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Book part
Publication date: 31 July 2013

Laura Gover and Linda Duxbury

This chapter seeks to increase our understanding of health care employees' perceptions of effective and ineffective leadership behavior within their organization.

Abstract

Purpose

This chapter seeks to increase our understanding of health care employees' perceptions of effective and ineffective leadership behavior within their organization.

Design/methodology/approach

Interviews were conducted with 59 employees working in a diversity of positions within the case study hospital. Interviewees were asked to cite behaviors of both an effective and an ineffective leader in their organization. They were also asked to clarify whether their example described the behavior of a formal or informal leader. Grounded theory data analysis techniques were used and findings were interpreting using existing leadership behavior theories.

Findings

(1) There was a consistent link between effective leadership and relationally oriented behaviors. (2) Employees identified both formal and informal leadership within their hospital. (3) There were both similarities and differences with respect to the types of behaviors attributed to informal versus formal leaders. (4) Informants cited a number of leadership behaviors not yet accounted for in the leadership behavior literature (e.g., ‘hands on’, ‘professional’, ‘knows organization’). (5) Ineffective leadership behavior is not simply the opposite of effective leadership.

Research implications

Findings support the following ideas: (1) there may be a relationship between the type of job held by employees in health care organizations and their perceptions of leader behavior, and (2) leadership behavior theories are not yet comprehensive enough to account for the varieties of leadership behavior in a health care organization. This study is limited by the fact that it focused on only those leadership theories that considered leader behavior.

Practical implications

There are two practical implications for health care organizations: (1) leaders should recognize that the type of behavior an employee prefers from a leader may vary by follower job group (e.g., nurses may prefer relational behavior more than managerial staff do), and (2) organizations could improve leader development programs and evaluation tools by identifying ineffective leadership behaviors that they want to see reduced within their workplace.

Social implications

Health care organizations could use these findings to identify informal leaders in their organization and invest in training and development for them in hopes that these individuals will have positive direct or indirect impacts on patient, staff, and organizational outcomes through their informal leadership role.

Value/originality

This study contributes to research and practice on leadership behavior in health care organizations by explicitly considering effective and ineffective leader behavior preferences across multiple job types in a health care organization. Such a study has not previously been done despite the multi-professional nature of health care organizations.

Details

Leading in Health Care Organizations: Improving Safety, Satisfaction and Financial Performance
Type: Book
ISBN: 978-1-78190-633-0

Keywords

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Article
Publication date: 3 May 2016

Alexander Styhre, Adam Roth and Jonas Roth

Health care organizations are increasingly demanded to balance the institutional logic of “medical professionalism” and “business-like health care,” that is, to both…

Abstract

Purpose

Health care organizations are increasingly demanded to balance the institutional logic of “medical professionalism” and “business-like health care,” that is, to both recognize physicians’ professional expertise while locating it in a wider social, economic, and political organizational setting. The purpose of this paper is to examine the implications from this shift in terms of leadership work in health care organizations.

Design/methodology/approach

Case study methodology including interviews with 15 residents in Swedish health care organizations.

Findings

A study of the willingness of residents to take on leadership positions show that leadership roles are treated as what is potentially hindering the acquisition of the know-how, skills, and expertise demanded to excel in the clinical work. Consequently, taking on leadership positions in the future was relatively unattractive for the residents. In order to overcome such perceived conflict between professional skill development and leadership roles, top management of health care organizations must help residents overcome such beliefs, or other professional groups may increasingly populate leadership positions, a scenario not fully endorsed by the community of physicians.

Originality/value

The paper demonstrates how complementary or completing institutional logics are influencing debates and identities on the “shop floors” of organizations.

Details

Leadership & Organization Development Journal, vol. 37 no. 3
Type: Research Article
ISSN: 0143-7739

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Book part
Publication date: 31 July 2013

Tony Simons and Hannes Leroy

We provide a review of the research in this volume and suggest avenues for future research.

Abstract

Purpose

We provide a review of the research in this volume and suggest avenues for future research.

Design/methodology/approach

Review of the research in this volume and unstructured interviews with health care executives.

Findings

We identified the three central themes: (1) trust in leadership, (2) leading by example, and (3) multi-level leadership. For each of these themes, we highlight the shared concerns and findings, and provide commentary about the contribution to the literature on leadership.

