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The purpose of this case study is to extend the understanding of leadership development in healthcare by documenting the impact of a systemic approach to developing frontline leaders in a large Canadian healthcare organization.

A total of 92 participants working in acute and community settings participated in an eight‐day certificate program that combined classroom instruction, practical skill development, and applied projects. Program content was based on a learning needs assessment conducted with potential participants and their supervisors.

Frontline leaders and their supervisors rated the program positively in terms of its impact on participants' confidence and willingness to lead, awareness of leadership opportunities, communication, problem solving, response to conflict, and the ability to support their teams through change. It was also found, however, that supervisors' ratings were generally lower than those of participants.

Systemic approaches to leadership development offer healthcare the best chance of addressing the current leadership crisis. The challenge is finding innovative ways to demonstrate sustainable benefits in an industry that is struggling to address cost pressures. In the present study, personal and supervisor evaluations were used in conjunction with completion of applied change projects to demonstrate a tangible return on investment.

Leadership can be learned and there is no better point of entry for development than those in frontline leadership positions. However, developing future leaders requires the commitment of an entire leadership community. Healthcare organizations that are experiencing leadership gaps must be prepared to make a long term investment if they want to achieve lasting healthcare reforms.

The purpose of this paper is to bring the discussion on the relationship between management and medicine a step forward by focussing on: first, how the notion of hybrid and hybridity has been used in the literature on healthcare management. Second, the authors have mapped the alternative ways that the concept have been used in order to conceptualize a more specific set of possible combinations of managerial and professional roles in healthcare management. Hybrid management is a topic that ought to be important for training, communication among researchers and for identifying areas of future research: in management, in healthcare reforms, in sociology of professions and in theory of organizations.

The authors provide a systematic literature review in order to map the various conceptualizations of hybrid management. The authors have searched for “hybrid leadership,” “hybrid management” combined with hospitals and health care in a whole range of journals, identified in Google scholar, Academic Search Premier, Academic Research Library and Sage Publication. The authors have also used already existing literature reviews. The search has resulted in more than 60 articles and book titles that have been classified according to whether they make a fit with three alternative ways of conceptualizing hybrid management. The authors are aware that they might have missed some relevant literature but the literature included is quite comprehensive.

In the literature the authors have found three conceptualizations of management. The clinical manager who combines professional self-governance with a general management logic. The commercialized manager who combines professional self-governance with an enterprise logic. The neo-bureaucratic manager who combines self-governance with a neo-bureaucratic logic.

In most analyses of hybridity in management and organization the notion of hybrid has been used in a rather superficial way. By mapping the various uses of hybrid in the literature and suggest how a professional logic may be combined with a set of alternative logics of management the authors provide a platform for developing the concept of hybrid management into a more useful tool for analyses of changes in healthcare management.

This paper aims to explore President Obama's leadership style during passage of this major and controversial piece of legislation. Specifically it addresses the historical development of healthcare reform in the USA, and provides an ethical analysis of President Obama's leadership in pursuing the health reform initiative.

Based on a review of the literature, speeches, and application of leadership and ethical theory, an analysis was done of President Obama's leadership and ethical approach to healthcare reform.

This analysis revealed that Obama's behavior was consistent with the full‐range leadership model articulated by Bass and Avolio. Moreover, his personal and strategic ethical approach to promulgating healthcare reform incorporated both deontological and teleological ethical principles.

This paper provides a current look at President Obama's leadership style and demonstrates how incorporating different ethical theories can result in the same outcome.

Physicians are instrumental in healthcare reform and their capacity to employ both leadership and management skills can affect change at all levels. This paper aims to present the challenges and opportunities for physicians in influencing system change and discuss how the two different but complementary skill sets may enable them to contribute to transformation of healthcare.

This is a conceptual paper and represents the viewpoints of both authors while incorporating current evidence through the literature.

Healthcare reform is important and underway in many Canadian provinces, yet it is difficult to achieve change. Leadership and management skills differ although these differences are often subtle in language. Physicians both lead and manage in the healthcare system; their capacity to do both is an advantage for healthcare reform.

This paper represents the opinions of both authors and is considered original as a conceptual paper.

In many countries leadership theories and leadership development programs in healthcare have been dominated by individualistic and heroic approaches that focus on developing the skills and competencies of health professionals. Alternative approaches have been proffered but mainly in the form of post‐heroic and distributed forms of leadership. The notion of “hybridity” has emerged to challenge the assumptions of distributed leadership. The paper seeks to explore how the concept of hybridity can be used to re‐theorize leadership in healthcare as it relates to clinician managers (or hybrid‐professional managers).

The theoretical developments are explored and empirical material is presented from research in Australian public hospitals to support the case for the existence of hybridized forms of leadership in healthcare. The paper discusses whether hybridity needs re‐theorizing to adequately account for clinician leadership. It contributes to debates surrounding the role of clinician leadership in healthcare reform particularly in relation to those doctors who occupy management positions at the division or unit levels as distinct to CEOs. The study uses qualitative research, i.e. interactive interviews to present accounts of how healthcare professionals describe leadership. It undertakes both deductive and inductive theme analysis of the interview material.

