Towards remote leadership in health care: Lessons learned from an integrative review

Measuring trust in healthcare with instruments developed in different disciplines - A scoping review

BACKGROUND

Trust is a key character at organizational level. Understanding the level of trust with timely relevant instrument is a significant process to capture the level of trust beyond organizational changes in healthcare.

OBJECTIVES

To gather, assess, and synthesize the items of instruments evaluating trust in healthcare organizations.

DESIGN

Scoping review methodology.

METHODS

The literature search with deductive-inductive content analysis. The data were charted from articles that involved the use of trust instruments in healthcare organizations.

DATA SOURCES

Search from eight databases was updated in January 2024 and included peer-reviewed articles published between 2010 and 2023.

RESULTS

A total of 13 instruments were found measuring trust in the organization, trust in the leader, and trust among peers in healthcare. The items of instruments about trust in the organization included strategic and operational cultures. The trust in the leader consisted of competence, consistency, openness, appreciative acceptance, and loyalty and risk, while instruments about trust among peers included dimensions of moral partnership, common interest, and competent peers.

CONCLUSIONS

Comprehensively measuring trust in the leader, trust in the organization, and trust among peers is significant due to the multifaceted dimension of trust. Measuring trust offers a possibility to recognize the working relationships and cultures in healthcare organizations.

[Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study]

Demands, resources, and work engagement of lower and middle level nurse managers: a cross-sectional study Abstract. Background: Given their responsibilities, lower- and middle-level nurse managers hold a key role in the health care system. Their performance and health are affected by their work engagement, which according to the Job-Demands-Resources-Model depends on job-related demands and resources. To date, there is a lack of studies on the demands, resources, and work engagement of nurse managers in Germany. Objective: First, the study aimed to describe the job demands and resources as well as the work engagement of lower and mid-level nurse managers in hospitals and geriatric care facilities in Germany. Second, the aim was to explore potential differences in these areas between different groups, particularly regarding gender, age, and management level. Methods: The study used a cross-sectional design. Data were collected by an online survey. N = 408 cases could be evaluated. Results: Work overload is the most prominent demand, followed by emotional demands. In terms of resources, nurse managers can primarily draw on positive social relationships. The available professional resources are rated critically. Work engagement is moderate. Conclusions: The study indicates a clear need for action regarding an improvement in work engagement. In particular, work overload and professional resources need to be addressed by appropriate systemwide and organization-related measures.

Female managers' organizational leadership during telework: experiences of job demands, control and support

The frequent use of telework during the COVID -19 pandemic has created a more challenging work situation for managers who need to lead effectively in the virtual space, this especially concerns female managers. Therefor it is of importance to investigate female managers' experiences of job related demands, control and support within this work context. Accordingly, we investigated female managers' experiences of demands, control and support in their organizational leadership during telework. The present study used a deductive, theory-driven, qualitative approach with predetermined themes defined within the demand-control-support model. Data were collected by semi-structured interviews. The female managers had at least 50% of their working hours as telework. The results showed that the female managers experienced demands in terms of hard, fast or even excessive work in order to be available and solve complex problems, and control as varied work content, new learning, planning and decision freedom. Support was experienced in terms of attentive superior manager, good cooperation and helpfulness among colleagues. Theoretical and practical implications of the results are discussed in terms of telework situation for female managers.

Digital leadership: Norwegian healthcare managers' attitudes towards using digital tools

Background

Health services are undergoing digitalization and applying new digital tools. These changes may provide healthcare managers with opportunities to exercise digital leadership. However, managers' attitudes may influence the extent to which they demonstrate digital leadership. This study explores the attitudes of Norwegian healthcare managers towards: (1) digital tools and change and (2) to what extent digital tools are applicable to various tasks of managers.

Methods

Cross-sectional study including 154 managers in hospitals and municipal health services in a Norwegian county. The questionnaire was about management and digital tools, and the data was analyzed by descriptive statistics, correlations, and content analysis.

Results

The healthcare managers perceived that digital tools facilitated a positive change in organizational work processes aligned with values and goals. Digital tools supported administrative tasks such as gaining control over responsibilities. However, 76 managers stated that certain tasks, including interactions with employees (e.g. performance appraisals and sick leave follow-up) and the building of an organizational culture, should not be performed using digital tools or using them only to a limited extent; for these tasks, they preferred in-person meetings.

