Leadership in the Context of Digital Health Services: A Concept Analysis

Healthcare Professionals' Perceptions of Future Leadership in Digital Healthcare: A Qualitative Study

AIM

To describe and enhance the understanding of healthcare professionals' perceptions of future leadership in digital healthcare.

DESIGN

A qualitative descriptive study.

METHODS

The data were collected remotely between February and November 2022 through semi-structured interviews. A total of 26 healthcare professionals were interviewed individually or in focus group interviews at the university hospital and university in Finland. The data were analysed using inductive content analysis.

RESULTS

Results revealed seven main categories that described the professionals' perceptions of future leadership in digital healthcare: building a future-oriented healthcare, strengthening a digitally minded organisational culture, being interactive in a digital environment, leading sustainably in digital healthcare, leading expertise in digital healthcare, leading collaboratively in digital healthcare and using artificial intelligence in leadership in digital healthcare.

CONCLUSION

Future leadership in digital healthcare will be about leading people in a humane way. Leaders will be at the forefront of digital solutions, sharing their expertise and enabling stakeholders' engagement. Through collaboration, future leaders will be building a future-led digital health system.

IMPACT

Digital healthcare is improving due to the implementation of new digital solutions and the possibility of artificial intelligence. Thus, leaders' competencies in digital healthcare need to be further developed through education and guided by policy to meet the expectations of future professionals, nurses and customers.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

REPORTING METHOD

The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used in the reporting.

A Robust ORMS Framework for Taiwanese Healthcare: Taguchi's Dynamic Method in Action

The study focused on the design of an ORMS in a medical center in central Taiwan, which also functions as a teaching hospital. Background/Objectives: The research objectives were to design an ORMS simulation system based on the status quo of the operating room planning and scheduling in the medical center, obtain the optimal parameter setting in the ORMS, and find improvement strategies according to the sensitivity analysis based on the optimal parameter setting for total performance. Methods: Taguchi's dynamic method was adopted to design the ORMS under human and material resource constraints. The scope of the study was internal medicine patients of the ORMS. A neural network was used to construct a relationship between parameters and performances. A genetic algorithm was used to obtain the optimal parameter setting for optimal performance. Results: This study successfully established a robust operating room management system (ORMS) to help hospital manager to plan and schedule operating rooms and take the ORMS into account to meet patient needs. Decision-makers can use the insights from the sensitivity analysis to refine their strategies effectively. The sensitivity analysis showed that the impact power (the percentage change in d) of the "number of circulating nurses (-0.15 to -1.25; -0.25 to -1.85)" factor was less than (<) that of the "number of holding nurses (-0.85 to -2.04; -0.91 to -2.07)" factor < that of the "number of preoperative beds (-2.57 to -4.53; -2.23 to -4.10)" factor < that of the "number of anesthetists (-3.13 to -7.50)" factor. Conclusions: In the optimal parameter setting obtained, the number of holding nurses was 18, the number of circulating nurses was 20, the number of anesthetists was 15, and the number of preoperative beds was 12. The optimal performance was 0.91.

Revolutionizing healthcare leadership the critical role of digital citizenship in knowledge sharing

This study explores the relationship between digital leadership (DLR), visionary leadership (VSL), and knowledge sharing (KNS) among healthcare professionals in Pakistan, focusing on the mediating role of digital citizenship behavior (DCZ). As leadership becomes increasingly crucial for promoting knowledge sharing in healthcare, understanding how DLR and VSL facilitate this behavior particularly through digital citizenship is essential. A quantitative approach was employed, gathering data from 202 healthcare professionals via a structured questionnaire assessing DLR, VSL, DCZ, and KNS. Structural equation modeling (SEM) was used to analyze the relationships and test the mediating effect of DCZ. Findings reveal significant positive relationships between both DLR and VSL with KNS. Notably, DCZ partially mediates the relationship between DLR and KNS, with a stronger mediation effect observed in this context. In the VSL-KNS relationship, DCZ's mediation was confirmed and indicating partial mediation. These results underscore the importance of fostering digital citizenship behaviors to enhance knowledge sharing, providing valuable insights for leadership development programs aimed at improving organizational performance in healthcare settings.

