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The purpose of this research study was to obtain healthcare executives’ perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color.

A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified.

The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles.

This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics.

The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of color in leadership roles that guide healthcare policy and access. This study connects contemporary literature to perspectives of executives in the field and offers practical solutions to improving the representation of people of color in executive healthcare leadership roles.

The recommendations offered as a result of this research effort serve to create awareness of the challenges that people of color face in career attainment. Although the process of increasing the representation of people of color in executive healthcare leadership will be a complex task that will involve a number of players over the course of several years, this study serves to provide a practical roadmap with actionable tactics that can be deployed.

This paper is an extension of the work that was done by the author during the course of completing the program requirements for the author’s doctoral program. The findings were previously discussed in the author’s dissertation. The value of these findings is significant because they validate some of the topics in contemporary literature with the perspectives of practicing healthcare executives. This study is also unique from other studies in that it offers a long-term plan to increase the representation of people of color in executive roles by creating an early disposition toward executive level roles and identifies a number of practical steps toward that end.

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.

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.

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.

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.

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.

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.

As the world of healthcare changes rapidly, healthcare leaders and managers must hone their leadership competencies in order to remain effective in their organizations. With changes such as the Affordable Care Act, increasing medical school costs, decreased graduation rates, and increased needs for care, how are current and future healthcare leaders adapting? In light of the large-scale changes in the healthcare field in recent years, the purpose of this study was to investigate which National Center for Healthcare Leadership (NCHL) competencies were referenced by exemplary healthcare leaders as most important for success in today’s changing healthcare environment. Interviews were conducted with 26 mid- and upper-level healthcare leaders identified by the C-level executives in their organizations as exemplary performers. Change leadership, self-development, talent development, and team leadership were the top four NCHL competencies most frequently referenced, with thematic analysis revealing additional underlying themes in the exemplary leaders’ dialogue.

The purpose of this study is to investigate the influence of servant leadership on job satisfaction within private healthcare practices.

Criterion sampling has been used to draw a sample of private healthcare practitioners and their employees. The data collected from 241 useable questionnaires have been statistically analysed. Factor analysis and Cronbach’s alpha coefficients have been used to assess the validity and reliability of the measuring instrument, and multiple regression analyses have been performed to test the influence of the dimensions of servant leadership on job satisfaction.

The findings show that private healthcare practitioners display the dimensions of servant leadership investigated in this study. Furthermore, a significant positive relationship between developing others and job satisfaction for both sample groups, but only between caring for others and job satisfaction for the employee sample group, was reported. Acts of humility and servanthood by practitioners were not found to influence job satisfaction.

Educators can use the findings of this study to identify gaps in the leadership training of healthcare practitioners, and healthcare regulators can use the recommendations provided to implement appropriate interventions to ensure that healthcare practitioners fulfil their mandate of practising in an appropriate manner.

This study contributes to the limited understanding of servant leadership among private healthcare practitioners and it provides recommendations on how private healthcare practitioners can improve their servant leadership behaviour.

Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change management perspective, the purpose of this paper is to increase scientific knowledge regarding factors that diminish the implementation gap and make the transition from the “toolbox lean” toward an actual transformation to lean healthcare.

A cross-sectional study was executed in an operating theatre of a Dutch University Medical Centre. Transformational leadership was expected to ensure the required top-down commitment, whereas team leadership creates the required active, bottom-up behavior of employees. Furthermore, professional and functional silos and a hierarchical structure were expected to impede the workforce flexibility in adapting organizational elements and optimize the entire process flow.

The correlation and regression analyses showed positive relations between the transformational leadership and team leadership styles and lean healthcare implementation. The results also indicated a strong relation between workforce flexibility and the implementation of lean healthcare.

With the use of a recently developed change management model, the Change Competence Model, the authors suggest leadership and workforce flexibility to be part of an organization’s change capacity as crucial success factor for a sustainable transformation to lean healthcare.

The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective corporate governance has traditionally focused on board architecture. Emerging research is bringing to light the importance of governance dynamics. This paper contributes to emerging research through highlighting how communication and leadership underpin effective engagement in governing healthcare quality.

A comparative case study of eight Australian public hospitals was undertaken involving document review, interviews and observations. Case studies were allocated into high- or low-engagement categories based on evidence of governance processes being undertaken, in order to compare and contrast influencing factors. Thematic analysis was undertaken to explore how communication and leadership influence healthcare governance.

Several key components of communication and leadership are shown to influence healthcare quality governance. Clear logical narratives in reporting, open communication, effective questioning and challenge from board members are important elements of communication found to influence engagement. Leadership that has a focus on healthcare excellence and quality improvement are aligned and promote effective meeting processes is also found to foster governance engagement. Effective engagement in these communication and leadership processes facilitate valuable reflexivity at the governance level.

The findings highlight the way in which boards and senior managers can strengthen governance effectiveness through attention to key aspects of communication and leadership.

The case study approach allows the exploration of communication and leadership in greater depth than previously undertaken at the corporate governance level in the healthcare setting.