Discussion

Norwegian healthcare managers' attitudes toward digital tools are generally positive, but there are areas where they find the tools less suitable.

Conclusions

The results provide new insights into healthcare by indicating that many managers may have positive attitudes toward digital tools. However, digital leadership may not be applicable equally in all areas of healthcare managers' work. This raises the question of whether digital leadership can or should be exercised uniformly in every area of health services.

Relationships between nursing leadership and organizational, staff and patient outcomes: A systematic review of reviews

AIM

To assess and describe reviews of nursing leadership styles associated with organizational, staff and patient outcomes.

DESIGN

A systematic review of reviews.

METHODS

Reviews describing a search strategy and quality assessment. The review followed the PRISMA statement. Nine databases were searched in February 2022.

RESULTS

After screening 6992 records, 12 reviews were included reporting 85 outcomes for 17 relational, nine task-oriented, five passive and five destructive leadership styles. Transformational leadership, which is one of the relational styles, was the most studied among all the styles. Of the outcomes, staff outcomes were the most reported, notably job satisfaction, and patient outcomes were less reported. Also, mediating factors between relational leadership styles and staff and patient outcomes were identified.

CONCLUSION

Extensive research shows the beneficial impacts of relational leadership; however, destructive leadership research is lacking. Relational leadership styles should be conceptually assessed. More research is needed on how nurse leadership affects patients and organizations.

Leadership Development Strategies in Interprofessional Healthcare Collaboration: A Rapid Review

Background

Contemporary healthcare practitioners require leadership skills for a variety of professional roles related to improved patient/client outcomes, heightened personal and professional development, as well as strengthened interprofessional collaboration and teamwork.

Objective/Aim

The aim of this study is to systematically catalogue literature on leadership in healthcare practice and education to highlight the leadership characteristics and skills required by healthcare practitioners for collaborative interprofessional service delivery and the leadership development strategies found to be effective.

Methods/Design

A rapid review was conducted. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) diagram shows that the 11 databases, yielded 465 records. A total of 147 records were removed during the initial screening phase. The remaining 318 records were uploaded onto Rayyan, an online collaborative review platform. Following abstract level screening, a further 236 records were removed with 82 records meeting the eligibility criteria at full text level, of which 42 were included in the data extraction. The Mixed Methods Appraisal Tool (MMAT) was used for quality appraisal.

Results

Results showed variability in methodologies used, representing various healthcare disciplines with a range in population size (n = 6 to n = 537). Almost half of the results reported on new programs, with interprofessional collaboration and teamwork being the most frequently mentioned strategies. The training content, strategies used as well as the length of training varied. There were five outcomes which showed positive change, namely skills, knowledge, confidence, attitudes, and satisfaction.

Conclusion

This rapid review provided an evidence-base, highlighted by qualitative, quantitative, and mixed methods research, which presents distinct opportunities for curriculum development by focusing on both content and the methods needed for leadership programs. Anchoring this evidence-base within a systematic search of the extant literature provides increased precision for curriculum development.

Nurse leaders' experiences of remote leadership in health care

PURPOSE

This study aimed to describe nurse leaders' experiences of remote leadership in health care sector.

DESIGN/METHODOLOGY/APPROACH

Semistructured interviews were conducted among nurse leaders (N = 12) between January and March 2022. All of the interviewees had experiences of remote leadership and worked as immediate - (n = 5) or middle-level (n = 7) leaders in health care organizations across four provinces in Finland. The collected data were analyzed by inductive content analysis.

FINDINGS

The leaders had experienced a rapid transition to remote leadership and highlighted the need for guidelines and joint discussions with different stakeholders. The interviewees felt that working life has changed in the last two years and that remote leadership will now be a key part of leadership in health care. The leaders' experiences highlighted how important trust is in remote leadership. Furthermore, the interviewees pointed out a need for face-to-face contact and described other good practices for remote leadership. Overseeing work-related well-being was also stressed as important in the remote context; however, the interviewees expressed a need for instructions and tools concerning the management of employee well-being. The sudden change to remote leadership was not only described as interesting but also challenging, which has affected the leaders' work-related well-being. Support - both from the organization and other employees - was found to be crucial to health care leaders' work-related well-being.

