A systematic review exploring the impact of focal leader behaviours on health care team performance

Personal and organisational attributes that support transformational leadership in acute healthcare: scoping review

Objective Transformational leadership benefits both patients and staff. The objective of this scoping review was to explore personal and organisational attributes that support transformational leadership in acute health care. Methods A scoping review was undertaken using Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Medline Complete, PsycInfo and Emerald Insight databases. Search terms were related to transformational leadership and acute care hospitals. Results A total of 18 studies were included: 14 reported personal attributes and 8 reported organisational attributes supporting transformational leadership. The most common personal attributes were manager educational preparation (n  = 5), years of management experience (n  = 4), age (n  = 3) and emotional intelligence (n  = 3). The most common organisational attributes reported were larger organisational size (n  = 2) and culture (n  = 2). Personal (manager) attributes were synthesised into the following categories: demographics, role characteristics, leadership preparation and traits. Organisational attributes were categorised as manager support, organisational characteristics and organisational processes. Conclusions Despite the beneficial outcomes of transformational leadership for patients, staff and organisations, the personal and organisational attributes supporting transformation leadership are not well understood.

Assessment of management styles among top nursing leaders in Slovenian primary health centers: a cross-sectional analysis

PURPOSE

This study aims to endeavor to discern the predominant leadership styles used by nursing managers within the framework of Slovenian primary health centers. Using a quantitative research approach, the study was conducted through the administration of a structured questionnaire.

DESIGN/METHODOLOGY/APPROACH

The investigation encompassed 67 nursing managers, representing the entire spectrum of primary health centers in Slovenia. A stratified representative subset comprising 53 top nursing managers actively participated in this study.

FINDINGS

The prevailing leadership style among nursing managers predominantly manifests as the "integrated" style, characterized by a balanced emphasis on both interpersonal relationships and task-oriented elements. These nursing leaders exhibited a proclivity for fostering collaborative teamwork, with their leadership approach notably shaped by traits such as positive thinking, self-assuredness, comprehensive leadership knowledge and an intrinsic motivation to guide and inspire individuals. Notably, leadership knowledge emerged as the most influential factor in determining the selected leadership style. The study's findings recognize specific areas in which leadership competencies among nurse managers may require further enhancement and development.

ORIGINALITY/VALUE

The study's findings are based on a specific subset of nursing leaders in a particular region, which can add to the originality, especially as there is limited prior research in this specific context. The study's exploration of leadership styles is original in the sense that it provides insights into the leadership behaviors and traits of nursing managers in the given context. The emphasis on factors such as positive thinking and leadership knowledge as influential elements adds originality to the study.

Collaborative leadership to support sustainability in practice for dietitians as allied health professionals

BACKGROUND

Allied health professionals (AHPs) have an important role to support the Greener National Health Service (NHS) agenda. Dietitians are AHPs who are already demonstrating strong influence on food sustainability advocacy. There is call for more collaboration across the health professions to optimise "green" leadership in the pursuit of planetary health. The present study aimed to investigate the perceived role of AHP leaders and future leaders around more sustainable healthcare practices.

METHODS

A mixed methods approach using audio-recorded semi-structured interviews with strategic AHP leaders (n = 11) and focus groups with student AHPs (n = 2). Standardised open-ended questions considered concepts of (i) leadership, (ii) green agenda, (iii) collaboration and (iv) sustainability. Purposive sampling used already established AHP networks. Thematic analysis systematically generated codes and themes with dietetic narratives drawn out specifically as exemplars.

RESULTS

The findings represent diverse AHP voices, with six of 14 AHPs analysed, including dietetic (future) leaders. Three key themes emerged: (1) collective vision of sustainable practice; (2) empowering, enabling and embedding; and (3) embracing collaborative change. Dietetic specific narratives included food waste, NHS food supply chain issues, and tensions between health and sustainability advice.

CONCLUSIONS

The present study shows that collaborative leadership is a core aspiration across AHP leaders and future leaders to inform the green agenda. Despite inherent challenges, participant perceptions illustrate how "change leadership" might be realised to support the net zero agenda within health and social care. Dietitians possess the relevant skills and competencies, and therefore have a fundamental role in evolving collaborative leadership and directing transformational change towards greener healthcare practices. Recommendations are made for future leaders to embrace this agenda to meet the ambitious net zero targets.

