Hybridity enabled: A research synthesis of the enabling conditions for hybrid professionalism in healthcare

Hybrid professionals in healthcare organizations play a critical role, the characteristics, processes and implications of which have been thoroughly studied by scholars in the field. However, not as much attention has been paid to the conditions under which such roles might be taken by professionals entering the ground of management. This gap results into a lack of conceptual clarity and eventually ends being an obstacle in framing and ameliorating the tools needed to act such a role in its different phases. This is a research area worthy of a finer-grained understanding: the ability of organizations to effectively support role hybridization, in fact, is a requisite for professionals-managers' willingness to stay in the role and cope with the complexity that such a two-fold position entails, no matter what. Based on the results of a scoping literature review, this paper presents the enabling conditions for hybrid professionalism in healthcare, and proposes a classification of them into categories corresponding to different facets of hybrid role-taking: opportunities for interaction with management, tools supporting sense-making, and provision of delegation and autonomy. For each of these categories, organizational and management tools discussed in the literature are presented. The results of the study provide a road-map of the enabling conditions for hybrid professionalism that aims to be of practical convenience for managers and policy-makers in health care. Eventually, suggestions for organizational design and personnel management, as well as directions for further research, are highlighted.

Training needs assessment of hospital CEOs in a developing country: the example of Iran

BACKGROUND

It is essential to identify the necessary competencies of hospital CEOs in order to improve the quality and efficiency of services they provide. Expert leadership skills and competencies can have a significant impact on the success of an organization, benefiting both patients and staff. This study aimed to assess the competencies and training needs of hospital CEOs in Iran public hospitals.

METHODS

We conducted this cross-sectional analytical study through a self-assessment questionnaire, which was a web-based platform developed by the WHO country office in Iran, between July 2018 and September 2018. The questionnaire was completed by 180 hospital CEOs and included a core set of 81 items based on Assessing the Competency of Hospital CEO. These items were categorized into five superordinate categories: leadership, personality and quality of individual behavior, knowledge and business skills, social responsibility, and healthcare environment. In addition, we conducted focus groups with 30 hospital CEOs, supervisor assessments with 10 hospital managers, and interviews with 10 supervisors.

RESULTS

Of the 180 questionnaires distributed, 78% were returned, and most respondents were medical specialists. The need for leadership competencies such as individual behavior skills and change management received the highest priority. Most respondents required training in management skills, including financial management, governance, strategic thinking, quality improvement, and disaster management.

CONCLUSION

Providing needs-based education is crucial, especially in developing countries. In this study, leadership and strategic thinking were found to be the most needed competencies among hospital CEOs in Iran. These findings serve as reference points for developing countries with similar backgrounds and healthcare environments as Iran.

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.

A qualitative study of hospital clinical staff perceptions of their interactions with healthcare middle managers

PURPOSE

The authors explored clinical staff perceptions of their interactions with middle management and their experiences of the uncongeniality of their working environment.

DESIGN/METHODOLOGY/APPROACH

Semi-structured interviews of clinical staff from an Australian public health service's Emergency, Surgery and Psychiatry departments. Volunteer interview transcripts were inductively coded using a reflexive thematic content analysis.

FINDINGS

Of 73 interviews, 66 participants discussed their interactions with management. Most clinicians considered their interactions with middle management to be negative based on a violation of their expectations of support in the workplace. Collectively, these interactions formed the basis of clinical staff perceptions of management's lack of capacity and fit for the needs of staff to perform their roles.

PRACTICAL IMPLICATIONS

Strategies to improve management's fit with clinicians' needs may be beneficial for reducing uncongenial workplaces for healthcare staff and enhanced patient care.

ORIGINALITY/VALUE

This article is among the few papers that discuss interactions with management from the perspective of clinical staff in healthcare. How these perspectives inform the perception of workplace uncongeniality for clinicians contributes greater understanding of the factors contributing to adversarial relationships between clinicians and managers.

Developing competent public hospital managers: a qualitative study from Iran

Purpose

Hospitals need highly trained and competent managers to be responsible for the strategic development, overall operation and service provision. The identification and confirmation of core management competency requirements is a fundamental first step towards developing the competent management workforce for sustainable hospital service provision. This paper reports on the finding of a recent study focusing on identifying managerial competencies required by middle and senior-level managers in the public hospitals in Iran.

Design/methodology/approach

The qualitative research design included position description analysis and focus group discussions with middle and senior-level public hospital managers in Iran. When analysing the identified knowledge, skills and attitudes, the validated MCAP framework was used to guide the grouping of them into associating management competencies.

