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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.

Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study aims to describe nurse leaders’ perceptions of what future leadership in hospital settings in the post-pandemic era needs to be like.

A qualitative descriptive study was used. A total of 20 nurse leaders from the Finnish central hospital were interviewed from June to October 2021. The data were analysed using inductive content analysis.

The analysis revealed five main categories describing nurse leaders’ perceptions of future leadership in hospital settings in the post-pandemic era: digitalisation and hybrid working culture, development of sustainable working conditions, moving smoothly to the post-pandemic era, dissolution of traditional regimes of organisation and flexibility in leadership.

In the post-pandemic era, the constantly changing demands and challenges currently facing healthcare systems have significantly increased the complexity of hospital organisations. This requires critical evaluation and change to traditional leadership. Enhancing flexibility and authenticity in leadership, strengthening competencies, implementing a wide range of digital resources and increasing the appeal of the nursing profession to build the next generation of nurses – all of these are needed to provide sustainability in future healthcare.

The results identify the critical points of leadership that need to be developed for future challenges and for maintaining a sufficient supply of qualified professionals. Acting on this information will enhance flexibility in organisations and lead to acceleration of changes and the development of new kinds of leadership in the future

Green transformation is more than simply a trend; it is a way of life, a set of habits, a field of knowledge and a dedication to resource conservation. Going green is surely a creative and transformative process for both individuals and organizations. This paper aims to “identify,” “analyse” and “categorise” the readiness factors for green transformation process in health care using total interpretive structural modelling (TISM) and neutrosophic-MICMAC.

To address the study objectives, the study used TISM and neutrosophic-MICMAC analysis. To identify the readiness factors, a literature study was conducted, and the factors were face-validated by the healthcare experts. The factors influence on one another were captured by using a scheduled interview with a closed ended questionnaire. The TISM addressed the identification and analysing of factors and the categorization and ranking the readiness factors is addressed by using neutrosophic-MICMAC analysis.

This study identified 11 green transformation process readiness factors for healthcare organizations. The study states that the key factors or driving factors are awareness of green governance principle, environment leadership and management, green gap analysis, information and communication technology and innovation dynamics.

The factor ranking is sensitive to the respondents’ ratings. The study relied on the past literature and experts’ opinion may result in the subjective biases. The complex nature of healthcare ecosystem challenges to capture all the factors. The study focussed on Indian hospitals.

Study significantly impacts the healthcare practitioners, academicians and policymakers by providing critical insights into the readiness factors required for the healthcare green transformation process. The study offers a better understanding of the crucial or key or driving factors that aid in embracing green and sustainable practices.

Identifying a gap in conceptual and theoretical frameworks for green transformation readiness factors in healthcare organizations and in Indian context. The study addresses this gap by aiming to create a thorough theoretical framework and highlighted by its focus on Indian hospitals.

The goal of this article is to provide an overview of healthcare entrepreneurship, both in terms of its current trends and future directions.

The article engages in a systematic review of extant research on healthcare entrepreneurship using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) as the review protocol and bibliometrics or scientometrics analysis as the review method.

Healthcare entrepreneurship research has fared reasonably well in terms of publication productivity and impact, with diverse contributions coming from authors, institutions and countries, as well as a range of monetary and non-monetary support from funders and journals. The (eight) major themes of healthcare entrepreneurship research revolve around innovation and leadership, disruption and technology, entrepreneurship models, education and empowerment, systems and services, orientations and opportunities, choices and freedom and policy and impact.

The article establishes healthcare entrepreneurship as a promising field of academic research and professional practice that leverages the power of entrepreneurship to advance the state of healthcare.

The article offers a seminal state of the art of healthcare entrepreneurship research.

Village health volunteers are community health volunteers in Thailand that have helped the government deliver public health services for many years, particularly during the coronavirus disease 2019 (COVID-19) pandemic. Though labeled as “volunteers,” the village health volunteers are recruited, trained and supervised in a manner similar to how a government agency recruits, trains and supervises its street-level bureaucrats (SLBs). This study examines the two factors that affect how these street-level quasi-bureaucrats use their professional discretion: transformational leadership and public service motivation (PSM). Transformational leadership means a leadership style that develops, shares and sustains a vision to elevate SLBs to higher levels of performance, while PSM is defined as an SLB’s predisposition to make a difference by working in the public sector with a sense of calling. This study attempts to analyze the mediating role of psychological empowerment in the relationship between transformational leadership, PSM and professional discretion.

