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The purpose of this study was to better understand the state of the healthcare facility management (FM) workforce and trends and how it compares to the nonhealthcare industries.

A survey was developed, based on relevant literature, regarding respondents’ gender, race, age, educational attainment and job tenure. The survey was sent electronically via Qualtrics^® system in February 2021 to members of the International Facility Management Association membership; 3,557 individuals completed the survey by April 2021, for a 29% response rate. Only data from 1,407 US respondents working in facility operations were included in this study. Of the 1,407 respondents included in this study, 89 worked in the healthcare industry. The majority of respondents not working in healthcare industry (1,318) were employed in government, education or banking and investment.

The demographics of facility managers in the healthcare industry are similar to the demographics of facility managers in other industries: the majority of the FM workforce is male, middle-aged, white, college educated and employed in-house. While healthcare and nonhealthcare facility managers have similar responsibilities across job levels, compensation for entry-level FM roles in the healthcare industry is significantly lower than for entry-level FM roles in other industries. This low pay in healthcare FM, compared to other industries, may exacerbate ongoing challenges related to talent recruitment and retention and justify pay banding increases to improve attraction of top talent into healthcare FM. Both healthcare and nonhealthcare industries hire new college graduates for entry-level FM jobs, but the healthcare industry is more likely to hire individuals who majored in liberal arts compared to other industries more likely to hire individuals who majored in subjects related to the built environment such as FM and engineering. To compensate for low entry-level pay, healthcare organizations may be focusing recruitment efforts on liberal arts students who have little to no training in the built environment because they have lower pay expectations. Older healthcare facility professionals also have shorter job tenures with their current employers than do older facility professionals in other industries; this trend appears to be recent and not be related to pay or the COVID-19 pandemic. A surge of senior-level FM retirements may be creating advancement opportunities for older entry- and mid-level FM personnel in healthcare; if this situation is a factor, research should be conducted to understand its implications for recruiting and developing healthcare FM talent.

Only data from US respondents who were working in healthcare facility operations at the time of the study were included in the data analysis.

Healthcare organizations can use the study’s findings to help address FM workforce challenges unique to their industry staff recruitment, retention and succession planning.

To discuss how managers contribute in promoting resilience in healthcare, and to suggest a model of managers' role in supporting resilience and elaborate on how future research and implementation studies can use this to further operationalize the concept and promote healthcare resilience.

The authors first provide an overview of and discuss the main approaches to healthcare resilience and research on management and resilience. Second, the authors provide examples on how managers work to promote healthcare resilience during a one-year Norwegian longitudinal intervention study following managers in nursing homes and homecare services in their daily quality and safety work. They use this material to propose a model of management and resilience.

The authors consider managerial strategies to support healthcare resilience as the strategies managers use to engage people in collaborative and coordinated processes that adapt, enhance or reorganize system functioning, promoting possibilities of learning, growth, development and recovery of the healthcare system to maintain high quality care. The authors’ model illustrates how managers influence the healthcare systems ability to adapt, enhance and reorganize, with high quality care as the key outcome.

In this study, the authors argue that managerial strategies should be considered and operationalized as part of a healthcare system's overall resilience. They propose a new model of managers' role in supporting resilience to be used in practice, interventions and future research projects.

Since the 1970s, the healthcare industry has undergone significant changes. Using neo‐institutional and resource dependency theories, the purpose of this paper is to explore how managers perceive constraint and enact agency amidst these historic challenges – perhaps most significantly, declining funding and increasing regulation.

The data come from ten interviews with healthcare managers, spanning for‐profit, non‐profit, and government legal forms and hospital and nursing home sub‐industries in both Queensland, Australia and North Carolina, USA. The authors look for patterns across the interviews.

The paper shows that governments and umbrella “parent” organizations force managers to adhere to institutional expectations in exchange for resource investment. Managers navigate these environmental obstacles using a shared business‐minded approach and competitive differentiation. Yet various interest groups – including front‐line workers, physicians, and patients – challenge this paradigm, as they demand a focus on quality of care. Managers' efforts are likewise curbed by the very resource and institutional pressures they resist.

The authors understand changes in the healthcare industry as resulting from an increasingly powerful managerial logic, at odds with traditional professional and societal values. Interest groups are best positioned to challenge this logic.

Exploring how to enhance innovative work behaviour (IWB) has been the main concern of top managers and researchers, particularly in knowledge-intensive and public organizations. Yet, studies investigating factors that shape innovative behaviour at work are scarce. Focussing on the healthcare setting, the purpose of this paper is to hypothesize a direct relationship between individuals’ perceived creative self-efficacy (CSE), creative collective efficacy (CCE) and IWB.

The research used survey data from 446 clinical managers working in public healthcare organizations in six different Italian regions and a set of previously validated questionnaires to measure the study variables.

Findings suggest that clinical managers’ perceptions of their CSE and their perceived CCE significantly influence their self-reported IWB.

Findings highlight the importance of constructing and developing clinical managers’ efficacy in creativity at both an individual and team level in order to incentivize the emergence of innovation behaviour. Further research is needed to assess the existence of mediating and/or moderating mechanisms underlying the relationships emerging from this study in order to support decision makers in diffusing innovation and creativity in healthcare organizations.

