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The degree of remote working has increased in the health-care sector, but remote leadership in health-care contexts has not been systematically studied. Thus, the purpose of this review was to map existing literature and research themes of remote leadership in health care and identify potential research gaps to guide future studies.

A scoping review with narrative synthesis was conducted, covering all published literature addressing remote, virtual, online or distance leadership practices. The ABI/INFORM Collection, CINALH, PsycArticles, Scopus and Web of Science, MedNar, Open Grey and PQDT Open databases were searched electronically, and Finnish Journal of eHealth and eWelfare was searched manually.

In total 15 articles were included in the review. Most literature concerning remote leadership in health care has been published during the past three decades. The main themes discerned in this research stream are related to interactions, work environments, leadership in practice, use of technology and needs for more study of remote leadership and guidance for remote leaders.

Research on remote leadership in health care is limited, patchy and associated concepts vary substantially. More comprehensive research on the phenomenon is needed, with more systematic attention to, and coverage of, relevant populations, concepts, contexts and the identified themes.

To the best of the authors’ knowledge, this appears to be the first review to map research on remote leadership in health care and identify research gaps, which is important as its prevalence has rapidly increased.

The purpose of this paper is to examine the supportive aspects of a team approach for a remote mental health team that report high stability in senior clinical roles, in a region where voluntary turnover is typically high.

This qualitative research study examines the reflections of team members on their role and job characteristics through informal semi-structured interviews.

The extant themes identified as supportive aspects of the team approach included engagement and both personal and professional support. The intrinsic role of support in remote work environments, and the impact of intrinsic job satisfaction through client-focussed practices further supported low turnover, improved stability and consistency of service provision.

Continued support for existing experienced health professionals will contribute to workforce stability in remote regions where needs are complex and continuity of care is improved by consistent, reliable services. With health professionals working in remote Australia reporting high levels of job satisfaction; it follows that the next steps involve minimising dissatisfaction through effective workforce support mechanisms. Health professionals already working in remote regions, suggest that this is about engagement and personal and professional support through flexible work systems. While the findings of this study may not be generalisable, the authors suggest that these supportive aspects are transferable to other multi-disciplinary team settings.

This conceptual article outlines the known effects of employee monitoring on employees who are working remotely. Potential implications, as well as practitioner suggestions, are outlined to identify how practitioners can create more supportive employee experiences as well as apply these to workplace health management scenarios.

This overview is based on a selective and practically oriented review of articles that hitherto considered the health implications of remote workers being monitored electronically over the last two years. This overview is subsequently complemented by a discussion of more recent findings that outline the potential implications of monitoring for remote employees, employees' work experience and workplace health management.

Several practitioner-oriented suggestions are outlined that can pave the way to a more supportive employee experience for remote workers, who are monitored electronically by their employers. These include the various health and social interventions, greater managerial awareness about factors that influence well-being and more collaboration with health professionals to design interventions and new workplace policies. Organizations would also benefit from using audits and data analytics from monitoring tools to inform their interventions, while a rethink about work design, as well as organizational reviews of performance and working conditions further represent useful options to identify and set up the right conditions that foster both performance as well as employee well-being.

The article outlines practitioner-oriented suggestions that can directly and indirectly support employee well-being by recognizing the various factors that affect performance and experience.

The mental and physical health of those residing in Australian rural and remote communities is poorer compared to major cities. Physical health comorbidities contribute to almost 80% of premature mortality for people living with mental illness. Leisure time physical activity (LTPA) is a well-established intervention to improve physical and mental health. To address the physical and mental health of rural and remote communities through LTPA, the community’s level of readiness should be first determined. This study aims to use the community readiness model (CRM) to explore community readiness in a remote Australian community to address mental health through LTPA.

Individual semi-structured interviews were conducted using the CRM on LTPA to address mental health. Quantitative outcomes scored the community’s stage of readiness for LTPA programmes to address mental health using the CRM categories of one (no awareness) to nine (high level of community ownership). Qualitative outcomes were thematically analysed, guided by Braun and Clark.

The community scored six (initiation) for community efforts and knowledge of LTPA programmes and seven (stabilisation) for leadership. The community’s attitude towards LTPA and resources for programmes scored four (pre-planning), and knowledge of LTPA scored three (vague awareness).

To the best of the authors’ knowledge, this is the first Australian study to use CRM to examine community readiness to use LTPA to improve mental health in a remote community. The CRM was shown to be a useful tool to identify factors for intervention design that might optimise community empowerment in using LTPA to improve mental health at the community level.

This paper seeks to present findings from a study soliciting the perspectives of child and youth mental health clinicians practising in rural/remote settings in British Columbia, Canada. Satisfaction is assessed in four areas: lifestyle, practice, preparation for practice, and fit of organizational standards.

