Career histories and managerial performance of health care chief executive officers: an empirical study in the Italian National Health Service

Management practices in facilities providing HIV services to key populations in Kenya and Malawi: A descriptive analysis of management in community-based organizations

HIV services for key populations (KP) at higher risk of HIV infection are often delivered by community-based organizations. To achieve HIV epidemic control, countries need to scale up HIV services for KP. Little is known about the management practices of community-based organizations delivering health services. We explored the management practices and facility characteristics of community-based health facilities providing HIV services to key populations as part of the LINKAGES program in Kenya and Malawi. We collected information on management practices from 45 facilities called drop-in centers (DICs) during US Government FY 2019, adapting the World Management Survey to the HIV community-based health service delivery context. We constructed management domain scores for each facility. We then analyzed the statistical correlations between management domains (performance monitoring, people management, financial management, and community engagement) and facility characteristics (e.g., number of staff, organization maturity, service scale) using ordinary least square models. The lowest mean management domain scores were found for people management in Kenya (38.3) and financial management in Malawi (25.7). The highest mean scores in both countries were for performance monitoring (80.9 in Kenya and 82.2 in Malawi). Within each management domain, there was significant variation across DICs, with the widest ranges in scores (0 to 100) observed for financial management and community involvement. The DIC characteristics we considered explained only a small proportion of the variation in management domain scores across DICs. Community-based health facilities providing HIV services to KP can achieve high levels of management in a context where they receive adequate levels of above-facility support and oversight-even if they deliver complex services, rely heavily on temporary workers and community volunteers, and face significant financial constraints. The variation in scores suggests that some facilities may require more above-facility support and oversight than others.

Exploring physician engagement in health care organizations: a scoping review

RATIONALE

Enhancing health system effectiveness, efficiency, and appropriateness is a management priority in most world countries. Scholars and practitioners have focused on physician engagement to facilitate such outcomes.

OBJECTIVES

Our research was intended to: 1) unravel the definition of physician engagement; 2) understand the factors that promote or impede it; 3) shed light on the implications of physician engagement on organizational performance, quality, and safety; and 4) discuss the tools to measure physician engagement.

METHOD

A scoping review was undertaken. Items were collected through electronic databases search and snowball technique. The PRISMA extension for Scoping Reviews (PRISMA-ScR) statement and checklist was followed to enhance the study replicability.

RESULTS

The search yielded 16,062 records. After an initial screening, 300 were selected for potential inclusion in this literature review. After removing duplicates and records not meeting the inclusion criteria, full-text analysis of 261 records was performed, yielding a total of 174 records.

DISCUSSION

Agreement on the conceptualization of physician engagement is thin; furthermore, scholars disagree on the techniques and approaches used to assess its implementation and implications. Proposals have been made to overcome the barriers to its adoption, but empirical evidence about implementing physician engagement is still scarce.

CONCLUSIONS

Our scoping review highlights the limitations of the extant literature about physician engagement. Physician engagement is a relatively ill-defined concept: developing an evidence base for its actual implementation is necessitated to provide reliable guidance on how the governance of health care organizations could be improved. Although we did not assess the quality or the robustness of current empirical research, our findings call for further research to: 1) identify potential drivers of physician engagement, 2) develop dependable assessment tools providing health care organizations with guidance on how to foster physician engagement, and 3) evaluate engagement's actual impact on health care organizations' performance.

Operational flexibility impact on hospital performance through the roles of employee engagement and management capability

BACKGROUND

Very limited empirical research has been done on operational flexibility management in the healthcare industry, especially in hospital settings. This study aimed to propose a model of the effects of operational flexibility on hospital performance through management capability and employee engagement as mediating variables.

METHODS

The proposed model is validated through an empirical study among 480 clinical and administrative staff from five hospitals in Jordan. Structural equation modeling and confirmatory factor analysis were the main techniques used to validate the model and examine the hypotheses.

RESULTS

Operational flexibility was demonstrated to have a positively significant impact on hospital performance, management capability, and employee engagement. Employee engagement was demonstrated to positively impact hospital performance. Management capability had a significant result on hospital performance without having a clear impact. In addition, management capability and employee engagement played a major role as partial mediating effects between operational flexibility and hospital performance, and there is a role for employee engagement as a partial mediating effect between management capability and hospital performance.

CONCLUSION

Significant progress has been achieved in hospital management, especially in terms of operational flexibility, management capability, and staff engagement.