Findings

The study identified 11 to 13 key tasks required by middle and senior-level managers and confirmed that the position descriptions used by current Iranian hospitals might not truly reflect the actual core responsibilities of the management positions. The study also confirmed seven core managerial competencies required to perform these tasks effectively. These core competencies included evidence-informed decision-making; operations, administration and resource management; knowledge of healthcare environment and the organisation; interpersonal, communication qualities and relationship management; leading people and organisation; enabling and managing change and professionalism.

Research limitations/implications

Competencies were identified based on managers' perceptions. Views and experiences of other stakeholders were not captured.

Practical implications

The seven core management competency identified in the current study provides a clear direction of competency development among senior and middle-level managers working at the Iranian public hospitals. The study also confirms that position descriptions do not reflect the actual responsibilities of current hospital managers, which are in need to urgent review.

Originality/value

This is the first study that has identified the core managerial competencies required by middle and senior-level hospital managers in Iran.

Managers in the publicly funded health services in China - characteristics and responsibilities

BACKGROUND

Health service managers are integral to supporting the effective and efficient delivery of services. Understanding their competencies is essential to support reform and improvement of healthcare provision in China. This paper examines the characteristics and educational background of senior managers working in the community health and hospital sectors in China. We also examine their levels of commitment to continued professional development and continuous education.

METHODS

A self-administered paper-based questionnaire was administered to 477 level I, II and III managers in community health services and public hospitals in China. The response rate was over 80%.

RESULTS

Findings demonstrate significant differences in terms of educational background and commitment to ongoing professional development between the managers in China across levels of management, and between the community and hospital sectors. Hospital managers tend to be older; hospital managers at higher management levels are predominantly male but predominantly female in the community health services. A greater proportion of hospital managers have postgraduate qualifications. In addition, the participants identified specific management tasks that they considered important.

CONCLUSIONS

This is the first large scale study examining the educational background and commitment to professional development of senior health service managers in China. This study determined that there are differences between the demographics of managers in China across levels of management, but more importantly between the CHC and the hospital sectors. The identification of important managerial tasks will facilitate the development of appropriate education and training for Chinese healthcare managers. All sectors and levels reported the need for informal education focussed on the core roles of developing organisation image and public relations, improving quality and safety of service provision and provision of leadership. Further research to explore the underlying reasons for the above differences is needed to design appropriate professional development for China's health services managers. In addition, the importance of managerial tasks across sectors and management levels requires further investigation.

Leadership and Management Competencies for Hospital Managers: A Systematic Review and Best-Fit Framework Synthesis

OBJECTIVE

Competent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system. To improve their management competence, understanding of management competency requirements is important. The purpose of this study was to synthesize the evidence related to the leadership and management competencies in healthcare organizations through the best-fit method.

METHODS

A systematic review of literature published between 2000 and 2020 was performed to identify studies focusing on confirming and/or identifying the competency requirements of hospital managers. The best-fit framework synthesis method was used to map the identified competencies and associated behavioral items against the validated management competency assessment program (MCAP) management competency framework.

RESULTS

Twelve studies were identified for inclusion in the review. The mapping of the identified competencies and behavioral items generated a competency model for hospital managers that can apply for different healthcare context. The new competency model includes the following seven core leadership and management competencies: evidence-informed decision-making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism.

CONCLUSION

This review and the mapping of the competencies identified in previous studies against the validated MCAP framework has resulted in the recommendation for an extended leadership and management competency framework for health service managers. It provides guidance for the formulation of training and development directions for the health service management workforce in a different healthcare context.

Developing senior hospital managers: does 'one size fit all'? - evidence from the evolving Chinese health system

Background

To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency.

Methods

A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n = 498) from three categories of hospital in Jinan, Shandong Province, China.

Results

The survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate. The core competencies identified in the Australia context were applicable to the management roles in Chinese hospitals. In addition, the senior executives had low levels of confidence in their management competence. Furthermore, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence.

Conclusions

The study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management.

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.

Are hospital managers ready for value-based healthcare?

Purpose

Hospital organisations are currently experiencing significant challenges that have encouraged a move towards a value-based approach to health care. However, such a transition requires understanding the underlying competencies required to enable such a focus. This paper aims to undertake a systematic review of the available literature on managerial competencies in hospitals and considers these in a value-based health-care context.

Design/methodology/approach

A systematic literature review was conducted to identify research studies that describe the characteristics of management competence in hospital environments.

