Systematic Review of Nurses' and Physicians' Management and Leadership Competencies

Tuesday, 31 October 2017: 9:20 AM

Tuula Kivinen, PhD1
Johanna Lammintakanen, PhD1
Vuokko Pihlainen, MHS2
(1)Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
(2)Department of Health and Social Management, University of Eastern Finland, Central Finland Central Hospital, Jyväskylä, Finland

Aims: To represent the characteristics of management and leadership competencies of nurse and physician managers and leaders in hospitals. Competence examined in this systematic review included knowledge, skills, attitudes and abilities needed in leadership and management work.

Background: The management and leadership competencies needed for current changes and for future challenges are remarkable topics in health care. The delivery of health care services is in transition and reforms are in progress. Additionally, performance improvement and performance profiles comparisons are an increasing trend in hospital organizations. Therefore, the development of management and leadership competencies systematically is necessary. However, for instance management and leadership as a career choice varied between health care professions. The approach of management and leadership competence included both nurse and physician managers and leaders in a hospital or clinical settings. This systematic review focused on a competence-based perspective. 

Design: A systematic literature review study executed in accordance with Fink.

Methods: A systematic literature review utilized systematic searches conducted in six electronic databases (CINAHL, PubMed, Cochrane, Scopus, Web of Science and Medic); thirteen articles were included in the systematic review and analyzed through inductive content analysis.

Results: The findings were categorized in three main groups of competence as health-care-context-related, operational and general. The health-care-context-related competence included four subcategories, which were social, organizational, business and financial competence. Social competence emerged especially in European studies. Organizational competence presented management and leadership tasks and work content. Business competence was comprised of knowledge and practice of business skills, but also processes of chance, services development and resource planning. Financial competence entailed knowledge, understanding and skills for financing, budgeting and marketing issues. Especially financial competence was assessed necessary in a nurse managers’ job.

Operational competence was broken down into process, operation, clinical and development competence. Process competence included improvements in service processes and in quality and a patient-centered approach. Operational competence was categorized as clinical skills to manage a ward, understanding operations and available resources and executive duties. Clinical competence included knowledge and abilities of professional and clinical work as well as professional credibility and ethics. Development competence involved staff development and improvement targets in work. Moreover, a proactive approach to clinical, organizational and unit-required changes was included.

General management and leadership competencies entailed were common to all professionals in managerial work. Subcategories included time management, interpersonal skills, strategic mindset, thinking and application skills, and human resource management. Strategic mindset and understanding were described as several expressions, for example “goals”, “planning”, “task management” and “vision”. Analytical thinking and target-orientation were also included in this subcategory. Human resource management (HRM) emerged as the most commonly mentioned management and leadership competencies in nursing management studies.

Conclusions: A lack of studies integrating nurses’ and physicians’ perspective of management and leadership competencies was discovered. However, more studies on management and leadership competencies were found in nursing science than in medicine. As a future challenge in health care, a framework for learning management and leadership in hospital organizations is needed. Managers and leaders should have possibilities to reflect on their actions and success with decent support in managerial roles. The need for a broader approach with a common and interprofessional framework is obvious to reach a shared understanding of management and leadership throughout an organization. Developing management and leadership competencies is a way to improve organizational performance and managerial functions. Furthermore, they help produce motivated, new potential managers and leaders for future needs.