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Open Access
Article
Publication date: 16 October 2023

Kevin Östergård, Suvi Kuha and Outi Kanste

The purpose of this study is to identify and synthesise the best evidence on health-care leaders’ and professionals’ experiences and perceptions of compassionate leadership.

1558

Abstract

Purpose

The purpose of this study is to identify and synthesise the best evidence on health-care leaders’ and professionals’ experiences and perceptions of compassionate leadership.

Design/methodology/approach

A mixed-methods systematic review was conducted in accordance with the Joanna Briggs Institute methodology for mixed-methods systematic reviews using a convergent integrated approach. A systematic search was done in January 2023 in PubMed, CINAHL, Scopus, Medic and MedNar databases. The results were reported based on Preferred Reporting Items for Systematic Reviews and Meta-analyses. The data was analysed using thematic analysis.

Findings

Ten studies were included in the review (five qualitative and five quantitative). The thematic analysis identified seven analytical themes as follows: treating professionals as individuals with an empathetic and understanding approach; building a culture for open and safe communication; being there for professionals; giving all-encompassing support; showing the way as a leader and as a strong professional; building circumstances for efficient work and better well-being; and growing into a compassionate leader.

Practical implications

Compassionate leadership can possibly address human resource-related challenges, such as health-care professionals’ burnout, turnover and the lack of patient safety. It should be taken into consideration by health-care leaders, their education and health-care organisations when developing their effectiveness.

Originality/value

This review synthesised the knowledge of compassionate leadership in health care and its benefits by providing seven core elements of health-care leaders’ and professionals’ experiences and perceptions of compassionate leadership.

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 26 March 2024

Zeba Khanam, Zebran Khan, Mohd Arwab and Ariba Khan

The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI).

Abstract

Purpose

The aim of this study is to investigate the extent to which organizational justice (OJ) mediates between responsible leadership (RL) and employee turnover intention (TI).

Design/methodology/approach

Both online and offline questionnaire was used to collect the data from 387 Indian health-care employees, and the data were analyzed using partial least squares structural equation modeling (PLS-SEM) with the help of SmartPLS 4.

Findings

The study’s findings demonstrated a significant positive association between RL and OJ and a negative association between OJ and employee TI. Furthermore, results also confirmed the mediating role of OJ between RI and TI.

Research limitations/implications

The generalizability of the study‘s data collection is limited because it is based on the responses of Indian health-care sector employees to an online and offline survey. The authors propose that the health-care sector uses RL as an approach that takes a broad view of the parties with a stake and focuses on creating fairness in acts and justice at the workplace to address the major issue of employee turnover.

Originality/value

This study expanded on previous research by demonstrating that the influence of responsible leadership on employee TI is mediated by OJ in the context of India’s health-care sector. It also contributes to the literature regarding RI, OJ and TI. The study also enriched the body of knowledge about using the PLS-SEM approach to predict employee TI.

Details

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

Keywords

Open Access
Article
Publication date: 30 June 2023

Carmel Bond, Gemma Stacey, Greta Westwood and Louisa Long

The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT).

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Abstract

Purpose

The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT).

Design/methodology/approach

A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants’ responses to the question “please tell us about the impact of your overall experience”, which culminated in a combined corpus of 75,053 words.

Findings

Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact.

Research limitations/implications

This in-depth qualitative evaluation of participants’ feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice.

Originality/value

Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments.

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 20 November 2023

Sean F. Griech, Stephen Carp and Todd E. Davenport

This paper aims to introduce the Theory of Ethical Leadership as a possible means of actualizing the mission and vision statements of the American Physical Therapy Association as…

Abstract

Purpose

This paper aims to introduce the Theory of Ethical Leadership as a possible means of actualizing the mission and vision statements of the American Physical Therapy Association as well as individual professional objectives. Specific examples of how this can be applied directly to the profession of physical therapy will be presented.

