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Jankelová N, Joniaková Z, Skorková Z, Gažová Adamková H. Impact of Structural Employee Empowerment on Hospital Ratings: Mediating Role of Social Climate and First-Line Managers' Resilience. Risk Manag Healthc Policy 2024; 17:883-901. [PMID: 38623577 PMCID: PMC11018137 DOI: 10.2147/rmhp.s453351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/24/2024] [Indexed: 04/17/2024] Open
Abstract
Objective The purpose of this article is to investigate the relationship between the structural empowerment of first-line health managers and health facility performance, examining the mediating roles of resilience and social climate in shaping the ratings of Slovak hospitals. Additionally, we aim to investigate the deeper mechanisms of this relationship, particularly the impact of resilience and the social climate, which can positively influence it. Materials and Methods The data collection was conducted through a questionnaire survey in February 2022. Respondents included 540 healthcare managers at the first level of management from 44 Slovak hospitals, all of which were part of the evaluation by the Institute for Economic and Social Reforms (INEKO). The analysis involved the use of the PLS-SEM method to examine the relationships between variables and assess direct and indirect effects, utilizing SmartPLS 3.3 software. Results The findings reveal a positive association between the structural empowerment of first-level managers and the ranking of health facilities. The hypotheses regarding the mediation of both variables - First-Level Managers' (FLMs) resilience and social climate - are supported, whether considered separately or jointly. In the case of joint mediation, a significant portion of the indirect effect is conveyed through FLMs' resilience, suggesting a potential avenue of support from hospital management to enhance health facility ratings. Conclusion Structural empowerment of first-line managers establishes the conditions for improving the ratings of health facilities. The total effect is significantly more pronounced in promoting their resilience and fostering a supportive social climate.
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Affiliation(s)
- Nadežda Jankelová
- Department of Management, Faculty of Business Management, University of Economics in Bratislava, Bratislava, Slovakia
| | - Zuzana Joniaková
- Department of Management, Faculty of Business Management, University of Economics in Bratislava, Bratislava, Slovakia
| | - Zuzana Skorková
- Department of Management, Faculty of Business Management, University of Economics in Bratislava, Bratislava, Slovakia
| | - Hana Gažová Adamková
- Department of Management, Faculty of Business Management, University of Economics in Bratislava, Bratislava, Slovakia
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Odendaal W, Chetty T, Tomlinson M, Goga A, Singh Y, Kauchali S, Marshall C, Hunt X. "If you work alone on this project, you can't reach your target": unpacking the leader's role in well-performing teams in a maternal and neonatal quality improvement programme in South Africa, before and during COVID-19. BMC Health Serv Res 2023; 23:1382. [PMID: 38066525 PMCID: PMC10709890 DOI: 10.1186/s12913-023-10378-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
The South African National Department of Health developed a quality improvement (QI) programme to reduce maternal and neonatal mortality and still births. The programme was implemented between 2018 and 2022 in 21 purposively selected public health facilities. We conducted a process evaluation to describe the characteristics and skills of the QI team leaders of well-performing teams. The evaluation was conducted in 15 of the 21 facilities. Facilities were purposively selected and comprised semi-structured interviews with leaders at three time points; reviewing of QI documentation; and 37 intermittently conducted semi-structured interviews with the QI advisors, being QI technical experts who supported the teams. These interviews focused on participants' experiences and perceptions of how the teams performed, and performance barriers and enablers. Thematic data analysis was conducted using Atlas.ti. Variation in team performance was associated with leaders' attributes and skills. However, the COVID-19 pandemic also affected team functioning. Well-performing teams had leaders who effectively navigated COVID-19 and other challenges, who embraced QI and had sound QI skills. These leaders cultivated trust by taking responsibility for failures, correcting members' mistakes in encouraging ways, and setting high standards of care. Moreover, they promoted programme ownership among members by delegating tasks. Given the critical role leaders play in team performance and thus in the outcomes of QI programmes, efforts should focus on leader selection, training, and support.
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Affiliation(s)
- Willem Odendaal
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, Western Cape, South Africa.