Nurse performance: A path model of clinical leadership, creative team climate and structural empowerment

AIMS AND OBJECTIVES

This study aimed to: (a) identify and examine the influence of clinical leadership, creative team climate (CTC) and structural empowerment (SE) on the nurse performance (NP) of clinical nurses in hospitals in Turkey, and (b) establish a model designed to verify the fit and effect of these factors.

BACKGROUND

Nurse performance is a significant indicator of work efficiency, patient care quality and patient safety. Existing studies explaining the mechanisms that lead to higher nurse performance have been limited.

DESIGN

This descriptive, cross-sectional study used relation prediction modelling and adhered to STROBE guidelines.

METHODS

This study used an online survey to collect data from volunteered 664 clinical nurses working in hospitals in Turkey. The data were analysed using SPSS version 26.0 and the AMOS 24.0 program. Path analysis was used to verify/test the hypothetical model, and the fit was evaluated by χ² /df, GFI, AGFI, NFI, CFI, IFI, RFI, TLI, RMR and RMSEA.

RESULTS

The fit index of the modified path model was χ² /df = 3.730, GFI = 0.904, AGFI = 0.892, NFI = 0.907, CFI = 0.923, IFI = 0.923, RFI = 0.906, TLI = 0.912, RMR = 0.078 and RMSEA = 0.064. Through creative team climate and structural empowerment, clinical leadership had the greatest standardised direct (β = .35) and indirect (β = .17) effects on clinical nurse performance, the final outcome variable. Creative team climate (β = .23) and structural empowerment (β = .19) also had a significant standardised direct effect on nurse performance. Clinical leadership, creative team climate and structural empowerment explained 39% of the total variance of nurse performance.

CONCLUSIONS

This study shows that clinical nurse performance in hospitals was significantly influenced by clinical leadership, creative team climate and structural empowerment. The results suggest that intervention programmes considering these factors could be implemented to enhance nurse performance.

RELEVANCE TO CLINICAL PRACTICE

Improved nurse performance requires strong clinical leadership, creative team climate and structural empowerment. Therefore, healthcare organisations may implement initiatives to enhance nurse performance by taking these factors into account.

The Effect of Leadership Style on Midwives' Performance, Southwest, Ethiopia

Background

Leadership is the basis of professional and organizational commitment, teamwork and success. Midwives leaders' leadership skills and capabilities have long been recognized as essential contributors to health services and outcomes. However, there are insufficient reports on the effect of leadership styles on midwives' performance in African countries including Ethiopia. Therefore, this study aimed to determine the effect of leadership style on midwives' performance in public health Institutions, southwest Ethiopia.

Objective

This study aimed to determine the effect of leadership style on midwives' performance, Southwest Ethiopia/2022.

Methods and Materials

A cross-sectional study was conducted on 121 midwives using a random sampling technique and a pre-tested questionnaire from May 19/2022-June to 6/2022. Data were entered into Epi-data version 4.4.2.1, edited, coded, categorized and cleaned before analysis. Data were analyzed using the SPSS version 24; and the results are presented in tables, and statements. Correlations and linear regressions were conducted to identify the relationship between leadership style and midwives' performance.

Results

In this study, the autocratic leadership style was predominantly practiced by midwifery leaders with a mean score of 2.996 followed by democratic (Mean=2.632) and laissez-faire (Mean=2.49) leadership styles. Inferential statistics (Correlation) analysis revealed a positive relationship between democratic and laissez-faire leadership styles and a negative relationship between autocratic styles and midwives' performance. Multiple linear regressions showed that both democratic (P=0.02) and laissez-faire leadership styles (P=0.00) had a positive effect where as autocratic leadership style (P=0.60) had a negative effect on midwives' performance.

Conclusion and Recommendation

Autocratic Leadership is the most practiced leadership style in the study area. An autocratic leadership style was negatively related to midwives' performance, while democratic and laissez faire styles were positively related. Therefore, health care leaders, administrators, supervisors and department heads should implement democratic and laissez-faire leadership styles to enhance midwives' performance.

Servant Leadership and Job Satisfaction and Organizational Commitment: Empirical Evidence from Surabaya Health Care Sector

Background: The concept of Servant Leadership has grown as a distinct management style with numerous applications in management research since its inception. It is likely one of the most successful styles for earnest management and for having a good attitude and concern for those around social organizations' well-being and quality of life. Quality human resources are essential to high commitment and satisfaction at work. Satisfy human resources who are committed will take care of the interests of the organization. Because of the practical nature of the problem among in the organization (Klinik Utama Usada Buana), Surabaya personnel, this research is expected to be conducted as an analytic study with a cross-sectional design. Methods: Therefore, data were collected using simple random sampling and then analyzed and interpreted to test the model. Result :The findings demonstrate that servant leadership styles can help people become more committed to their jobs and feel more satisfied. This model's practical and theoretical aspects have been discussed in the relevant sections of this article.

