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The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

Despite much attention being devoted to shared leadership, the negotiation of such arrangements remains underexplored. In parallel, the revival of interest in matrix structures reveals their challenges but neglects the dynamics of shared leadership. In this case study, the author analyzes the tensions experienced by senior managers of a healthcare organization transitioning from a hierarchical to matrix structure as they negotiate their leadership roles in this new arrangement.

The author interviewed 16 senior managers, observed their meetings and analyzed documents. These data were combined with secondary data including previous interviews and observations of this top leadership team. The author then conducted an inductive data analysis.

The author's analysis reveals that the tensions experienced by senior managers as they negotiate their roles reflect the co-existence of leadership surpluses (too much leadership) and deficits (too little leadership) in matrix organizations. The author argues that surpluses and deficits are not mutually exclusive but are interrelated and shows how leadership surpluses can create leadership deficits.

The author’s findings suggest that in contexts of leader abundance, actors should explore leadership voids. Particular attention should be paid to incidents of intrusion and exclusion, moments of transition and intense role negotiation, as those contexts are particularly conducive to leadership deficits.

While previous work on matrix structures focuses on leadership surpluses, the author discusses leadership deficits. The author explores how more leaders do not necessarily mean more leadership, but instead how more leaders may result in leadership voids.

This study investigates the role of leadership and cultural transformation in facilitating Lean Six Sigma (LSS) practices in clinical pharmacy settings to reduce medicine waste within the UK National Health Services (NHS).

A systematic literature review on Lean Six Sigma in health care was conducted to develop an analytical framework. This was followed by a qualitative case study of an English NHS trust to test the framework, exploring pharmacists' adoption of LSS practices and their impact on staff behaviour, focussing on leadership decisions and organisational culture.

The research highlights the significance of leadership’s prioritisation in waste reduction efforts and its influence on staff engagement. It also examines the intricate relationship between leadership decisions, education and training, resource allocation, and the prevailing clinical culture, which shapes pharmacists' behaviours and attitudes towards LSS practices and waste reduction.

The study’s focus on a single NHS trust limits the generalisability of the findings, suggesting the need for further research across different healthcare settings.

The study recommends a cultural transformation, earlier training, and reformation in service strategy to enhance the adoption of LSS practices and contribute to a more sustainable future for the wider health services.

Effective medicine waste management prevents harm and helps address the current NHS medicine shortage. The NHS can allocate resources efficiently, ensure timely treatment, and prepare for future disruptions by implementing the proposed framework.

We developed a leadership model for the NHS to reduce medicine waste, offering a novel approach to addressing the challenge of medicine waste through leadership and cultural transformation.

The aim of this study was to explore and understand the leadership experiences of medical consultants prior to a major hospital move. Health and care is becoming increasingly complex and there is no greater challenge than the move to a new hospital. Effective leadership has been identified as being essential for successful transition. However, there is very little evidence of how medical consultants experience effective leadership.

A qualitative methodology was utilized with one-to-one semi-structured interviews conducted with ten medical consultants. These were transcribed verbatim and analyzed using inductive thematic analysis. The research complied with the consolidated criteria for reporting qualitative research (COREQ).

Four themes were found to influence medical consultants’ experience of leadership: collaboration, patient centredness, governance and knowledge mobilization. Various factors were identified that negatively influenced their leadership effectiveness. The findings suggest that there are a number of factors that influence complexity leadership effectiveness. Addressing these areas may enhance leadership effectiveness and the experience of leadership in medical consultants.

This study provides a rich exploration of medical consultants’ experience of collective leadership prior to a transition to a new hospital and provides new understandings of the way collective leadership is experienced in the lead up to a major transition and makes recommendations for future leadership research and practice.

The findings suggest that there are a number of factors that influence complexity leadership effectiveness. Addressing these areas may enhance leadership effectiveness and the experience of leadership in medical consultants.

Clinical leadership is associated with better outcomes for patients therefore any interventions that enhance leadership capability will improve outcomes for patients and therefore benefit society.

This is the first research to explore medical consultants’ experience of collective leadership prior to a transition to a new hospital.

This study aims to examine nurses’ motivation for leadership and explore important challenges nurses face in leadership positions.

Semi-structured interviews were conducted with 20 nurses in leading positions. Thematic analysis was used to analyse the data.

Nurse leaders are recruited from clinical settings, and the transition process from clinical nurse to leader is demanding. Their motivation for leadership seems to be in human values and caring for others. Lack of strategic focus might be a challenge. Nurses in leadership positions emphasize the importance of good relationships with the staff and require an increased focus on strategic leadership.

