Medical leaders or masters?-A systematic review of medical leadership in hospital settings.
Medical leaders or masters?-A systematic review of medical leadership in hospital settings.
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DOI：
10.1371/journal.pone.0184522
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Hilders CGJM
中科院分区：
文献类型：
--
作者：
Berghout MA;Fabbricotti IN;Buljac-Samardžić M;Hilders CGJM
医疗领导力越来越被认为是提高护理质量和医疗保健可持续性的关键。然而，在文献和实践中缺乏概念上的明确性。因此，科学文献进行了系统的审查，以揭示不同的概念化的医疗领导的定义，角色和活动，以及个人和上下文的特定功能。系统地检索了8个数据库中的合格研究，包括在同行评审期刊上发表的实证研究，其中包括在医院环境中担任管理者或领导角色的医生。最后，纳入34篇文献，并对其研究结果进行综合分析。在文献中，医疗领导力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，医疗领导者必须进行一般的管理和领导活动，并采取行动，以平衡管理和医疗，因为这些医生必须完成组织和医务人员的目标。为了有效地执行，医疗同行之间的信誉似乎是最重要的因素，其次是分散的知识，技能和态度领域。相互矛盾的逻辑、角色模糊以及缺乏时间和支持被视为障碍。然而，在何种程度上，医生必须掌握所有引发的功能，仍然是模棱两可的。此外，医疗领导在多大程度上需要改变或重新分配作为医疗专业工作核心的任务，这一点仍然不清楚。未来的研究应实施更强的研究设计，其中更多的理论被用来研究医疗领导的专业工作，医务人员的治理，并随后，护理的质量和效率的影响。
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.
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影响因子：
3.4
作者：
Chreim, Samia;Langley, Ann;Reay, Trish
通讯作者：
Reay, Trish
影响因子：
5.4
作者：
Doolin, B
通讯作者：
Doolin, B
影响因子：
0.6
作者：
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通讯作者：
Evetts, Julia
影响因子：
2.7
作者：
Edmonstone, John
通讯作者：
Edmonstone, John
影响因子：
3.1
作者：
Hopkins, Margaret M.;O'Neil, Deborah A.;Stoller, James K.
通讯作者：
Stoller, James K.