An online survey using a variety of closed and open‐ended questions was administered to clinicians practising in four distinct settings: small rural, large rural, small remote, and large remote. Closed questions were analyzed using SPSS 17.0 while open ended questions were analyzed using manual open and axial coding.

Findings indicate moderate to high levels of satisfaction in all areas. Satisfaction with rural lifestyle and professional practice was strongest for clinicians recruited from within the community. However, clinicians from small remote communities indicated much lower levels of satisfaction in all four areas.

The study underscores the importance of understanding the diversity of rural practice settings in mental health workforce development. In particular it highlights the need for greater attention to evidence based approaches to support mental health practitioners in small remote settings.

Retention of medical doctors and nurses in remote and rural areas is a key issue in India. The purpose of this paper is to assess the relevant policies and provisions with respect to health care professionals, aiming to develop feasible retention strategies in rural areas of Odisha state of India.

The study employed documentary review and key informant interviews with policy elites (health planners, policy maker, researchers, etc.). The document review included published and unpublished reports, policy notifications and articles on human resources for health (HRH) in Odisha and similar settings. Throughout the study, the authors adapted World Health Organization’s framework to study policies relevant to HRH retention in rural areas. The adapted framework comprised of the four policy domains, education, regulation, financial incentives, professional and personal support, and 16 recommendations.

In Odisha, the district quota system for admission is not practiced; however, students from special tribal and caste (Scheduled Tribe and Scheduled Caste) communities, Socially and Educationally Backward Classes of citizens, and Persons with Disabilities have some allocated quota to study medicine and nursing. Medical education has a provision of community placement in rural hospitals. In government jobs, the newly recruited medical doctors serve a minimum of three years in rural areas. Doctors are given with location-based incentives to work in remote and difficult areas. The government has career development, deployment, and promotion avenues for doctors and nurses; however, these provisions are not implemented effectively.

The government could address the rural retention problems, as illustrated in the study and put in place the most effective policies and provisions toward recruitment, deployment and attraction of HRH in remote and rural areas. At the same time, implementation HRH strategies and activities must be rigorously monitored and evaluated effectively.

There is an increasing interest in using information and communication technologies to support health services. But the adoption and development of even basic ICT communications services in many health services is limited, leaving enormous gaps in the broad understanding of its role in health care delivery. The purpose of this paper is to address a specific (intercultural) area of healthcare communications consumer disadvantage; and it examines the potential for ICT exploitation through the lens of a conceptual framework. The opportunity to pursue a new solutions pathway has been amplified in recent times through the development of computer-based ontologies and the resultant knowledge from ontologist activity and consequential research publishing.

A specific intercultural area of patient disadvantage arises from variations in meaning and understanding of patient and clinician words, phrases and non-verbal expression. Collection and localization of data concepts, their attributes and individual instances were gathered from an Aboriginal trainee nurse focus group and from a qualitative gap analysis (QGA) of 130 criteria-selected sources of literature. These concepts, their relationships and semantic interpretations populate the computer ontology. The ontology mapping involves two domains, namely, Aboriginal English (AE) and Type II diabetes care guidelines. This is preparatory to development of the Patient Practitioner Assistive Communications (PPAC) system for Aboriginal rural and remote patient primary care.

The combined QGA and focus group output reported has served to illustrate the call for three important drivers of change. First, there is no evidence to contradict the hypothesis that patient-practitioner interview encounters for many Australian Aboriginal patients and wellbeing outcomes are unsatisfactory at best. Second, there is a potent need for cultural competence knowledge and practice uptake on the part of health care providers; and third, the key contributory component to determine success or failures within healthcare for ethnic minorities is communication. Communication, however, can only be of value in health care if in practice it supports shared cognition; and mutual cognition is rarely achievable when biopsychosocial and other cultural worldview differences go unchallenged.

There has been no direct engagement with remote Aboriginal communities in this work to date. The authors have initially been able to rely upon a cohort of both Indigenous and non-Indigenous people with relevant cultural expertise and extended family relationships. Among these advisers are health care practitioners, academics, trainers, Aboriginal education researchers and workshop attendees. It must therefore be acknowledged that as is the case with the QGA, the majority of the concept data is from third parties. The authors have also discovered that urban influences and cultural sensitivities tend to reduce the extent of, and opportunity to, witness AE usage, thereby limiting the ability to capture more examples of code-switching. Although the PPAC system concept is qualitatively well developed, pending future work planned for rural and remote community engagement the authors presently regard the work as mostly allied to a hypothesis on ontology-driven communications. The concept data population of the AE home talk/health talk ontology has not yet reached a quantitative critical mass to justify application design model engineering and real-world testing.

