Clinical Leadership and the Changing Governance of Public Hospitals: Implications for Patient Experience

Veronesi, Gianluca; Kirkpatrick, Ian; Altanlar, Ali

doi:10.1111/padm.12183

Cited by 34 publications

(39 citation statements)

References 42 publications

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“…Turning our attention to the European settings, Veronesi et al [ 12 ] report that a greater ratio of clinical members on governing boards of English hospital trusts generates better ratings of the quality of the service provided, as well as being associated with a reduction in morbidity rates. In a later study, Veronesi et al [ 39 ] also show that the involvement of clinicians on the board of directors improves the overall patient experience of the care provided by acute hospitals when clinical managers operate in a more autonomous organisational form. A similar methodology was also applied to the Italian NHS, where Sarto and colleagues [ 22 ] find a positive correlation between the clinical background of public hospital CEOs and quality outcomes, measured as medical and surgical appropriateness as well as patient length of stay in hospital.…”

Section: Analysis Of the Literaturementioning

confidence: 99%

Clinical leadership and hospital performance: assessing the evidence base

Sarto¹,

Veronesi²

2016

BMC Health Serv Res

128

110

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Background: A widespread assumption across health systems suggests that greater clinicians' involvement in governance and management roles would have wider benefits for the efficiency and effectiveness of healthcare organisations. However, despite growing interest around the topic, it is still poorly understood how managers with a clinical background might specifically affect healthcare performance outcomes. The purpose of this review is, therefore, to map out and critically appraise quantitatively-oriented studies investigating this phenomenon within the acute hospital sector. Methods: The review has focused on scientific papers published in English in international journals and conference proceedings. The articles have been extracted through a Boolean search strategy from ISI Web of Science citation and search source. No time constraints were imposed. A manual search by keywords and citation tracking was also conducted concentrating on highly ranked public sector governance and management journals. Nineteen papers were identified as a match for the research criteria and, subsequently, were classified on the basis of six items. Finally, a thematic mapping has been carried out leading to identify three main research sub-streams on the basis of the types of performance outcomes investigated. Results and contribution: The analysis of the extant literature has revealed that research focusing on clinicians' involvement in leadership positions has explored its implications for the management of financial resources, the quality of care offered and the social performance of service providers. In general terms, the findings show a positive impact of clinical leadership on different types of outcome measures, with only a handful of studies highlighting a negative impact on financial and social performance. Therefore, this review lends support to the prevalent move across health systems towards increasing the presence of clinicians in leadership positions in healthcare organisations. Furthermore, we present an explanatory model summarising the reasons offered in the reviewed studies to justify the findings and provide suggestions for future research.

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Section: Analysis Of the Literaturementioning

confidence: 99%

Clinical leadership and hospital performance: assessing the evidence base

Sarto¹,

Veronesi²

2016

BMC Health Serv Res

128

110

View full text Add to dashboard Cite

show abstract

“…The results show that organisations, and hospitals in particular, would be better off increasing the overall level of heterogeneity in their boardrooms as this leads to improved overall organisational performance. This finding is particularly significant given the increasing pressures on public sector organisations, and specifically hospitals, to not only improve the quality of services and the efficient use of resources, but also to improve the experience of patients (Veronesi, Kirkpatrick, & Altanlar, 2015). Furthermore, the study emphasises how line managers play a crucial role in relation to staff satisfaction in particular with reference to motivation levels of employees, their perception of the organisation as a positive place to work in and, in general, their contentment with the managerial styles and practices adopted.…”

Section: Discussionmentioning

confidence: 99%

Board Heterogeneity and Organisational Performance: The Mediating Effects of Line Managers and Staff Satisfaction

2016

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Upper Echelons (UE) theory posits that organisational performance reflect the personal values and cognitive frames of the top management team (TMT) and, crucially, that greater heterogeneity in individual backgrounds of senior executives leads to better outcomes.However, often missing from this research is a more developed account of how this relationship between the characteristics of TMTs and performance is also mediated by internal conditions within organisations. In this paper we begin to address this deficiency focusing on the mediating impact of employee satisfaction and the styles and practices of line managers. Looking at the empirical case of English National Health Services acute care hospital trusts, we use a multiple mediation model to analyse the relationship between board heterogeneity, performance and these two (internal) organisational factors. A variance-based structural equation modelling approach (Partial Least Square) is applied to a sample of 102 boards of directors. First, the results lend support to the UE hypothesis that there is a positive impact of board heterogeneity and hospital-level performance. Second, the analysis shows that the relationship heterogeneity-performance is positive influenced by: a) the styles and practices of line managers; b) the levels of staff satisfaction; and by their mutually reinforcing roles.

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“…Simple, easy-to-action findings also exist. For example, Veronesi et al 4 found a quality premium associated with increased numbers of clinicians on trust boards. Interestingly, the improvement (in patient experience) was only significant when clinician numbers were four or more with five yet more significant.…”

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confidence: 99%