Background: Some challenges that the hospitals will face in the future are such as an ageing workforce, increased requirements for multi-professional education, and synergistic enhancement of work practices with implementations of health IT. Improvements in management and leadership competences can be used to tackle these issues. In accordance with systems theory perspective, a broader organizational viewpoint is needed to improve MLC.
Moreover, physicians and nurses still seem to fall into managers’ and leaders’ positions accidentally with poor training and preparation in hospitals. In studies several prevalent shortcomings have been identified and described: basic knowledge of management and leadership, commitment to managerial work, fundamental administrative leadership skills and contextual knowledge in healthcare settings.
Design: The Argument Delphi Method was used to collect the research material. 33 Finnish management and leadership related experts were recruited to participate anonymously in an Argument Delphi panel. They represented hospital managers or leaders, researchers and teachers, management or healthcare students, representatives of physicians’ or nurses’ trade unions, and political decision-makers.
Methods: The Argument Delphi process was organized as three-round and web-based. The gathered research material underwent an inductive content analysis.
Results: The findings were categorized in perceptions of the elements of management and leadership competence and perceptions of its development. Experts’ perceptions of the elements of MLC concerned core management and leadership competences, management and leadership competence shortcomings and future competence requirements. The experts highlighted financial knowledge, time management skills, change management, and people management abilities including communication and interaction skills as core management and leadership competences.
Lack of MLC revealed varying strategic competence, and diverse management knowledge base. Experts’ opinions varied a lot about the importance of and the need for the strategy. Some of the experts considered strategic management competence a necessary skill but they described it as being inconsistent and inadequate. They emphasized that the thinking and understanding of many managers and leaders are limited due to the paucity of their knowledge of managerial and organizational theories and concepts. Identified future training requirements included greater awareness of evolving management paradigms and changes in operational management practices.
The future leaders were described to be goal-oriented with strong decision-making skills. However, some argued that incompleteness and uncertainty will be prevalent in future decision-making. Therefore, identifying appropriate responses to changing management situations will be an important element of MLC.
MLC can be developed by using various relevant activities and methods. It can be developed at work and strengthened by differentiating management tasks from clinical practice. Moreover, key organizational activities including such as recruitment of competent managers and leaders, establishment of conditions that promote MLC development and facilitate practical management tasks, were identified to be improved. The identification of required MLC and training, acquisition of managerial experience and interest in management duties were seen important for the future.
Conclusions: The findings highlighted the importance of combining organizational and individual interests to improve MLC and managerial career-thinking systematically. This indicates that improving MLC in hospital organizations should be seen as a process to start from recruitment. Therefore, a systems perspective is needed in developing management and leadership subsystems and MLC. An applicant must possess or acquire every require attribute but also be motivated and want to manage.
To develop MLC requires systematic training with varied methods and practices with appropriate support models. The low participation in formal preparation leadership programs could be countered by employing several kinds of informal support, such as networks, peer support and mentors to respond to new management requirements through sharing knowledge and experience.