ORIGINALITY/VALUE

The current study complements the little-researched topic of remote leadership in the health care sector. The results provide insights that can be used to develop remote leadership and/or guide future research.

Exploring the impact of virtual leadership on job satisfaction in the post-COVID-19 era: The mediating role of work–life balance and trust in leaders

Leadership remains a highly important role in the management of employees' psychological and physical well-being, particularly in the aftermath of the COVID-19 pandemic. As various sectors adapted virtual settings to overcome the restrictions posed by the pandemic, the vitality of virtual leaders became more pivotal as they could enhance the virtual work environment for employees and steer teams toward organizational goals. This study assessed the effect of virtual leaders on employees' job satisfaction in the information technology sector as a high-performance industry. Furthermore, the mediating effects of trust in leaders and work–life balance on the virtual leadership–job satisfaction relationship were assessed in the proposed model of this research. Through a deductive quantitative approach and using purposive and convenience sampling techniques, a total of 196 respondents participated in the research. The data analysis process was deployed via Smart PLS software and the PLS-SEM technique. The results showed that virtual leaders play a major role in determining information technology (IT) employees' job satisfaction while the mediating effects of both trust in leaders and work–life balance are significant factors that can enhance the work environment for leaders to achieve better results. The statistically significant findings of this research suggest a number of positive work outcomes and pathways with scholarly and managerial implications that can be beneficial for leaders in relevant sectors.

Exploring Hybrid Leadership: Experiences of Remote Leadership in Healthcare

OBJECTIVE

The aim of this study was to describe leaders' experiences of remote leadership during the 1st year of the COVID-19 pandemic.

BACKGROUND

The COVID-19 pandemic accelerated remote work. However, there is little research on the experience of remote leadership in the healthcare setting.

METHODS

Data were collected using focus group interviews and analyzed by thematic analysis.

RESULTS

A total of 8 leaders from a psychiatric care setting participated. The following themes were identified: increased work efficiency, work well-being, lack of organizational support, the need to be present, and the desire for a hybrid leadership model for the future.

CONCLUSIONS

Remote leadership includes both benefits and challenges for healthcare leaders and organizations. Leaders in this study emphasized the need to be present for the clinical personnel and proposed a hybrid leadership model. To succeed in combining remote and face-to-face work and leadership in a new model, organizations need to provide clear guidelines and training for remote work and leadership.

Facing the Post-Pandemic Challenges: The Role of Leadership Effectiveness in Shaping the Affective Well-Being of Healthcare Providers Working in a Hybrid Work Mode

The COVID-19 pandemic has brought new challenges to the medical industry, including hybrid work, in which specialists can perform some of their duties remotely, in addition to physical contact with patients and their teams. Hybrid work provides opportunities, but also generates difficulties (e.g., accurate long-distance diagnosis); therefore, there is a need to ensure the well-being of healthcare workers, especially in the context of leadership strategies. As there is little research on leadership practices in remote and hybrid medical worker management, this study analyses the relationship between certain behavioural strategies and competencies of leaders and the affective well-being of hybrid employees. The research was conducted among a group of employees (N = 135) from seven countries who provide healthcare in a hybrid model. The correlations between the variables showed the statistical significance of all leadership strategies introduced into the model and focused on building involvement (employee empowerment and team orientation), creating a shared vision, defining clear goals and strategies, promoting adaptability (change management, promotion of organisational learning and patient focus), managing consistency through shared values, agreement and effective coordination, as well as competencies such as communicativeness, credibility, self-development and digital readiness. Despite the significance of all the relationships, the linear regression showed that the variability of affective well-being was explained mainly by the adaptability leadership strategy. The results of the study expand the knowledge on the competencies of healthcare leaders, and shed new light on the management of medical employees performing remote and hybrid work. Because such research into well-being has not been published to date, the analysis begins an important discussion on redefining leadership in the healthcare sector, taking into account the digital transformation.