UNASSIGNED: Health services are undergoing digitalization and applying new digital tools. These changes may provide healthcare managers with opportunities to exercise digital leadership. However, managers\' attitudes may influence the extent to which they demonstrate digital leadership. This study explores the attitudes of Norwegian healthcare managers towards: (1) digital tools and change and (2) to what extent digital tools are applicable to various tasks of managers.
UNASSIGNED: Cross-sectional study including 154 managers in hospitals and municipal health services in a Norwegian county. The questionnaire was about management and digital tools, and the data was analyzed by descriptive statistics, correlations, and content analysis.
UNASSIGNED: The healthcare managers perceived that digital tools facilitated a positive change in organizational work processes aligned with values and goals. Digital tools supported administrative tasks such as gaining control over responsibilities. However, 76 managers stated that certain tasks, including interactions with employees (e.g. performance appraisals and sick leave follow-up) and the building of an organizational culture, should not be performed using digital tools or using them only to a limited extent; for these tasks, they preferred in-person meetings.
UNASSIGNED: Norwegian healthcare managers\' attitudes toward digital tools are generally positive, but there are areas where they find the tools less suitable.
UNASSIGNED: The results provide new insights into healthcare by indicating that many managers may have positive attitudes toward digital tools. However, digital leadership may not be applicable equally in all areas of healthcare managers\' work. This raises the question of whether digital leadership can or should be exercised uniformly in every area of health services.

Acute leukemia is a rapidly progressive cancer of the blood and bone marrow that requires a high degree of complex, specialized, resource-intensive clinical and supportive care. The aging Canadian population has introduced an unprecedented demand on the health care system for a variety of illnesses, including acute leukemia. The purpose of this work was to develop organizational requirements for service providers delivering care for patients aged 18 years and older with acute leukemia within a single-payer health care system in Ontario. This initiative was intended to support streamlining high-quality health care across Ontario. We worked collaboratively with an expert panel to conduct a review of the literature to synthesize the organizational requirements for delivering acute leukemia care. A total of 229 requirements were developed. The requirements were categorized into themes including (1) facility requirements, including infrastructure, data management, safety, policies and procedures; (2) availability of clinical services and service complexity; (3) personnel, including roles, responsibilities, and ongoing education; (4) patient care; (5) quality management; (6) clinical research; and (7) laboratory services. These requirements will act as a framework for the provision of service, complexity of care, safety, accessibility, and quality care across all levels from the patient, organization, and system perspectives. This framework will help support person-centred care, emphasizing providing care close to home, while optimizing the use of specialized resources. Moving forward, Ontario Health (Cancer Care Ontario) will continue to work with acute leukemia service providers in the province to determine compliance and focus improvement efforts in priority areas.

UNASSIGNED: Within the public sector, health managers occupy positions that are typically filled by individuals with a medical, clinical, or nursing experience who are entrusted with assuming an additional role. The primary objective of this study was to employ a scoping review methodology to ascertain a cluster of prevalent subjects encompassing the development of a proficient health care manager.
UNASSIGNED: The purpose of this scoping review study was to identify critical components in the field of management professionalization, as described by Arksey and O\'Malley. A total of 13 studies, characterized by predefined keywords, were meticulously culled from Scopus, Web of Science, PubMed, and Embase, Magiran, and SID databases. The inclusion and exclusion criteria considered factors such as language, temporal relevance, redundancy, thematic alignment with the professionalization domain, and congruence with the overarching objectives and methodologies of the present investigation. Subsequently, the contents of the selected studies were subjected to rigorous thematic analysis and judicious categorization using a framework analysis approach.
UNASSIGNED: From a total of 10,117 articles, a rigorous selection process yielded 13 articles to be included in this study. The identified dimensions are classified and elucidated across 6 overarching domains; namely, the science of management, educational trajectory, and curriculum, cultural infrastructure and ideologies, standards, professional institutions and associations, and licenses and certifications.
UNASSIGNED: To enhance the efficacy of health management, policymakers and planners ought to adeptly incorporate these dimensions within the framework of the country\'s health system.