Sustainable healthcare futures: how digital leadership stimulates nurses' green creativity: a quasi-experimental study

BACKGROUND

In the context of increasing environmental consciousness, integrating sustainable practices in healthcare is essential. Nurses' green creativity, defined as their ability to generate innovative, eco-friendly solutions, is pivotal in this transformation. Digital leadership, which leverages technology to guide sustainable practices, plays a critical role in fostering this creativity among nurses.

AIM

This study aimed to investigate the impact of digital leadership on enhancing nurses' green creativity and to evaluate the effectiveness of digital leadership strategies in promoting sustainability within healthcare settings. Research hypothesis: H1: Participation in a digital leadership program will lead to a significant enhancement in nurses' knowledge about digital leadership.H2: A digital leadership program will have a significantly positive impact on fostering nurses' green creativity.

METHODS

A quasi-experimental design was employed, involving 128 nurses randomly assigned to intervention and control groups. The intervention group participated in a digital leadership training program. Data were collected using a self-administered questionnaire, the Digital Leadership Competency Scale, and the Green Creativity Scale, before and after the intervention.

RESULTS

The mean knowledge score in the intervention group increased from 15.21 ± 4.22 pre-intervention to 44.29 ± 2.61 post-intervention (p < 0.001). For digital leadership competency, the mean score in the intervention group rose from 191.67 ± 20.43 to 552.14 ± 16.72 (p < 0.001). The mean score for green creativity in the intervention group significantly improved from 15.58 ± 1.68 to 42.31 ± 2.54 (p < 0.001).

CONCLUSION

The study concluded that digital leadership programs significantly enhance nurses' green creativity. Integrating digital leadership into nursing practice can promote sustainability and innovation in healthcare settings.

Digital health readiness - insights from healthcare leaders in operational management: a cross-sectional survey

BACKGROUND

Developing countries' public health systems struggle with digital health implementation, and reports of low digital health readiness exist within the workforce. This study investigates the perceived digital health readiness of healthcare leaders in operational management to implement digital health tools.

METHODS

A cross-sectional survey using the E-Ready 2.0 scale was used to measure digital health readiness (n = 329) in 11 hospitals in the Western Cape, South Africa (September 2023 - March 2024). Descriptive statistics summarised respondent characteristics and the E-Ready 2.0 subscales: conditions for change at the workplace and among individuals, support and engagement from management, colleagues' readiness, consequences for the status quo and workplace attitudes. Statements scoring 60% or more were considered to have higher readiness. Chi-square and Mann-Whitney U tests were used to examine associations between demographic variables and subscale statements.

RESULTS

A total of 143 healthcare leaders responded (56.1% response rate) (n = 114 nurses [79.7%], n = 29 medical doctors [20.3%]). The average age was 46.4 ± 10.0 years. Overall, higher levels of readiness (above 70%) were observed with statements related to workplace attitudes, whereas conditions for change at the workplace and among individuals showed lower readiness (below 50%).

CONCLUSION

Despite significant investment in digital health tools, there remains limited digital health readiness among those responsible for leading these implementations.

The impact of digital transformational leadership on digital intensity among primary healthcare entities: a moderated mediation model

BACKGROUND

Uncertain times require healthcare entities to demonstrate strong leadership, develop digitalisation, and respond to change in a creative and flexible manner. Based on emerging new institutional theory, we developed and tested a model of how digital transformational leadership (DTL) affects digital intensity (DI) among healthcare entities through the mediating role of organisational agility (OA). In this article, we also examine the moderating role of the country in the studied relationship.

METHODS

The study population consisted of 400 managers of primary healthcare entities from Poland and the Netherlands. Data was collected using a questionnaire method with a seven-point Likert scale. The gathered data was analysed using descriptive statistics and structural equation modelling (SEM). The analysis was performed using the statistical package SPSS with Andrew F. Hayes PROCESS macro and AMOS v. 29 (Predictive Solution, Poland).

RESULTS

The results of structural equation modelling (SEM) revealed that DTL directly and indirectly affects DI, and OA mediates this relationship. Moreover, this indirect effect is moderated by a country.