Design/methodology/approach

Leadership influences can profoundly affect a profession, an organization and an individual. This has led to exploring which leadership style would be most effective in moving their organization forward. Through a review of the literature, this viewpoint paper compares leadership theories present in the health-care literature, as well as why they may fall short of actualizing the mission and vision statements of the American Physical Therapy Association as well as individual professional objectives.

Findings

Most research has separated ethics from leadership, but all agree that to be successful, the leader needs to exhibit a strong moral compass and demonstrate positive ethical behavior. At the intersection of ethics and leadership is the emerging theory of ethical leadership. Ethical leadership is based on the premise that employees look outside of themselves for ethical guidance and that leaders have an opportunity to provide this moral awareness by making an ethical message sufficiently salient to be recognized in the organizational context as well as allowing the leader to stand out against an ethically neutral ground.

Originality/value

This paper is an original work and has not been published previously, either in whole or in part. Additionally, this paper is not under consideration for publication by any other journal.

Details

Leadership in Health Services, vol. 37 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 1 April 2024

Daryl Mahon

Employee burnout is increasingly coming under attention due to its negative impact on employee well-being and organisational effectiveness. This study, a systematic review, aims…

Abstract

Purpose

Employee burnout is increasingly coming under attention due to its negative impact on employee well-being and organisational effectiveness. This study, a systematic review, aims to evaluate the role of servant leadership and its mediators in preventing and mitigating against burnout experiences in organisations.

Design/methodology/approach

A preferred reporting items for systematic review and meta-analyses (PRISMA) was conducted using three databases, Academic search Complete, Embase and Scopus, in addition to bibliography searches. Articles were included if they reported on primary data, in English from inception to 2023. The mixed methods critical appraisal tool was used to assess the quality of articles, and a narrative synthesis was used to report results.

Findings

The search strategy yielded 4,045 articles, of which (N = 17), with total sample size of (N = 10,444) are included. Findings suggest that servant leadership is predictive of burnout, and that several mediators impact this relationship. Most studies were conducted in health care (n = 8) and banking (n = 3), and while the quality of the studies was mostly high (64%), the methods used were mainly descriptive and cross-sectional, which limits the extent to which causality can be inferred. A theory of change is provided based on the findings from this review and integrated with the extant literature on servant leadership theory, and can be used by organisations to support the policy, training and practice of servant leadership to reduce burnout.

Originality/value

Servant leadership is predictive of burnout; however, further research needs to be undertaken in this important emerging area.

Details

Mental Health and Social Inclusion, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-8308

Keywords

Open Access
Article
Publication date: 16 April 2024

Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the…

Abstract

Purpose

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Design/methodology/approach

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

Findings

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

Originality/value

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

Open Access
Article
Publication date: 15 April 2024

Ingrid Marie Leikvoll Oskarsson and Erlend Vik

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem…

Abstract

Purpose

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.

Design/methodology/approach

In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.

Findings

Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.

Research limitations/implications

This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.

Practical implications

The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.

Originality/value

This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 13 February 2024

Lisa Knight, Rafaela Neiva Ganga and Matthew Tucker

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of…

Abstract

Purpose

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances?

Design/methodology/approach

Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013).

Findings

The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system.

Research limitations/implications

Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context.

Originality/value

This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.

Details

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

Keywords

Article
Publication date: 27 November 2023

Else Marie Lysfjord and Siv Skarstein

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

Abstract

Purpose

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

Design/methodology/approach

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

Findings

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.

Research limitations/implications

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.

Practical implications

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).

Originality/value

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.

Details

Leadership in Health Services, vol. 37 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Open Access
Article
Publication date: 3 August 2023

Fury Maulina, Mubasysyir Hasanbasri, Jamiu O. Busari and Fedde Scheele

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in…

Abstract

Purpose

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle‐income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

Design/methodology/approach

This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants’ knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick’s model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.

Findings

The workshop yielded positive results, as evidenced by participants’ increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.

Originality/value

The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

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