Vuokko Pihlainen, Tuula Kivinen and Johanna Lammintakanen
The purpose of this study is to elicit and analyze experts’ perceptions of management and leadership competence (MLC) and likely MLC developments and requirements in hospital…
Abstract
Purpose
The purpose of this study is to elicit and analyze experts’ perceptions of management and leadership competence (MLC) and likely MLC developments and requirements in hospital contexts by 2030.
Design/methodology/approach
A three-round, web-based Argument Delphi process was used to gather critically discussed opposing perceptions of 33 Finnish experts, which were subjected to inductive content analysis to identify themes.
Findings
Current deficiencies in MLC and several trends (e.g. an ongoing shift towards collaborative management) and required improvements (e.g. a need to adopt more holistic approaches) were identified. However, there were some conflicting perceptions, regarding for example the desirability of fixed-term positions for managers.
Research limitations/implications
The findings provide qualitative indications of a group of Finnish experts’ perceptions of MLC and requirements for its development, elicited using the Argument Delphi Method. Thus, they are subject to the usual limitations of the applied methodology and should be generalized to other contexts cautiously.
Practical implications
The identification of current deficiencies and future requirements for MLC may facilitate the formulation of robust approaches for improving it in hospital contexts.
Social implications
The findings may be useful for improving MLC in hospitals, thereby enhancing efficiency, teamwork, safety and client satisfaction in healthcare settings.
Originality/value
The Argument Delphi Method has been rarely used in health management science studies and healthcare context. It is intended to develop relevant arguments and reveal reasons for differing views about focal issues, thereby providing deeper understanding of experts’ perceptions of MLC and its likely development.
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Vuokko Pihlainen, Tuula Kivinen and Johanna Lammintakanen
The purpose of this paper is to describe how Finnish experts perceive future (year 2030) hospital management and leadership.
Abstract
Purpose
The purpose of this paper is to describe how Finnish experts perceive future (year 2030) hospital management and leadership.
Design/methodology/approach
A total of 33 experts participated in a three-round Argument Delphi process. Opposing views of management and leadership in 2030 were analyzed using inductive content analysis.
Findings
The experts’ perceptions were divided into two main categories: management and leadership orientation and future organization. Perceptions relating to management and leadership orientation were classified as relating to patient-centred, clinical dominance, professionally divided and management career options. Perceptions relating to future management and leadership organization were classified as representing shared, pair, team and the individual-centered leadership. The results highlighted the most distinctive issues raised by the participants.
Research limitations/implications
This qualitative study was conducted in the context of Finnish healthcare according to the principles of the Argument Delphi Method. The panel consisted of high-level experts representing a diverse set of roles. However, as suggested in previous literature, these experts may not be the most astute in predicting the future development of hospital organizations.
Practical implications
The findings can be used to develop and renew management and leadership training and management practices in hospitals.
Social implications
The findings can be exploited in discussions, planning and decision making regarding future management and leadership in hospitals.
Originality/value
Only a few studies have investigated perceptions of future management in hospitals. This study adopted the Argument Delphi Method to identify distinct perceptions on the future orientation and organization of management and leadership in hospitals.
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Vuokko Pihlainen, Tuula Kivinen and Johanna Lammintakanen
The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment…
Abstract
Purpose
The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment. Health-care leaders and managers in this study were both nursing and physician managers. Competence was assessed by evaluating the knowledge, skills, attitudes and abilities that enable management and leadership tasks.
Design/methodology/approach
A systematic literature review was performed to find articles that identify and describe the characteristics of management and leadership competence. Searches of electronic databases were conducted using set criteria for article selection. Altogether, 13 papers underwent an inductive content analysis.
Findings
The characteristics of management and leadership competence were categorized into the following groups: health-care-context-related, operational and general.
Research limitations/implications
One limitation of the study is that only 13 articles were found in the literature regarding the characteristics of management and leadership competence. However, the search terms were relevant, and the search process was endorsed by an information specialist. The study findings imply the need to shift away from the individual approach to leadership and management competence. Management and leadership need to be assessed more frequently from a holistic perspective, and not merely on the basis of position in the organizational hierarchy or of profession in health care.
Originality/value
The authors’ evaluation of the characteristics of management and leadership competence without a concentrated profession-based approach is original.
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Ingrid Marie Leikvoll Oskarsson and Erlend Vik
Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem…
Abstract
Purpose
Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.
Design/methodology/approach
In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.
Findings
Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.
Research limitations/implications
This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.
Practical implications
The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.
Originality/value
This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.