Research implications

While relation-oriented leadership is important in health care, there is a danger of too much emphasis on relations in an already caring profession. Moreover, in most health care organizations, leadership is distributed and scholars need to adopt the appropriate methods to investigate these multi-level phenomena.

Practical implications

In health care organizations, hands-on leadership, through role modeling, may be necessary to promote change. However, practicing what you preach is not as easy as it may seem.

Value/originality

We provide a framework for understanding current research on leadership in health care organizations.

Details

Leading in Health Care Organizations: Improving Safety, Satisfaction and Financial Performance
Type: Book
ISBN: 978-1-78190-633-0

Keywords

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Article
Publication date: 14 January 2021

Keren Dopelt, Baruch Levi and Nadav Davidovitch

This paper aims to examine the views of physicians in senior management positions regarding the distinctive characteristics and roles of leaders in the Israeli health-care

Abstract

Purpose

This paper aims to examine the views of physicians in senior management positions regarding the distinctive characteristics and roles of leaders in the Israeli health-care system and what might be the interactions between management and leadership.

Design/methodology/approach

In total, 13 semi-structured in-depth interviews were conducted with physicians in senior management positions. Interviews were recorded, transcribed and analyzed using the qualitative-phenomenological method.

Findings

Interviewees discerned leaders as exhibiting traits of transformational leadership and managers, as expressing characteristics of transactional leadership. Most interviewees asserted that physicians should act as social leaders promoting public health and equality in health care, beyond their clinical practice. They agreed that physicians should fill most senior positions in the health-care system, provided they undergo appropriate training in management, leadership and interdisciplinary collaboration.

Originality/value

Interviewees revealed gaps between the aspiration to lead, perceptions of physicians as leaders and what occurs in reality: physicians wish to assume leadership roles in the health-care system and emphasize the qualities of transformative leadership, but medical education does not include leadership training. Therefore, there is a need to develop training programs for physicians in management and leadership. There is also a need to integrate physicians from various communities to promote local leadership in the health-care field and to reduce disparities. The consideration of health-care leadership is especially applicable in the context of the Covid-19 pandemic, which has placed the question of leadership within and outside of the medical community in a broader social context.

Details

Leadership in Health Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1751-1879

Keywords

Content available
Article
Publication date: 19 April 2018

Jamiu Busari, Ming-Ka Chan, Deepak Dath, Anne Matlow and Diane de Camps Meschino

This paper aims to describe the evolution of Sanokondu, highlighting the rationale, achievements and lessons learnt from this initiative. Sanokondu is a multinational…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Leadership in Health Services, vol. 31 no. 2
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 7 August 2018

Ahmed Al Kuwaiti and Fahd A. Al Muhanna

This paper aims to examine the challenges faced by health-care leadership in teaching hospitals in attaining accreditation for their institutions.

Abstract

Purpose

This paper aims to examine the challenges faced by health-care leadership in teaching hospitals in attaining accreditation for their institutions.

Design/methodology/approach

This paper is based on a study of current literature on health-care leadership, hospital accreditation and quality of patient care and identifies the challenges facing health-care leadership in attaining accreditation for teaching hospitals.

Findings

Based on a review and analysis of literature, infrastructure, finance, legal support, workforce recruitment and training, documentation and technology are identified as challenges faced by health-care leadership in teaching hospitals. The key challenges facing health-care leadership with respect to medical education and clinical research are found to be integration of education into hospital operations, compliance with all regulatory and professional requirements and adequacy of resources in executing research programs.

Originality/value

This study draws the attention of health-care leadership in teaching hospitals on the challenges they face in obtaining accreditation for their institutions so that they may develop appropriate strategies to overcome them.

Details

Leadership in Health Services, vol. 32 no. 2
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 2 September 2014

Michael A. West, Joanne Lyubovnikova, Regina Eckert and Jean-Louis Denis

The purpose of this paper is to examine the challenges that health care organizations face in nurturing and sustaining cultures that ensure the delivery of continually…

Abstract

Purpose

The purpose of this paper is to examine the challenges that health care organizations face in nurturing and sustaining cultures that ensure the delivery of continually improving, high quality and compassionate care for patients and other service users.

Design/methodology/approach

Based on an extensive review of the literature, the authors examine the current and very challenging context of health care and highlight the core cultural elements needed to enable health care organizations to respond effectively to the challenges identified.

