Guidance for management competency identification and development in the health context: a systematic scoping review

BACKGROUND

Using management competency-based frameworks to guide developing and delivering training and formal education to managers has been increasingly recognized as a key strategy in building management capacity. Hence, interest in identifying and confirming the competency requirements in various contexts have been witnessed. Therefore, learnings from how competency studies were designed and conducted, how competencies were identified, and strategies in ensuring success in competency identification are of great value to researchers planning and conducting competency studies in their own country.

METHODS

A scoping review was conducted guided by the Arksey and O'Malley framework and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). All papers that published empirical studies aiming at identifying and assessing manager's competencies at the peer-reviewed journals were identified from Web of sciences, PubMed, Scopus and Emerald Management between 2000 and 2021. In order to maximize learning, studies focusing on health and non-health sectors are all included.

RESULTS

In total, 186 studies were included in the review including slightly more than half of the studies conducted in health sector (54.5%). 60% of the studies focused on mid to senior level managers. Surveys and Interviews were the two most commonly used methods either solely or as part of the mix-method in the studies. Half of the studies used mixed methods approach (51.1%). Large proportion of the papers failed to include all information that is necessary to contribute to learning and improvement in future study design. Based on the results of the scoping review a four steps framework was developed that can guide designing and implementing management competency studies in specific country vs. sector context and to ensure benefits of the studies are maximised.

CONCLUSION

The review confirmed the increasing trend in investing in management competency studies and that the management competency identification and development process varied substantially, in the choice of methods and processes. The identification of missing information in majority of the published studies calls for the development of more rigorous guidelines for the peer-review process of journal publications. The proposed framework of improving the quality and impact of the future management competency study provides clear guidance to management competency identification and development that promotes the functional alignment of methods and strategies with intended uses and contexts.

Competencies of hospital managers - A systematic scoping review

Hospital managers around the world work under constant pressure to adapt their organizations to new challenges and health policy goals. This requires a comprehensive set of competencies. The objective of this scoping review was to identify, map, and systematize the literature on hospital manager competencies. The review involved six steps: (1) defining research questions; (2) identifying relevant literature; (3) selecting publications; (4) data extraction; (5) data analysis and result reporting; and (6) consultations. A total of 57 full-text publications were included (46 empirical studies, six literature reviews, four expert opinions/guidelines, and one dissertation). Interest in this topic has grown in recent years, with most of the identified studies published since 2015. The empirical studies fall into three major groups: 34.8% (16/46) examined hospital managers' competencies in terms of their types or classifications; 30.4% (14/46) focused on their measurement; and 30.4% (14/46) examined both aspects. In majority of studies, both 'hard competencies,' such as specific technical knowledge or skills acquired through practical training, and 'soft competencies,' e.g., adaptability, leadership, communication, teamwork, are echoed for effective hospital management. These point out the importance of both 'external' formal education trainings as well as 'internal' peer-support and/or coaching as complementary competency improvement approaches. This scoping review helps build a knowledge base around the topic and provides implications for future research. The latter can involve: a targeted systematic review addressing the methods for measuring the level of competence of hospital managers or studies focused on identifying the need for new types of competencies.

Leadership Theories and the Veterinary Health Care System

This descriptive review aims to illustrate the different leadership theories as they may apply to the veterinary health care sector, and specifically, to the affection and sports animal subsectors. The increasing and ever-changing challenges veterinary health care operators and investors operating in these subsectors face are briefly described, as well as the most known leadership theories and styles, each with its possible advantages and disadvantages specific to its application to the veterinary health care system. The different theories are illustrated in their key aspects and their historical evolution. Finally, the discussion focuses on transformational leadership as it is seen as the most progressive and promising leadership style to hold up to said challenges in the veterinary health care system.

Differentiating between average and high-performing public healthcare managers: implications for public sector talent management

Objective Ensuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual and organisational performance, there have been few studies exploring these concepts in the public healthcare sector. This study addresses this gap by exploring the perceived differences in demonstration of core competencies between average and higher-performing managers in public sector healthcare organisations. Methods Mixed methods were used to define and measure a set of competencies for health service managers. In addition, supervisors of managers were asked to identify the differences in competence between the average and high-performing managers reporting to them. Results Supervisors could clearly distinguish between average and higher-performing managers and identified related competencies. Conclusions The consistent pattern of competence among community health and hospital public sector managers demonstrated by this study could be used to develop a strategic approach to talent management for the public healthcare sector in Australia. What is known about this topic? Although there are validated competency frameworks for health service managers, they are rarely used in practice in Australia. What does this paper add? This paper illustrates the perceived differences in competencies between top and average health services managers using a validated framework. What are the implications for practitioners? The public health sector could work together to provide a more effective and efficient approach to talent management for public hospitals and community health services.

Leadership and management competencies required for Bhutanese primary health care managers in reforming the district health system

OBJECTIVE

This study aims to identify the required management competencies, current competency levels, and strategies for improving the management competencies of Bhutanese primary health care (PHC) managers.

METHODS

A quantitative method with a cross-sectional survey using self-administered questionnaires. This study recruited 339 PHC managers across Bhutan. The data were analyzed using statistical software.