CONCLUSION

This study contributes to the development of DI and offers practical insights for managers of primary healthcare entities navigating the uncertainty and volatility of the post-pandemic market. Ultimately, this work provides important insights into the leadership style and agility of healthcare organizations in relation to digital transformation, considering the healthcare system's role.

Current nursing and midwifery contribution to leading digital health policy and practice: An integrative review

AIM

To review the current nursing and midwifery contribution to leading digital health (DH) policy and practice and what facilitates and/or challenges this.

DESIGN

Integrative literature review.

METHODS

Pre-defined inclusion criteria were used. Study selection and quality assessment using the appropriate critical appraisal tools were undertaken by two authors, followed by narrative synthesis.

DATA SOURCES

Six databases and hand searching for papers published from 2012 to February 2024.

FINDINGS

Four themes were identified from 24 included papers. These are discussed according to the World Health Organization's Global Strategic Directions for Nursing and Midwifery and indicate nurses/midwives are leading DH policy and practice, but this is not widespread or systematically enabled.

CONCLUSION

Nurses and midwives are ideally placed to help improve health outcomes through digital healthcare transformation, but their policy leadership potential is underused.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Nurses/midwives' DH leadership must be optimized to realize maximum benefit from digital transformation. A robust infrastructure enabling nursing/midwifery DH policy leadership is urgently needed.

IMPACT

This study addresses the lack of nursing/midwifery voice in international DH policy leadership. It offers nurses/midwives and health policymakers internationally opportunity to: drive better understanding of nursing/midwifery leadership in a DH policy context; enhance population outcomes by optimizing their contribution; Develop a robust infrastructure to enable this.

REPORTING METHOD

Reporting adheres to the EQUATOR network, Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Digital Competence among Healthcare Leaders: A Mixed-Methods Systematic Review

Background

New evidence on the digital competencies of healthcare leaders can provide essential knowledge for building training for the leaders to ensure high-quality patient care.

Objective

The aim of this mixed-methods systematic review was to identify the current best evidence from qualitative, quantitative, and mixed-methods studies on healthcare leaders' digital competence experiences and perceptions and factors associated with it.

Methods

A mixed-methods systematic review was conducted following the Joanna Briggs Institute guidelines for mixed-methods systematic reviews by including original qualitative and quantitative observational studies and mixed-methods studies published in English or Finnish between January 2012 and January 2024. The studies were retrieved from four databases (CINAHL, PubMed, Scopus, and Medic). In total, 4470 articles were screened, 122 were eligible for full-text screening, and 19 articles were included in the review according to the established inclusion and exclusion criteria. Data Extraction and Synthesis. Data tabulation and narrative synthesis for quantitative studies and content analysis for qualitative studies.

Results

The synthesis of qualitative data identified five main categories that describe healthcare leaders' experiences with digital competencies: (1) the need for developing leader's own, professionals', and patients' competence in the digitalisation of healthcare, (2) the need for expertise in the health IT implementation process, (3) positive perceptions towards technology, (4) negative perceptions towards technology, and (5) ability to act as an advocate to implement technology into practice. Data from the selected quantitative studies presents that factors associated with the digital competence of healthcare leaders include individual characteristics, career characteristics, training, and other factors.

Conclusion

This review suggests that developing and supporting healthcare leaders' digital competencies should be considered in healthcare organizations, research, and education to make their digital competencies meet the demands of increasingly digitalising healthcare development work.

Digital leadership: Norwegian healthcare managers' attitudes towards using digital tools

Background

Health services are undergoing digitalization and applying new digital tools. These changes may provide healthcare managers with opportunities to exercise digital leadership. However, managers' attitudes may influence the extent to which they demonstrate digital leadership. This study explores the attitudes of Norwegian healthcare managers towards: (1) digital tools and change and (2) to what extent digital tools are applicable to various tasks of managers.

Methods

Cross-sectional study including 154 managers in hospitals and municipal health services in a Norwegian county. The questionnaire was about management and digital tools, and the data was analyzed by descriptive statistics, correlations, and content analysis.

