Department of Business Administration and Social Sciences, Molde University College, Molde, Norway.
Leadersh Health Serv (Bradf Engl). 2024 Apr 15;37(5):99-129. doi: 10.1108/LHS-08-2023-0059.
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.
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.
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.
由于对服务的需求不断增加且更加复杂，医疗保健服务提供者面临压力。预算和人力资源的压力增加，使得问题不断增加。需要有能力的领导者来确保有效的、表现良好的医疗保健组织提供平衡的结果和高质量的服务。研究人员已经做出了巨大的努力来确定和定义医疗保健领导力的决定性能力。然而，诸如“能力”等广泛的术语本身存在变得过于通用而无法增加分析价值的风险。本研究的目的是为理解医疗保健领导力能力提出一个整体框架，这对于为研究人员、决策者和从业者实施重要的医疗保健领导力能力至关重要。
设计/方法/方法：在本研究中，进行了批判性解释性综合（CIS），以分析医疗保健领导者的能力描述。这些描述来自于 2010 年至 2022 年期间发表的旨在确定医疗服务领导力能力的同行评审实证研究。扎根理论用于对数据进行编码，并归纳出新的医疗保健领导力能力类别。然后对分类进行分析，提出医疗保健领导力能力的整体框架。
共有 41 篇论文被纳入审查。对能力描述进行编码和分析导致了 12 个医疗保健领导力能力类别：（1）性格，（2）人际关系，（3）领导力，（4）专业精神，（5）软性人力资源管理，（6）管理，（7）组织知识，（8）技术，（9）医疗保健环境知识，（10）变革与创新，（11）知识转化，（12）跨越边界。基于这一结果，提出了一个理解和分析医疗服务领导力能力的整体框架。该框架表明，医疗保健领导力能力的 12 个类别包括一系列知识、技能和能力，可以在个人和技术维度、组织内部和外部能力方面进行理解。
研究局限性/影响：本文献综述仅对两个电子数据库的检索结果进行了分析。因此，可能存在可以为能力类别或可能与本分析中使用的一些描述相矛盾的实证研究，这些描述被认为相当协调。CIS 也可以进行更广泛的搜索，包括灰色文献、书籍、政策文件等，但本研究仅限于同行评审的实证研究。这种限制也可能影响结果，因为复杂的现象，如能力，可能在书籍等中更详细地揭示。
医疗保健领导力能力的整体框架提供了对“模糊”概念（如能力）的共同理解，并可用于确定医疗保健组织的具体能力需求，制定医疗保健领导力的战略能力计划和教育计划。
原创性/价值：本研究揭示了人们对能力概念的使用和理解缺乏共识，并且纳入论文中讨论的关键能力在涉及他们所涉及的知识、技能和能力方面描述得非常不同。这对医疗服务领导力能力的实施提出了挑战。提出的医疗服务领导力能力框架提供了对工作相关能力的共同理解，并提供了基于整体框架分析关键领导力能力的可能性。
