Perspectives on healthcare leader and leadership development (original) (raw)
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Complex Leadership in Healthcare: A Scoping Review
2018
Background: Nowadays, health systems are generally acknowledged to be complex social systems. Consequently, scholars, academics, practitioners, and policy-makers are exploring how to adopt a complexity perspective in health policy and system research. While leadership and complexity has been studied extensively outside health, the implications of complexity theories for the study of leadership in healthcare have received limited attention. We carried out a scoping review of complex leadership (CL) in healthcare to investigate how CL in healthcare has been defined, theorised and conceptualised and to explore how 'CL' has been applied in healthcare settings. Methods: We followed the methodological steps proposed by : (1) specifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating and summarizing the findings, and (6) reporting the results. We searched using Medline, Psychinfo, Wiley online library, and Google Scholar. Our inclusion criteria were: publication type (peer reviewed articles, theses, and book chapters); phenomenon of interest: complex leadership; context: healthcare and period of publication: between 2000 and 2016. Results: Our search and selection resulted in 37 papers (16 conceptual papers, 14 empirical studies and 7 advocacy papers). We note that empirical studies on CL are few and almost all research reported by these papers was carried out in the North (mainly in USA and UK). We found that there is some variation in definitions of CL. Furthermore, the research papers adopt mostly an explorative or explanatory approach and do not focus on assessing effectiveness of CL approaches. Finally, we found that the majority of researchers seem to adhere to the mathematical complexity perspective. Conclusion: Complexity concepts derived from natural sciences may not automatically fit management of health services. Further research into how social complexity theories may offer researchers useful grounds to empirically test CL theories in health settings is warranted. Specific attention should be paid to the multi-layered nature of leadership.
Complex Leadership in Healthcare: A Scoping Review Scoping Review
Background: Nowadays, health systems are generally acknowledged to be complex social systems. Consequently, scholars, academics, practitioners, and policy-makers are exploring how to adopt a complexity perspective in health policy and system research. While leadership and complexity has been studied extensively outside health, the implications of complexity theories for the study of leadership in healthcare have received limited attention. We carried out a scoping review of complex leadership (CL) in healthcare to investigate how CL in healthcare has been defined, theorised and conceptualised and to explore how 'CL' has been applied in healthcare settings. Methods: We followed the methodological steps proposed by : (1) specifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating and summarizing the findings, and (6) reporting the results. We searched using Medline, Psychinfo, Wiley online library, and Google Scholar. Our inclusion criteria were: publication type (peer reviewed articles, theses, and book chapters); phenomenon of interest: complex leadership; context: healthcare and period of publication: between 2000 and 2016. Results: Our search and selection resulted in 37 papers (16 conceptual papers, 14 empirical studies and 7 advocacy papers). We note that empirical studies on CL are few and almost all research reported by these papers was carried out in the North (mainly in USA and UK). We found that there is some variation in definitions of CL. Furthermore, the research papers adopt mostly an explorative or explanatory approach and do not focus on assessing effectiveness of CL approaches. Finally, we found that the majority of researchers seem to adhere to the mathematical complexity perspective. Conclusion: Complexity concepts derived from natural sciences may not automatically fit management of health services. Further research into how social complexity theories may offer researchers useful grounds to empirically test CL theories in health settings is warranted. Specific attention should be paid to the multi-layered nature of leadership.
Health care leadership in an age of change
Australian Health Review, 2003
This study examined the leadership practices of a sample of network and hospital administrators in metropolitan Victoria, Australia. It was undertaken in the mid-1990s when the State Liberal-National (Coalition) Government in Victoria established Melbourne's metropolitan health care networks. I argue that leadership,and the process of leading, contributes significantly to the success of the hospital in a time of turmoil and change.The sample was taken from the seven health care networks and consisted of 15 network and hospital administrators. Bolman and Deal's frames of leadership - structural, human resource, political and symbolic - were used as a framework to categorize the leadership practices of the administrators. The findings suggest a preference for the structural frame - an anticipated result, since the hospital environment is more conducive to a style of leadership that emphasizes rationality and objectivity. The human resource frame was the second preferred frame,...
Leadership development in complex health systems: a qualitative study
BMJ Open, 2020
Objective Leadership is associated with organisational performance in healthcare, including quality, safety and clinical outcomes for patients. Leadership development programmes have proliferated in recent years. Nevertheless, very few have examined participant experiences in depth in order to understand which programmatic aspects they regard as most valuable relative to leadership in increasingly complex systems, or whether and how learnings may sustain over time. Accordingly, we explored experiences of participants in an interdisciplinary leadership development programme using qualitative methods over an extended look-back period. Setting Health and social care sectors in the UK. Participants Key informants from three cohorts of individuals working in leadership roles in health and social care in the UK: 2013/2014, 2015/2016 and 2017/2018. We contacted 32 participants, and 26 completed interviews (81% response rate). Primary and secondary outcomes We explored (1) whether and how s...