- Department of Psychiatry, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town, Western Cape, South Africa.
| | - Terusha Chetty
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, Western Cape, South Africa
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Mark Tomlinson
- Institute for Life Course Health Research, Stellenbosch University, Franzi Van Zijl Drive, Tygerberg, Cape Town, Western Cape, South Africa
- School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Ameena Goga
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, Western Cape, South Africa
- Department of Paediatrics and Child Health, University of Pretoria, Steve Biko Academic Hospital, Pretoria, Gauteng, South Africa
| | - Yages Singh
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, Western Cape, South Africa
| | - Shuaib Kauchali
- Department of Paediatrics and Child Health, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Carol Marshall
- South African National Department of Health, Voortrekker Road, Pretoria, Gauteng, South Africa
| | - Xanthe Hunt
- Institute for Life Course Health Research, Stellenbosch University, Franzi Van Zijl Drive, Tygerberg, Cape Town, Western Cape, South Africa
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Singh SS, Mohammadnezhad M, Tamani L. Perceptions of public health nursing Team Leaders (TLs) and Team Supervisors (TSs) on nurse's development in Fiji. BMC Health Serv Res 2022; 22:1546. [PMID: 36529719 PMCID: PMC9760534 DOI: 10.1186/s12913-022-08898-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Nurse team leaders are responsible for contributing to managing the quality of service delivery and facility output of their nurses to ensure there is a high quality of care delivered by the health system. This study aimed to explore the perceptions of public health nursing Team Leaders (TLs) and public health nursing Team Supervisors (TSs) on nurses' development in Fiji. METHODS A qualitative study was used to gather information using in-depth phone interviews among TLs and TSs comprising Chief Midwifery Nursing Officer (CMNO), Director of Nursing (DON), Sub-divisional Nursing Managers (SDNMs), acting SDNMs and Nursing Manager (NM) at Central health division in Fiji. The data was collected through semi-structured open-ended questionnaires and were audio recorded. The data was analyzed using manual thematic analysis process. RESULTS The study comprised of 26 participants, which included 10 TSs and 16 TLs. Four themes were identified for the results amongst TSs and TLs: ethical development; professional development; psychological development; and recommendations. However, nine sub- themes were identified for TSs and eight sub-themes were identified for the result amongst TLs. CONCLUSION This study highlighted that TLs and TSs elaborated on the need for the ethical, professional, psychological development, nursing development and also on the importance of policies and guidelines. Professional ethics should be integrated into the Continuous Profession Development (CPD) points that are used to renew yearly nursing licenses as well as exposing the need for having competencies on professional ethics in nurses' logbooks. Further research is needed to determine the in-depth barriers.
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Affiliation(s)
| | - Masoud Mohammadnezhad
- grid.6268.a0000 0004 0379 5283School of Nursing and Healthcare Leadership, University of Bradford, Bradford, UK ,grid.10223.320000 0004 1937 0490Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Ledua Tamani
- grid.417863.f0000 0004 0455 8044School of Public Health and Primary Care, Fiji National University (FNU), Suva, Fiji
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Julnes SG, Myrvang T, Reitan LS, Rønning G, Vatne S. Nurse leaders' experiences of professional responsibility towards developing nursing competence in general wards: A qualitative study. J Nurs Manag 2022; 30:2743-2750. [PMID: 35861024 PMCID: PMC10087392 DOI: 10.1111/jonm.13745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/17/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
AIM To explore nurse leaders' experiences of professional responsibility to facilitate nursing competence in general wards. BACKGROUND Nurse leaders are responsible for maintaining high levels of competence among nurses to improve patient safety. METHODS Qualitative analysis was conducted between February and April 2019 using semi-structured interview data from 12 nurse leaders in surgical and medical wards at three Norwegian hospitals. RESULTS Four main themes were identified: struggle to achieve nursing staff competence; focus on operational and budgetary requirements rather than professional development; demands to organize sick leaves and holiday periods; and challenges in facilitating professional development. CONCLUSION Nurse leaders felt that their responsibilities were overwhelming and challenging. They witnessed more support for current administrative tasks than for the implementation of professional development. Additionally, unclear work instructions from the employer provided few opportunities to facilitate professional development. Hospital management failed to ensure quality of care and patient safety in general wards by not supporting the strengthening of nurses' professional competence and preventing turnover. IMPLICATIONS FOR NURSING MANAGEMENT Management may integrate formal work instructions that clarify nurse leaders' responsibilities as professional developers, allowing nurse leaders to meet their obligation of maintaining adequate professional competence among nursing staff in general wards.