The research adds to the debate on improving IWB by introducing perceived individual and team creative efficacy as determinants of IWB in healthcare organizations. The research is among the first attempts to contribute to healthcare organizations’ management through exploring clinical managers’ characteristics that influence their IWB.

This paper aims to understand the strategic management of innovation by examining the effect that management control systems (MCS) have on innovation activities during the strategic change process.

A case study was carried out at an innovative company as they undertook a strategic change from closed innovation to open innovation. Simons’ levers of control was used to frame the ways in which MCS were designed and used by managers and the effect MCS have on the innovation activities of organization members.

The findings indicate that while managers designed and used MCS to support a drive toward open innovation, organization members did not change their innovation activities. Instead, the findings show that new MCS enabled improvements to their closed innovation strategy. This led to a decrease in the time taken to develop new products, which resulted in increased customer satisfaction, which contributed to the achievement of organizational goals.

By focusing on the relationship between MCS and innovation activities in the strategic change process, the paper sheds new light on the ability of MCS to change the innovation activities of organization members. Even though the innovation activities at our case company did not change the interactions between the MCS enabled organizational goals to be achieved as they provided the necessary information infrastructure and motivated goal congruence.

The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations.

In total, 18 of Sweden’s 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians’ sickness certification practice. A discourse analysis approach was used for data analysis.

Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes “physician” or “non-physician” to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of “yes, but […]” approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers.

Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians.

The results suggest that there is a need to address the organisational conditions for managers’ role taking in healthcare organisations.

Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.

Senior executives in healthcare organizations increasingly display preference for a closer handling of operational levels, bypassing middle managers, and de-emphasizing the need to cultivate the next cadre of leaders, creating the potential for leadership and performance gaps. The authors argue that middle managers are a vital resource for healthcare organizations and review the benefits for including them in leadership development and succession planning programs. The paper aims to discuss these issues.

Current theories and common practices in addition to data collected from government sources (e.g. BLS), business and industry surveys and reports (e.g. Moody’s, Witt/Kieffer, Deloitte, American Hospital Association) are used to classify the roles, skills, and strategic value of middle managers in healthcare organizations.

The combination of a greater executive span with less hierarchical depth creates a dual effect of devaluing middle management, and a decrease in middle managers’ autonomy. Healthcare middle managers who stay away or lay low further trigger perceptions of low expectations leading to low morale and high levels of stress. Others become hypereffective or develop exit strategies. Major problems are: rising turnover costs; and insufficient attention to succession planning, internal promotion, and leadership development.

The outcomes of this study are useful for management development, particularly at times of change. Practitioners and researchers can have a better understanding of the value of middle managers and their development needs as well as the factors and dynamics that can influence their motivation and affect retention.

Understanding and implementing the ideas developed in this paper by healthcare organizations and other companies can lead to a drastic change in the current perceptions of the importance of middle managers and should lead to long-term retention, well-being, and extrinsic benefits for both the company and its employees.

The purpose of this study is to create a knowledge base for decision-making in healthcare design by seeking, analyzing and discussing the preferences of facility managers of healthcare facilities regarding floor finishes and their selection criteria. The goal is to enable a simplified and holistic selection of floor finishes based on multiple criteria. The authors studied floor finish selection in three healthcare units: emergency, surgery and in-patient units.

The authors completed a literature review to identify types of floor finishes currently used in healthcare facilities and the criteria applied for their selection. Using the literature survey results, a questionnaire was designed and administered to healthcare facility managers. The descriptive statistical analysis and the Friedman and Wilcoxon signed-ranks tests were used for reporting and analyzing the survey data.

The top five floor finishes used in the healthcare sector were identified as vinyl flooring, vinyl composite tile (VCT), rubber, linoleum and ceramic flooring. The top five selection criteria for floor finishes were durability, infection control, ease of maintenance, maintenance cost and user safety. The non-parametric test results show that the floor finish rankings and selection criteria were similar in the three healthcare units under study.

The most significant contribution of this research is to the design decision-making process of healthcare facilities. These results offer an understanding of what floor finishes are preferred by healthcare facility managers and why. This knowledge is crucial for designers and facility managers to make informed choices and floor finish manufacturers to keep their product line relevant to the industry.

Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask whether it has to be that way or whether is possible to nurture an innovative culture in a healthcare organisation. The aim of this paper is to describe and analyse nurturing an innovative culture within a healthcare organisation and how culture can support innovations in such a healthcare organisation.

Based on a qualitative case study of a healthcare unit that changed, within a few years, from having no innovations to repeatedly generating innovations, the authors describe important aspects of how innovative culture can be nurtured in healthcare. Data were analysed using inductive and deductive analysis steps.

The study shows that it is possible to nurture an innovative culture in a healthcare organisation. Relationships and competences beyond healthcare, empowering structures and signalling the importance of innovation work with resources all proved to be important. All are aspects that a manager can influence. In this case, the manager's role in nurturing innovative culture was very important.

This study highlights that an innovative culture can be nurtured in healthcare organisations and that managers can play a key role in such a process.

The paper describes and analyses an innovative culture in a healthcare unit and identifies important conditions and strategies for nurturing innovative culture in healthcare organisations.

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.