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The search strategy aims to locate both published and unpublished documents (ie, grey literature) using a three-step search strategy.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As this study neither involves human participants nor unpublished secondary data, an ethics approval is not required.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).

The Hospital of Tomorrow Case Study: Multidisciplinarity, Inclusiveness and Holistic Approaches to Foster Innovation in Complex Organizations

BACKGROUND

This case study describes and analyses an action research initiative undertaken by management, staff and WHO at the St. Orsola-Malpighi Polyclinic in Bologna, Italy. The initiative utilised staff engagement approaches developed during the COVID-19 pandemic to rethink and reshape future development plans. The initiative provides a 'how-to' case study for complex health facilities on ways to create similar multisectoral, inclusive and holistic processes in planning structural, functional and organizational solutions for their 'hospitals of tomorrow'.

METHODS

The case study utilised an action research approach coordinated by a team of WHO facilitators in close collaboration with the Board of Hospital Directors. Heterogeneous and multidisciplinary working groups were created, with members from different levels of the hospital staff. In the context of facilitated group meetings held weekly over a one-year period, participants were asked to review topics of interest to future plans of the hospital and make recommendations on effective/innovative ways of addressing these in the short and long term. Working groups focused on different challenges.

RESULTS

The initiative was successful in creating and sustaining broad staff engagement in the future planning processes. 80% groups maintained high staff participation throughout the entire project year. Participating staff reported enhanced communication and cooperation between departments represented in different groups. 87% of the proposed plans suggested by the working groups were approved by the Board for implementation.

CONCLUSION

Key factors contributing to the high approval rate of plans, strong engagement record of staff and enhanced cooperation between involved departments; included: multisectoral/cross hierarchal staff involvement, group attention to defining time-bound contextual goals, flexible implementation monitoring approaches, personnel skills and profiles of participants, direct and open communication at all levels and times, member commitment and clear exit strategy. The case study is presented as a model to stimulate similar actions in other complex health care facilities.

The quality of servitization in project-oriented organizations

Purpose

This study examines the criteria for evaluating the quality of servitization and the factors influencing the project–service system's success.

Design/methodology/approach

Evidence was collected through three rounds of Delphi consensus with 42 project managers.

Findings

The results indicate that the quality of servitization in project-oriented organizations is conceptualized as a cumulative construct driven by the product-service system's overall ability to offer more customer value. This value is defined by three interconnected dimensions: the service, the project and the integration system. The study also proposes a novel customer-oriented quality process with two connected levels comprising eight key factors influencing the quality of the project–service systems and nine key quality criteria that assist in evaluating the project–service systems.

Practical implications

Offering extra services is crucial for successful project-oriented organizations to deliver more customer value. The value of servitization is the combined value of products and services. The failure of one of these components to satisfy customers leads to the collapse of the whole system, which entails the need for a balanced-focus quality system toward projects and services.

Originality/value

This study contributes to the quality of servitization in project-oriented organizations, arguing that a balance between service orientation and project orientation is preferred to increase customer value and reduce the clash and ambiguity between project operations and service provision.

Organizational arrangements as a key to enhancing innovativeness and efficiency - analysis of a restructuring hospital in Finland

Background

Challenged to innovate and improve efficiency both at the policy level and in everyday work, many health care organizations are undergoing radical change. However, in many earlier studies, the significance of individuals’ perceptions of their organization and its innovativeness and efficiency during restructuring is not well acknowledged. Our study examines how various organizational arrangements; performance-, hierarchy-, tradition-, and leader-focused types, as well as collaborative and fragmented ones, connect to reaching innovativeness and efficiency in health care during restructuring.

Method

We built on previous organization and management research, innovation studies, and on research focusing in health care restructuring, and conducted an exploratory quantitative case study in a public sector hospital in Finland. Data comprising 447 responses from 19 professional groups across the hospital was analyzed using hierarchical regression analysis.

Results

Our results demonstrate that multiple, co-existing organizational arrangements can promote innovation and efficiency. The perceptions of the organizational members of the nature of their organization need to be generally positive and reflect future-orientation to show positive connections with efficiency and innovativeness; fragmentation in the members’ perceptions of the character of their organization and their inability to go beyond established organizational traditions pose risks of inefficiency and stagnation rather than fruitful exploration. Our study further shows, somewhat surprisingly, that while collaborative organizational arrangements are positively related to increases in perceived efficiency, the same does not apply to innovativeness.

Conclusions

Our study addresses understudied, yet inherently important aspects in providing high-quality health care: the relationships between different organizational arrangements and exploitation and exploration-related outcomes. In particular, examination of individuals’ perceptions (that may have even more weight for the subsequent developments than the actual situation) adds insight to the existing knowledge that has addressed more objective factors. Implications on how to support high levels of performance are drawn for management of professional and pluralistic organizations undergoing restructuring. Our findings also generate information that is useful for policy making concerned with public sector health care.

Fatores críticos de sucesso em inovação de serviços por meio do Design Thinking

O serviço possui papel de protagonista no contexto mercadológico atual. Para manter este destaque, o foco em inovação e sucesso são pontos essenciais para o desenvolvimento dos serviços. O design thinking surge como uma estrutura para aperfeiçoar os serviços e promover a inovação. Porém, faz-se necessário verificar o sucesso que essa metodologia proporciona aos serviços. Sendo assim, esta pesquisa buscou avaliar quais são os fatores críticos de sucesso presentes em casos de desenvolvimento de serviços que utilizaram a metodologia do design thinking. Treze fatores críticos de sucesso foram avaliados por meio da técnica de análise de conteúdo em vinte quatro casos de desenvolvimento de serviços que usaram a metodologia do design thinking. Como resultado, foi verificada a presença de todos os fatores críticos nos casos, reforçando a grande orientação para sucesso que o design thinking possui em inovação de serviços. Destaca-se ainda o foco nas necessidades de mercado, a utilização de recursos tecnológicos e a orientação para gestão de projetos como os principais fatores. Esta pesquisa contribuiu para o âmbito prático da inovação em serviços, tendo como limitações a definição de outros fatores críticos de sucessos não abarcados na teoria e casos não analisados de outras consultorias.

Can Leaders’ Humility Enhance Project Management Effectiveness? Interactive Effect of Top Management Support

This paper aims to explore the effect of humble leadership on project management effectiveness by integrating the mediating role of employee creativity. Top management support moderates the direct (humble leadership and project management effectiveness) and indirect relationships through employee creativity. Time-lagged data were obtained from 332 persons working in a matrix organization on sustainable information technology projects. The results show that humble leadership enhances project management effectiveness by mediating and moderating processes. This study provides a solution to an underlying research question that has gone unanswered in prior studies. What are the strategies proposed for humble leadership in fostering the effectiveness of project management?