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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.

This paper aims to critically examine the accounting and information systems literature to understand the changes that are occurring in the management accounting profession. The changes the authors are interested in are linked to technology-driven innovations in managerial decision-making and in organizational structures. In addition, the paper highlights research gaps and opportunities for future research.

The authors adopted a grounded theory literature review method (Wolfswinkel et al., 2013) to achieve the study’s aims.

The authors identified four research themes that describe the changes in the management accounting profession due to technology-driven innovations: structured vs unstructured data, human vs algorithm-driven decision-making, delineated vs blurred functional boundaries and hierarchical vs platform-based organizations. The authors also identified tensions mentioned in the literature for each research theme.

Previous studies display a rather narrow focus on the role of digital technologies in accounting work and new competences that management accountants require in the digital era. By contrast, the authors focus on the broader technology-driven shifts in organizational processes and structures, which vastly change how accounting information is collected, processed and analyzed internally to support managerial decision-making. Hence, the paper focuses on how management accountants can adapt and evolve as their organizations transition toward a digital environment.

As healthcare continues to become more expensive and complex, considering the voice of the patient in the design and operation of healthcare practices is important. Wound care and rural healthcare scenarios pose additional complexities for providers and patients. This study sought to identify key determinants of patient service quality in wound care.

Patients at the wound care/ostomy clinic (WOC) in a rural hospital were surveyed using the Kano model. The Kano model enables the categorization of quality attributes based on the attributes' contribution to the subject's overall satisfaction (and dissatisfaction). Chi-square goodness-of-fit testing, multinomial analysis and power analysis were then used to determine the Kano categories for each satisfaction-related attribute.

The analyses resulted in 14 one-dimensional attributes and 3 indeterminable attributes. For the one-dimensional attributes, customer satisfaction is directly proportional to the level of performance for that attribute. The one-dimensional attributes included providing correct care on the first, provision of necessary supplies for care, appropriately qualified medical staff and confidence in care provided by medical staff, among others. Understanding the attributes important to the patient drive patient-centered care, which improves positive patient outcomes and recovery. These attributes can then be used by healthcare professionals to design patient-centric processes and services. This research provides a framework for incorporating the voice of the patient into healthcare services.

While the research methodology can be used in other healthcare settings, the findings are not generalizable to other wound care clinics. This research was conducted in one small, rural hospital. In addition, the sample size was small due to the size of the wound clinic; therefore, an analysis of the differences between demographics could not be performed.

Considering the perspectives of rural wound care patients is important, as the patients are an under-served population with unique challenges related to patient care. The research findings detail rural patients' expectations during wound care treatments, which enable the clinic to focus on improving patient satisfaction. This research contributes to understanding the factors that are important to patient satisfaction in wound care. Further, the methodology presented can be applied to other healthcare settings.

While studies exist using the Kano model in healthcare and the literature is sparse in rural healthcare, this is the first case study using the Kano model in wound care to understand patient preferences.

Paramedics became nationally registered in 2018 in Australia. Prior to this, there was no central regulation of the profession with reliance on organisational regulation through employers. As paramedics expanded their scope, role and range of employers, especially outside statutory agencies, there was increasing need to engage in professional regulation. Regulation is more than a legal and bureaucratic framework. The purpose of the paper states that the way paramedics interact with their new regulatory environment impacts and is influenced by the professionalisation of the discipline. Regulation also redefines their positionality within the profession.

Two mixed-method surveys were undertaken. A pre-registration survey occurred in the month prior to regulation commencing (N = 419) followed by the second survey 31 months later (N = 407). This paper reports the analysis of qualitative data from the post-registration survey and provides comparison to the pre-registration survey which has been previously reported. Analysis was undertaken using interpretive phenomenological analysis (IPA).

Themes from the pre-registration survey continued however became more nuanced. Participants broadly supported registration and saw it as empowering to the profession. Some supported registration but were disappointed by its outcome, others rejected registration and saw it as divisive and oppressive.

Paramedics are beginning to come to terms with increasing professionalisation, of which regulation is one component. Changes can be seen in professional identity and engagement with professional practice; however, this is nascent and is deserving of additional research to track the profession as it continues to evolve.

During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

The purpose of this paper is to systematically review the history and current state of lesson study (LS) in Germany. In particular, this paper describes the development of LS over time and its stakeholders.

Conducting a systematic literature review, we searched three scientific databases and Google Scholar, examined 806 results and included 50 articles in our final sample, which we analyzed systematically.

The spread of LS in Germany can be divided into three phases, characterized by their own LS projects as well as their own ways of understanding LS. Although interest in LS has increased significantly in recent years, it is only present at a small number of schools and universities in Germany if compared internationally. Furthermore, this paper identifies the so-called learning activity curves as a tool frequently used for observation and reflection that appears to be unknown outside German-speaking countries.

This paper may act as an outline for countries without large-scale LS projects and with limited support from policymakers. The experience from Germany demonstrates the outcomes and challenges that can arise in such a situation and shows how unique LS features and proceedings have emerged.

Leadership is an essential contributor to employee creative self-efficacy, and past research suggests a positive relationship between servant leadership and creative self-efficacy. However, the relationship is complex and contingent upon moderating variables, and this research examines the moderating effect of role clarity by drawing on social exchange theory and social cognitive theory.

Data collected from a survey among 116 emergency room employees is used to test the research model using moderated ordinary least squares regression.

The results confirm a positive relationship between servant leadership and creative self-efficacy and suggest a U-shaped relationship between role clarity and creative self-efficacy. Furthermore, role clarity positively moderates the relationship between servant leadership and creative self-efficacy.

The sample used for this research mainly consisted of highly educated employees within a specific setting. Future research is needed to study if the relationships found in this research can be generalized to other organizational settings.

This research suggests that leaders can support employees' creative self-efficacy through servant leadership, particularly when coupled with high role clarity.

Rapidly changing work environments are characterized by decreased role clarity, so attention is needed to its moderating role on the relationship between servant leadership and creative self-efficacy.

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.

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.

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.

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.

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

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

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.

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.

This study focuses on the reasons leading health organisations to adopt a cooperation strategy and the benefits they can draw from that inter-organisational relation.

To this end, a mixed research approach – qualitative and quantitative – was adopted, taking a real case between a Health Centre Group in inland Portugal (ACeS-CB) and the Faculty of Health Sciences at a university situated in the same region (FCS-UBI). To gather information, a questionnaire survey was directed to medical students in this faculty, together with semi-structured interviews with those in charge of both types of organisation in the inter-organisational cooperation studied here.

After content analysis of the interviews and descriptive analysis of the questionnaires, it was concluded that this cooperation is based on a relation of a formal nature, as each organisation is independent from the other, as are their administrative and management organs. The benefits obtained from this cooperative relation regard mainly the share of human resources, particularly elements of the clinical staff in ACeS-CB who have taken on teaching duties at FCS-UBI.

Articulation of theoretical training with clinical practice and the exchange of knowledge were other benefits identified. The study also reveals that students perceive this inter-organisational cooperation as satisfactory, corresponding to what was defined by those in charge of the institutions as its main objectives.

This study focuses on the reasons leading health organisations to adopt a strategy of cooperation with other organisations in the same sector and the benefits they can obtain from that relation. It represents a tool to support managers in health organisations and other stakeholders in an inter-organisational cooperation relation, in planning strategies and understanding the impact of this type of cooperation.