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Affiliation(s)
- Signe Gunn Julnes
- Department for Health and Social CareMolde University CollegeMoldeNorway
| | - Tove Myrvang
- Department for Health and Social CareMolde University CollegeMoldeNorway
| | - Laila Solli Reitan
- Department for Health and Social CareMolde University CollegeMoldeNorway
| | - Gry Rønning
- Department of Intensive Care MedicineMolde Hospital TrustMoldeNorway
| | - Solfrid Vatne
- Department for Health and Social CareMolde University CollegeMoldeNorway
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Jankelová N, Joniaková Z, Skorková Z. Perceived Organizational Support and Work Engagement of First-Line Managers in Healthcare - The Mediation Role of Feedback Seeking Behavior. J Multidiscip Healthc 2021; 14:3109-3123. [PMID: 34785904 PMCID: PMC8590451 DOI: 10.2147/jmdh.s326563] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND First-line managers play a significant role in the management system of a health-care organization because they provide support and bridge for both senior management and their subordinates. Their work engagement becomes the foundation of facility functioning, encompassing both meeting organizational goals and the patient-centered care approach, but also meeting the expectations and needs of subordinate staff. The purpose of our study is to examine the relationship between perceived organizational support and work engagement of first-line health-care managers and the deeper mechanisms in the form of feedback seeking behavior that may positively influence this relationship. METHODS Data collection was carried out in the form of a questionnaire survey in the period February 2021. Respondents were first-level medical managers from different types of clinical areas and from all Slovak hospitals (221). The PLS-SEM method was used to analyze paths between variables and to analyze direct and indirect effects using SmartPLS 3.3 software. RESULTS The findings indicate a positive association of perceived organizational support and work engagement. Hypotheses about the mediation of the two components of feedback seeking behavior (monitoring and inquiring) have support in both their separate and joint mediation. At the same time, in joint mediation, a larger part of the indirect effect is transmitted by the feedback seeking behavior inquiring and thus represents a possible direction of interest for the top management of hospitals to strengthen the work engagement of their first-level managers not only for the purpose of their higher performance, but also of their job satisfaction. CONCLUSION Perceived organizational support enhances the work engagement of first-line managers. However, the total effect is significantly higher when feedback seeking behavior is involved not only in monitoring, but especially in inquiring.
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Affiliation(s)
- Nadežda Jankelová
- Department of Management, Faculty of Business Management, University of Economics in Bratislava, Bratislava, Slovakia
| | - Zuzana Joniaková
- Department of Management, Faculty of Business Management, University of Economics in Bratislava, Bratislava, Slovakia
| | - Zuzana Skorková
- Department of Management, Faculty of Business Management, University of Economics in Bratislava, Bratislava, Slovakia
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Communication Skills and Transformational Leadership Style of First-Line Nurse Managers in Relation to Job Satisfaction of Nurses and Moderators of This Relationship. Healthcare (Basel) 2021; 9:healthcare9030346. [PMID: 33803822 PMCID: PMC8003159 DOI: 10.3390/healthcare9030346] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/24/2021] [Accepted: 03/15/2021] [Indexed: 11/17/2022] Open
Abstract
The job satisfaction of nurses is reflected in almost all organizational outputs of medical facilities. First-line nurse managers (FLNMs), who are directly related to subordinate nurses, have a great influence on this satisfaction. The aim of our paper is to examine the connection between communication skills and the transformation style of FLNMs management with the job satisfaction of nurses and to verify the influence of three moderators on the strength of this relationship. The chosen moderators-the practice of managing FLNMs, the degree of control (span of control) and psychosocial work-follow from theoretical studies. The moderating effect of the variable management practice is also significant from the point of view of Slovak legislation. The sample consisted of 132 FLNMs from five university hospitals in Slovakia. Data collection took place in the form of a questionnaire. All data were processed using the SPSS 24 software package. A series of regression analyzes were used to identify the proposed hypotheses. ANOVA analysis was used to analyze multiple dependencies. We worked at a 5% level of significance. The findings point to the strong direct effects of communication skills and the transformational leadership style of FLNMs on nurses' job satisfaction. Moderation effects are mild, but significant in the case of management and span of control practices. The lower values of both variables reinforce the positive relationships among the two predictors and the job satisfaction of nurses. The third moderator, psychosocial work factors, also have a significant moderating effect, which is negative, and the higher value of this moderator mitigates both positive direct effects.
