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Medical leaders or masters?—A systematic review of medical leadership in hospital settings

机译:是医疗领导者还是大师??对医院环境中医疗领导者的系统评价

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摘要

Medical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal the different conceptualizations of medical leadership in terms of definitions, roles and activities, and personal–and context-specific features. Eight databases were systematically searched for eligible studies, including empirical studies published in peer-reviewed journals that included physicians carrying out a manager or leadership role in a hospital setting. Finally, 34 articles were included and their findings were synthesized and analyzed narratively. Medical leadership is conceptualized in literature either as physicians with formal managerial roles or physicians who act as informal ‘leaders’ in daily practices. In both forms, medical leaders must carry out general management and leadership activities and acts to balance between management and medicine, because these physicians must accomplish both organizational and medical staff objectives. To perform effectively, credibility among medical peers appeared to be the most important factor, followed by a scattered list of fields of knowledge, skills and attitudes. Competing logics, role ambiguity and a lack of time and support were perceived as barriers. However, the extent to which physicians must master all elicited features, remains ambiguous. Furthermore, the extent to which medical leadership entails a shift or a reallocation of tasks that are at the core of medical professional work remains unclear. Future studies should implement stronger research designs in which more theory is used to study the effect of medical leadership on professional work, medical staff governance, and subsequently, the quality and efficiency of care.
机译:人们越来越多地认为医疗领导对于提高护理质量和医疗保健的可持续性至关重要。但是,文献和实践中缺乏概念上的明确性。因此,对科学文献进行了系统的回顾,以揭示医学领导力在定义,角色和活动以及针对个人和具体情况的特征方面的不同概念。系统地搜索了八个数据库以寻找符合条件的研究,包括在同行评审期刊上发表的经验研究,其中包括在医院中担任经理或领导角色的医生。最后,纳入34篇文章,并对他们的发现进行综合和叙述性分析。在文献中,医学领导被概念化为具有正式管理角色的医生或在日常实践中充当非正式“领导者”的医生。在这两种形式中,医务负责人必须进行一般管理和领导活动,并采取行动在管理和医学之间取得平衡,因为这些医师必须同时实现组织和医务人员的目标。为了有效发挥作用,医疗同行之间的信誉似乎是最重要的因素,其次是知识,技能和态度领域的分散列表。竞争逻辑,角色模糊性以及缺乏时间和支持被视为障碍。但是,医生必须掌握所有引致特征的程度仍然不明确。此外,医疗领导人员在多大程度上需要转移或重新分配医疗专业工作的核心任务,目前尚不清楚。未来的研究应实施更强大的研究设计,其中应使用更多的理论来研究医疗领导对专业工作,医务人员治理以及随后的护理质量和效率的影响。

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