </strong>A major limitation of the studies is that errors are often analyzed in a transversal way and associated with patient safety, and not as a single concept.</p><p><strong>Practical implications: </strong>Healthcare managers should promote training dedicated to head nurses and their leadership style, for creating a good work environment in which nurses feel free and empowered to report errors, learn from them and prevent their reoccurrence in the future.</p><p><strong>Originality/value: </strong>There is a positive relationship between nursing leadership and error management in terms of reduced errors and increased benefits. Positive nursing leadership leads to improvements in the caring quality.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"37 4","pages":"526-547"},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356114","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":"Exploring the relationship between patient safety culture and the full-range leadership theory in primary care settings: a conceptual analysis.","authors":"Made Indra Wijaya","doi":"10.1108/LHS-04-2024-0037","DOIUrl":"https://doi.org/10.1108/LHS-04-2024-0037","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the conceptual relationship between full-range leadership theory (FRLT) and patient safety culture in primary care settings, aiming to understand how leadership styles influence the development and sustainability of a culture prioritizing patient safety.</p><p><strong>Design/methodology/approach: </strong>Using a conceptual analysis approach, the study builds a theoretical framework that integrates FRLT - which includes transformational, transactional and laissez-faire leadership styles - with the elements of patient safety culture. This framework serves as the basis for a comprehensive literature review, allowing for the formulation of hypotheses regarding the impact of each leadership style on patient safety culture.</p><p><strong>Findings: </strong>The analysis demonstrates that transformational leadership bolsters patient safety culture by fostering open communication, encouraging error reporting and facilitating continuous improvement. Transactional leadership yields mixed effects, effectively supporting compliance and operational outcomes but showing limitations in promoting a proactive safety culture. Conversely, laissez-faire leadership is associated with negative outcomes for patient safety culture, mainly due to its passive and detached approach.</p><p><strong>Originality/value: </strong>The originality of this study is rooted in its focused examination of FRLT's impact on patient safety culture within primary care settings, the development of a unique conceptual framework and its contribution of actionable insights for health-care leadership. These elements collectively advance the understanding of how leadership can enhance patient safety culture, providing a solid foundation for future research and practical application in primary care environments.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"37 4","pages":"499-510"},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356113","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":"Unlocking the creative potential of health-care employees: a serial mediation model.","authors":"Edem M Azila-Gbettor, Francis Fonyee Nutsugah, Jewel Dela Novixoxo, Stanley Nelvis Glate, Ben Q Honyenuga","doi":"10.1108/LHS-09-2023-0071","DOIUrl":"https://doi.org/10.1108/LHS-09-2023-0071","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the mediating roles of servant leadership and employee vitality in the relationship between psychological ownership and employee creativity among healthcare workers in Ghana.</p><p><strong>Design/methodology/approach: </strong>A sample of 736 public and private healthcare respondents was selected using a convenience sampling technique. Data collected using a self-reported questionnaire was analyzed via partial least square structural equation modeling.</p><p><strong>Findings: </strong>The findings reveal that psychological ownership directly improves employee creativity, while servant leadership and employee vitality mediate the relationship between psychological ownership and employee creativity separately and complementarily.</p><p><strong>Research limitations/implications: </strong>The research used self-reported data, increasing the potential for common method variance. However, sufficient care was taken to minimize these limitations.</p><p><strong>Practical implications: </strong>This research makes valuable contributions to the field of healthcare practice literature. The findings suggest that management of health care entities should focus on creating a workplace culture that cultivates psychological ownership among employees and policies that enhance employee vitality and promote servant behavior to foster employee creativity.</p><p><strong>Originality/value: </strong>This study represents one of the earliest attempts to examine a theoretical framework that connects servant leadership, employee vitality, employee creativity and psychological ownership within the context of the health service industry.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"37 4","pages":"548-569"},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356115","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 case study of a pilot leadership skills program to clarify professional fulfillment sources for academic physicians.","authors":"Ashwini Nadkarni, Fiona Fennessy","doi":"10.1108/LHS-11-2023-0090","DOIUrl":"https://doi.org/10.1108/LHS-11-2023-0090","url":null,"abstract":"<p><strong>Purpose: </strong>In this case study, the authors aimed to investigate the usefulness of five interactive workshops on leadership skills relevant to academic physicians for their professional fulfillment. Workshops were led by experts in finance, negotiation, business administration and digital tools and enhanced a practical understanding of skills in 1) financial investment; 2) growing clout on social media; 3) negotiation; 4) navigating institutional culture as a woman; and 5) conflict management.</p><p><strong>Design/methodology/approach: </strong>Workshops were deployed to faculty in the departments of Radiology and Psychiatry. Attendance at seminars was captured, categorized as in-person (when offered), virtual-live or virtual-recording views post hoc. The authors also collected responses to a brief, 5-question survey which assessed faculty familiarity with the topic pre-and post-seminar and evaluated the perceived relevance of the topic to professional fulfillment.</p><p><strong>Findings: </strong>The highest attendance was for the seminar on financial investments, and the lowest attendance was for that on conflict management. The seminar that the highest proportion of respondents deemed important as a leadership skill was on the topic of navigating institutional culture as a woman in the workplace. The seminar that focused on cultivating clout on social media was the seminar that the highest proportion of respondents deemed worth attending.</p><p><strong>Originality/value: </strong>From this case study, the authors learned that financial literacy, discerning institutional culture, managing conflicts, negotiating and using digital tools are topics which have relevance to physician professional fulfillment. Such topics could be valuable as the building blocks for future programs which provide leadership training to physicians.