There is support for hybridized configurations of leadership in interview materials of healthcare professionals but other aspects were also noted that cannot be explained by this approach alone.

The paper is the first to examine the concept of hybridity in the context of clinician leadership. Many approaches to leadership in healthcare fail to address the complexity of leadership within the ranks of clinician managers and thus are unable to deal adequately with the role of leadership in healthcare reform and change.

The Health Service Executive in Ireland seeks to further develop healthcare in the community. It has identified that this reform requires developing leadership amongst the staff. This study aims to identify what kind of leadership staff in community healthcare observe in practice and their leadership preferences. The core objective has been to identify the readiness of the organisation to implement the adopted national policy of integrated community care reform in terms of leadership development.

An online cross-sectional survey was conducted using the Organisational Cultural Assessment Instrument, based on the Competing Values Framework. This tool identifies four overarching leadership types: Clan (Collaborative), Adhocracy (Creative), Market (Competitive) and Hierarchy (Controlling). Participants (n = 445) were a representative sample of regional community health care employees. They were asked to identify presently observed leadership and preferred leadership in practice. The statistical analysis emphasised a comparison of observed and preferred leadership types.

Participants reported the current prevailing leadership type as Market (M = 34.38, SD = 6.22) and Hierarchical (M = 34.38, SD = 22.62), whilst the preferred or future style was overwhelmingly Clan (M = 40.38, SD = 18.08). Differences were significant (all p’s < 0.001). The overall outcome indicates a predominance of controlling and competitive leadership and a lack of collaborative leadership to implement the planned reform.

During reform in healthcare, leadership in practice must be aligned to the reform strategy, demonstrating collaboration, flexibility and support for innovation. This unique study demonstrates the importance of examining leadership type and competencies to indicate readiness to deliver national community health care reform.

In recent years, effective leadership initiatives have been emphasized in the healthcare industry all over the world. This paper aims to examine contemporary healthcare development in the Kingdom of Saudi Arabia (KSA) and prescribe four essential policy dimensions to its leadership, depicting the imperative needs for direction, integration, revision, and evidence – the “DIRE needs” approach.

The paper reviews literature on the contemporary KSA health system and provides guidelines for policy reforms vis‐à‐vis the emerging challenges.

First, the paper offers a conceptual model to examine the ongoing and future health policy development of the KSA. It identifies four key policy dimensions – direction, integration, revision, and evidence and links these to the scope of broader health sector reforms. Second, it characterizes these dimensions as key initiatives for health resource capacity and infrastructural development, essentially the primary health care, which need to be taken up by KSA mainstream health services leadership. Third, it underlines the importance of integrating institutional research and information systems for evidence‐based policy‐making and practicable implementation. Fourth, it offers a social science research perspective to the need for multi‐dimensional health policy reforms in the KSA.

This paper opens up KSA health leadership initiatives that may be viewed as the DIRE needs, to be mainstreamed in the domains of policy and strategic planning, research and development, and healthcare management practices.

Social research in KSA health policy and planning is rare. This paper introduces a context‐specific multi‐dimensional model that provides critical insights into challenges and complexities that the Saudi health leadership must attend to. It defines a set of four essential benchmarking dimensions for guiding future policy reforms.

The purpose of this paper is to explore involving doctors in shared leadership. It examines the policies that have led to the focus on shared leadership and the implications for practice.

This is a conceptual paper, examining policy developments and key literature to understand the move towards shared leadership. It focuses on UK NHS, and in particular doctors, although the concepts will be relevant to other disciplines in healthcare, and healthcare systems in other countries.

This paper suggests that the shared-leadership approach for doctors has potential given the nature of clinical practice, the inherently collaborative nature of healthcare and the demands of new healthcare organisations. Health policy reform, generally, will mean that all doctors need to be engaged with leadership, albeit, perhaps, at different levels, and with different degrees of formality. Leadership will remain an important precondition for the success of the reforms. This is likely to be the case for other countries involved in healthcare reform.

To highlight the benefits and barriers to shared leadership for doctors.

Offers an alternative to traditional approaches to leadership.

The purpose of this paper is to explore work motivation among professionals at well-functioning primary healthcare centers subject to a national healthcare reform which include financial incentives.

Five primary healthcare centers in Sweden were purposively selected for being well-operated and representing public/private and small/large units. In total, 43 interviews were completed with different medical professions and qualitative deductive content analysis was conducted.

Work motivation exists for professionals when their individual goals are aligned with the organizational goals and the design of the reform. The centers’ positive management was due to a unique combination of factors, such as clear direction of goals, a culture of non-hierarchical collaboration, and systematic quality improvement work. The financial incentives need to be translated in terms of quality patient care to provide clear direction for the professionals. Social processes where professionals work together as cohesive groups, and provided space for quality improvement work is pivotal in addressing how alignment is created.

Leaders need to consistently translate and integrate reforms with the professionals’ drives and values. This is done by encouraging participation through teamwork, time for structured reflection, and quality improvement work.

The design of the reforms and leadership are essential preconditions for work motivation.

The study offers a more complete picture of how reforms are managed at primary healthcare centers, as different medical professionals are included. The value also consists of showing how a range of aspects combine for primary healthcare professionals to successfully manage external reforms.