Adaptive leadership in health care: a rapid review

Objective Adaptive leadership has gained attention in health care as a useful framework for navigating increasing complexity and unpredictability. This rapid review examined the application of adaptive leadership in healthcare settings and the associated outcomes. Methods The systematic search was conducted in Medline Complete, PubMed, Embase, CINAHL and PsycInfo databases. Articles were included if they were peer-reviewed empirical studies on adaptive leadership in primary and acute healthcare settings that assessed an organisational or individual outcome, and were published between 2010 and 2025. Results Fifteen peer-reviewed studies were eligible for inclusion. Several main study designs were present, with one-third being case studies, case reports or case series. Three studies used a cross-sectional quantitative survey and another was quasi-experimental. Adaptive leadership was primarily used as a framework to analyse qualitative data. Two studies applied it as a problem-solving approach and three studies measured it quantitatively. While acknowledging the limitations of drawing causal inferences from case studies and qualitative research, study authors generally interpreted their results as supporting positive effects of adaptive leadership, including its role in: (a) supporting change initiatives and innovation in care planning; (b) improving safety citizenship behaviours, increasing employee engagement and facilitating the identification of process improvements; and (c) enhancing trust, helping patients co-create solutions and learn new skills. Conclusions The scarcity of research and diversity of outcomes limits the overall conclusions that can be made regarding the efficacy of adaptive leadership in health care. Further research is required with more rigorous study designs examining direct applications of adaptive leadership

A systematic review of well-being interventions and initiatives for Australian and New Zealand emergency service workers

Emergency service workers (i.e., police, fire, ambulance, rescue personnel) are exposed to stressful events that can adversely impact their mental health and well-being. This systematic review investigated (1) what well-being initiatives and interventions have been implemented with Australian and New Zealand emergency service workers, (2) how they have been evaluated, and (3) whether they were effective. A systematic literature search identified 19 peer-reviewed studies eligible for inclusion. Eleven studies examined secondary interventions, seven examined primary interventions and only one study examined a tertiary intervention. Most studies measured mental health outcomes (e.g., depression, anxiety). However, some studies used evaluation measures that were not directly related to mental health or well-being (e.g., satisfaction, changes to attitudes). Interventions including physical activity, manager mental health training, social support, psychological debriefing, mindfulness, and an ambulance chaplaincy initiative were found to lead to improvements in mental health and well-being in Australian and New Zealand emergency service workers. Only two ongoing and self-sustaining mental health initiatives were reported. Further research is required into primary interventions and organisational-level initiatives to enable a preventative approach to mitigate daily stress and enhance the mental and physical well-being of emergency workers. What is already known about this topic:Emergency service workers have higher rates of Post-Traumatic Stress Disorder (PTSD), anxiety, and depression than the general population.Evidence based mental health and well-being support is crucial for emergency service workers to ensure they can protect their respective communities effectively.Research focused on the prevalence of mental health issues for emergency workers is well represented in the literature, however, evidence for interventions designed to improve mental health outcomes is scarce. Emergency service workers have higher rates of Post-Traumatic Stress Disorder (PTSD), anxiety, and depression than the general population. Evidence based mental health and well-being support is crucial for emergency service workers to ensure they can protect their respective communities effectively. Research focused on the prevalence of mental health issues for emergency workers is well represented in the literature, however, evidence for interventions designed to improve mental health outcomes is scarce. What this topic adds:This review contributes by identifying and evaluating studies focused on mental health and well-being interventions for emergency service workers in Australia and New Zealand.This review distinguished between interventions (programs with defined start and end points) and initiatives (programs that are ongoing and self-sustaining), and only two initiatives were reported.Interventions that led to improvements in mental health and well-being were those related to mindfulness, physical activity, manager mental health training, social support, psychological debriefing, and an ambulance chaplaincy initiative. This review contributes by identifying and evaluating studies focused on mental health and well-being interventions for emergency service workers in Australia and New Zealand. This review distinguished between interventions (programs with defined start and end points) and initiatives (programs that are ongoing and self-sustaining), and only two initiatives were reported. Interventions that led to improvements in mental health and well-being were those related to mindfulness, physical activity, manager mental health training, social support, psychological debriefing, and an ambulance chaplaincy initiative.</p