Distributed leadership in healthcare: leadership dyads and the promise of improved hospital outcomes

A systematic review of leadership styles in healthcare sector: Insights and future directions

In light of the ongoing global health crisis, the significance of leadership within the healthcare sector has intensified. Given this consideration, the significance of appropriate leadership styles cannot be overstated. The objective of this paper is to critically review published studies on leadership elements in the healthcare sector. Using Bibliometrix R package and VOS viewer, we conducted bibliometric and network analyses on publications retrieved from the Web of Science (WOS) database, with content analysis integrated throughout the paper to deepen understanding. Ultimately, 243 articles were identified as relevant. The findings revealed transformational leadership emerges as the most extensively discussed leadership style. 91% of the articles' theme focus on quantitative research methods. This study synthesizes the influencing factors of the three most frequently discussed leadership styles-transformational, authentic, and ethical leadership-emphasizing the importance of job satisfaction and organizational citizenship behavior. And provides direction for future research through thematic analysis.

Leadership to promote patient safety culture in public hospitals managed by social health organizations

PURPOSE

This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.

DESIGN/METHODOLOGY/APPROACH

Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.

FINDINGS

Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.

RESEARCH LIMITATIONS/IMPLICATIONS

All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents' profiles, demographic variables were not analyzed.

PRACTICAL IMPLICATIONS

This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.

ORIGINALITY/VALUE

This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

Leadership Development: Exploring Relational Leadership Implications in Healthcare Organizations

(1) Background: Relational Leadership Theory (RLT) has been gaining rising attention for the past 20 years with studies investigating multiple implications and practices of relationships within organizations. Yet, less attention has been given in healthcare settings. By virtue of the emerging need to move beyond exploring the quality of relationships and to move towards the exploitation of relational dynamics that influence leadership development in healthcare organizations, this study explores both the dyad relationships and the context in which those occur. With recent attention directed to the implementation of human-centered practices and the creation of effective networks to bring desired results, RLT is called on to advance this agenda within healthcare organizations. (2) Material and Methods: Research articles that examined leadership theories over the past thirty years were selected from computerized databases and manual searches. (3) Results: It is argued that the way and context in which relationships are formed between leaders and members is a social process that, in turn, shapes the effectiveness of the management of those organizations. Leadership is not rank-it is the relationship with the relational dynamics that play in the same context, creating evolutionary organizational processes. (4) Conclusions: This paper challenges leadership theory one step further. Exploring an organization through relational leadership theory is much like wearing the lens of 'cause and effect' in leadership behavioral studies. Therefore, this study contributes to this direction with a robust co-examination of relational dynamics that take place in the healthcare sector, showcasing a broader framework in which relational leadership is germinated and influences its outcomes.

Shared accountability in distributed leadership for improved healthcare access: a study of a US dental institution

PURPOSE

Accountability within distributed leadership (DL) is critical for DL to drive positive outcomes in health services organizations. Despite this, how accountability emerges in DL is less clear. This study aims to understand how accountability emerges in DL so that distributed leaders can drive improvements in healthcare access - an increasingly important outcome in today's health services environment.

DESIGN/METHODOLOGY/APPROACH

The authors use an instrumental case study of a dental institution in the USA, "Environ," as it underwent a strategic change to improve healthcare access to rural populations. The authors focused on DL occurring within the strategic change and collected interview, observation and archival data.

FINDINGS

The findings demonstrate accountability in DL emerged as shared accountability and has three elements: personal ownership, agentic actions and a shared belief system. Each of these was necessary for DL to advance the strategic change for improved healthcare access.

PRACTICAL IMPLICATIONS

Top managers should be cognizant of the emergence processes driven by DL. This includes enabling pockets of employees to connect, align and link up so that ideas, processes and practices can emerge and allow for shared accountability in DL.

ORIGINALITY/VALUE

The overarching contribution of this research is identifying shared accountability in DL and its three elements: personal ownership, agentic actions and a shared belief system. These elements serve as a platform to demonstrate "how DL works" in a healthcare organization.

Modeling the turnover intentions of Thai health-care personnel in pandemic times: moderating role of Covid-19 burnout

PURPOSE

Covid-19 cases are rising at a high rate in Thailand. Thailand's administration has formulated many initiatives to combat the spread of coronavirus. However, during a pandemic, health-care workers have a diverse range of tasks that make it more challenging to continue working in hospitals. Consequently, the authors modeled the turnover intentions of health-care personnel to capture relevant psychological aspects of employees during the pandemic. Specifically, this study aims to focused on the moderating role of Covid-19 burnout (CBO) in the relationship between transformational leadership (TL) and job turnover intentions (JTI) with job satisfaction (JS) and knowledge hiding (KH) as mediators.

DESIGN/METHODOLOGY/APPROACH

This research collected data using self-administered questionnaire. A two-stage partial least square-structural equation modeling (PLS-SEM) is carried out as an analysis technique to measure the linear relationship among constructs. The study tests hypotheses (direct and indirect effects) using 310 sample size of health-care personnel.

FINDINGS

The findings indicated that CBO intensified the JTI of health-care personnel and strengthened the association of JS and KH with JTI during the Covid-19 pandemic. TL had a negative indirect effect on JTI. In addition, JS had a negative impact on JTI.

ORIGINALITY/VALUE

The study highlights the importance of TL and JS as ways to reduce or alleviate JTI in health-care personnel during the Covid-19 pandemic in Thailand. Furthermore, CBO and KH can enhance JTI in health-care personnel.