Findings

Categories and sub-categories of management competence in hospitals were identified and considered in a value-based health-care context.

Research limitations/implications

The systematic literature review identifies a need for further research regarding managerial competencies of managers of hospitals. Competencies for managing in a value-based health-care model also require deeper investigation.

Practical implications

The categories of management competence provide guidance to organisations transitioning towards value-based health care in terms of identifying and developing management competencies. Hospitals should consider the development of a competency model that includes broader categories of competencies than purely clinical or professional competencies.

Originality/value

This study builds upon and advances previous reviews of management competence in hospitals, and the competency categories presented can be used as a basis to identify management competency requirements in hospitals.

A health management competency framework for Australia

ObjectiveThis study examined whether the management competency framework for health service managers developed in the Victorian healthcare context is applicable to managers in other Australian states. MethodsAn online questionnaire survey of senior and middle-level health service managers in both community health services and hospitals was conducted in New South Wales and Queensland. ResultsThe study confirmed that the essential tasks for senior and middle-level managers are consistent across health and social care sectors, as well as states. Core competencies for health services managers identified in the Victorian healthcare context are relevant to other Australian states. In addition, two additional competencies were incorporated into the framework. ConclusionThe Management Competency Assessment Program competency framework summarises six competencies and associated behaviours that may be useful for guiding performance management and the education and training development of health service managers in Australia. What is known about the topic?The evidence suggests that competency-based approaches can enhance performance and talent management, and inform education and training needs, yet there has been no validated competency framework for Australian health service managers. What does the paper add?This paper explains the process of the finalisation of the first management competency framework for guiding the identification of the training and development needs of Australian health service managers and the management of their performance. What are the implications for practice?The Management Competency Assessment Program competency framework can guide the development of the health service management workforce in three Australian states, and may be applicable to other jurisdictions. Further studies are required in the remaining jurisdictions to improve the external validity of the framework.

Developing Characteristics and Competences of a Health Care Manager: Literature Review

Broadly educated professionals are a rely valuable resource for the Russian public health system in the current socio-economic conditions. Their capability to flexibly switch the focus and content of their activities in the changing and challenging environment is essential for successful performance.

The purpose of our study is to analyze the international evidence on managing the process of competencies’ development in healthcare managers.

Competence-oriented education and training of future health-care managers is of special interest. In light of this, the study of international data on the organization of the processes of key competence development is important. Here with, it is necessary to take into account the content of the studies, resources and technologies, factors that influence on this process, the development and evaluation of models aimed at improvement of the education of healthcare management professionals at medical schools.

We believe that the results of this review will help to develop and offer a number of practical steps aimed at optimizing the education and training of healthcare managers. In addition to a review of international data, this article presents an innovative project for the development of professional competencies of health managers – the Academy of Talent Development in Healthcare (ATDH). This project involves students of the Sechenov University who want to learn how to lead healthcare teams efficiently.

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.

Evidence-based management - healthcare manager viewpoints

Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

A Leadership and Managerial Competency Framework for Public Hospital Managers in Vietnam

Objective

The aim of this paper was to develop a leadership and managerial competency framework for public hospital managers in Vietnam.

Methods

This mixed-method study used a four-step approach. The first step was a position description content analysis to identify the tasks hospital managers are required to carry out. The resulting data were used to identify the leadership and managerial competency factors and items in the second step. In the third step, a workshop was organized to reach consensus about the validity of these competency factors and items. Finally, a quantitative survey was conducted across a sample of 891 hospital managers who are working in the selected hospitals in seven geographical regions in Vietnam to validate the competency scales using exploratory factor analysis (EFA) and Cronbach's alpha.

Results

The study identified a number of tasks required for public hospital managers and confirmed the competencies for implementing these tasks effectively. Four dimensions with 14 components and 81 items of leadership and managerial competencies were identified. These components exhibited 83.8% of variance and Cronbach's alpha were at good level of 0.9.

Conclusions

These competencies are required for public hospital managers which provide guidance to the further development of the competency-based training for the current management taskforce and preparing future hospital managers.

