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Article

Tiina A. Tuononen, Anna Liisa Suominen and Johanna Lammintakanen

The purpose of this paper was to study the career paths of leaders with a career background as a dentist from basic degree to chief or executive leadership positions and…

Abstract

Purpose

The purpose of this paper was to study the career paths of leaders with a career background as a dentist from basic degree to chief or executive leadership positions and individual factors that influenced their decisions.

Design/methodology/approach

Semi-structured interview and a questionnaire were used to study 13 leaders using the structure of Edgar Schein’s career anchor interview and career orientation inventory questionnaire. Theory-driven content analysis was used to analyze the data according to themes which included career paths, factors associated with job and career changes and thoughts about future careers.

Findings

Three different career path types were identified: Progressives (Type A), By chance (Type B), and Enthusiasts (Type C). The main motives were: the Progressives’ goal orientation to proceed to higher leadership positions, the By chance group’s job and even career changing by taking a chance on an interesting possibility that comes their way and the Enthusiasts’ willingness to make a difference and search for possibilities to change things. The most important career anchor was “pure challenge” among the Progressives and By chance groups and “general managerial competence” among the Enthusiasts.

Originality/value

Studies on personal factors associating with career paths in health care are scarce and similarly leaders with a dentist background are less studied, even though leadership could be an excellent career choice for a dentist. Different individuals can have varied motives and career paths toward executive positions. Because of the multi-professional functions in health care, organizations could benefit from having leaders with different expertise backgrounds.

Details

Leadership in Health Services, vol. 31 no. 4
Type: Research Article
ISSN: 1751-1879

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Article

Vuokko Pihlainen, Tuula Kivinen and Johanna Lammintakanen

The purpose of this paper is to describe how Finnish experts perceive future (year 2030) hospital management and leadership.

Abstract

Purpose

The purpose of this paper is to describe how Finnish experts perceive future (year 2030) hospital management and leadership.

Design/methodology/approach

A total of 33 experts participated in a three-round Argument Delphi process. Opposing views of management and leadership in 2030 were analyzed using inductive content analysis.

Findings

The experts’ perceptions were divided into two main categories: management and leadership orientation and future organization. Perceptions relating to management and leadership orientation were classified as relating to patient-centred, clinical dominance, professionally divided and management career options. Perceptions relating to future management and leadership organization were classified as representing shared, pair, team and the individual-centered leadership. The results highlighted the most distinctive issues raised by the participants.

Research limitations/implications

This qualitative study was conducted in the context of Finnish healthcare according to the principles of the Argument Delphi Method. The panel consisted of high-level experts representing a diverse set of roles. However, as suggested in previous literature, these experts may not be the most astute in predicting the future development of hospital organizations.

Practical implications

The findings can be used to develop and renew management and leadership training and management practices in hospitals.

Social implications

The findings can be exploited in discussions, planning and decision making regarding future management and leadership in hospitals.

Originality/value

Only a few studies have investigated perceptions of future management in hospitals. This study adopted the Argument Delphi Method to identify distinct perceptions on the future orientation and organization of management and leadership in hospitals.

Details

Journal of Health Organization and Management, vol. 33 no. 5
Type: Research Article
ISSN: 1477-7266

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Article

Anne Kanerva, Tuula Kivinen and Johanna Lammintakanen

The organisational level and leadership development are crucial elements in advancing patient safety, because patient safety weaknesses are often caused by system…

Abstract

Purpose

The organisational level and leadership development are crucial elements in advancing patient safety, because patient safety weaknesses are often caused by system failures. However, little is known about how frontline leader and director teams can be supported to develop patient safety practices. The purpose of this study is to describe the patient safety development process carried out by nursing leaders and directors. The research questions were: how the chosen development areas progressed in six months’ time and how nursing leaders view the participatory development process.

Design/methodology/approach

Participatory action research was used to engage frontline nursing leaders and directors into developing patient safety practices. Semi-structured group interviews (N = 10) were used in data collection at the end of a six-month action cycle, and data were analysed using content analysis.

Findings

The participatory development process enhanced collaboration and gave leaders insights into patient safety as a part of the hospital system and their role in advancing it. The chosen development areas advanced to different extents, with the greatest improvements in those areas with simple guidelines to follow and in which the leaders were most participative. The features of high-reliability organisation were moderately identified in the nursing leaders’ actions and views. For example, acting as a change agent to implement patient safety practices was challenging. Participatory methods can be used to support leaders into advancing patient safety. However, it is important that the participants are familiar with the method, and there are enough facilitators to steer development processes.

