Alignment of Perceived Competencies and Perceived Job Tasks among Primary Care Managers

Identifying core leadership competencies to success non-communicable disease control and prevention programs: A mixed-methods study

INTRODUCTION

Strengthening strong leadership skills is essential for program managers to successfully implement programs for the prevention and control of noncommunicable diseases (NCDs). This study identified leadership competencies for managers of individuals with noncommunicable diseases in Iran.

METHODS

The study had three steps: a literature review, an expert panel, and a Delphi technique survey. First, the literature was reviewed to compile a list of leadership competencies in the field of primary health care (public health, NCDs). To refine and adapt the original list of leadership competencies, it was provided to the expert panel in two stages. The list of leadership competencies was sent via email to 30 experts over the course of two Delphi rounds. Descriptive statistics were used to analyze the outcomes.

RESULTS

Fifteen leadership competencies, comprising multisectoral collaboration, political awareness, evidence-informed decision making, risk and disaster management, planning, innovation, leading and managing change, team building, communication, quality improvement, systematic thinking, management, ethics and professionalism, motivation and inspiration and personality, were identified.

CONCLUSION

The leadership competencies identified in this study can be a helpful tool in evaluating and identifying skills, knowledge, and attitudes with program managers for the prevention and control of NCDs and in designing training programs to strengthen leadership skills.

Competencies required for the performance of primary health care managers: a systematic review

This study aimed to identify the competencies required by primary health care managers for the effective performance of their functions. A systematic review was conducted according to PRISMA, in the databases PubMed, Scopus, Web of Science, and CINAHL, up to May 2023, in the last 10 years. The inclusion criteria were quantitative, qualitative, or mixed studies that evaluated the competencies required for primary health care managers and published in English, Spanish, or Portuguese. Methodological quality was assessed using the Mixed Methods Appraisal Tool. This article identified 171 studies, including six to the analysis. The importance of leadership, teamwork, and communication was highlighted. Furthermore, the need for disciplinary training in the health area, knowledge in administration, and use of management indicators, as well as an autonomous and flexible attitude to challenges were highlighted. The evaluation of methodological quality showed an overall good performance, except for some studies that do not report sufficient information to determine sample representativeness. Primary health care managers must possess specific competencies to effectively perform their roles, given the relevance of primary care in each country's health system. This study provides a general framework of the required competencies for managerial responsibilities in this area. However, it is necessary to consider the particularities and local contexts of each center to develop managerial profiles adapted to their specific needs.

Nurse leaders' interpersonal communication competence: A mixed-method systematic review

AIM(S)

To identify and synthesize evidence available on nurse leaders' interpersonal communication competence.

DESIGN

Systematic mixed-methods review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist.

METHODS

The data were collected following predefined inclusion criteria. Two authors independently performed the study selection using Covidence software. Three authors assessed the quality using Joanna Briggs' Institute's critical appraisal tool and the mixed-methods appraisal tool. The data-based convergent synthesis design and narrative synthesis were used.

DATA SOURCES

CINAHL, PubMed, Scopus, Business Source Elite, Academic Search Premier, Communication & Mass Media Complete, PsycInfo, Web of Sciences, Medic and Finna.fi were searched and the screening of citations in relevant articles. The final searches were performed on 17 October 2022.

RESULTS

A total of 26 studies-15 quantitative, 9 qualitative and 1 of both mixed-method and multi-method-met the inclusion criteria. The nurse leaders' interpersonal communication competences described in the extant literature were categorized into three themes: message competence, relational competence and task competence. There were considerable differences in the levels of competence, as some competences were considered basic communication skills, while others required more advanced level competences. Furthermore, three competence levels were identified: novice, competent and expert.

CONCLUSIONS

This study unravels a unique hierarchical description of communication skills across competence categories, supported by the assumption that communication skills are structured hierarchically. The studies reviewed herein had a narrow perception of nurse leaders' interpersonal communication competence and indicated a transmissional understanding of communication.