Computer ontologies avail us of the opportunity to use assistive communications technology applications as a dynamic support system to elevate the pragmatic experience of health care consultations for both patients and practitioners. The human-machine interactive development and use of such applications is required just to keep pace with increasing demand for healthcare and the growing health knowledge transfer environment. In an age when the worldwide web, communications devices and social media avail us of opportunities to confront the barriers described the authors have begun the first construction of a merged schema for two domains that already have a seemingly intractable negative connection. Through the ontology discipline of building syntactically and semantically robust and accessible concepts; explicit conceptual relationships; and annotative context-oriented guidance; the authors are working towards addressing health literacy and wellbeing outcome deficiencies of benefit to the broader communities of disadvantage patients.

Some of Australia’s most severe and protracted workforce shortages are in public sector community mental health (CMH) services. Research identifying the factors affecting staff turnover of this workforce has been limited. The purpose of this paper is to identify work factors negatively affecting the job satisfaction of early career health professionals working in rural Australia’s public sector CMH services.

In total, 25 health professionals working in rural and remote CMH services in New South Wales (NSW), Australia, for NSW Health participated in in-depth, semi-structured interviews.

The study identified five work-related challenges negatively affecting job satisfaction: developing a profession-specific identity; providing quality multidisciplinary care; working in a resource-constrained service environment; working with a demanding client group; and managing personal and professional boundaries.

These findings highlight the need to provide time-critical supports to address the challenges facing rural-based CMH professionals in their early career years in order to maximise job satisfaction and reduce avoidable turnover.

Overall, the study found that the factors negatively affecting the job satisfaction of early career rural-based CMH professionals affects all professionals working in rural CMH, and these negative effects increase with service remoteness. For those in early career, having to simultaneously deal with significant rural health and sector-specific constraints and professional challenges has a negative multiplier effect on their job satisfaction. It is this phenomenon that likely explains the high levels of job dissatisfaction and turnover found among Australia’s rural-based early career CMH professionals. By understanding these multiple and simultaneous pressures on rural-based early career CMH professionals, public health services and governments involved in addressing rural mental health workforce issues will be better able to identify and implement time-critical supports for this cohort of workers. These findings and proposed strategies potentially have relevance beyond Australia’s rural CMH workforce to Australia’s broader early career nursing and allied health rural workforce as well as internationally for other countries that have a similar physical geography and health system.

This study seeks to undertake a systematic review to consolidate existing empirical evidence on the impact of financial and non‐financial incentives on motivation and retention of health workers in Ghana's district hospitals.

The study employed a purely quantitative design with a sample of 285 health workers from ten district hospitals in four regions of Ghana. A stepwise regression model was used in the analysis.

The study found that financial incentives significantly influence motivation and intention to remain in the district hospital. Further, of the four factor model of the non‐financial incentives, only three (leadership skill and supervision, opportunities for continuing professional development and availability of infrastructure and resources) were predictors of motivation and retention.

A major limitation of the study is that the sample of health workers was biased towards nurses (n=160; 56.1 percent). This is explained by their large presence in remote districts in Ghana. A qualitative approach could enrich the findings by bringing out the many complex views of health workers regarding issues of motivation and retention, since quantitative studies are better applied to establish causal relationships.

The findings suggest that appropriate legislations backing salary supplements, commitment‐based bonus payments with a set of internal regulations and leadership with sound managerial qualities are required to pursue workforce retention in district hospitals.

Education, training and continuing professional development are amongst the evidence-based initiatives for attracting and retaining rural and remote health professionals. With rapidly increasing access to and use of digital technology worldwide, there are new opportunities to leverage training and support for those who are working in rural and remote areas. In this paper we determine the key elements associated with the utility of digital technologies to provide education, training, professional learning and support for rural health workforce outside the University and tertiary sector.

A scoping review of peer-reviewed literature from Australia, Canada, US and New Zealand was conducted in four bibliographic databases – Medline complete, CINAHL, Academic Search complete and Education Complete. Relevant studies published between January 2010 and September 2020 were identified. The Levac et al. (2010) enhanced methodology of the Arksey and O'Malley (2005) framework was used to analyse the literature.

The literature suggests there is mounting evidence demonstrating the potential for online platforms to address the challenges of rural health professional practice and the tyranny of distance. After analysing 22 publications, seven main themes were found – Knowledge and skills (n = 13), access (n = 10), information technology (n = 7), translation of knowledge into practice (n = 6), empowerment and confidence (n = 5), engagement (n = 5) and the need for support (n = 5). Ongoing evaluation will be critical to explore new opportunities for digital technology to demonstrate enhanced capability and retention of rural health professionals.

To date there has been limited examination of research that addresses the value of digital platforms on continuing professional development, education and support for rural health professionals outside the university and tertiary training sectors.