Validation of a management competency assessment tool for health service managers

Purpose The purpose of this paper is to report on the validation of a management competency assessment tool for health services managers (HSM), which resulted from the development and validation of the framework, addressed by a previous paper. Design/methodology/approach The management competency assessment tool (MCAP Tool) was validated using assessment data from a sample of 117 senior and middle managers working in two public hospitals and five community services in Victoria, Australia. The assessments were conducted between January 2013 and September 2014. Findings Both validity and reliability of the MCAP Tool were demonstrated. Practical implications The MCAP Tool has the potential to assist in the measurement of the competencies of HSM. Further research is required to determine if the framework and tool are applicable to HSM in other settings. Originality/value This is the first published study outlining the validity and reliability of an assessment tool to measure the management competencies of Australian health service managers.

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.

No need to grow my resumé? Mentorship and the intersection of learning between emerging and established leaders

Active ongoing learning is a foundational expectation of every healthcare leader whether at the beginning or end of their career. In order for leaders to be nimble and responsive to the ongoing changes in the healthcare environment, they must actively engage in a multiplicity of learning activities. One way of ensuring diversity of learning is for emerging and established leaders to learn together through formal or informal mentoring. This article will explore that intersection and the value add of a reciprocal mentoring relationship where mentor and mentee roles become blurred and joint learning becomes the goal. Capabilities from the LEADS in a Caring Environment framework will be drawn upon, and a challenge is suggested for experienced leaders to go beyond resumé building and invest in emerging leaders, as ultimately it is an investment in their own learning and the future.

Outcomes and Impact of Training and Development in Health Management and Leadership in Relation to Competence in Role: A Mixed-Methods Systematic Review Protocol

Background: The need for competence training and development in health management and leadership workforces has been emphasised. However, evidence of the outcomes and impact of such training and development has not been systematically assessed. The aim of this review is to synthesise the available evidence of the outcomes and impact of training and development in relation to the competence of health management and leadership workforces. This is with a view to enhancing the development of evidence-informed programmes to improve competence.

Methods and Analysis: A systematic review will be undertaken using a mixed-methods research synthesis to identify, assess and synthesise relevant empirical studies. We will search relevant electronic databases and other sources for eligible studies. The eligibility of studies for inclusion will be assessed independently by two review authors. Similarly, the methodological quality of the included studies will be assessed independently by two review authors using appropriate validated instruments. Data from qualitative studies will be synthesised using thematic analysis. For quantitative studies, appropriate effect size estimate will be calculated for each of the interventions. Where studies are sufficiently similar, their findings will be combined in meta-analyses or meta-syntheses. Findings from quantitative syntheses will be converted into textual descriptions (qualitative themes) using Bayesian method. Textual descriptions and results of the initial qualitative syntheses that are mutually compatible will be combined in mixed-methods syntheses.

Discussion: The outcome of data collection and analysis will lead, first, to a descriptive account of training and development programmes used to improve the competence of health management and leadership workforces and the acceptability of such programmes to participants. Secondly, the outcomes and impact of such programmes in relation to participants’ competence as well as individual and organisational performance will be identified. If possible, the relationship between health contexts and the interventions required to improve management and leadership competence will be examined

Performance Analysis of Hospital Managers Using Fuzzy AHP and Fuzzy TOPSIS: Iranian Experience

Background and Objectives:

Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals.

Methods:

This research was a cross-sectional study. First, reviewing the literature and using experts’ viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEO_s in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS).

Results:

To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively.

Conclusions:

The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them.

Health LEADS Australia and implications for medical leadership

Purpose

– The purpose of this paper is to call for strong medical co-leadership in transforming the Australian health system. The paper discusses how Health LEADS Australia, the Australian health leadership framework, offers an opportunity to engage medical clinicians and doctors in the leadership of health services.

Design/methodology/approach

– The paper first discusses the nature of medical leadership and its associated challenges. The paper argues that medical leaders have a key role in the design, implementation and evaluation of healthcare reforms, and in translating these reforms for their colleagues. Second, this paper describes the origins and nature of Health LEADS Australia. Third, this paper discusses the importance of the goal of Health LEADS Australia and suggests the evidence-base underpinning the five foci in shaping medical leadership education and professional development. This paper concludes with suggestions on how Health LEADS Australia might be evaluated.

Findings

– For the well-being of the Australian health system, doctors need to play an important role in the kind of leadership that makes measurable differences in the retention of clinical professions; improves organisational cultures; enhances the engagement of consumers and their careers; is associated with better patient and public health outcomes; effectively addresses health inequalities; balances cost effectiveness with improved quality and safety; and is sustainable.

Originality/value

– This is the first article addressing Health LEADS Australia and medical leadership. Australia is actively engaging in a national approach to health leadership. Discussions about the mechanisms and intentions of this are valuable in both national and global health leadership discourses.