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"37 4","pages":"587-594"},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356112","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":"Strategic hospital resilience capability response to adversity: fusing government regulation and COVID-19 pandemic.","authors":"Teguh Endaryono, Harris Turino Kurniawan, Prijono Tjiptoherijanto","doi":"10.1108/LHS-01-2024-0014","DOIUrl":"https://doi.org/10.1108/LHS-01-2024-0014","url":null,"abstract":"<p><strong>Purpose: </strong>Strategic leadership plays an important role in achieving organizational success in surviving and growing in a challenging business environment. This study aims to examine the role of strategic leadership in responding to a rare moment in the health industry, which is the combination of government regulations that tend to continue to change and the emergence of COVID-19 pandemic.</p><p><strong>Design/methodology/approach: </strong>A total of 358 respondents from 141 type C and D hospitals in Indonesia participated in this research. This study used six latent variables and 27 dimensions, processed using structural equation modeling.</p><p><strong>Findings: </strong>The results of this study confirmed that resilient leaders will not seek new partners by developing network capabilities; but rather choose to save the hospital first, by resources reconfiguration as response to the unanticipated adversity caused by fusing the government regulation and emergence of the COVID-19 pandemic.</p><p><strong>Originality/value: </strong>This study makes an important contribution that enables hospital management to develop action plans in response to national health-care regulations coupled with the emergence and extension of the COVID-19 pandemic; as well as the results of the investigation into organizational resources, and to implement strategic resilience capability more effectively.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"ahead-of-print ahead-of-print","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298267","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":"Sensemaking through crisis: critical care pharmacist (CCP) leadership during COVID-19","authors":"Adegbayi Ukoha, Gareth Edwards","doi":"10.1108/lhs-10-2023-0077","DOIUrl":"https://doi.org/10.1108/lhs-10-2023-0077","url":null,"abstract":"Purpose\u0000The purpose of this study is to understand how critical care pharmacists (CCPs) coped during the COVID-19 crisis by investigating what sense-making and leadership processes were evident during the crisis.\u0000\u0000Design/methodology/approach\u0000Data from ten semi-structured interviews of lead CCPs across different National Health Service organisations in the UK was analysed through a thematic process.\u0000\u0000Findings\u0000The findings identified that strong pre-existing relationships and high levels of trust play a significant role in successfully navigating a crisis. Four sense-making processes seem important to building and maintaining these relationships and trust, namely, identifying cues for change; authoring and labelling; interpretation and storytelling; negotiation and deliberation.\u0000\u0000Originality/value\u0000The research also highlights the need for organisations to acknowledge the leadership roles undertaken by CCP teams and leverage this role by investing in leadership training, thereby increasing resilience and preparedness for future storms or crises on the horizon.\u0000","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"54 21","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927836","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":"Collaborative leadership to empower nurses to implement ABCDE emergency nursing in an emergency department in Nepal","authors":"Sushil Khadka, P. Subedi, Buddhike Sri Harsha Indrasena, D. Lamsal, Jill Aylott","doi":"10.1108/lhs-12-2023-0100","DOIUrl":"https://doi.org/10.1108/lhs-12-2023-0100","url":null,"abstract":"Purpose\u0000Emergency medicine can save lives and in 2018 the World Health Assembly passed resolution 72.16 ensuring the role of emergency care in all health systems. With a continued global shortage of emergency physicians, with many low-medium-income countries (LMIC) still to develop emergency medicine as a speciality, the role of emergency nurses is critical to deliver the WHO Emergency Care System Framework (WHO, 2018). Emergency medicine doctors play a critical role in collaborating with nurses, in emergency medicine where nurses are often the first clinicians are often the first clinicians to interact with patients in emergency care settings, making up the majority of health-care professionals in LMIC (Mamalelala, 2024). Yet emergency nursing has yet to become established in Nepal, where nurses are often recruited to emergency departments, without having received any training in emergency or critical care treatment and management. The purpose of this paper is to outline a collaborative leadership approach to co-design an airway, breathing, circulation, disability, exposure (ABCDE) structured approach to an emergency nursing training module designed for nurses to feel empowered in the emergency department and to report on its findings.\u0000\u0000Design/methodology/approach\u0000This study draws upon mixed methodology research, enrolling 30 nurses (n = 30) from an emergency department in a tertiary hospital in Nepal through three stages of the project: Stage 1: training module co-design, collaborative leadership exploring the rationale for a training module and core features of design based on the ABCDE of emergency medicine; Stage 2: quantitative data were collected to assess baseline pre- and post-intervention knowledge and follow-up knowledge assessment at 30 and 45 days; Stage 3: qualitative data were collected with 24/30 (80%) nurses to evaluate the impact and application of the nurses ABCDE learning 7 months post-training. The qualitative survey was undertaken using online Google Forms.\u0000\u0000Findings\u0000Nurses were fully engaged in the co-design and collaboration of the development of an ABCDE training module which was delivered over 3 h. Full engagement was secured from all nurses in the department, and there were statistically significant advances in ABCDE emergency knowledge from the baseline, however, this knowledge began to decrease at 30 and 45 days. A follow-up qualitative survey was distributed to nurses seven months after training with an 80% return rate, which reported a range of examples of how nurses were continuing to apply their learning in practice.\u0000\u0000Originality/value\u0000This training module for emergency nurses was designed collaboratively from the “bottom up” in a tertiary hospital in Nepal, recognising the need to develop emergency nursing in the emergency department. The data revealed promising findings, while knowledge decreased from the post-training questionnaire, qualitative evidence revealed significant changes in practice, with the greates","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"63 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813059","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}