Involving clinicians in management: assessing views of doctors and nurses on hybrid professionalism in clinical directorates

Prenestini, Anna; Sartirana, Marco; Lega, Federico

doi:10.1186/s12913-021-06352-0

Cited by 13 publications

(14 citation statements)

References 44 publications

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“…Moreover, the recent experience of the Covid-19 pandemic has accentuated the need to overcome the traditional rigidity of professional organizations, in favor of a more interdisciplinary and multidisciplinary model. 89 However, academic research in the field of hybrid professionalism seems to struggle to expand on the organizational level of the discourse, beside those - well developed - of macro institutional logics and identity work micro-processes.…”

Section: Discussionmentioning

confidence: 99%

Hybridity enabled: A research synthesis of the enabling conditions for hybrid professionalism in healthcare

Sartirana

Giacomelli

2023

Health Serv Manage Res

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Hybrid professionals in healthcare organizations play a critical role, the characteristics, processes and implications of which have been thoroughly studied by scholars in the field. However, not as much attention has been paid to the conditions under which such roles might be taken by professionals entering the ground of management. This gap results into a lack of conceptual clarity and eventually ends being an obstacle in framing and ameliorating the tools needed to act such a role in its different phases. This is a research area worthy of a finer-grained understanding: the ability of organizations to effectively support role hybridization, in fact, is a requisite for professionals-managers' willingness to stay in the role and cope with the complexity that such a two-fold position entails, no matter what. Based on the results of a scoping literature review, this paper presents the enabling conditions for hybrid professionalism in healthcare, and proposes a classification of them into categories corresponding to different facets of hybrid role-taking: opportunities for interaction with management, tools supporting sense-making, and provision of delegation and autonomy. For each of these categories, organizational and management tools discussed in the literature are presented. The results of the study provide a road-map of the enabling conditions for hybrid professionalism that aims to be of practical convenience for managers and policy-makers in health care. Eventually, suggestions for organizational design and personnel management, as well as directions for further research, are highlighted.

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Section: Discussionmentioning

confidence: 99%

Hybridity enabled: A research synthesis of the enabling conditions for hybrid professionalism in healthcare

Sartirana

Giacomelli

2023

Health Serv Manage Res

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“…2,3 This is what is happened during the pandemic when to healthcare professionals have been asked to learn a 'new normality' imposed by the events. [4][5][6] Although within a hospital, various managerial responsibilities can be assigned to physicians, nurses and 1 Dipartimento di Scienze Economiche e Aziendali "Marco Fanno", Università degli Studi di Padova, Padova, Italy 2 administrative figures, 7 within the currently adopted organizational models, hospital CEOs decentralize the governance of clinical directorates and ward units to specific figures named Clinical Directors and Head of ward units. These are physicians who coordinates at different levels the activity of colleagues as primus inter pares.…”

Section: Introductionmentioning

confidence: 99%

“…These are physicians who coordinates at different levels the activity of colleagues as primus inter pares. 7,8 To them are assigned both clinical and managerial responsibilities, [9][10][11] acting as "twoway windows". 12 During the emergency although all the healthcare professionals dealt with the new virus, adapting their routines, converting physical assets and so on, 13 the designated managers of clinical directorates and ward units have been asked to completely exercise their managerial role.…”

Section: Introductionmentioning

confidence: 99%

Framing doctor-managers’ resilience during Covid-19 pandemic: A descriptive analysis from the Italian NHS

Leonelli

Morandi

Giancipoli

et al. 2023

Health Serv Manage Res

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With the aim of providing evidence about doctor-managers’ resilience during the Covid-19 pandemic, this study analyzes the characteristics of 114 doctor-managers operating within the Italian National Health Service (NHS). During the emergency, doctor-managers had to show adaptive capacities to deal with unexpected situations and develop new paradigms, procedures, and quick responses to patients’ needs. This is in line with resilience, and in this perspective, it is crucial to investigate resilience determinants. The paper, therefore, provides an identikit of the resilient doctor-manager. The research was conducted between November and December 2020. Primary data were collected through an online questionnaire consisting of six sections. Participation was voluntary and anonymous. Data were analyzed using quantitative techniques and employing Stata 16. Confirmatory Factor Analysis was employed to test construct validity and scale reliability. Results show that increasing levels of individual resilience are related to increasing levels of managerial identity. Moreover, physicians’ individual resilience has a positive association with commitment, knowledge diffusion, and Evidence-Based Medicine adoption. Finally, physicians’ individual resilience has a negative association with their role in the university, their specialty, and their gender. The study suggests some practical implications for healtcare organizations. In general, career paths are decided primarily on competency assessment, while an important role should be devoted to behavioral characteristics. Furthermore, organizations should take care of the levels of individual commitment and encourage professional networking because both help doctor-managers cope with uncertainty. The originality of the study relies on a fresh look at all previous work. There are currently few contributions in the literature to explore and investigate resilience elements in doctor-managers during the pandemic era.

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“…Davies et al [ 4 ] argued that physicians are primarily loyal to patients and specialization and commit to the organization only secondarily. They are predominantly focused on patient health, treatment effectiveness, and evidence-based practice, and are less predisposed to embracing their organization’s strategic and operative goals [ 5 ]. Hence, physicians expect discretion when performing their work, with autonomy being a core principle reflected in the predominance of individual/group interests over organizational concerns [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring physician engagement in health care organizations: a scoping review

Prenestini,

Palumbo,

Grilli

et al. 2023

BMC Health Serv Res

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Rationale Enhancing health system effectiveness, efficiency, and appropriateness is a management priority in most world countries. Scholars and practitioners have focused on physician engagement to facilitate such outcomes. Objectives Our research was intended to: 1) unravel the definition of physician engagement; 2) understand the factors that promote or impede it; 3) shed light on the implications of physician engagement on organizational performance, quality, and safety; and 4) discuss the tools to measure physician engagement. Method A scoping review was undertaken. Items were collected through electronic databases search and snowball technique. The PRISMA extension for Scoping Reviews (PRISMA-ScR) statement and checklist was followed to enhance the study replicability. Results The search yielded 16,062 records. After an initial screening, 300 were selected for potential inclusion in this literature review. After removing duplicates and records not meeting the inclusion criteria, full-text analysis of 261 records was performed, yielding a total of 174 records. Discussion Agreement on the conceptualization of physician engagement is thin; furthermore, scholars disagree on the techniques and approaches used to assess its implementation and implications. Proposals have been made to overcome the barriers to its adoption, but empirical evidence about implementing physician engagement is still scarce. Conclusions Our scoping review highlights the limitations of the extant literature about physician engagement. Physician engagement is a relatively ill-defined concept: developing an evidence base for its actual implementation is necessitated to provide reliable guidance on how the governance of health care organizations could be improved. Although we did not assess the quality or the robustness of current empirical research, our findings call for further research to: 1) identify potential drivers of physician engagement, 2) develop dependable assessment tools providing health care organizations with guidance on how to foster physician engagement, and 3) evaluate engagement’s actual impact on health care organizations’ performance.

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Involving clinicians in management: assessing views of doctors and nurses on hybrid professionalism in clinical directorates

Cited by 13 publications

References 44 publications

Hybridity enabled: A research synthesis of the enabling conditions for hybrid professionalism in healthcare

Hybridity enabled: A research synthesis of the enabling conditions for hybrid professionalism in healthcare

Framing doctor-managers’ resilience during Covid-19 pandemic: A descriptive analysis from the Italian NHS

Exploring physician engagement in health care organizations: a scoping review

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