In today\'s complex healthcare landscape, exacerbated by resource constraints at various levels, optimization of health professionals\' roles is becoming increasingly paramount. Interprofessional collaboration, underpinned by role recognition and teamwork, leads to improved patient and organizational outcomes. Hospital pharmacists play a pivotal role in multidisciplinary teams, and it is imperative to understand multidisciplinary viewpoints on hospital pharmacists\' roles to guide role prioritization and organizational efficiency. However, no study extensively investigated multidisciplinary views on values of diverse pharmacist roles in tertiary settings. This study aims to address this gap by examining non-pharmacist health professionals\' views on hospital pharmacists\' roles, recognizing their specialized niches as a crucial step towards optimizing their roles and services in Australia and internationally. Multiple focus group discussions and interviews were held via a virtual conferencing platform. Study participants were recruited using the study investigators\' professional networks who were non-pharmacist health professionals with experience working with pharmacists in hospital settings. Data were collected from transcripts of the focus group recordings, which were later summarized using descriptive statistics and thematic analysis. Overarching themes were categorized and mapped against work system models to conceptualize organizational implications of multidisciplinary feedback, linking them to patient and organizational outcomes. Twenty-seven health professionals participated across focus groups and interviews, with the majority of professions being doctors and nurses. Three major themes were identified as follows: (i) overarching perceptions regarding hospital pharmacists; (ii) professional niches of hospital pharmacists; and (iii) future opportunities to optimize hospital pharmacy services. Valued professional niches included patient and health professional educators, transition-of-care facilitators, and quality use of medicines analysts. The study highlights critical insights into hospital pharmacists\' roles in Australia, identifying their niche expertise as vital to healthcare efficiency and success. Based on multidisciplinary feedback, the study advocates for strategic role optimization and targeted research for enhanced clinical, economic, and organizational outcomes.

UNASSIGNED: Although it is known that resilience is negatively associated with burnout, and that certain interventions can effectively increase resilience, little is known about online resilience-enhancing interventions during the COVID-19 crisis. The aim of this study was to identify the association between an online resilience-enhancing intervention and workplace social support, and burnout among nurses working in the mainland and remote islands of Japan during the COVID-19 crisis.
UNASSIGNED: Pretest-posttest was conducted between April 2020 and February 2021, and the questionnaire survey included the bidimensional resilience scale, the Japanese version of Pine\'s Burnout Measure, and the workplace social support scale. Changes in burnout, resilience, and social support and the associations with nursing discussions as intervention were analyzed. Participants were 98 Nurses with 1 to 10 years of experience from Japan\'s mainland and remote island hospitals of Kagoshima Prefecture participated in a baseline survey in April 2020. Of these, 76 participated in a secondary survey in September 2020, and 69 participated in the intervention program and a third survey in February 2021. The online intervention over Zoom consisted of small-group nursing discussions based on the broaden-and-build theory.
UNASSIGNED: Changes in burnout showed a significant negative association with change in workplace social support (Coef. = -0.019, 95% CI -0.035- -0.003), as did the interaction between change in acquired resilience and intervention (Coef. = -0.088, 95% CI -0.164- -0.011).
UNASSIGNED: Change in workplace social support was significantly negatively associated with changes in burnout, as was the interaction of intervention and acquired resilience. Promotion of this intervention and making workplace social support more accessible may contribute to reduce burnout in nurses.

Description Leadership is hard to define but easy to recognize and is found in every facet of life. Leaders themselves range from good to bad, the extremities of which are determined by their character, actions, perception of self, how they are perceived by others and their worldviews. An individual\'s values provide the basis for ethical decisions, which makes self-awareness a critical element in the development of one\'s leader identity. This article provides an overview of leader identity development and offers ways for leaders to apply ethics in their everyday lives.

Description A learning organization engages their teams to garner a commitment to learning and leverage organizational knowledge thereby positioning themselves better for future innovation. Organizations that focus on interrelated learning at the individual, group or team and organizational levels are optimally positioned to maximize organizational competitiveness in dynamic, competitive environments. A leader\'s responsibility is to devote more effort to guide the organization\'s continuous development, members, and themselves. Through constant learning, the organization can leverage learning to create competitive strategies while cultivating transformative opportunities. However, successful learning outcomes are not the product of any individual or leader, and instead, the collective work of all involved. Leaders focused on organizational learning realize the dynamic nature of operating a business in a competitive environment and encourage members to seek feedback, new educational opportunities, open communication, and innovative problem-solving strategies, the combination of which enable the collective organization to not just survive but thrive.