Findings

The role of leadership is found to be critical for nurturing high-quality care cultures. In particular, the authors focus on the construct of collective leadership and examine how this type of leadership style ensures that all staff take responsibility for ensuring high-quality care for patients.

Practical implications

Climates for quality and safety can be accomplished by the development of strategies that ensure leaders, leadership skills and leadership cultures are appropriate to meet the challenges health care organizations face in delivering continually improving, high quality, safe and compassionate patient care.

Originality/value

This paper provides a comprehensive integration of research findings on how to foster quality and safety climates in healthcare organizations, synthesizing insights from academic literature, practitioner reports and policy documents to propose clear, timely and much needed practical guidelines for healthcare organizations both nationally and internationally.

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Article
Publication date: 1 October 2005

Ann Scheck McAlearney

To improve understanding of mentoring and other leadership development practices in health care organizations, focusing on three questions: What has been done? What is…

Abstract

Purpose

To improve understanding of mentoring and other leadership development practices in health care organizations, focusing on three questions: What has been done? What is being done? What should be done?

Design/methodology/approach

First, 160 key informant interviews explored mentoring and leadership development practices in health care between September 2003 and December 2004. Second, all US hospital chief executives were surveyed between August‐December 2004 (844 respondents) and asked about mentoring and leadership development.

Findings

No interviewed executives and fewer than one‐quarter of chief executive respondents reported participating in formal mentoring programs as a protégé. Nearly one in three executives surveyed reported that a formal mentoring program was available within their organizations; however, only three key informants described programs in existence longer than five years. Issues such as assuring senior leadership support, sustaining budgetary commitment, and dedicating qualified personnel were all reportedly important for health care organizations striving to design and implement mentoring and other leadership development practices.

Research limitations/implications

While limited by a modest response rate within a chief executive population, survey results highlight the importance of mentoring in framing perceptions about leadership development. Future research should attempt to better understand how perspectives guide program development decisions.

Practical implications

By considering opportunities to use mentoring to help employees advance, organizations can build investments in leadership development, ideally helping under‐represented groups to attain higher management ranks.

Originality/value

This paper is among the first to combine qualitative and quantitative methods to explore mentoring and leadership development in health care organizations.

Details

Career Development International, vol. 10 no. 6/7
Type: Research Article
ISSN: 1362-0436

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Article
Publication date: 4 July 2016

Colleen Marie Grady

The purpose of this paper is to describe research that examined physician leadership development using complexity science principles.

Abstract

Purpose

The purpose of this paper is to describe research that examined physician leadership development using complexity science principles.

Design/methodology/approach

Intensive interviewing of 21 participants and document review provided data regarding physician leadership development in health-care organizations using five principles of complexity science (connectivity, interdependence, feedback, exploration-of-the-space-of-possibilities and co-evolution), which were grouped in three areas of inquiry (relationships between agents, patterns of behaviour and enabling functions).

Findings

Physician leaders are viewed as critical in the transformation of healthcare and in improving patient outcomes, and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system, such as health care. Physician leadership development remains a low priority for most health-care organizations, although physicians admit to being limited in their capacity to lead. This research was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can provide data regarding leadership development for physicians. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician’s relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership and medical education that provides minimal opportunity for leadership skill development.

Practical Implications

This research provides practical applications for physician leadership development and emphasizes that it is incumbent upon physicians and organizations to focus attention on this to achieve improved patient and organizational outcomes.

Originality/value

This study pairing complexity science and physician leadership represents a unique way to view the development of physician leaders within the context of the complex system that is health care.

Details

Leadership in Health Services, vol. 29 no. 3
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 15 November 2017

Maya M. Jeyaraman, Sheikh Muhammad Zeeshan Qadar, Aleksandra Wierzbowski, Farnaz Farshidfar, Justin Lys, Graham Dickson, Kelly Grimes, Leah A. Phillips, Jonathan I. Mitchell, John Van Aerde, Dave Johnson, Frank Krupka, Ryan Zarychanski and Ahmed M. Abou-Setta

Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of…

Abstract

Purpose

Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments.

Design/methodology/approach

The authors performed a scoping review using the Arksey and O’Malley framework, searching eight databases from 2006 through June 2016.

Findings

Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail.

Originality/value

This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations.

Details

Leadership in Health Services, vol. 31 no. 1
Type: Research Article
ISSN: 1751-1879

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