Leadership Effectiveness in Healthcare Settings: A Systematic Review and Meta-Analysis of Cross-Sectional and Before–After Studies

Vincenzo Restivo (), Giuseppa Minutolo, Alberto Battaglini, Alberto Carli, Michele Capraro, Maddalena Gaeta, Anna Odone, Cecilia Trucchi, Carlo Favaretti, Francesco Vitale and Alessandra Casuccio
Additional contact information
Vincenzo Restivo: Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
Giuseppa Minutolo: Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
Alberto Battaglini: Vaccines and Clinical Trials Unit, Department of Health Sciences, University of Genova, Via Antonio Pastore 1, 16132 Genova, Italy
Alberto Carli: Santa Chiara Hospital, Largo Medaglie d’oro 9, 38122 Trento, Italy
Michele Capraro: School of Public Health, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
Maddalena Gaeta: Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy
Anna Odone: Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy
Cecilia Trucchi: Planning, Epidemiology and Prevention Unit, Liguria Health Authority (A.Li.Sa.), IRCCS San Martino Hospital, Largo R. Benzi 10, 16132 Genoa, Italy
Carlo Favaretti: Centre on Leadership in Medicine, Catholic University of the Sacred Heart, Largo F. Vito 1, 00168 Rome, Italy
Francesco Vitale: Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
Alessandra Casuccio: Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy

IJERPH, 2022, vol. 19, issue 17, 1-13

Abstract: To work efficiently in healthcare organizations and optimize resources, team members should agree with their leader’s decisions critically. However, nowadays, little evidence is available in the literature. This systematic review and meta-analysis has assessed the effectiveness of leadership interventions in improving healthcare outcomes such as performance and guidelines adherence. Overall, the search strategies retrieved 3,155 records, and 21 of them were included in the meta-analysis. Two databases were used for manuscript research: PubMed and Scopus. On 16th December 2019 the researchers searched for articles published in the English language from 2015 to 2019. Considering the study designs, the pooled leadership effectiveness was 14.0% (95%CI 10.0–18.0%) in before–after studies, whereas the correlation coefficient between leadership interventions and healthcare outcomes was 0.22 (95%CI 0.15–0.28) in the cross-sectional studies. The multi-regression analysis in the cross-sectional studies showed a higher leadership effectiveness in South America (β = 0.56; 95%CI 0.13, 0.99), in private hospitals (β = 0.60; 95%CI 0.14, 1.06), and in medical specialty (β = 0.28; 95%CI 0.02, 0.54). These results encourage the improvement of leadership culture to increase performance and guideline adherence in healthcare settings. To reach this purpose, it would be useful to introduce a leadership curriculum following undergraduate medical courses.

Keywords: leadership effectiveness; healthcare settings; healthcare workers; private healthcare setting; public hospital; before–after; cross-sectional; leadership style (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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