Towards remote leadership in health care: Lessons learned from an integrative review

Aim: To gather and synthesize current empirical evidence on remote leadership and to provide knowledge that can be used to develop successful remote leadership in health care.Design: A integrative literature review with an integrated mixed methods design.Data sources: The literature search was carried out between February and March 2019 in the CINAHL, Medline (Ovid), PsycInfo, Scopus, SocIndex, Web of Science and Business Source Elite (EBSCO) databases.Review methods: An integrative review was conducted to identify relevant studies published from 2010 to 2019. Of the 88 eligible studies, 21 studies met the inclusion criteria and were selected for the final review. The included studies were analysed using mixed methods synthesis, more specifically, data-based convergent synthesis.Results: The performed analysis identified three main themes: characteristics of successful remote leadership; enhancing the leader-member relationship; and challenges in remote leadership. The first theme included the following sub-themes: remote leader characteristics; trust; communication; and leading the team culture. The second theme covered the importance of organizing regular face-to-face meetings, clear communication policies and the connection between positive team spirit and good remote leader-member relationship, while the third theme emphasized leader- and member-related challenges for remote work.Conclusions: As none of the identified studies had been conducted in a health care setting, future remote leadership research must also specifically consider the health care context. This will be pivotal to exploring how remote work can foster a safe workplace culture, empower health care workers, increase job satisfaction and improve patient outcomes.Impact: Remote leadership has rarely been studied in the health care context. Trust, communication, team spirit and a leader's characteristics are central to remote leadership, a finding which is useful for re-evaluating and improving the current culture at health care organizations.</p

Optimoitu sote-ammattilaisten koulutus- ja osaamisuudistus

Hankkeen tavoitteena oli kuvata millaisia osaamistarpeita sote-uudistus synnyttää, mitä olisi tehtävä, jotta näihin uusiin tarpeisiin pystyttäisiin vastaamaan ja mitä tapahtuu, jos tarpeisiin vastaamisessa epäonnistutaan. Tutkimushankkeessa toteutettiin kansainvälinen systemoitu kirjallisuuskatsaus ja meta-analyysi, sote-asiantuntijoiden ja työntekijöiden empiirinen aineistonkeruu, kansallinen osaamishanke-kartoitus sekä verkkokysely koulutuksen asiantuntijoille. Tutkimushankkeen tulokset syventävät ja monipuolistavat sote-ammattilaisten tulevaisuuden osaamistarpeita. Ammattialakohtainen substanssiosaaminen muodostaa tulevaisuuden osaamisen ytimen. Tämän lisäksi kaikkia sote-ammattiryhmiä koskeva geneerinen osaaminen sisältää asiakastyöosaamisen, palvelunkehittämisosaamisen sekä työntekijyyden ja yhteistoiminnan muutososaamisen. Lisäksi tulee arvioida, onko tarvetta uusille tutkinnoille tai nykyisten tutkintojen uusille kelpoisuuksille, jotta sosiaali- ja terveyssektorit ylittävien asiakkuuksien tarpeisiin voitaisiin vastata. Näillä kohdistuksilla ja muutoksilla voidaan varmistaa, että tulevaisuudessa sosiaali- ja terveydenhuollon ammattien osaaminen on ammattialakohtaisesti näyttöön perustuvaa, ja ammattilaisilla on jaettua, toimintaympäristön muutostarpeisiin vastaavaa osaamista tuottaa asiakaslähtöistä ja vaikuttavaa hoitoa ja palvelua. Osaamisen kehittäminen edellyttää aiempaa systemaattisempaa osaamisen arviointia ja näyttöön perustuvien koulutusinterventioiden käyttöä. Uusien geneeristen osaamisalueiden perustaidot tulee sisällyttää sote-alan tutkintoon johtaviin koulutuksiin, mutta erityisen ajankohtaista on vastata osaamisvajeisiin täydentävällä koulutuksella. Työelämässä toteutettavat kehittämishankkeet ovat tarpeen alueelliseen ja paikalliseen osaamisen kohdistamiseen. Osaamiseen kohdistuvien hankkeiden alueellinen ja valtakunnallinen koordinointi tukisi hankkeiden kohdistamista, toteuttamista ja raportointia sekä mahdollistaisi hyvien käytänteiden jakamisen. Sosiaali- ja terveydenhuollon ammatillinen osaaminen on ja tulee olla jatkuvassa muutoksessa, ja keinoja osaamisen parantamiseksi ja ajantasaistamiseksi on kehitettävä ja arvioitava koko ajan

The value that social workers’ competencies add to health care : an integrative review