Studies have revealed the frustration associated with the role of a nursing leader. According to an evaluation of a clinical leadership development programme, nurses were found to be inadequately prepared for their roles. They had not experienced positive role models, they felt overwhelmed and they regarded colleagues and nursing management structures as unsupportive. There is a need for further research into effective measures to strengthen nurse managers.

The role of leaders has changed over time. There are now increasing requirements and objectives with regard to laws, action plans, improvement projects and cost-effectiveness. A nurse leader has both many tasks and great responsibility. Good leadership relies on skilled nurse leaders meeting statutory requirements in patient care and delivering good quality and patient-safe services. Engaging in process-oriented guidance, such as mentoring, is one way to become more aware of oneself as a professional leader (Mathena, 2002).

By identifying and understanding the specific challenges that nurse leaders face, this study can contribute to the development of interventions and strategies to improve leadership practices, thereby enhancing organizational effectiveness.

The purpose of this paper is to determine whether charismatic leadership strategies can be successfully implemented within structures, systems and tasks for social workers to increase case management successes, particularly client well-being, given that the six key charismatic leadership traits align with presented professionally bound ethical expectations.

A short generic qualitative review was done over fifteen publications, emphasizing the effects of charismatic leadership in domestic and foreign occupational domains.

Methodological, thematic and theoretical analyses show that charismatic leadership strategies are active in relevant social work domains with positive participant impacts.

The paper is intended to primarily investigate whether charismatic leadership is present in social work domains, and does not consider other leadership modalities.

High-quality reviews from the presented methodological investigations suggest that charismatic leadership is an effective leadership modality that should be considered into client-involved structures and systems.

Healthcare tribalism refers to the phenomenon through which different groups in a healthcare setting strictly adhere to their profession-based silo, within which they exhibit stereotypical behaviours. In turn, this can lead to deleterious downstream effects upon productivity and care delivered to patients. This study highlights a clinician-led governance model, implemented at a National Health Service (NHS) trust, to investigate whether it successfully overcame tribalism and helped drive innovation.

This was a convergent mixed-methods study including qualitative and quantitative data collected in parallel. Qualitative data included 27 semi-structured interviews with representatives from four professional groups. Quantitative data were collected through a verbally administered survey and scored on a 10-point scale.

The trust arranged its services under five autonomous business units, with a clinician and a manager sharing the leadership role at each unit. According to interviewees replies, this equivalent authority was cascaded down and enabled breaking down professional siloes, which in turn aided in the adoption of an innovative clinical model restructure.

This study contributes to the literature by characterizing a real-world example in which healthcare tribalism was mitigated while reflecting on the advantages yielded as a result.

Previous studies from all over the world identified major differences in the perspectives of different healthcare professional groups. In the United Kingdom, clinicians largely felt cut off from decision-making and dissatisfied with their managerial role. The study findings explain a governance model that allowed harmony and inclusion of different professions. Given the long-standing strains on healthcare systems worldwide, stakeholders can leverage the study findings for guidance in developing and implementing innovative managerial approaches.

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme’s aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.

The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners’ interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.

The authors’ evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another’s experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.

Despite a small sample size, the authors’ results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.

The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.

ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

The 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.

Data from ten semi-structured interviews of lead CCPs across different National Health Service organisations in the UK was analysed through a thematic process.

The 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.

The 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.

A local healthcare organisation providing healthcare to 288,000 residents in Sweden struggled with a longstanding budget deficit. Several attempts to overcome the demanding financial situation have failed. A decommissioning programme was launched, and two years later, an evaluation indicated positive outcomes. The aim of this study was to explore factors politicians and public servants perceived as enablers to the successful implementation of the programme.

A deductive content analysis approach using a framework of factors facilitating successful implementation of decommissioning decisions was applied to analyse interviews with 18 informants.

Important factors were: (1) a review report contributing to the clarity of evidence, which (2) made the clarity of the rationale for change undeniable and (3) strengthened the political support for change. Additional factors were: (4) the strength of executive leadership, (5) the strength of clinical leadership supported by (6) the quality of project management and (7) a cultural and behavioural change seen as an important outcome for the path forward. A way to maximise the potential for a successful implementation of a large-scale decommissioning programme is to build a shared vision and a collaboration grounded in convincing evidence. Include public servants with a clinical background in the executive leadership team to contribute with legitimacy, competence, and trust in the decommissioning programme’s intention.

The paper addresses the limited knowledge of best practices in decommissioning processes and contributes empirical knowledge from a successful case.