Results

The healthcare managers perceived that digital tools facilitated a positive change in organizational work processes aligned with values and goals. Digital tools supported administrative tasks such as gaining control over responsibilities. However, 76 managers stated that certain tasks, including interactions with employees (e.g. performance appraisals and sick leave follow-up) and the building of an organizational culture, should not be performed using digital tools or using them only to a limited extent; for these tasks, they preferred in-person meetings.

Discussion

Norwegian healthcare managers' attitudes toward digital tools are generally positive, but there are areas where they find the tools less suitable.

Conclusions

The results provide new insights into healthcare by indicating that many managers may have positive attitudes toward digital tools. However, digital leadership may not be applicable equally in all areas of healthcare managers' work. This raises the question of whether digital leadership can or should be exercised uniformly in every area of health services.

Technology trends in practice: A survey of occupational therapy practitioners

BACKGROUND

Given the evolving digital revolution, technology and digital tools are becoming inseparable from work and daily occupations. Occupational therapy practitioners (OTPs) focus on supporting individuals in their desired and needed activities. Many of these daily activities (i.e., online banking, shopping, social media, smartphone use) require digital skills at a growing rate, and insufficient technological skills may subject individuals to limited engagement and social isolation.

OBJECTIVE

To understand OTPs attitudes regarding technology utilization.

METHODS

We surveyed 109 OTPs about their attitudes, work practices, and barriers to addressing their clients' digital technological functioning.

RESULTS

The findings of our study suggest that while OTPs acknowledge the importance and potential benefit of technology for their clients, there is a notable professional gap in the training and skills of OTPs to support their clients' digital functioning effectively and to integrate technology into their practice.

CONCLUSIONS

There is a need to improve and expand OTP's digital skills and knowledge regarding addressing clients' digital functioning and technology implementation in occupational therapy practice.

Developing Health Management Competency for Digital Health Transformation: Protocol for a Qualitative Study

BACKGROUND

Globally, the health care system is experiencing a period of rapid and radical change. In response, innovative service models have been adopted for the delivery of high-quality care that require a health workforce with skills to support transformation and new ways of working.

OBJECTIVE

The aim of this research protocol is to describe research that will contribute to developing the capability of health service managers in the digital health era and enabling digital transformation within the Australian health care environment. It also explains the process of preparing and finalizing the research design and methodologies by seeking answers to the following three research questions: (1) To what extent can the existing health service management and digital health competency frameworks guide the development of competence for health service managers in understanding and managing in the digital health space? (2) What are the competencies that are necessary for health service managers to acquire in order to effectively work with and manage in the digital health context? (3) What are the key factors that enable and inhibit health service managers to develop and demonstrate digital health competence in the workplace?

METHODS

The study has adopted a qualitative approach, guided by the empirically validated management competency identification process, using four steps: (1) health management and digital health competency mapping, (2) scoping review of literature and policy analysis, (3) focus group discussions with health service managers, and (4) semistructured interviews with digital health leaders. The first 2 steps were to confirm the need for updating the current health service management curriculum to address changing competency requirements of health service managers in the digital health context.

RESULTS

Two initial steps have been completed confirming the significance of the study and study design. Step 1, competency mapping, found that nearly half of the digital competencies were only partially or not addressed at all by the health management competency framework. The scoping review articulated the competencies health service managers need to effectively demonstrate digital health competence in the workplace. The findings effectively support the importance of the current research and also the appropriateness of the proposed steps 3 and 4 in answering the research questions and achieving the research aim.

CONCLUSIONS

This study will provide insights into the health service management workforce performance and development needs for digital health and inform credentialing and professional development requirements. This will guide health service managers in leading and managing the adoption and implementation of digital health as a contemporary tool for health care delivery. The study will develop an in-depth understanding of Australian health service managers' experiences and views. This research process could be applied in other contexts, noting that the results need contextualization to individual country jurisdictions and environments.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/51884.

Nursing Informatics' Contribution to One Health

OBJECTIVES

To summarise contemporary knowledge in nursing informatics related to education, practice, governance and research in advancing One Health.

