Leadership skills essential in the value-based care era

Value-Based Healthcare From the Perspective of the Healthcare Professional: A Systematic Literature Review

Introduction: Healthcare systems increasingly move toward “value-based healthcare” (VBHC), aiming to further improve quality and performance of care as well as the sustainable use of resources. Evidence about healthcare professionals' contributions to VBHC, experienced job demands and resources as well as employee well-being in VBHC is scattered. This systematic review synthesizes this evidence by exploring how VBHC relates to the healthcare professional, and vice versa.

Method: Seven databases were systematically searched for relevant studies. The search yielded 3,782 records, of which 45 were eligible for inclusion based on a two-step screening process using exclusion criteria performed by two authors independently. The quality of the included studies was appraised using the Mixed Methods Appraisal Tool (MMAT). Based on inductive thematic analysis, the Job Demands-Resources (JD-R) model was modified. Subsequently, this modified model was applied deductively for a second round of thematic analysis.

Results: Ten behaviors of healthcare professionals to enhance value in care were identified. These behaviors and associated changes in professionals' work content and work environment impacted the experienced job demands and resources and, in turn, employee well-being and job strain. This review revealed 16 constructs as job demand and/or job resource. Examples of these include role strain, workload and meaning in work. Four constructs related to employee well-being, including engagement and job satisfaction, and five constructs related to job strain, including exhaustion and concerns, were identified. A distinction was made between job demands and resources that were a pure characteristic of VBHC, and job demands and resources that resulted from environmental factors such as how care organizations shaped VBHC.

Conclusion and Discussion: This review shows that professionals experience substantial job demands and resources resulting from the move toward VBHC and their active role therein. Several job demands are triggered by an unsupportive organizational environment. Hence, increased organizational support may contribute to mitigating or avoiding adverse psychosocial factors and enhance positive psychosocial factors in a VBHC context. Further research to estimate the effects of VBHC on healthcare professionals is warranted.

The COVID-19 pandemic and the role of responsible leadership in health care: thinking beyond employee well-being and organisational sustainability

PURPOSE

The unprecedented crisis of the COVID-19 pandemic has posed an enormous challenge ever for health-care organisations to find strategies to deal with their survival. The health-care employees are the frontline soldiers to fight against COVID-19 pandemic. Currently, there is a lack of research regarding the conceptualisation of COVID-19 and its impact on health-care employees' well-being and their organisational sustainability. Extending the role of responsible leadership (RL), the purpose of this paper is to develop a multi-level conceptual model to overcome the crisis of COVID-19 pandemic and promote employee (e.g. workers, nurses and professionals) well-being and organisational sustainability.

DESIGN/METHODOLOGY/APPROACH

With a comprehensive literature review, this paper presents five testable propositions and highlights the impact of COVID-19 pandemic on employee well-being and organisational sustainability.

FINDINGS

The proposed model counsels that organisations need to go beyond the simple application of strategic climate and should enable RL to protect and maintain employee well-being and organisational sustainability.

RESEARCH LIMITATIONS/IMPLICATIONS

The proposed conceptual model is a step forward to not only explore future empirical research but also it will help the health-care policymakers to take responsible initiatives to increase employee well-being and uphold organisational sustainability.

ORIGINALITY/VALUE

There is a lack of research regarding the conceptualisation of the COVID 19 pandemic and its impact on health-care employees' well-being and organisational sustainability. The proposed conceptual model opens and guides a novel research avenue for the alignment of strategic management (as a moderator) and RL on the relationships among the COVID-19 pandemic, employee well-being and organisational sustainability.