Configurations of leadership practices in hospital units

Meier, Ninna

doi:10.1108/jhom-01-2014-0009

Cited by 16 publications

(8 citation statements)

References 40 publications

(61 reference statements)

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“…Finally, medical leaders must influence and negotiate (N = 2) with, medical peers, non-medical managers, and stakeholders outside the hospital to acquiesce the changes that are necessary for organizational purposes. In the processes of negotiating or influencing, medical leaders must balance between clinical and organizational practices to safeguard both the quality and efficiency of care [ 2 , 15 , 53 ]. Some even argue that the effectiveness of these processes will increase if a physician acts as a leader instead of a manager who seeks to exercise authority over others [ 8 , 15 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…Recently, medical leadership in hospitals has received increasing attention from both scholars and practitioners. Medical leadership is considered to play an important role in improving organizational performance, including the quality of care, patient safety and cost-efficient care [ 1 , 2 , 3 , 4 ]. Furthermore, many argue that medical leadership is necessary for overcoming the divide between medical and managerial logics in hospitals that hampers improvement in healthcare [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Medical leaders or masters?—A systematic review of medical leadership in hospital settings

et al. 2017

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Medical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal the different conceptualizations of medical leadership in terms of definitions, roles and activities, and personal–and context-specific features. Eight databases were systematically searched for eligible studies, including empirical studies published in peer-reviewed journals that included physicians carrying out a manager or leadership role in a hospital setting. Finally, 34 articles were included and their findings were synthesized and analyzed narratively. Medical leadership is conceptualized in literature either as physicians with formal managerial roles or physicians who act as informal ‘leaders’ in daily practices. In both forms, medical leaders must carry out general management and leadership activities and acts to balance between management and medicine, because these physicians must accomplish both organizational and medical staff objectives. To perform effectively, credibility among medical peers appeared to be the most important factor, followed by a scattered list of fields of knowledge, skills and attitudes. Competing logics, role ambiguity and a lack of time and support were perceived as barriers. However, the extent to which physicians must master all elicited features, remains ambiguous. Furthermore, the extent to which medical leadership entails a shift or a reallocation of tasks that are at the core of medical professional work remains unclear. Future studies should implement stronger research designs in which more theory is used to study the effect of medical leadership on professional work, medical staff governance, and subsequently, the quality and efficiency of care.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Medical leaders or masters?—A systematic review of medical leadership in hospital settings

et al. 2017

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“…In addition to considering the leadership of a trauma team from an individual leader's perspective, however, the leadership can also be perceived as a collective and relational phenomenon. Leadership may be regarded, for example, as coordinated, contingent, distributed, functional, flexible or shared (Brandstorp et al, 2015;Klein et al, 2006;Meier, 2015;Paquin et al, 2018), and perceived as inextricably bound to its context (Endrissat and von Arx, 2013).…”

Section: Introductionmentioning

confidence: 99%

An ethnographic study on leadership-as-practice in trauma simulation training

Vuojärvi

Korva

2020

LHS

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Purpose This study aims to discover how leadership emerges in a hospital’s trauma team in a simulated trauma care situation. Instead of investigating leadership from a leader-centric perspective, or using a metrics-based approach to reach generalizable results, the study aims to draw from post-heroic theories by applying leadership-as-practice and sociomaterial perspectives that emphasize the cultural-historical context and emergent nature of leadership. Design/methodology/approach The study was conducted in a Finnish central hospital through ethnographic observations of 14 in situ trauma simulation trainings over a period of 13 months. The data consist of vignettes developed and written from field notes. The analysis was informed by the cultural-historical activity theory. Findings Leadership in a trauma team during an in situ simulation training emerges from a complex system of agencies taking place simultaneously. Contextual elements contributed to the goal. Clarity of roles and task division, strong execution of leadership at critical points, active communication and maintenance of disciplined communication helped to overcome difficulties. The team developed coordination of the process in conjunction with the care. Originality/value The study considers trauma leadership to be a practical phenomenon emerging from the trauma team’s sociomaterial context. The results can be used to develop non-technical skills training within the field of simulation-based medical training.

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“…One strategy that has been broadly employed in working to meet these targets has involved decentralizing leadership (Kim et al, 2014;Meier, 2015). In many facilities, this has meant a move from centralized and hierarchical departmental structures for occupational therapists to more decentralized program-based assignments for clinicians (Salvatori, Simonavicius, Moore, Rimmer, & Patterson, 2008).…”

mentioning

confidence: 99%