Health and social care professionals' competencies have traditionally been separated because of the different aims of the two professions. These competencies need to be integrated, to make sure that seamless services are provided that meet the often complex needs of patients and clients in a coordinated and timely way. The aim of this integrative review was to identify, describe and synthetise previous studies on integrated competencies in health and social care. Electronic literature searches were carried out on the CINAHL, ProQuest, PsycInfo, PubMed, Scopus and SocIndex databases for peer‐reviewed scientific papers that were published in English between 1 January 2007 and 31 December 2019. This identified 3,231 papers, after duplicates were removed, and 18 focused on the integration of social workers' competencies with health care. Other types of integration were not found. The value added by integrating social workers' competencies with health care focused on engaging working orientation, improving communication with family members, increasing understanding of service resources and mastering successful discharge procedures so that they met comprehensive, complex health and well‐being needs. Social workers added value when they worked with multi‐professional teams, but there were challenges to integrating competencies and these were related to professional collaboration and fragmented leadership. In future, more attention needs to be paid to diversifying and optimising the integration of professional health and social care competencies that meet clients' and patients' care and service needs. It is also vital to focus on developing the professional and leadership strategies that are needed to combine those competencies

Relationships between nursing leadership and organizational, staff and patient outcomes : A systematic review of reviews

Aim: To assess and describe reviews of nursing leadership styles associated with organizational, staff and patient outcomes. Design: A systematic review of reviews. Methods: Reviews describing a search strategy and quality assessment. The review followed the PRISMA statement. Nine databases were searched in February 2022. Results: After screening 6992 records, 12 reviews were included reporting 85 outcomes for 17 relational, nine task-oriented, five passive and five destructive leadership styles. Transformational leadership, which is one of the relational styles, was the most studied among all the styles. Of the outcomes, staff outcomes were the most reported, notably job satisfaction, and patient outcomes were less reported. Also, mediating factors between relational leadership styles and staff and patient outcomes were identified. Conclusion: Extensive research shows the beneficial impacts of relational leadership; however, destructive leadership research is lacking. Relational leadership styles should be conceptually assessed. More research is needed on how nurse leadership affects patients and organizations.Peer reviewe

Relationships between nursing leadership and organizational, staff and patient outcomes:a systematic review of reviews

Abstract Aim: To assess and describe reviews of nursing leadership styles associated with organizational, staff and patient outcomes. Design: A systematic review of reviews. Methods: Reviews describing a search strategy and quality assessment. The review followed the PRISMA statement. Nine databases were searched in February 2022. Results: After screening 6992 records, 12 reviews were included reporting 85 outcomes for 17 relational, nine task-oriented, five passive and five destructive leadership styles. Transformational leadership, which is one of the relational styles, was the most studied among all the styles. Of the outcomes, staff outcomes were the most reported, notably job satisfaction, and patient outcomes were less reported. Also, mediating factors between relational leadership styles and staff and patient outcomes were identified. Conclusion: Extensive research shows the beneficial impacts of relational leadership; however, destructive leadership research is lacking. Relational leadership styles should be conceptually assessed. More research is needed on how nurse leadership affects patients and organizations

Effects of individual differences, society, and culture on youth-rated problems and strengths in 38 societies

BACKGROUND: Clinicians increasingly serve youths from societal/cultural backgrounds different from their own. This raises questions about how to interpret what such youths report. Rescorla et al. (2019, European Child & Adolescent Psychiatry, 28, 1107) found that much more variance in 72,493 parents' ratings of their offspring's mental health problems was accounted for by individual differences than by societal or cultural differences. Although parents' reports are essential for clinical assessment of their offspring, they reflect parents' perceptions of the offspring. Consequently, clinical assessment also requires self-reports from the offspring themselves. To test effects of individual differences, society, and culture on youths' self-ratings of their problems and strengths, we analyzed Youth Self-Report (YSR) scores for 39,849 11-17 year olds in 38 societies. METHODS: Indigenous researchers obtained YSR self-ratings from population samples of youths in 38 societies representing 10 culture cluster identified in the Global Leadership and Organizational Behavioral Effectiveness study. Hierarchical linear modeling of scores on 17 problem scales and one strengths scale estimated the percent of variance accounted for by individual differences (including measurement error), society, and culture cluster. ANOVAs tested age and gender effects. RESULTS: Averaged across the 17 problem scales, individual differences accounted for 92.5% of variance, societal differences 6.0%, and cultural differences 1.5%. For strengths, individual differences accounted for 83.4% of variance, societal differences 10.1%, and cultural differences 6.5%. Age and gender had very small effects. CONCLUSIONS: Like parents' ratings, youths' self-ratings of problems were affected much more by individual differences than societal/cultural differences. Most variance in self-rated strengths also reflected individual differences, but societal/cultural effects were larger than for problems, suggesting greater influence of social desirability. The clinical significance of individual differences in youths' self-reports should thus not be minimized by societal/cultural differences, which-while important-can be taken into account with appropriate norms, as can gender and age differences