Originality/value

Research brings more knowledge of how leaders can increase their effectiveness in advancing patient safety and promoting high-reliability organisation features in the healthcare organisation.

Details

Leadership in Health Services, vol. 30 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

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Article

Teija Norri-Sederholm, Minna Joensuu and Johanna Lammintakanen

The purpose of this paper is to investigate opportunities and challenges for multi-professional paramedic-firefighter units in small municipalities in Finland.

Abstract

Purpose

The purpose of this paper is to investigate opportunities and challenges for multi-professional paramedic-firefighter units in small municipalities in Finland.

Design/methodology/approach

The data were collected by means of four focus group interviews conducted with managers (N =12) and a questionnaire comprising open-ended questions for the personnel working in the units (n =73). Data from both sources were analyzed using inductive content analysis.

Findings

The empirical results suggest that the use of multi-professional units (MPUs) may be one means of providing a better standard of service in rural areas. However, the working practices and different professional backgrounds in MPUs are considered challenging by the personnel. Managers had a broader perspective; during the interviews they raised matters such as citizen characteristics, legal issues like varying working hours, and economic aspects. Both the personnel and the managers agreed on the strengths and weaknesses of the MPU model in principle.

Practical implications

The results of this study may clarify the opportunities and challenges posed by MPUs in rural areas from the perspectives of personnel and managers.

Originality/value

The study provides novel information on MPUs comprising paramedics and firefighters, who function at the interface of emergency medical services and rescue services and who have new tasks in rural areas, including home healthcare support and accident prevention.

Details

International Journal of Emergency Services, vol. 8 no. 2
Type: Research Article
ISSN: 2047-0894

Keywords

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Article

Vuokko Pihlainen, Tuula Kivinen and Johanna Lammintakanen

The purpose of this study is to elicit and analyze experts’ perceptions of management and leadership competence (MLC) and likely MLC developments and requirements in…

Abstract

Purpose

The purpose of this study is to elicit and analyze experts’ perceptions of management and leadership competence (MLC) and likely MLC developments and requirements in hospital contexts by 2030.

Design/methodology/approach

A three-round, web-based Argument Delphi process was used to gather critically discussed opposing perceptions of 33 Finnish experts, which were subjected to inductive content analysis to identify themes.

Findings

Current deficiencies in MLC and several trends (e.g. an ongoing shift towards collaborative management) and required improvements (e.g. a need to adopt more holistic approaches) were identified. However, there were some conflicting perceptions, regarding for example the desirability of fixed-term positions for managers.

Research limitations/implications

The findings provide qualitative indications of a group of Finnish experts’ perceptions of MLC and requirements for its development, elicited using the Argument Delphi Method. Thus, they are subject to the usual limitations of the applied methodology and should be generalized to other contexts cautiously.

Practical implications

The identification of current deficiencies and future requirements for MLC may facilitate the formulation of robust approaches for improving it in hospital contexts.

Social implications

The findings may be useful for improving MLC in hospitals, thereby enhancing efficiency, teamwork, safety and client satisfaction in healthcare settings.

Originality/value

The Argument Delphi Method has been rarely used in health management science studies and healthcare context. It is intended to develop relevant arguments and reveal reasons for differing views about focal issues, thereby providing deeper understanding of experts’ perceptions of MLC and its likely development.

Details

Leadership in Health Services, vol. 32 no. 2
Type: Research Article
ISSN: 1751-1879

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Article

Johanna Lammintakanen and Tuula Kivinen

The purpose of this paper is to describe and compare the views of nurses of different ages on continuing professional development (CPD). The authors were interested in…

Abstract

Purpose

The purpose of this paper is to describe and compare the views of nurses of different ages on continuing professional development (CPD). The authors were interested in possible differences in the use of formal and especially informal CPD practices between nurses of different ages, and likewise in possible differences in attitudes of nurses of different ages to CPD.

Design/methodology/approach

A postal questionnaire was sent to a random sample of nursing staff (n=653) in six Finnish hospital districts. Three age groups were formed for this study: 39 or under, 40‐50 and 51 or older. The data were analyzed with statistical methods.

Findings

The youngest nurses participated least in those CPD practices that enhanced transfer of tacit knowledge. In addition, they reported more experiences of injustice in terms of CPD than their older colleagues.

Research limitations/implications

These results are preliminary, but supported by earlier research.

