Impact of C-level positions on hospital performance: a scoping review protocol

INTRODUCTION

The objective of this scoping review is to identify evidence of the impact of hospital managers in top management (c-suite) on hospital performance. Managers generally have various effects on organisational objectives of their organisations. In recent years, the healthcare sector has experienced alterations in hospital governance structures, together with the emergence of new c-suite positions, aligning more closely with those found in private organisations. Their impact on hospital performance (ie, quality of care) is not well known. This scoping review seeks to identify all the available evidence of their impact on the organisational objectives. This scoping review will include primary studies, reviews and commentaries that describe the impact of top management team members on organisational outcomes in a hospital setting.

METHODS AND ANALYSIS

The search strategy aims to locate both published and unpublished documents (ie, grey literature) using a three-step search strategy. An exploratory search of Medline and Google Scholar identified keywords and Medical Subject Headings terms. A second search of Medline (PubMed), Web of Science Core Collection, ScienceDirect, Business Source Premier (EBScoHost), JSTOR, BASE, Lens.org and the Google Search Engine will be performed. The scope of the search will cover 1990-present time using English search terms. Manual searching by two reviewers will be added to the search strategy. The identified documents will be independently screened, selected by two researchers and extracted by one researcher. The data are then presented in tables and graphics coupled with a descriptive summary.

ETHICS AND DISSEMINATION

As this study neither involves human participants nor unpublished secondary data, an ethics approval is not required. Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal.

TRIAL REGISTRATION NUMBER

The protocol was registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/EBKUP).

Framing doctor-managers' resilience during Covid-19 pandemic: A descriptive analysis from the Italian NHS

With the aim of providing evidence about doctor-managers' resilience during the Covid-19 pandemic, this study analyzes the characteristics of 114 doctor-managers operating within the Italian National Health Service (NHS). During the emergency, doctor-managers had to show adaptive capacities to deal with unexpected situations and develop new paradigms, procedures, and quick responses to patients' needs. This is in line with resilience, and in this perspective, it is crucial to investigate resilience determinants. The paper, therefore, provides an identikit of the resilient doctor-manager. The research was conducted between November and December 2020. Primary data were collected through an online questionnaire consisting of six sections. Participation was voluntary and anonymous. Data were analyzed using quantitative techniques and employing Stata 16. Confirmatory Factor Analysis was employed to test construct validity and scale reliability. Results show that increasing levels of individual resilience are related to increasing levels of managerial identity. Moreover, physicians' individual resilience has a positive association with commitment, knowledge diffusion, and Evidence-Based Medicine adoption. Finally, physicians' individual resilience has a negative association with their role in the university, their specialty, and their gender. The study suggests some practical implications for healtcare organizations. In general, career paths are decided primarily on competency assessment, while an important role should be devoted to behavioral characteristics. Furthermore, organizations should take care of the levels of individual commitment and encourage professional networking because both help doctor-managers cope with uncertainty. The originality of the study relies on a fresh look at all previous work. There are currently few contributions in the literature to explore and investigate resilience elements in doctor-managers during the pandemic era.

From bureaucratic administration to effective intervention: Comparing early governmental responses to the COVID-19 virus across East Asian and western health systems

The outbreak of COVID-19 in early 2020 created dangerous public health conditions which pressured governments and health systems to respond in a rapid and effective manner. However, this type of rapid response required many governments to bypass standing; bureaucratic structures of health sector administration and political governance to quickly take; essential measures against a rapidly evolving public health threat. Each government’s particular; configuration of governmental and health system decision-making created specific structural and functional challenges to these necessary centrally developed and coordinated strategies. Most East Asian governments (except Japan) succeeded relatively quickly in centralizing essential disease control and treatment initiatives in a timely manner. In contrast, a number of European countries, especially those with predominantly tax-based financing and politically managed health delivery systems, had greater difficulty in escaping bureaucratic governance and management constraints. Drawing on data about these governments’ early stage COVID-19 control experiences, this article suggests that structural changes will be necessary if low-performing governments are to better respond to a pandemic. This paper also summarizes other relatively successful strategies. By adopting such strategies, nations can help overcome structural bureaucratic and administrative obstacles in responding to further waves of COVID-19 or similar future pandemic events.

Sense of Coherence and Burnout in Healthcare Professionals in the COVID-19 Era

Emotional exhaustion in the context of vulnerability to burnout is a part of the universal narrative of high stress and systematically reported in healthcare professionals. The sense of coherence (SOC) is a salutogenic construct, operationalized by A. Antonovsky as a generalized resistance resource (GRR) to stress in three dimensions: meaningfulness (Me), the desire of a person to be motivated to cope; comprehensibility (C), the belief that the challenge is understood; and manageability (Ma), the belief that coping resources are available. The relation between SOC and the dimensions of burnout-Emotional Exhaustion (EE), Depersonalization (D), and Personal Accomplishment (PA)-is a part of salutogenic functioning, which reveals the inner motivation and self-organization of the psycho-emotional energetic resource. This study traces the salutogenic functioning of Bulgarian healthcare professionals during the pandemic. A general psychological background of coherence and exhaustion has been identified. All components of the SOC were positively correlated to Personal Accomplishment. Emotional Exhaustion and Depersonalization correlated negatively with coherence. SOC was validated as a possible determinant to predict the reduction of exhaustion and depersonalization as well as high levels of professional performance. The dimension of Meaningfulness in the coherence phenomenon was demonstrated to have the highest predictive value for professional burnout.

Engaging to innovate: an investigation into the implications of engagement at work on innovative behaviors in healthcare organizations

PURPOSE

Organizational innovation relies on the employees' active participation in improving extant processes and practices. In particular, it has been argued that employees' engagement triggers innovation-oriented behaviors at work. Nevertheless, there is a paucity of evidence of the implications of work engagement on the health professionals' innovation propensity. The article intends to push forward what we currently know about this issue, providing some food for thought to scholars and practitioners.

DESIGN/METHODOLOGY/APPROACH

A path analysis based on ordinary least square (OLS) regression and 10,000 bootstrap samples was designed to investigate the direct and indirect implications of employees' engagement on innovative behaviors at work in a large sample of health professionals operating in Europe. The quality of employee-manager relationships and the organizational climate were included as mediating variables affecting the relationship between work engagement and propensity to innovation-oriented behaviors.

FINDINGS

The research findings highlighted that being engaged at work fosters the willingness of health professionals to partake in the improvement of organizational processes and practices. The positive implications of employees' engagement on innovative behaviors at work are catalyzed by good employee-manager relationships and a positive organizational climate.

PRACTICAL IMPLICATIONS

Healthcare organizations should uphold the health professional's engagement to enhance their innovation potential. Targeted interventions are needed to merge work engagement with the enhancement of the organizational environment in which health professionals accomplish their activities. A positive organizational climate enacts an empowering work environment, which further incentivizes innovation.

ORIGINALITY/VALUE

The article adopts a micro-level perspective to investigate the triggers of innovative behaviors among healthcare professionals, providing evidence which is relevant for theory and practice.