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Meta-Analysis
. 2022 Sep 2;19(17):10995.
doi: 10.3390/ijerph191710995.

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

Vincenzo Restivo  1 , Giuseppa Minutolo  1 , Alberto Battaglini  2 , Alberto Carli  3 , Michele Capraro  4 , Maddalena Gaeta  5 , Anna Odone  5 , Cecilia Trucchi  6 , Carlo Favaretti  7 , Francesco Vitale  1 , Alessandra Casuccio  1
Affiliations
Meta-Analysis

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

Vincenzo Restivo et al. Int J Environ Res Public Health. .

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: before–after; cross-sectional; healthcare settings; healthcare workers; leadership effectiveness; leadership style; private healthcare setting; public hospital.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow-chart of selection manuscript phases for systematic review and meta-analysis on leadership effectiveness in healthcare workers.
Figure 2
Figure 2
Effectiveness of leadership in before after studies. Dashed line represents the pooled effectiveness value [29,31,32,33,34,35,36,37,38,39,40,41].
Figure 3
Figure 3
Effectiveness of leadership in cross-sectional studies. Dashed line represents the pooled effectiveness value [30,42,43,44,45,46,47,48,49].
See this image and copyright information in PMC

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