Exploration of the mediating role of physicians' managerial attitude in the relationship between their self-efficacy and workplace performance

PURPOSE

Self-efficacy, or a person's belief in his/her ability to perform specific tasks, has been correlated with workplace performance and role adjustments. Despite its relevance, and numerous studies of it in the management literature, evidence regarding its function in professionals employed in hybrid roles, such as doctor-managers, is lacking. The aim of this study was to fill this gap by exploring the mediating effect of physicians' managerial attitude on the relationship between their self-efficacy and workplace performance.

DESIGN/METHODOLOGY/APPROACH

Primary and secondary data from 126 doctor-managers were obtained from the Italian National Health Service. A structural equation modeling approach was used for analysis.

FINDINGS

This study's results provide for the first time empirical evidence about a surprisingly little-analyzed topic: how physicians' managerial attitude mediates the relationship between their self-efficacy and workplace performance. The study offers important evidence both for scholars and organizations.

PRACTICAL IMPLICATIONS

This study's results provide valuable input for the human resources management of hybrid roles in professional-based organizations, suggesting a systematic provision of feedback about doctor-managers' performance, the adoption of a competence approach for their recruitment, and a new design of doctor-managers' career paths.

ORIGINALITY/VALUE

The authors provide new evidence about the importance of managerial traits for accountable healthcare organizations, documenting that behavioral traits of physicians enrolled into managerial roles matter for healthcare organizations success.

The microfoundations of physicians' managerial attitude

Background

Accountable care has profoundly changed the organizational models adopted by health care organizations and, consequently, the skill set required for doctor-managers who have become middle managers and must deal with the operational management of their units. The aim of this study was to identify the psychological microfoundations (i.e., traits) of physicians’ managerial attitude. Specifically, we analysed the roles played by narcissism, specialization choices and identification with the organization.

Methods

We collected primary data on a population of ward unit heads in the Italian National Health Service. A logistic regression model predicting the levels of managerial attitude was employed.

Results

The results indicate that high levels of narcissism and identification with the organization are related to higher managerial attitude (instead of clinical attitude). Additionally, we found that physicians with a technique-oriented specialization present a higher probability of manifesting managerial attitude (in comparison to clinical attitude).

Conclusions

Hospital managers can benefit from the use of these findings by developing a strategic approach to human resource management that allows them to identify, train and select the right mix of technical knowledge and managerial skills for middle-management roles.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06210-z.

Leadership and organizational performance: Is it essential in healthcare systems improvement? A review of literature

Neoteric studies have called attention to the prominence of management in healthcare sectors. Positive relationship have been noticed between performance management, clinical performance, and clinical outcome. However, there is still debate related to which managers have to lead healthcare organizations, and what kind of management should be followed, we are now about to analyze. Systematic review of the literature is a starting point to present and discuss the current of information concerning with how management can affect the quality and perpetuity of health systems. Through in-depth analysis of 27 studies, we concluded that the performance of healthcare systems and organizations positively consistent with leadership, management practices, manager characteristics, and cultural features that are related to values and administrative approaches. There was also testimony that doctors who lead healthcare organizations show excellence in performance better than others. Finally, this review acting as roadmap which indicating how do the relationship between the management and performance of healthcare systems, and organizations can be furtherly investigated.

Career path from a dentist to a leader

Purpose The purpose of this paper was to study the career paths of leaders with a career background as a dentist from basic degree to chief or executive leadership positions and individual factors that influenced their decisions. Design/methodology/approach Semi-structured interview and a questionnaire were used to study 13 leaders using the structure of Edgar Schein's career anchor interview and career orientation inventory questionnaire. Theory-driven content analysis was used to analyze the data according to themes which included career paths, factors associated with job and career changes and thoughts about future careers. Findings Three different career path types were identified: Progressives (Type A), By chance (Type B), and Enthusiasts (Type C). The main motives were: the Progressives' goal orientation to proceed to higher leadership positions, the By chance group's job and even career changing by taking a chance on an interesting possibility that comes their way and the Enthusiasts' willingness to make a difference and search for possibilities to change things. The most important career anchor was "pure challenge" among the Progressives and By chance groups and "general managerial competence" among the Enthusiasts. Originality/value Studies on personal factors associating with career paths in health care are scarce and similarly leaders with a dentist background are less studied, even though leadership could be an excellent career choice for a dentist. Different individuals can have varied motives and career paths toward executive positions. Because of the multi-professional functions in health care, organizations could benefit from having leaders with different expertise backgrounds.