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Formal structured leadership training is increasingly incorporated as a regular fixture in developed nations to produce competent leaders to ensure the provision of quality patient care. However, most low- and middle-income countries (LMICs) rely on one-off external training opportunities for selected individuals as they lack the necessary resources to implement long-term training for a wider pool of potential health care leaders. This case study shares the establishment process of the Talent Grooming Programme for technical health care professionals (TGP), a three-year in-house leadership training programme specially targeted at potential health care leaders in Malaysia.

This case study aims to share a comprehensive overview of the ideation, conceptualisation and implementation of TGP. The authors also outlined its impact from the individual and organisational perspectives, besides highlighting the lessons learned and recommendations for the way forward.

TGP set out to deliver experiential learning focusing on formal training, workplace experiences, practical reflection and mentoring by supervisors and other esteemed leaders to fulfil the five competency domains of leadership, organisational governance, communication and relationship, professional values and personal values. The successes and challenges in TGP programme delivery, post-training assessment, outcome evaluation and programme sustainability were outlined.

The authors’ experience in setting up TGP provided valuable learning points for other leadership development programme providers. As for any development programme, a continuous evaluation is vital to ensure its relevance and sustainability.

Certain aspects of TGP establishment can be referenced and modified to adapt to country-specific settings for others to develop similar leadership programme, especially those in LMICs.

In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.

This paper aims to describe the evolution of Sanokondu, highlighting the rationale, achievements and lessons learnt from this initiative. Sanokondu is a multinational community of practice dedicated to fostering health-care leadership education worldwide. This platform for health-care leadership education was conceived in 2014 at the first Toronto International Summit on Leadership Education for Physicians (TISLEP) and evolved into a formal network of collaborators in 2016.

This paper is a case study of a multinational collaboration of health-care leaders, educators, learners and other stakeholders. It describes Sanokondu’s development and contribution to global health-care leadership education. One of the major strategies has been establishing partnerships with other educational organizations involved in clinical leadership and health systems improvement.

A major flagship of Sanokondu has been its annual TISLEP meetings, which brings various health-care leaders, educators, learners and patients together. The meetings provide opportunities for dialog and knowledge exchange on leadership education. The work of Sanokondu has resulted in an open access knowledge bank for health-care leadership education, which in addition to the individual expertise of its members, is readily available for consultation. Sanokondu continues to contribute to scholarship in health-care leadership through ongoing research, education and dissemination in the scholarly literature.

Sanokondu embodies the achievements of a multinational collaboration of health-care stakeholders invested in leadership education. The interactions culminating from this platform have resulted in new insights, innovative ideas and best practices on health-care leadership education.

The purpose of this paper is to gain insight into how population health management (PHM) strategies can successfully integrate and reorganize public health, health care, social care and community services to improve population health and quality of care while reducing costs growth, this study compared four large-scale transformation programs: Greater Manchester Devolution, Vancouver Healthy City Strategy, Gen-H Cincinnati and Gesundes Kinzigtal.

Following the realist methodology, this explorative comparative case-study investigated PHM initiatives' key features and participants' experiences of developing such initiatives. A semi-structured interview guideline based on a theoretical framework for PHM guided the interviews with stakeholders (20) from different sectors.

Five initial program theories important to the development of PHM were formulated: (1) create trust in a shared vision and understanding of the PHM rationale to establish stakeholders' commitment to the partnership; (2) create shared ownership for achieving the initiative's goals; (3) create shared financial interest that reduces perceived financial risks to provide financial sustainability; (4) create a learning environment to secure initiative's credibility and (5) create citizens' and professionals' awareness of the required attitudes and behaviours.

The study highlights initial program theories for the implementation of PHM including different strategies and structures underpinning the initiatives. These insights provide a deeper understanding of how large-scale transformation could be developed.

Achieving integrated care is a key focus for health systems and has resulted in various structures between and within organisations. The reorganisation of the Irish health system into hospital networks/groups aims to encourage work across hospitals to integrate care. This study evaluated if collective leadership emerged over time through increased interaction and collaboration following the organisation of hospitals into a network. A secondary aim was to elucidate the potential for collective leadership, through understanding the barriers and enablers perceived by participants.

This study employed social network analysis and qualitative interviews. Leaders across the hospital group were invited to participate in an online network survey and interviews (analysed using thematic analysis) at three time points over an 18-month period.

Although there was evidence that some parts of network were beginning to operate collectively, the structures observed were more typical of a hierarchical network. Disruption in the network and uncertainty regarding permanence of the organisational structure had a negative impact on the potential for collective leadership. Yet, progress was evident in terms of establishing building blocks for collective leadership and integration, including developing trust, mutual understanding and creating space for change.

This study contributes to the literature by reflecting on the mechanisms and initiatives perceived as enabling/inhibiting collective leadership. Based on this research, it is important to communicate a clear and consistent message about the plans for the organisations involved and be clear regarding the roles and expectations for those involved in introducing new approaches to leadership and integration. Honest collaboration, openness and certainty in communication will likely be important in order to help create the contextual conditions to enable collective and system approaches to introduce “stepping stones” to change. These conditions include developing interpersonal relationships between leaders, creating time and space for deep and shared reflection, and enhancing trust among colleagues.

A key strength of this study is the linking of leadership-as-networks theory with social network methods to investigate collective leadership in practice. This study contributes to the literature by reflecting on the mechanisms and initiatives perceived as enabling/inhibiting collective leadership.

Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean, a management philosophy with roots in manufacturing industries that emphasizes elimination of waste. Successful lean implementation requires systemic change and strong leadership. Despite the importance of leadership to successful lean implementation, few researchers have probed the question of ideal leadership attributes to achieve lean thinking in health care. The purpose of this paper is to provide insight into applicable attributes for lean leaders in health care.

The authors systematically reviewed the literature on principles of leadership and, using Dombrowski and Mielke’s (2013) conceptual model of lean leadership, developed a parallel theoretical model for lean leadership in health care.

This work contributes to the development of a new framework for describing leadership attributes within lean management of health care.

The summary of attributes can provide a model for health-care leaders to apply lean in their organizations.

The Health Service Executive in Ireland seeks to further develop healthcare in the community. It has identified that this reform requires developing leadership amongst the staff. This study aims to identify what kind of leadership staff in community healthcare observe in practice and their leadership preferences. The core objective has been to identify the readiness of the organisation to implement the adopted national policy of integrated community care reform in terms of leadership development.

An online cross-sectional survey was conducted using the Organisational Cultural Assessment Instrument, based on the Competing Values Framework. This tool identifies four overarching leadership types: Clan (Collaborative), Adhocracy (Creative), Market (Competitive) and Hierarchy (Controlling). Participants (n = 445) were a representative sample of regional community health care employees. They were asked to identify presently observed leadership and preferred leadership in practice. The statistical analysis emphasised a comparison of observed and preferred leadership types.

Participants reported the current prevailing leadership type as Market (M = 34.38, SD = 6.22) and Hierarchical (M = 34.38, SD = 22.62), whilst the preferred or future style was overwhelmingly Clan (M = 40.38, SD = 18.08). Differences were significant (all p’s < 0.001). The overall outcome indicates a predominance of controlling and competitive leadership and a lack of collaborative leadership to implement the planned reform.

During reform in healthcare, leadership in practice must be aligned to the reform strategy, demonstrating collaboration, flexibility and support for innovation. This unique study demonstrates the importance of examining leadership type and competencies to indicate readiness to deliver national community health care reform.

A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate.

The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes.

In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem.

The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes.

This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

The purpose of this paper is to describe progress in an across sectorial approach to primary health care at the district health service (DHS) level in Thailand in response to recent innovative national public policy directions which have been enshrined in constitutional doctrine and publicly endorsed by the Prime Minister. This paper describes one response to the Prime Minister’s challenge for Thailand to become the centre of learning in the sub-region in health management.

The authors utilised a descriptive case study approach utilising an analysis of the Naresuan University initiative of establishing the College of Health Systems Management (NUCHSM). Within that case study, there is a focus on challenges relevant to the socio-economic determinants of health (SOED) and an emphasis on utilising Sustainable Development Goals (SDGs) within the DHS structure.

The findings describe the establishment of the NUCHSM. A Master of Science (Health Systems Management) by research and a PhD degree have been created and supported by an international faculty. The Thailand International Cooperation Agency recognised NUCHSM by providing scholarships. International students are from Bangladesh, Bhutan, Kenya, Malawi and Timor Leste. Research consultancy projects include two in Lao People’s Democratic Republic; plus, a prototype DHS management system responsive to SDG attainment; and a project to establish a sustainable Ageing Society philosophy for a Thai municipality.

The case study on NUCHSM and its antecedents in its development have demonstrated originality in a long-standing international collaboration, and it has been recognised by the national government to provide scholarships to citizens of the countries in the sub-region to undertake postgraduate studies in health management. The concept of learning from each other and together, simultaneously as a group, through action research projects funded to enhance the evolution of DHSs is innovative.

The spread of COVID-19 is not just a health crisis. The pandemic has taken a geopolitical dimension. The health crisis amplified the competitive dynamics between the USA and China, affected the provision of global public goods and injected instability into the global order. In line with the geopolitical zero-sum thinking, both the USA and China have sought to capitalize on the crisis to boost their international profile. Instead of working together to mitigate the health and economic impacts of COVID-19, the two powers fear that the other will exploit the current situation to accrue political, economic or military gains that will give it an edge after the pandemic subsides. The spread of COVID-19 has set off a “battle of narratives,” in which China and the USA are accusing each other of failing to rise to the challenge. The world seems to be falling into a “Kindleberger Trap,” in which the established power is unable to lead while the rising power is unwilling to assume responsibility. The COVID-19 crisis is occurring amid the collapse of global cooperation. The USA, the traditional leader of international collective efforts in times of crisis, has abandoned its role entirely. The lack of leadership at the global level during an international crisis may cause the breakdown of the international order.

This paper examines the US-China competitive dynamics through the lens of the work of Charles Kindleberger, which both liberals and realists regard as foundational when examining the dynamics of global crisis management. This paper also uses the meta-geopolitics framework to determine the ability of both China and the USA to respond to the current COVID-19 crisis and its implications for their power and standing in the international system.

This paper concludes that the only way to escape the Kindleberger trap is “to embed Sino-American relations in multilateralism.”

As rivals, both the USA and China are seeking to capitalize on the crisis to boost their international profile. This paper probes how China and the USA navigated the ongoing COVID-19 crisis to determine whether or not they are currently in a “Kindleberger Trap,” using elements of the meta-geopolitics framework of analysis, namely, health issues, domestic politics, economics, science and international diplomacy. Using the meta-geopolitics framework will help us determine the ability of both China and the USA to respond to the current COVID-19 crisis and the implications of that on their power and standing in the international system.