RESULTS

This study identified three competency domains and seven key sub-domain competencies. People domain was perceived to be the highest required competency with a mean score of 4.2376, followed by execution (4.1851), and the transformation (4.0501) domains. For the seven key sub-domains, the communication sub-domain (4.3220) was perceived as the highest required competency, followed by professionalism (4.2967), managing change (4.1776), relationship building (4.1686), analytical thinking (4.1091), leadership (4.0980), and innovative thinking (3.9794). The current competency levels of PHC managers in domains and sub-domain competencies were the people domain (3.7322), execution (3.6471), and the transformation (3.5554). For the sub-domains, communication (3.8092), professionalism (3.7939), relationship building (3.6603), analytical thinking (3.6396), leadership (3.5805), managing change (3.5723), and innovative thinking (3.4543).

CONCLUSION

Findings of Bhutan health managers' competencies are consistent with the findings of other international contexts. This study suggests that agencies responsible for health system need to focus more on the competencies defined by the study to positively influence health leadership and management development interventions.

An evidence-based approach to understanding the competency development needs of the health service management workforce in Australia

BACKGROUND

Competent managers are essential to the productivity of organisations and the sustainability of health systems. Effective workforce development strategies sensitive to the current competency development needs of health service managers (HSMs) are required.

PURPOSE

To conduct a 360° assessment of the competence of Australian HSMs to identify managerial competence levels, and training and development needs.

METHODS

Assessment of 93 middle-level HSMs from two public hospitals (n = 25) and five community health services (CHS) (n = 68), using the Managerial Competency Assessment Partnership (MCAP) framework and tool, conducted between 2012 and 2014 in Victoria, Australia.

RESULTS

Mean competency scores from both self- and combined colleagues' assessments indicated competence (scores greater than five but less than six) without guidance, but many HSMs have not had extensive experience. Around 12% of HSMs were unable to demonstrate the competency of 'evidence-informed decision-making' and 4% of HSMs were unable to demonstrate the competency of 'enabling and managing change'.

CONCLUSION

The assessments confirmed managerial competence for the majority of middle-level HSMs from hospitals and CHS in Victoria, but found competency gaps. In addition, the assessment confirmed managerial strengths and weaknesses varied across management groups from different organisations. These findings suggest that the development of strategies to strengthen the health service management workforce should be multifaceted.

PRACTICE IMPLICATIONS

A focus on competency in performance evaluation and development using the MCAP framework and tool not only provides insights into performance of HSMs, but also has the potential to provide an organisation strategic advantage through succession planning and advancing managers' competence via learning needs analysis and targeted professional development. Linking competencies of HSMs to organisational objectives and strategies provides optimal use of the human resource capacity, improving the organisation's productivity and sustainability.

Development and validation of health service management competencies

Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to introduce a validated process in management competency identification and development applied in Australia - a process leading to a management competency framework with associated behavioural items that can be used to measure core management competencies of health service managers. Design/methodology/approach The management competency framework development study incorporated both qualitative and quantitative methods, implemented in four stages, including job description analysis, focus group discussions and online surveys. Findings The study confirmed that the four-stage process could identify management competencies and the framework developed is considered reliable and valid for developing a management competency assessment tool that can measure management competence amongst managers in health organisations. In addition, supervisors of health service managers could use the framework to distinguish perceived superior and average performers among managers in health organisations. Practical implications Developing the core competencies of health service managers is important for management performance improvement and talent management. The six core management competencies identified can be used to guide the design professional development activities for health service managers. Originality/value The validated management competency identification and development process can be applied in other countries and different industrial contexts to identify core management competency requirements.

What makes a hospital manager competent at the middle and senior levels?

Objective. The purpose of this paper is to confirm the core competencies required for middle to senior level managers in Victorian public hospitals in both metropolitan and regional/rural areas. Methods. This exploratory mixed-methods study used a three-step approach which included position description content analysis, focus group discussions and online competency verification and identification survey. Results. The study validated a number of key tasks required for senior and middle level hospital managers (levels II, III and IV) and identified and confirmed the essential competencies for completing these key tasks effectively. As a result, six core competencies have been confirmed as common to the II, III and IV management levels in both the Melbourne metropolitan and regional/rural areas. Conclusions. Six core competencies are required for middle to senior level managers in public hospitals which provide guidance to the further development of the competency-based educational approach for training the current management workforce and preparing future health service managers. With the detailed descriptions of the six core competencies, healthcare organisations and training institutions will be able to assess the competency gaps and managerial training needs of current health service managers and develop training programs accordingly. What is known about the topic? A competent health service management workforce is critical to the effective functioning of the healthcare system. Consequently, a competency-based educational approach has been proposed to prepare current and future health professionals including health service managers. Although the literature has suggested that core competencies exist for different management levels in different healthcare settings, there has been no study which has provided valuable data to indicate what the core competencies are for hospitals managers in Australian public hospitals. What does this paper add? This paper identified and confirmed that six core competencies are common to middle to senior level managers (levels II-IV) in Victorian public hospitals in both Melbourne metropolitan and regional/rural areas. What are the implications for practitioners? The findings of the study is the first step towards supporting the competency-based educational approach for training and preparing current and future health service managers for their roles. The six identified core competencies provide a very useful guide to the identification of competency gaps and managerial training needs, and the further development of the health service management training curriculum.