The paper uses a three-wave survey-based quantitative method to avoid common method biases. This method provides evidence gathered from 105 subdistrict health promotion hospitals and 798 village health volunteers (VHVs) in five provinces in Thailand.

PSM and transformational leadership influence the village health volunteers' use of professional discretion indirectly through the psychological empowerment mechanisms that make them feel positive toward their village health volunteer role and responsibility. The authors' findings suggest that the hospital directors' transformational leadership induces the village health volunteers' use of professional discretion by making them feel competent to do their work and feel fulfilled and valuable about their work. Similarly, the village health volunteers' PSM leads them to use professional discretion by making them feel fulfilled and valuable and by convincing them of the social and community impact of their work.

While existing research focuses on VHVs' role in alleviating capacity constraints on the health care system, this study revealed an equally important role played by hospital directors. These directors' transformational leadership was instrumental in enhancing VHVs' psychological empowerment – particularly their perceptions of the meaning of their work and their competence – that ultimately enabled them to use professional discretion in their work. This study also highlighted the importance of VHVs' PSM, which leads to their use of professional discretion via the meaning and impact dimensions of psychological empowerment. Based on this study, PSM should also be incorporated into the community health volunteers' recruitment criteria. Also, public health agencies should consider including transformational leadership in the hospital directors' training programs and their promotion criteria.

As VHVs' high-PSM level was found to enhance their professional discretion, the process of recruiting ordinary citizens to serve as community health volunteers should incorporate assessment of the candidates' PSM. Also, the Ministry of Public Health should design and assign tasks that citizen volunteers, particularly VHVs, consider meaningful and at which they feel competent.

Aside from technical training, directors of the subdistrict health promotion hospitals should regularly receive soft skill training (i.e. leadership training) and transformational leadership characteristics should be included in the government criteria for promotion.

While past research has examined the impact of other leadership styles on psychological empowerment, this study took a further step by examining the mediating effects of psychological empowerment on the relationship between transformational leadership and professional discretion among VHVs. The authors analyzed the mechanism linking PSM to the VHVs' professional discretion. In addition, by examining the relative importance of different dimensions of psychological empowerment, this study offers a nuanced understanding of the psychological processes by which transformational leadership and PSM shape the SLBs' use of professional discretion in their work.

Organizations have increasingly been compelled to engage in ecological businesses in recent decades, necessitating identifying environmental practices contributing to enhanced sustainability. One of the main reasons for doing this research is to see how far down the path to green transformational leadership (GTFL) in Green Human Resource Management (GHRM) practices in the healthcare industry in Pakistan. Additionally, this research aims to analyze how this change affects the long-term success of businesses in sustainable performance (SP).

To identify factors related to the study variables, the research utilized master journals, as well as the Web of Science and Scopus databases. The ISM-DEMATEL (Interpretive Structural Modeling - Decision Making Trial and Evaluation Laboratory) technique was employed to establish a hierarchical model. This model facilitated the identification of cause-and-effect relationships among factors, which were further elucidated using the DEMATEL interrelationship diagram.

The analysis of the results indicates that Green Training (F4), Green Job Analysis (F1), Intellectual Stimulation (F10), and Green Product Innovation (F9) are the primary factors that have a significant impact on achieving Environmental Policies and Regulations (F13), and Subjective Environment Norms (F14) of SP factors.

The study is implemented in the healthcare industry of Pakistan, with a focus on practical and managerial aspects. It encourages managers to develop and adapt their human resources policies and environmental strategies. Implementing safety health standards is crucial to mitigate the detrimental effects on the environment. The research was carried out during the period of the pandemic. The scope of this study was restricted to the healthcare industry in Pakistan.

In order to improve SP, this study presents a unique strategy combining sustainability into decision-making procedures with the function of GTFL in GHRM. Implementing safety health standards is crucial to mitigate the detrimental effects on the environment.

