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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.

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.

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.

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.

This study aimed to describe nurse leaders’ experiences of remote leadership in health care sector.

Semistructured interviews were conducted among nurse leaders (N = 12) between January and March 2022. All of the interviewees had experiences of remote leadership and worked as immediate – (n = 5) or middle-level (n = 7) leaders in health care organizations across four provinces in Finland. The collected data were analyzed by inductive content analysis.

The leaders had experienced a rapid transition to remote leadership and highlighted the need for guidelines and joint discussions with different stakeholders. The interviewees felt that working life has changed in the last two years and that remote leadership will now be a key part of leadership in health care. The leaders’ experiences highlighted how important trust is in remote leadership. Furthermore, the interviewees pointed out a need for face-to-face contact and described other good practices for remote leadership. Overseeing work-related well-being was also stressed as important in the remote context; however, the interviewees expressed a need for instructions and tools concerning the management of employee well-being. The sudden change to remote leadership was not only described as interesting but also challenging, which has affected the leaders’ work-related well-being. Support – both from the organization and other employees – was found to be crucial to health care leaders’ work-related well-being.

The current study complements the little-researched topic of remote leadership in the health care sector. The results provide insights that can be used to develop remote leadership and/or guide future research.

This study aims to make visible the dynamic nature of leader–member exchange (LMX) in the changing realm of health-care leadership.

The qualitative study used an open questionnaire, which was distributed amongst nursing staff and managers at a Finnish public university hospital.

The participants described partly LMX theory, but the leader-member relationship was also influenced by the organizational culture and the existing management practices. Nursing staff were found to have a more variable and dynamic role in the LMX relationship than has previously been reported. The research therefore provided novel information for the field of health-care research.

The presented research was limited by the content of the data, as the collected single narratives were rather short; however, the fact that a large number of narratives were collected from diverse participants strengthened the ability to reliably answer the research questions.

Although the participants described partly LMX theory, the leader–member relationship is also influenced by the organizational culture and existing management practices; the finding that nurses have more variable roles in LMX relationships in the health-care context was new insight in this field. Therefore, the presented findings can help decision-makers change the current, perhaps antiquated, leadership practices at health-care organizations.

This study provides new insight into the field of LMX research in terms of the important role of nursing staff, the organizational factors that influence the LMX relationship and the dynamic nature of LMX relationships.

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

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.

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.

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.

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

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

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.

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.

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.

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.

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.

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

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.

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.

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

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.

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.

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.

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.

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.

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

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

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.

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.

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.

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.

These results are preliminary, but supported by earlier research.

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.

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.

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.

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.

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.

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

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.

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