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Sabbah IM, Ibrahim TT, Khamis RH, Bakhour HAM, Sabbah SM, Droubi NS, Sabbah HM. The association of leadership styles and nurses well-being: a cross-sectional study in healthcare settings. Pan Afr Med J 2020; 36:328. [PMID: 33193982 PMCID: PMC7603809 DOI: 10.11604/pamj.2020.36.328.19720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 07/12/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction the nurses´ perception of their supervisors´ leadership styles has a substantial impact on their well-being. Effective leadership in health care is crucial in improving and enhancing the effectiveness of health care systems. This study aims to assess the leadership styles of nurse leaders as perceived by employees, and to explore the relationship between perceived leadership styles and the quality of life of nurses in Lebanese hospital settings. Methods it was a cross-sectional study conducted in 2017 and involved a sample of 250 nurses chosen randomly in eight hospitals. The survey included questions on socio-demographic and health-related characteristics, Multifactor Leadership Questionnaire 5X Short Form, and the Short Form Health Survey-12 V2 (SF-12v2). Results the managers used enough transformational leadership style, whereas they used fairly often transactional leadership. The Laissez-faire style was adopted from time to time by the managers. Male nurses perceive their managers as transformational significantly more than female nurses (2.94 vs. 2.73; p = 0.05). Transformational leadership style was statistically related to all scales scores of the SF-12v2 (p < 0.001) except the Social Functioning domain (p = 0.42). The transactional leadership style was associated with the Vitality scale scores (p < 0.001). The physical (p < 0.05) and Emotional Role (p < 0.001) and the mental health summary measure (p < 0.05) were lower in persons who perceived the leadership style of their manager as Laissez-faire. Conclusion this study highlights the existence of a positive effect of leadership styles in the wellbeing of nurses, and confirms that nursing management has been identified as a challenge in the Lebanese hospitals.
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Affiliation(s)
| | | | | | | | - Sanaa Mohamad Sabbah
- Institute of Social Science, Lebanese University, Saida, Lebanon.,Doctoral School of Literature, Humanities and Social Sciences, Lebanese University, Beyrouth, Lebanon
| | | | - Hala Mohamad Sabbah
- Faculty of Economic Sciences and Business Administration, Lebanese University, Nabatieh, Lebanon
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Harmoinen M, Suominen T. Realizing appreciative management from the viewpoint of first-line managers in social and health care. Scand J Caring Sci 2019; 34:78-86. [PMID: 31111519 DOI: 10.1111/scs.12707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/10/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND First-line managers are links between an organizations' administration and the workforce. They transmit information from higher managers to workers and vice versa. Their management skills and especially their interaction with staff are a key point in successful management. AIM To describe how first-line managers realized appreciative management in their everyday management practice in health and social care. METHOD A quantitative descriptive study was conducted by means of an electronic survey among social and healthcare managers in Finland. RESULTS Based on the self-evaluations of the managers, appreciative management is well realized. The most recognition was given to equality and the least to appreciative know-how. Connections were seen between appreciative management and gender, education, education level and managers with higher education, and those with fewer work units below them tended to have a better realization of appreciative management. CONCLUSION The education level of first-line nurse managers is meaningful when realizing appreciative management in social and healthcare settings. IMPLICATIONS FOR NURSING MANAGEMENT More advanced education levels of first-line managers help to promote appreciative management in social and health care, together with the amount of work units (meaning outpatient and inpatient wards). A first-line manager is responsible for the needs of their workforce and needs to be critically assessed so that they might have more time for managing in an appreciative way. Appreciative management should be given increased focus when educating nurse managers.
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Olu-Abiodun O, Abiodun O. Perception of transformational leadership behaviour among general hospital nurses in Ogun State, Nigeria. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2017. [DOI: 10.1016/j.ijans.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Kvas A, Seljak J. A competency-based performance appraisal for nurse leaders. OBZORNIK ZDRAVSTVENE NEGE 2016. [DOI: 10.14528/snr.2016.50.1.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: An employee performance appraisal is used internationally to improve employee performance, productivity, efficiency and effectiveness in nursing care. The purpose of the study was to assess the performance and efficiency of nurse leaders at all levels of leadership, identify deficient areas for each individual leader and propose improvements.
Methods: Two surveys were conducted in 15 Slovenian public hospitals. The sample from the first survey included 1311 nurses who assessed the level of competencies of their immediate superiors. The sample from the second survey included 236 nurse leaders. Data envelopment analysis is used in this study to develop a model of practice outputs and inputs to help identify the most efficient nurse leaders.
Results: Significant differences exist in the performance appraisal among the leaders in nursing. A total of 203 (86 %) nurse leaders are defined as inefficient and could improve their leadership performance. On average, inefficient leaders could improve their behaviour most in the areas of generic leadership competencies (by 51.7 %) and interprofessional relationships (by 47.7 %).
Discussion and conclusion: The areas with the worst performance are generic leadership competencies and interprofessional relationships where also the most significant improvements are possible. Nurse leaders and hospital managers can use the analysis results to determine in which areas the leaders in their organisation should improve the levels of their competencies.
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