The purpose of this paper is to enlarge the debate on total quality management (TQM) implementation in the healthcare sector and to evaluate how and whether leadership can affect TQM implementation.

This paper is based on findings from a literature review of TQM and leadership. The authors analysed these findings to categorise causes of a lack of leadership in TQM programme implementations.

The authors propose three categories of causes of a lack of leadership in TQM programme implementation. The first cause is well-known: a lack of senior managers’ involvement and commitment. The second category is the “combined leadership” that occurs in large healthcare organisations; and the third category is the influence of an external “political leadership” on public healthcare.

This paper presents researchers with three categories of causes of failure of leadership in TQM implementation that can be investigated. It also encourages reflections from practitioners concerning TQM leadership in the healthcare sector.

The authors request that practitioners reflect on ways to create or sustain a “monolithic” leadership, especially in large organisations, to ensure a common vision, values and attitude for unitary TQM governance.

In an original way, this paper analyses and proposes three categories of causes linked to a lack of TQM leadership in the healthcare sector.

This empirical study aims to identify the essential strategic leadership and management factors underlying sustainability in healthcare. It also examines which factors drive sustainability performance outcomes (SPO) in health-care organizations, an analysis lacking to date. It provides a strategic leadership and management perspective toward sustainable healthcare, responding to the United Nations Sustainable Development Goals.

The investigation adopted Sustainable Leadership as its research framework. Using a cross-sectional survey, 543 employees working in health-care and pharmaceutical companies in Thailand voluntarily provided responses. Factor analyses and structural equation modeling were employed.

The results revealed an emergent research model and identified 20 unidimensional strategic leadership and management factors toward sustainability in healthcare. The findings indicate significant positive effects on SPO in health-care organizations. Significant factors include human resource management/development, ethics, quality, environment and social responsibility, and stakeholder considerations.

The study was conducted in one country. Future studies should examine these relationships in diverse contexts. In practice, health-care firms should foster significant strategic leadership and management practices to improve performance outcomes for sustainability in healthcare.

This paper is the first empirical, multidisciplinary study with a focus on strategic leadership, health-care management and organizational sustainability. It identifies a proxy for measuring the effects of essential strategic leadership and managerial factors for sustainability in pharmaceutical health-care companies. It advances our currently limited knowledge and provides managerial implications for improving performance outcomes toward sustainable healthcare.

The purpose of this paper is to determine the particular competencies demonstrated by effective physician leaders. Changing organizational and environmental dynamics present unique challenges to leaders in the field of healthcare. An accelerated emphasis on increasing the quality of health care delivery, containing costs, and restructuring the delivery of health care itself are redefining the very nature of healthcare and the roles of physicians as leaders. Given this context, the authors propose to identify the essential competencies for twenty-first century physician leadership.

In all, 53 critical incident interviews from 28 physicians identified as emerging leaders at the Cleveland Clinic, a top-rated US academic healthcare institution, were examined in two ways: an existing leadership competency model was applied to each critical incident and inductively derived themes were identified through thematic analysis of the incidents.

The predominant distinguishing leadership competencies demonstrated by the physician leaders included: Empathy, Initiative, Emotional Self-Awareness and Organizational Awareness. Communicating deliberately, getting buy-in from colleagues, focussing on the mission of the organization and showing respect for others were also discovered through thematic analysis to be essential practices of these effective physician leaders. Over 90 percent of the critical incident stories dealt with colleague-to-colleague interactions.

The research was conducted in one academic healthcare organization, thus limiting the generalizability of the results. Additional research testing these results in a variety of healthcare institutions is warranted.

This study identified specific competencies that distinguish effective physician leaders. These leaders actively sought to work with colleagues to obtain their input and consensus in order to enact organizational change and improve health care delivery in their institution. Importantly, their intentions were neither self-focussed nor self-promoting but strongly mission driven. The identification of physician leader competencies will assist incumbent and emerging physician leaders in their ability to be effective leaders, as well as inform the design of training and development programs for physicians.

The purpose of this paper is to gain a deeper understanding of the main contemporary challenges for healthcare leaders in their everyday work practice, and the support they need to master their experienced dilemmas.

Qualitative in‐depth interviews (n=52), and focus‐group interviews (n=6) with 31 first‐line and 45 second‐line healthcare leaders are analysed in line with constructivist grounded theory.

In this paper, two leadership models are proposed for defining and differentiating ways of meeting different logics and demands made on leaders in the healthcare sector. The first model is leadership by separating different logics and fragmentation of time. Here, leaders express a desire for support in defining, structuring, dividing, and allocating tasks. The second model is leadership by integrating different logics and currentness of solutions. In this case, leaders want support in strengthening proactive leadership and shaping the basis for participative employeeship.

This research is designed to describe what people experience rather than to assess the frequency of that experience in the studied settings. However, it would be interesting to elaborate on the findings of this study using other research methodologies.

The findings contribute to contextual knowledge that is of relevance in supporting healthcare leaders. This is helpful in identifying important conditions that support the establishment of leadership and employeeship, leading to improvements in healthcare practice.

The paper describes how contemporary leadership in the healthcare sector is constituted through different strategies for meeting multiple logics.