Practical implications

A crucial challenge for nursing management is how to balance the needs of nurses of different ages and enable the use of all the options currently available for CPD in health care organizations. Nurse managers need also to consider opportunities for workplace learning when they allocate nursing resources in their units. Due to the retirement of older workers it is essential to make tacit knowledge explicit in health care organizations and give the younger workers an opportunity to learn from older nurses' experiences and vice versa.

Originality/value

Recent studies have emphasized the importance of retaining older workers. The results of the effects of age on participating in different CPD practices have been somehow contradictory.

Details

Journal of Workplace Learning, vol. 24 no. 1
Type: Research Article
ISSN: 1366-5626

Keywords

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Article

Markku Myllykangas, Olli‐Pekka Ryynänen, Johanna Lammintakanen, Veli‐Pekka Isomäki, Juha Kinnunen and Pirjo Halonen

The aim of this study was to investigate the acceptability of 14 prioritisation criteria from nurses’, doctors’, local politicians’ and the general public's perspective…

Abstract

The aim of this study was to investigate the acceptability of 14 prioritisation criteria from nurses’, doctors’, local politicians’ and the general public's perspective. Respondents (nurses, n=682, doctors, n=837 politicians, n=1,133 and the general public, n=1,178) received a questionnaire with 16 imaginary patient cases, each containing 2‐3 different prioritisation criteria. The subjects were asked to indicate how important it was for them that the treatments in the presented patient cases be subsidised by the community. All respondents preferred treatments for poor people and children. With the exception of the doctors, the three other study groups also prioritised elderly patients. Treatment for institutionalised patients, those with self‐induced disease, diseases with both poor and good prognosis, and mild disease were given low priorities. Priority setting in health care should be regarded as a continuous process because of changes in attitudes. However, the best method for surveying opinions and ethical principles concerning prioritisation has not yet been discovered.

Details

Journal of Health Organization and Management, vol. 17 no. 5
Type: Research Article
ISSN: 1477-7266

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Article

Vuokko Pihlainen, Tuula Kivinen and Johanna Lammintakanen

The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital…

Abstract

Purpose

The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment. Health-care leaders and managers in this study were both nursing and physician managers. Competence was assessed by evaluating the knowledge, skills, attitudes and abilities that enable management and leadership tasks.

Design/methodology/approach

A systematic literature review was performed to find articles that identify and describe the characteristics of management and leadership competence. Searches of electronic databases were conducted using set criteria for article selection. Altogether, 13 papers underwent an inductive content analysis.

Findings

The characteristics of management and leadership competence were categorized into the following groups: health-care-context-related, operational and general.

Research limitations/implications

One limitation of the study is that only 13 articles were found in the literature regarding the characteristics of management and leadership competence. However, the search terms were relevant, and the search process was endorsed by an information specialist. The study findings imply the need to shift away from the individual approach to leadership and management competence. Management and leadership need to be assessed more frequently from a holistic perspective, and not merely on the basis of position in the organizational hierarchy or of profession in health care.

Originality/value

The authors’ evaluation of the characteristics of management and leadership competence without a concentrated profession-based approach is original.

Details

Leadership in Health Services, vol. 29 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Content available
Article

Sara Cervai and Tauno Kekäle

Abstract

Details

Journal of Workplace Learning, vol. 24 no. 1
Type: Research Article
ISSN: 1366-5626

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Article

Axel Kaehne

The purpose of this paper is to critically reflect on the practice, rhetoric and reality of integrating care. Echoing Le Grand's framework of motivation, agency and…

Abstract

Purpose

The purpose of this paper is to critically reflect on the practice, rhetoric and reality of integrating care. Echoing Le Grand's framework of motivation, agency and policy, it is argued that the stories the authors tell themselves why the authors embark on integration programmes differ from the reasons why managers commit to these programmes. This split between policy rhetoric and reality has implications for the way the authors investigate integration.

Design/methodology/approach

Examining current integration policy, practice and research, the paper adopts the critical framework articulated by Le Grand about the underlying assumptions of health care policy and practice.

Findings

It is argued that patient perspectives are speciously placed at the centre of integration policy but mask the existing organizational and managerial rationalities of integration. Making the patient the measure of all things integration would turn this agenda back on its feet.

Originality/value

The paper discusses the underlying assumptions of integration policy, practice and research. Increasing the awareness about the gap between what the authors do, why the authors do it and the stories the authors tell themselves about it injects a much needed amount of criticality into research and practice.

Details

Journal of Integrated Care, vol. 28 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

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