High-quality nursing home (NH) care has long been a challenge within the United States. For decades, policymakers at the state and federal levels have adopted and implemented regulations to target critical components of NH care outcomes. Simultaneously, our delivery system continues to change the role of NHs in patient care. For example, more acute patients are cared for in NHs, and the Center for Medicare and Medicaid Services (CMS) has implemented value payment programs targeting NH settings. As a part of these growing pressures from the broader healthcare delivery system, the culture-change movement has emerged among NHs over the past two decades, prompting NHs to embody more person-centered care as well as promote settings which resemble someone's home, as opposed to institutionalized healthcare settings.

Researchers have linked culture change to high-quality outcomes and the ability to adapt and respond to the ever-changing pressures brought on by changes in our regulatory and delivery system. Making enduring culture change within organizations has long been a challenge and focus in NHs. Despite research suggesting that culture-change initiatives that promote greater resident-centered care are associated with several desirable patient outcomes, their adoption and implementation by NHs are resource intensive, and research has shown that NHs with high percentages of low-income residents are especially challenged to adopt these initiatives.

This chapter takes a novel approach to examine factors that impact the adoption of culture-change initiatives by assessing knowledge management and the role of knowledge management activities in promoting the adoption of innovative care delivery models among under-resourced NHs throughout the United States. Using primary data from a survey of NH administrators, we conducted logistic regression models to assess the relationship between knowledge management and the adoption of a culture-change initiative as well as whether these relationships were moderated by leadership and staffing stability. Our study found that NHs were more likely to adopt a culture-change initiative when they had more robust knowledge management activities. Moreover, knowledge management activities were particularly effective at promoting adoption in NHs that struggle with leadership and nursing staff instability. Our findings support the notion that knowledge management activities can help NHs acquire and mobilize informational resources to support the adoption of care delivery innovations, thus highlighting opportunities to more effectively target efforts to stimulate the adoption and spread of these initiatives.

Despite much attention being devoted to shared leadership, the negotiation of such arrangements remains underexplored. In parallel, the revival of interest in matrix structures reveals their challenges but neglects the dynamics of shared leadership. In this case study, the author analyzes the tensions experienced by senior managers of a healthcare organization transitioning from a hierarchical to matrix structure as they negotiate their leadership roles in this new arrangement.

The author interviewed 16 senior managers, observed their meetings and analyzed documents. These data were combined with secondary data including previous interviews and observations of this top leadership team. The author then conducted an inductive data analysis.

The author's analysis reveals that the tensions experienced by senior managers as they negotiate their roles reflect the co-existence of leadership surpluses (too much leadership) and deficits (too little leadership) in matrix organizations. The author argues that surpluses and deficits are not mutually exclusive but are interrelated and shows how leadership surpluses can create leadership deficits.

The author’s findings suggest that in contexts of leader abundance, actors should explore leadership voids. Particular attention should be paid to incidents of intrusion and exclusion, moments of transition and intense role negotiation, as those contexts are particularly conducive to leadership deficits.

While previous work on matrix structures focuses on leadership surpluses, the author discusses leadership deficits. The author explores how more leaders do not necessarily mean more leadership, but instead how more leaders may result in leadership voids.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within the healthcare sector and investigates their evolution in emerging economies (EEs) and developed economies (DEs). This study aims to uncover these two contexts' shared characteristics and unique variances through a comparative analysis.

The paper systematically investigates and consolidates the literature on healthcare by employing the antecedents, decisions and outcomes (ADO) framework and finally examines 71 shortlisted articles published between 2003 and 2022.

The recognition of the BM within healthcare is increasing, both in EEs and DEs. EEs prioritize value creation and capture through cost efficiency, while DEs focus on innovation. Key theories employed include a resource-based view, the network theory and the theory of innovation. Case studies are commonly used as a methodology. Further research is needed to explore the decisions and outcomes of BMs.

The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Beyond comparing and highlighting gaps in BMs between EEs and DEs, benchmarking DE's healthcare business models (HBMs) helps healthcare organizations in EEs align their practices, mitigate risks and establish efficient healthcare systems tailored to their specific contexts. The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

The study analyzes HBMs using an SLR framework perspective and provides practical implications for academicians and practitioners to enhance their decision-making.