METHODS

This descriptive study combined a theoretical and an empirical approach. Published literature on recent advancements and areas of interest in nursing informatics was explored. In addition, empirical data from International Medical Informatics Association (IMIA) Nursing Informatics (NI) society reports were extracted and categorised into key areas regarding needs, established activities, issues under development and items not current.

RESULTS

A total of 1,772 references were identified through bibliographic database searches. After screening and assessment for eligibility, 146 articles were included in the review. Three topics were identified for each key area: 1) education: "building basic nursing informatics competence", "interdisciplinary and interprofessional competence" and "supporting educators competence"; 2) practice: "digital nursing and patient care", "evidence for timely issues in practice" and "patient-centred safe care"; 3) governance: "information systems in healthcare", "standardised documentation in clinical context" and "concepts and interoperability", and 4) research: "informatics literacy and competence", "leadership and management", and "electronic documentation of care". 17 reports from society members were included. The data showed overlap with the literature, but also highlighted needs for further work, including more strategies, methods and competence in nursing informatics to support One Health.

CONCLUSIONS

Considering the results of this study, from the literature nursing informatics would appear to have a significant contribution to make to One Health across settings. Future work is needed for international guidelines on roles and policies as well as knowledge sharing.

Nurse leaders' experiences of remote leadership in health care

PURPOSE

This study aimed to describe nurse leaders' experiences of remote leadership in health care sector.

DESIGN/METHODOLOGY/APPROACH

Semistructured interviews were conducted among nurse leaders (N = 12) between January and March 2022. All of the interviewees had experiences of remote leadership and worked as immediate - (n = 5) or middle-level (n = 7) leaders in health care organizations across four provinces in Finland. The collected data were analyzed by inductive content analysis.

FINDINGS

The leaders had experienced a rapid transition to remote leadership and highlighted the need for guidelines and joint discussions with different stakeholders. The interviewees felt that working life has changed in the last two years and that remote leadership will now be a key part of leadership in health care. The leaders' experiences highlighted how important trust is in remote leadership. Furthermore, the interviewees pointed out a need for face-to-face contact and described other good practices for remote leadership. Overseeing work-related well-being was also stressed as important in the remote context; however, the interviewees expressed a need for instructions and tools concerning the management of employee well-being. The sudden change to remote leadership was not only described as interesting but also challenging, which has affected the leaders' work-related well-being. Support - both from the organization and other employees - was found to be crucial to health care leaders' work-related well-being.

ORIGINALITY/VALUE

The current study complements the little-researched topic of remote leadership in the health care sector. The results provide insights that can be used to develop remote leadership and/or guide future research.

Facing the Post-Pandemic Challenges: The Role of Leadership Effectiveness in Shaping the Affective Well-Being of Healthcare Providers Working in a Hybrid Work Mode

The COVID-19 pandemic has brought new challenges to the medical industry, including hybrid work, in which specialists can perform some of their duties remotely, in addition to physical contact with patients and their teams. Hybrid work provides opportunities, but also generates difficulties (e.g., accurate long-distance diagnosis); therefore, there is a need to ensure the well-being of healthcare workers, especially in the context of leadership strategies. As there is little research on leadership practices in remote and hybrid medical worker management, this study analyses the relationship between certain behavioural strategies and competencies of leaders and the affective well-being of hybrid employees. The research was conducted among a group of employees (N = 135) from seven countries who provide healthcare in a hybrid model. The correlations between the variables showed the statistical significance of all leadership strategies introduced into the model and focused on building involvement (employee empowerment and team orientation), creating a shared vision, defining clear goals and strategies, promoting adaptability (change management, promotion of organisational learning and patient focus), managing consistency through shared values, agreement and effective coordination, as well as competencies such as communicativeness, credibility, self-development and digital readiness. Despite the significance of all the relationships, the linear regression showed that the variability of affective well-being was explained mainly by the adaptability leadership strategy. The results of the study expand the knowledge on the competencies of healthcare leaders, and shed new light on the management of medical employees performing remote and hybrid work. Because such research into well-being has not been published to date, the analysis begins an important discussion on redefining leadership in the healthcare sector, taking into account the digital transformation.