Karin Lundin, Bernice Skytt, Marit Silén, Maria Engström and Annika Strömberg
The purpose of this paper is to describe first-line managers’ (FLMs’) experiences and reflections on structural conditions for management practice within hospital settings using…
Abstract
Purpose
The purpose of this paper is to describe first-line managers’ (FLMs’) experiences and reflections on structural conditions for management practice within hospital settings using Kanter’s theory of structural empowerment.
Design/methodology/approach
A qualitative deductive approach with a descriptive design was used. Interviews were conducted with 11 FLMs in charge of medical or surgical hospital units spread across Sweden. Data were analyzed using a directed content analysis, based on Kanter’s theory of structural empowerment, encompassing such as access to necessary and sufficient resources, information, support and opportunities to learn and develop.
Findings
Findings of this study from the FLMs’ descriptions and reflections shed light on the impact of power dynamics on the structural conditions for management practice. The availability of nursing staff was a fundamental resource in the FLMs’ work performance, ensuring delivery of care to patients and a sound work environment for staff. Additionally, the other structural elements outlined in Kanter’s theory were evident in the findings, as the FLMs wished for structured information flow, identified potential and challenged opportunities for development and emphasized the importance of receiving support from people with a genuine understanding of their work situation.
Originality/value
The results of this study contribute to the understanding of FLMs’ structural conditions for management practice in hospital settings. The paper’s originality stems from the use of a deductive approach, providing a structured lens with the potential to inform future research and practice in the field of health-care management.
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Bernice Skytt, Hans Högberg and Maria Engström
The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.
Abstract
Purpose
The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.
Design/methodology/approach
Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).
Findings
The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.
Originality/value
The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.
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Charlotte Roos, Anna Swall, Lena Marmstål Hammar, Anne-Marie Boström and Bernice Skytt
Dignity and well-being are key aspects of the legislation and policies that regulate care of older persons worldwide. In addition, care of older persons should be person-centred…
Abstract
Purpose
Dignity and well-being are key aspects of the legislation and policies that regulate care of older persons worldwide. In addition, care of older persons should be person-centred. Dignity and well-being are described as results of person-centred care (PCC). The purpose of this study was to gain an understanding of important aspects for older persons to experience dignity and well-being in residential care facilities (RCFs).
Design/methodology/approach
This study had a qualitative approach, and individual semi-structured interviews were conducted with 20 older persons living in RCFs. Data were analysed using inductive content analysis.
Findings
To experience dignity and well-being older persons emphasized the importance of preserving their identity. To do this, it was important to be able to manage daily life, to gain support and influence and to belong to a social context. However, the findings indicate a need for improvements.
Practical implications
Insights into older persons’ experiences of important aspects for experiencing dignity and well-being in RCFs can be used by first-line managers and registered nurses when designing improvement strategies to promote PCC.
Originality/value
Dignity and well-being are described as results of PCC. The findings provide an understanding of what older persons perceive as important for experiencing dignity and well-being in RCFs. The findings are useful when designing improvement strategies to promote PCC.
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Maria Lindberg, Bernice Skytt, Magnus Lindberg, Katarina Wijk and Annika Strömberg
Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager’s job demands. The…
Abstract
Purpose
Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager’s job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers’ perceptions of, prerequisites for and experiences from the implementation of changes in their manager’s work conditions.
Design/methodology/approach
A grounded theory–based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis.
Findings
Three thematic areas were identified: engagement, facilitation and achievement. The second-line managers’ descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process.
Originality/value
This study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up.
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Annika Strömberg, Maria Engström, Heidi Hagerman and Bernice Skytt
The purpose of this paper is to contribute new knowledge about how first line managers (FLMs) in elderly care perceive their situation, with a focus on differences in management…
Abstract
Purpose
The purpose of this paper is to contribute new knowledge about how first line managers (FLMs) in elderly care perceive their situation, with a focus on differences in management approaches at the intersection of the central and local parts of the organization.
Design/methodology/approach
The present study has a qualitative approach and is part of a larger project on FLMs in elderly care. The results presented here are based on a secondary analysis of 15 of the total of 28 interviews carried out in the project.
Findings
The main results are twofold: the majority of FLMs perceived differences in management approaches between local and central management; the differences caused some struggle because FLMs perceived that the management system did not support the differences. The two main aspects that caused the FLMs to struggle were differences in the foci of the management levels and difficulties in influencing the conditions of management.
Originality/value
The results contribute to the debate on what aspects are important to sustainable management of elderly care. It is common knowledge that FLMs have a complex position, intermediate to the central, upper level management and their subordinates at the local level – levels with different foci and interests. The study contributes new knowledge about what these differences consist of and the dilemmas they cause and offers suggestions as to what can be done to reduce both energy waste and the risk of low job satisfaction.
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Bernice Skytt, Birgitta Ljunggren, Maria Engström and Marianne Carlsson
The purpose of this paper is to examine whether two groups of first‐line nurse managers perceived improvements in skills and knowledge regarding interpersonal skills and group…
Abstract
Purpose
The purpose of this paper is to examine whether two groups of first‐line nurse managers perceived improvements in skills and knowledge regarding interpersonal skills and group management, achievement orientation, and organizational view and political savvy after participation in two different development programmes, compared to participants in a comparison group. Further, to understand the first‐line nurse managers' expectations for and experiences of the programme as well as its strengths and weaknesses.
Design/methodology/approach
A total of 13 first‐line nurse managers participated in a training programme, 14 in a self‐development programme, and 14 in a comparison group. Group interviews were used to describe the managers' expectations for and experiences of the programmes, the Leadership and Management Inventory were used to assess the impact of the programmes.
Findings
The results of the interviews showed that the programmes met many of the participants' expectations. Participants perceived significant improvements – in organizational knowledge following the training programme and in achievement orientation following the self‐development programme.
Research limitations/implications
Participation in the groups was not based on random assignment.
Practical implications
Different development programmes focussing on different issues can increase flexibility and decrease costs, as managers can apply to programmes suited to their development needs.
Originality/value
Mixed methods have been used in this study: qualitative methods to describe the participants' experiences of the programmes, and quantitative methods to describe the impact of two different leadership programmes and to contrast these results with a comparison group.