Leadership research in healthcare: A realist review

Abstract

Being largely considered a human right, healthcare needs leaders who are able to make choices and to set directions. Following the recommendations expressed by Gilmartin and D'Aunno's review and roadmap compiled in 2008, today, it is important to acknowledge researchers' contributions to outline this landscape. The realist review of 77 publications answered questions such as "what works, for whom, and in which circumstances" highlighting: the effectiveness and acceptance of transformational and collaborative approaches; professionalism, expertise, and good task delegation within operational teams; distributed leadership, relationships, and social responsibility at a systemic level. The relevancy and need of leadership development programs, framed within a wider strategy, emerged. Nonetheless, gaps still exist and require further investigation: particular needs in public vs. private contexts; professionals' and women's differentiating characters; generational gaps; associations between leadership and recruitment HR practices research; how (and if) leaders (should) influence the organizational culture and values; and developing countries specific challenges. Also, a greater proportion of relevant findings should be drawn by empirical and more rigorous studies. Finally, a major attention could be paid to interactions happening at the team, organizational, and systemic level among different leaders and among leaders, followers and external actors.

The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis

“…Powell et al, 350 West et al, 364 Roland et al, 365 Apekey et al 376 and Lega et al 377 Team and organisational development (mechanisms)…”

“…van Dongen et al, 348 Powell et al, 350 Roland et al, 365 Akhnif et al, 366 Perreira et al, 367 Lega et al, 377 McMullen et al 378 and Storey et al 379 Leadership development (mechanisms) van Dongen et al, 348 Ghate et al, 362 West et al, 364 Roland et al, 365 Donahue et al, 368 Fillingham and Weir, 91 Smith et al, 369 Timmins, 370 Frich et al, 371 Hardacre et al, 372 Rosenman et al, 373 West et al, 374 Willis et al, 375 Apekey et al, 376 McMullen et al 378 and Storey et al 379…”

“…A longer-term view is needed to build the relationships that are needed to support complex change, and this will also help to develop insight to spot opportunities in an environment of ambiguity and uncertainty. 372 A key priority is to develop primary care staff, at all levels, to support quality improvement and innovation, 365,376,377 with a clear role for mid-level managers in creating and sustaining change. 368,378 The pace and scale of change involved in new models has the potential to demotivate staff.…”

Success factors of high performance organization transformations

“…The realist review of the literature should answer questions such as "What works, for whom, and under which circumstances?" (Lega et al, 2017). We give shape to this approach by first conducting a review of the current literature on large-scale transformations, then collecting and summarizing findings from multiple case studies involving HPO transformations, and finally comparing these to arrive at a theoretical and practical sound overview of success factors.…”

Ledelsesutvikling for leger

“…Legers kompetanse i ledelse er satt på dagsordenen nasjonalt og internasjonalt, og en rekke forfattere har pekt på at det bør etableres en mer systematisk tilnaerming til ledelsesutvikling for leger (6)(7)(8)(9)(10). Medisinstudenter har poengtert at dagens studenter er fremtidens helseledere, og har etterlyst økt oppmerksomhet om ledelse i grunnutdanningen og mulighet for studieløp som kombinerer utdanning i helseledelse med medisinstudiet (11).…”