Experiences of healthcare middle managers in developing capacity and capability to manage complexity: a systematic review protocol

Hartviksen, Trude Anita; Aspfors, Jessica; Uhrenfeldt, Lisbeth

doi:10.11124/jbisrir-2016-003286

Cited by 5 publications

(13 citation statements)

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“…There is thus broad knowledge about the roles HMMs are anticipated to fulfill. There is less knowledge about how to acquire these specific competencies, within a complex and changing organization [ 9 , 12 , 15 , 18 ]. Dickson [ 3 ] suggests that present leadership should be understood through complexity theory.…”

Section: Introductionmentioning

confidence: 99%

Healthcare middle managers` experiences developing leadership capacity and capability in a public funded learning network

Hartviksen

Sjølie

Aspfors

et al. 2018

BMC Health Serv Res

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BackgroundHealthcare middle managers (HMMs) have, as the leaders closest to clinical practice, a crucial position in healthcare today. There is broad knowledge about the demands on HMMs’ capacity, their situation in general, and the challenges this presents for the improvement of healthcare quality. There is less knowledge about how to facilitate HMMs` capacity and capability with regard to their leadership and how to handle this in a complex context. The purpose of this study was to identify and discuss the facilitation of HMMs’ development of capacity and capability for leadership.MethodA critical hermeneutic design was chosen. Data were collected through three focus group interviews with Norwegian HMMs who participated in a learning network. A user representative (from among the recipients of public healthcare), involved in the same learning network, participated in all three interviews. A qualitative interpretive approach guided the analysis.ResultsThe results show two main themes: 1. Trusted interaction despite organizational and structural frames and 2. Knowledgeable understanding of a complex context.ConclusionThis learning network facilitated HMMs` development of capacity and capability for leadership. The development included a combination of understanding the complex context, knowledge, trust, and confidence. The approaches in the learning network were based on transformative learning, coherence, reflection, discussion, repetition, knowledge sharing, and short lectures. These approaches can be recommended for the facilitation and support of HMMs.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3259-7) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Healthcare middle managers` experiences developing leadership capacity and capability in a public funded learning network

Hartviksen

Sjølie

Aspfors

et al. 2018

BMC Health Serv Res

Self Cite

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“…This comprehensive systematic review was based on an a priori published, peer-reviewed protocol [12], which implies similarities in the design and methods between this review and the published protocol. Both the review and protocol were inspired by the meta-aggregation guidelines established in the Joanna Briggs Institute (JBI) Reviewers’ Manual for qualitative studies [46–48], where both the appraisal and extraction processes before the synthesis added to the critical perspective.…”

Section: Methodsmentioning

confidence: 99%

“…The aggregation combined the parts into a whole that was more than the sum of the individual results, which is analogous to a meta-analysis. Based on the a priori published, peer-reviewed protocol [12], the method involved a process of seven steps: 1. formulating a PICo question (Participants, phenomena of Interest, Context), 2. developing a search strategy, 3. searching for knowledge, 4. selecting studies, 5. critically appraising studies, 6. extracting and analysing data and 7. synthesizing data [46]. These seven steps were implemented while conducting this review and were followed up through the presentation of the methods and results.…”

Section: Methodsmentioning

confidence: 99%

“…HMMs’ capacity and capability have been shown to develop through several different individual and collaborative approaches. These approaches have included learning specific competencies through cognitive, social, and technical strategies, system thinking, personal mastery, mental models, the development of a shared vision, team learning, training, programmes, management systems and coaching [12]. Developing assignments, feedback and training in actual organizational challenges, and the prioritization of leadership development in the organization have proven to be good strategies [13, 14].…”

Section: Introductionmentioning

confidence: 99%

“…Developing assignments, feedback and training in actual organizational challenges, and the prioritization of leadership development in the organization have proven to be good strategies [13, 14]. HMMs’ development of capacity and capability involves self-awareness [14] and changing integrated cultures, attitudes and habits [12]. However, leadership development programs have had a tendency to focus on skills training and technical and conceptual knowledge, and to a lesser extent on personal growth and awareness [15].…”

Section: Introductionmentioning

confidence: 99%

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Healthcare middle managers’ experiences of developing capacity and capability: a systematic review and meta-synthesis

Hartviksen

Aspfors

Uhrenfeldt

2019

BMC Health Serv Res

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Background Healthcare middle managers play a central role in reducing harm, improving patient safety, and strengthening the quality of healthcare. The aim of this systematic review was to identify the present knowledge and critically discuss how healthcare middle managers experienced to develop the capacity and capability for leadership in a healthcare system characterized by high complexity. Methods This comprehensive systematic review provided evidence of healthcare middle managers’ experiences in developing the capacity and capability for leadership in public healthcare. The three-step literature search was based on six databases and led by a PICo question. The review had a critical hermeneutic perspective and was based on an a priori published, protocol. The methods were inspired by the Joanna Briggs Institute and techniques from Kvale and Brinkmann. The results were illustrated by effect size, inspired by Sandelowski and Barroso. Results Twenty-three studies from four continents and multiple contexts (hospitals and municipal healthcare) published from January 2005–February 2019 were included. Based on experiences from 482 healthcare middle managers, 2 main themes, each with 2 subthemes, were identified, and from these, a meta-synthesis was developed: Healthcare middle managers develop capacity and capability through personal development processes empowered by context. The main themes included the following: 1. personal development of capacity and capability and 2. a need for contextual support. From a critical hermeneutic perspective, contrasts were revealed between how healthcare middle managers experienced the development of their capacity and capability and what they experienced as their typical work situation. Conclusions This review provides evidence of the need for a changed approach in healthcare in relation to criticisms of present organizational structures and management methods and suggestions for how to strengthen healthcare middle managers’ capacity and capability for leadership in a healthcare system characterized by high complexity. Evidence of how leadership development affected the clinical context and, thus, the quality of healthcare was found to be a field requiring further research. PROSPERO registration number CRD42018084670

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Capability as a concept in advanced practice nursing and education: a scoping review protocol

Whitfield

Bleah

Bachynski

et al. 2022

JBI Evidence Synthesis

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Experiences of healthcare middle managers in developing capacity and capability to manage complexity: a systematic review protocol

Abstract: The objective of this review is to explore the experiences of healthcare middle managers in developing capacity and capability to manage in a leadership role characterized by high complexity.

Cited by 5 publications

References 26 publications

Healthcare middle managers` experiences developing leadership capacity and capability in a public funded learning network

Healthcare middle managers` experiences developing leadership capacity and capability in a public funded learning network

Healthcare middle managers’ experiences of developing capacity and capability: a systematic review and meta-synthesis

Capability as a concept in advanced practice nursing and education: a scoping review protocol

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