IMPACT

This is the first mixed-methods systematic review that describes and synthesizes the evidence on nurse leaders' communication competencies hierarchically and across competence levels. The study suggests that further research should focus on a broader and more analytical understanding of the cognitive and affective aspects of interpersonal communication competence.

PROSPERO ID

CRD42023385058.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Suggesting a holistic framework for understanding healthcare services leadership competence - a critical interpretive synthesis

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.

Impact of Critical Success Factors on Project Success Through the Mediation of Knowledge Creation

Several factors affect health project success. This research aims to examine the impact of critical success factors on health project success and show how the essential factors of success interact with knowledge creation to impact health project success. The self-administered questionnaire was distributed to collect data from 246 managers, supervisors and zonal supervisors of DHQ hospital Attock and PIMS hospital Islamabad. The analysis was done using Smart PLS to understand the effect of exogenous variables over endogenous variables and the impact of mediating variables between two constructs. The results show that all critical success factors (MGTRF, DRF, CRF, PMRF, CLRF) are significantly affecting project success, in addition, tacit knowledge creation mediate the association between critical success factors and project success. In contrast, explicit knowledge creation does not mediate the relationship between critical success factors and project success. This study intends to expand the theoretical understanding of process improvement by providing practical insights into the impact of strategies used by project managers to develop new knowledge by capturing explicit and implicit information. This study also reinforces past findings and increases awareness about using knowledge creation to gain a competitive advantage in the health sector.

Perceived importance of competencies by nurse managers at all levels: A cross-sectional study

AIM

To explore nurse managers' perceived importance of competencies for their current job at different levels and the associated factors.

BACKGROUND

Little work to date has explored the perceived importance of competencies in nursing leadership and management or considered the related factors in the Taiwan healthcare context.

METHODS

Data collected from a previous large study comprising a cross-sectional web-based survey were analysed. Kruskal-Wallis test, two-sided Fisher exact test and multiple linear regression models were used for statistics analysis.

RESULTS

The mix of three skills in Katz's model indicated that human skills were equally important in all three managerial levels. Of the 23 competencies, effective communication and political astuteness were rated by nurse managers at all levels as the highest-scored (M = 4.88, SD = 0.34) and lowest-scored competency (M = 3.92, SD = 0.78), respectively. Managerial level was a significant predictor of the perceived importance of competency.

CONCLUSIONS

Relationship-based competencies were prominent in the perceived importance of competencies among nurse managers at different levels. Managerial hierarchy influences the relative importance of the different managerial competencies.

IMPLICATIONS FOR NURSING MANAGEMENT

This study's results provide the talent strategy framework required for improving the competencies of nurse managers at all levels.

Financial sustainability strategies of public primary health care centres in the Republic of Srpska, Bosnia and Herzegovina

BACKGROUND

The literature on the functioning of public health facilities in health systems with significant arrears is limited. The growing liabilities of health facilities and the accumulating arrears have been a challenge in the Republic of Srpska. Most public primary healthcare (PHC) centres generated a gross loss in 2018.

METHOD

Guided by the 'positive deviance' approach, we used an exploratory case study design to identify strategies used by managers to achieve financial sustainability in eight top-performing PHC centres. Qualitative data were collected through face-to-face in-depth semistructured interviews with key informants from the PHC centres that reported positive financial results in 2018.

RESULTS

Seven organisational goals, comprising 34 financial sustainability strategies, were recognised during the data analysis and were used to build an organisational-level model for a PHC centre.

CONCLUSION

Managers concurrently used multiple strategies to ensure financial sustainability. Each centre tailored its range of strategies to the organisational context, local context, and wider environment of the health system. The strategies were conceived and implemented by managers operating at different organisational levels under the leadership of top-level managers. Managers of indebted health facilities can learn from the positively deviant peers who manage facilities that achieved satisfactory financial performance.