Health Literacy in Patients’ Clinical Records of Hospital Settings: A Systematic Review

Introduction

Health literacy (HL) can be defined as the individual's ability to understand and process health information. A low level of HL can be viewed as a stronger predictor of a person's health status than age, education level, and race. Although HL is an important determinant of health, it is often underestimated. This systematic review investigates the evidence on HL assessment in hospital settings.

Methods

PubMed Medline, CINAHL, Scopus, Web of Science and Educational Resources Information Centre databases were searched, with the date last searched being 16 March 2020. The PRISMA guidelines were applied, and the protocol of the study was registered with PROSPERO (CRD42021236029). The quality of the included studies was appraised using the STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.

Results

Five studies reported HL assessments in hospital patients’ clinical records. Four main strategies were used to implement HL routine assessment in hospitals: multidisciplinary teams, stakeholders, training, and monitoring. Different performance measures were used to monitor the feasibility of incorporating HL assessment into electronic health records (EHRs).

Conclusion

This review examined how inpatients’ HL is recorded in hospital settings. HL is poorly measured in a hospital setting. These results guide hospital leadership in involving nurses in HL assessment implementation in hospitals and support nurses in creating a specific performance measure dashboard to monitor effective HL assessments in hospitals.

Nurses' clinical leadership in the hospital setting: a systematic review

Aim

This study aims to identify the most effective interventions to facilitate nurses' clinical leadership in the hospital setting.

Background

There is a gap in the literature on the identification and measurement of effective interventions for leadership skill development among clinical nurses in hospitals. To the best of our knowledge, no systematic review has been performed on this issue.

Evaluation

A systematic review was conducted. The PubMed, CINAHL, PsycINFO and Cochrane databases were reviewed. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.

Key issues

The evidence reveals that interventions designed to promote nurses' clinical leadership are complex, requiring that cognitive, interpersonal and intrinsic competencies as well as psychological empowerment, emotional intelligence and critical reflexivity skills be addressed.

Conclusions

The development of multicomponent, theory‐based and mixed‐format programmes may be more suitable to facilitate nurses' clinical leadership in the hospital setting.

Implications for Nursing Management

Strategies to facilitate nurses' clinical leadership in the hospital setting should address simultaneously the knowledge and ability of bedsides nurses to solve the practical problem collaboratively with a sense of control, competency and autonomy. Hence, it would promote high quality care, satisfaction and retention of bedside nurses.

Relationship between psychological characteristics, personality traits, and training on performance in a neonatal resuscitation scenario: A machine learning based analysis

BACKGROUND

In life-threatening emergency events, prompt decision-making and accurate reactions are essential for saving a human's life. Some of these skills can be improved by regular simulation trainings. However, besides these factors, individual characteristics may play a significant role in the patients' outcome after a resuscitation event. This study aimed to differentiate personality characteristics of team members who take responsibility for their actions, contextualizing the effect of training on resuscitation performance.

METHODS

Six hundred and two third-year medical students were asked to answer psychological and personality questionnaires. Fifty-five of them performed in a neonatal simulation resuscitation scenario. To assess participants' performances in the NLS scenario, we used a scenario-based designed NLS checklist. A machine learning design was utilized to better understand the interaction of psychological characteristics and training. The first model aimed to understand how to differentiate between people who take responsibility for their actions vs. those who do not. In a second model, the goal was to understand the relevance of training by contextualizing the effect of training to other important psychological and personality characteristics like locus of control, anxiety, emotion regulation, openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism.

RESULTS

No statistically significant differences were found for psychological characteristics between the training group and the no training group. However, as expected, differences were noted in favor of the training group for performance and within gender for psychological characteristics. When correcting for all these information in a model, anxiety and gender were the most important factors associated with taking responsibility for an action, while training was the only relevant factor in explaining performance during a neonatal resuscitation scenario.

CONCLUSION

Training had a significantly stronger effect on performance in medical students in a neonatal resuscitation scenario than individual characteristics such as demographics, personality, and trait anxiety.