Better with GPs as managers? - Variation in perceptions of feedback messages, goal-clarity and performance across manager´s in Swedish primary care

BACKGROUND

Primary care in several countries is developing towards team-based and multi-professional care, requiring leadership and management capabilities at the primary care practice level. This article reports findings from a study of primary care managers in Sweden, focusing variation in performance and perceptions of feedback messages and goal-clarity, depending on managers' professional background.

METHODS

The study was designed as a cross-sectional analysis of primary care practice managers' perceptions combined with registered data on patient-reported performance. Managers perceptions was collected through a survey to all 1 327 primary care practice managers in Sweden. Data about patient-reported performance was collected from the 2021 National Patient Survey in primary care. We used bivariate (Pearson correlation) and multivariate (ordinary least square regression analysis) statistical methods to describe and analyse the possible association between managers' background, responses to survey statements and patient-reported performance.

RESULTS

Both GP and non-GP managers had positive perceptions of the quality and support of feedback messages from professional committees focusing medical quality indicators, although managers perceived that the feedback facilitated improvement work to a lower degree. Feedback from the regions as payers scored consistently lower in all dimensions, especially among GP-managers. Results from regression analysis indicate that GP-managers correlate with better patient-reported performance when controlling for selected primary care practice and managerial characteristics. A significant positive relationship with patient-reported performance was also found for female managers, a smaller size of the primary care practice and a good staffing situation of GPs.

CONCLUSIONS

Both GP and non-GP managers rated the quality and support of feedback messages from professional committees higher than feedback from regions as payers. Differences in perceptions were especially striking among GP-managers. Patient-reported performance was significantly better in primary care practices managed by GPs and female managers. Variables reflecting structural and organizational, rather than managerial, characteristics contributed with additional explanations behind the variation in patient-reported performance across primary care practices. As we cannot exclude reversed causality, the findings may reflect that GPs are more likely to accept being a manager of a primary care practice with favourable characteristics.

Linking public leadership with project management effectiveness: Mediating role of goal clarity and moderating role of top management support

Objective

Grounding on social learning theory (SLT), this study examines the effect of public leadership on project management effectiveness (PME). Further, this study examines the mediating role of goal clarity and moderating role of top management support.

Methodology

Hierarchical linear regressions were used to investigate the relationships. PROCESS Hayes (2003) Model 7 was used for the moderation and mediation analysis. The data was collected from 322 Pakistani public sector developmental project employees.

Findings

The results show that public leadership positively affects goal clarity (β = 0.049, p < 0.001) and project management effectiveness (0.032, p < 0.001). In addition, goal clarity mediates the association between public leadership and project management effectiveness (0.36, p < 0.001). Furthermore, the strength of the mediated relationship between public leadership and project management effectiveness (via goal clarity) depends on top management support. The indirect effect of public leadership on project management effectiveness is high when top management support is high (compared to low).

Conclusion

The role of public leadership contributes significantly to the project's success. The project leader recognises, enlists, and promotes the organisation's core competencies, identifies, corrects, and controls key rigidities, places a high value on goal clarity, and continually lines up procedures with the project's overarching goals.

Implications

Public leadership is crucial in project management effectiveness, especially in the public sector, where projects often involve multiple stakeholders, limited resources, and complex regulatory requirements. Effective public leadership ensures that projects are aligned with the organization's mission and goals and carried out efficiently, on time, and within budget.