Developing leaders and leadership in health care: a case for rebalancing
Leadership in Health Services, 2011
Purpose -The paper aims to describe the emerging critique of leader development in health care and to describe an alternative approach. Design/methodology/approach -The paper explores the growing critique of leader development, highlighting the concentration on the development of individual human capital. The creation of social capital through an emphasis on leadership development is explained. Design principles and potential obstacles are identified. Findings -A rebalancing of the field from an over-concentration on the development of individual leaders to an emphasis on context and relationships is necessary. Practical implications -Although the basic building-blocks of development will remain the same, there is a need to rebalance them towards leadership rather than leaders. Originality/value -The paper brings together in one place various strands of concern over leader development in health care and makes a case for change.
2014
There is a trend in health systems around the world to place great emphasis on and faith in improving ‘leadership’. Leadership has been defined in many ways and the elitist implications of traditional notions of leadership sit uncomfortably with modern healthcare organisations. The concept of distributed leadership incorporates inclusivity, collectiveness and collaboration, with the result that, to some extent, all staff, not just those in senior management roles, are viewed as leaders. Leadership development programmes are intended to equip individuals to improve leadership skills, but we know little about their effectiveness. Furthermore, the content of these programmes varies widely and the fact that many lack a sense of how they fit with individual or organisational goals raises questions about how they are intended to achieve their aims. It is important to avoid simplistic assumptions about the ability of improved leadership to solve complex problems. It is also important to evaluate leadership development programmes in ways that go beyond descriptive accounts.
Unlocking medical leadership’s potential: a multilevel virtuous circle?
BMJ Leader
Background and aim Medical leadership (ML) has been introduced in many countries, promising to support healthcare services improvement and help further system reform through effective leadership behaviours. Despite some evidence of its success, such lofty promises remain unfulfilled.Method Couched in extant international literature, this paper provides a conceptual framework to analyse ML’s potential in the context of healthcare’s complex, multifaceted setting.Results We identify four interrelated levels of analysis, or domains, that influence ML’s potential to transform healthcare delivery. These are the healthcare ecosystem domain, the professional domain, the organisational domain and the individual doctor domain. We discuss the tensions between the various actors working in and across these domains and argue that greater multilevel and multistakeholder collaborative working in healthcare is necessary to reprofessionalise and transform healthcare ecosystems.
Theories of Leadership in Healthcare Sector, a Critical Review
Background: Hospitals and health service organizations in general operate in a peculiar environment in which leadership is divided into different executives, not only based on their position in the hierarchy structure, but also based on the prestige and special power of this category of employees and especially medical doctors. Leadership refers to the processes by which an individual (the leader) influences the behavior and actions of other individuals in order to achieve certain desired goals. Materials and Methods: The aim of the present work was to review the basic theories of leadership in the field of healthcare sector, to critically mention the advantages and disadvantages off their application as well as to present some examples based on leadership theories in the field of healthcare sector. Results: Theoretical approaches in leadership include both classical and modern theories. Classical theories include trait theory, behavioral theories, and dependency theories. The major modern theories include quantum leadership, transactional leadership, transformational leadership, shared leadership, and service leadership. Conclusion: Many leaders simply try to guide their staff to a specific goal, while others simply succeed without convincing employees of the value of their effort. Theoretical approaches configure and support the image of a flexible leader in healthcare sector who has the ability to learn and adapt into different demanding situations.
Leadership in Nursing and Health Care in the Light of Complexity Thinking
Revista Da Escola De Enfermagem Da Usp, 2022
This study aims to perform a critical-reflective analysis of leadership in nursing and health in the light of complexity thinking. This is a theoretical-reflexive essay based on the framework of complexity thinking. A parallel is conceived between traditional Cartesian leadership, outlined from a defined linear hierarchical structure, and leadership from a systemic-complex perspective. A schematic structure is demonstrated between the pyramidal conception and systemiccomplex leadership, leading to circularity, complementarity, interdependence, and interactivity. Leadership's central role in nursing and health care is reaffirmed based on interactive, dialogic, and interdependent movements. The theoretical reflection calls for evolutionary and shared leadership in nursing and health, determined by the quality of interactions between members and different systems, in order to respond to the complexity of health phenomena quickly, effectively, and sustainably.
The Aspects of Shared Leadership in Health Care
SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference, 2018
Leadership is overwhelming the thinking of contemporary society. A well-functioning organization is first identified with its leader very often. Therefore, it is very important to question the attitude of leadership constantly, not to devalue it, but to understand it better and realize it. Moreover, the expression of leadership in different organizations is very distinct, and its specificity in areas such as health care is still insufficiently explored. Healthcare organizations hold strict hierarchy, therefore leadership is considered as equal to the administrative position. Modern conceptualizations such as transactional, shared, authentic and other leadership theories point to the educational power of a leadership; however, implementation remains challenging. The article presents the analytical-theoretical point of view and interpretive approach for case study about leadership. Firstly, the article introduces research evidence analysis of leadership educational impact for integrat...