A Framework for Developing Leadership Model Based on National Culture Aspects

This is a conceptual paper inspired by studies that focus on leadership in specific cultural settings. It is based on the assumption that there is a systematic way by which national culture shapes multinational corporations’ leadership styles. Such leadership styles should be consistent with host-countries’ cultural values shared by members working in companies’ subsidiaries.  Unfortunately, researches conducted on such area failed to present a simple model for managers and executives to implement it. Further, companies attempts to identifying the company-specific leadership attributes that apply around-the-world, failed in employing the right steps and procedures. This paper proposes a framework that helps in bridging a gap between theory and practice. It proposes a user-friendly framework to help companies develop their unique leadership model. When companies apply such framework on their subsidiaries in different host countries, they will be able to identify and consider the generalizable and idiosyncratic (context-specific) characteristics of effective leadership. This will increase the companies’ ability to maintain its competitive advantage and to activate its code of conduct. The paper also presents a checklist based on which companies can follow up on the process presented in the framework. The framework focuses on leaders’ activities, followers’ perception towards leadership styles, as well as the contextual factors, other than culture, that may impact this process. This is not a onetime process. It should be replicated, especially if host-countries experience unusual social changes, or companies are entering new markets. The paper proposes that both case study research and action research are the best research methodologies that help in implementing the framework and building the leadership model. Key words: national culture, leadership, cultural fit, contextual factors

A Gap Between Theory and Practices: Best Leadership Practices in Multinational Corporations: An Egyptian Case Study

Purpose – This research aims to describe leadership practices that fit into Egypt national culture, in Multinational Companies (MNCs) work environment. Taking two of the top companies in leadership field as an example, this research helps in presenting guidelines for the best leadership practices for MNCs, operating in Egypt.Design/methodology/approach – This research employed qualitative case study, using semi-structured interviews. Two-case studies were conducted to reach more comprehensive findings. Findings –Leadership practices associated with Egypt’s national culture are macro managing employees; involving employees in decision making;  providing clear vision and objectives; maintaining context which includes providing clear rules and guidelines, coaching employees, maintaining a follow up system on employees performance  and maintaining a clear rewarding and penalizing system; and focusing on humane aspects which includes managing conflicts, keeping employees in harmony and considering individuals’ differences. Implications– This research highlights a gap between theory and practice. Some of the presented leadership practices presented in this research contradict with the literature’s classification for Egypt’s’ national. This indicates that further research work should be conducted to generalize findings.Originality/value –The research emphasizes that there is a shift in people’s perception towards best leadership styles and practices. The cultural aspects identified in this research challenges the classification of Egypt as high power distance and masculine society. Further, findings present new prospective for some of the leadership practices. The paper also proposes that short-term orientation is also a cultural aspect associated with workplace. Keywords: National culture, Humane-orientation, Short-term orientation, Leadership practices, Individualized consideration, Employees’ performance, Case study, Interviews analysis techniques DOI: 10.7176/DCS/9-3-07 Publication date:March 31st 201

Contextual Factors That Impact Leadership Practices In Cross-Cultural Settings: An Egyptian Case Study

This paper explores the contextual factors, other than culture, that affect the implementation of companies’ leadership competencies models, in cross-cultural settings. The study employs qualitative case study, using semi-structured interviews. Two-case studies were conducted to reach more comprehensive findings. Based on the research findings, leaders’ personality and national culture, subordinates’ level of experience, the host-country situation, the company’s strategy, and the nature of the company’s departments may cause variance in leaders’ practices. However the overall variance in leader’s practices between the company’s different offices may decrease due to the company’s culture of origin as and the company’s cross-cultural experience. Thus, companies operating in cross-cultural settings should consider such factors when developing and customizing their leadership model to reach a sound cultural fit.  Based on research findings the paper proposes a model that needs to be tested in further research work. This study was conducted only on two multinational companies from the same origin and operating in the same host-country. Thus, further research work should be conducted on companies from other origins to generalize findings. This research is among the few studies that address the contextual factors, other than culture, that impact the implementation of companies’ leadership practices in cross-cultural settings. It is also among the few studies that investigates Egyptian business environment in cross-cultural settings. Keywords: leadership, contextual factors, national culture, multinational companies, Egyp

A Shift in Employees’ Perception towards Leadership Practice: An Egyptian Case Study under Cross-Cultural Settings

Employees’ work related values change as their cultural values change over time, specially as their societies experience unusual social changes. Changes in employees work related values may increase the need for remarkable modifications in companies’ leadership practices and approaches. This research takes Egypt as an example of a host-country that is undergoing unusual social changes. The study aims to explore the impact of changes on employees’ perception towards best leadership practices, in cross-cultural settings. Two case studies were conducted with replication logic. The researcher conducted semi-structured interviews with Egyptian employees working in two multinational companies, operating in Egypt. The study findings regarding best leadership styles and practices contradict with literature’s classification for Egypt as high power distance and masculinity culture. This indicates that companies should reconsider employees’ cultural values that impact workplace. However, further researches should be conducted on such cultural aspects to reach more generalizable findings. This paper is among the few studies that tackled Egypt business environment from a cross-cultural perspective. Egypt presents a good example for cultural changes, since it has undergone major social changes since the year 2011. The research not only presents the recommended leadership practices but also emphasizes on their managerial implications. Further, the research is among the few studies that addressed the impact of national culture on leadership with reference to other contextual factor. Keywords: leadership, national culture, Egypt, power distance, masculinity, contextual factor

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research