Several Canadian provinces and territories have reformed their health systems by centralizing power, resources, and responsibilities. Our study explored motivating factors and perceived impacts of centralization reforms on public health systems and essential operations.
A multiple case study design was used to examine three Canadian provinces that have undergone, or are in the process of undergoing, health system reform. Semi-structured interviews were conducted with 58 participants within public health at strategic and operational levels, from Alberta, Ontario, and Québec. Data were analyzed using a thematic analytical approach to iteratively conceptualize and refine themes.
Three major themes were developed to describe the context and impacts of health system centralization reforms on public health: (1) promising \"value for money\" and consolidating authority; (2) impacting intersectoral and community-level collaboration; and (3) deprioritizing public health operations and contributing to workforce precarity. Centralization highlighted concerns about the prioritization of healthcare sectors. Some core public health functions were reported to operate more efficiently, with less duplication of services, and improvements in program consistency and quality, particularly in Alberta. Reforms were also reported to have diverted funding and human resources away from core essential functions, and diminished the public health workforce.
Our study highlighted that stakeholder priorities and a limited understanding about public health systems influenced how reforms were implemented. Our findings support calls for modernized and inclusive governance, stable public health funding, and investment in the public health workforce, which may help inform future reforms.
RéSUMé: OBJECTIFS: Plusieurs provinces et territoires canadiens ont réformé leur système de santé en centralisant le pouvoir, les ressources et les responsabilités. Notre étude a exploré les facteurs sous-jacents et les impacts perçus des réformes de centralisation sur les systèmes et les opérations essentielles de santé publique. MéTHODES: Nous avons mené une étude de cas multiples pour examiner la situation de trois provinces canadiennes qui ont subi ou qui sont en train de réaliser une réforme du système de santé. Des entrevues semi-structurées ont été menées auprès de 58 participants de la santé publique aux niveaux stratégique et opérationnel, en Alberta, en Ontario et au Québec. De façon itérative, nous avons thématiquement analysé les données recueillies. RéSULTATS: Trois thèmes principaux ont été formulés pour décrire le contexte et les impacts des réformes de centralisation du système de santé sur la santé publique : 1) la promesse d’une « optimisation des ressources » et la consolidation de l’autorité, 2) l’impact sur la collaboration intersectorielle et communautaire, et 3) la privatisation des opérations de santé publique et la précarisation de la main-d’œuvre. La centralisation a mis en lumière des préoccupations quant à la priorité accordée aux services de santé. Certaines fonctions essentielles de la santé publique fonctionneraient de manière plus efficace, avec moins de dédoublement des services et des améliorations de la cohérence et de la qualité des programmes, notamment en Alberta. Les réformes auraient aussi détourné des fonds et des ressources humaines des fonctions essentielles de base et auraient réduit les effectifs de la santé publique. CONCLUSION: Notre étude a mis en exergue les priorités des parties prenantes et une compréhension limitée des systèmes de santé publique qui ont influencé la manière dont les réformes ont été mises en œuvre. Nos résultats soutiennent les appels à une gouvernance plus modernisée et inclusive, à un financement stable de la santé publique et à un investissement dans le personnel de santé publique, pouvant ainsi contribuer à alimenter les futures réformes.

Purpose: The purpose of this study was to explore professional practice leadership models (PPLMs) within the Toronto Academic Health Science Network (TAHSN) by outlining the PPLMs currently in use, identifying elements of the PPLMs from physiotherapists\' perspectives, and determining key features of PPLMs that enhance physiotherapy (PT) practice. Methods: In this qualitative, cross-sectional study, we used focus groups to explore physiotherapists\' knowledge about their facility\'s PPLM, physiotherapists\' role within the PPLM, the impact of professional practice leaders on PT practice, the impact of the PPLM on physiotherapists\' job satisfaction, and the elements of an ideal PPLM. We coded transcripts using qualitative software and followed an inductive data analysis approach to develop themes. Results:We conducted eight focus groups with physiotherapists from six TAHSN facilities (four organizations). Five key features of PPLMs emerged from participants\' perspectives: support network, organizational structure, professional development opportunities, influence of the leader in professional practice, and balance of workloads and accountabilities. Each key feature encompassed a group of interrelated elements - that is, components of the PPLMs that influenced PT practice. Conclusions: Our study is the first to explore elements and key features of the PPLMs used in TAHSN facilities as they relate to PT. We provide five recommendations to enhance PPLMs with respect to the PT profession.
Objectif :  explorer les modèles de leadership en pratique professionnelle (MLPP) au sein du Toronto Academic Health Science Network (TAHSN). Pour ce faire, répertorier les MLPP en usage, déterminer les éléments du MLPP du point de vue des physiothérapeutes et établir les caractéristiques clés des MLPP qui améliorent l’exercice de la physiothérapie. Méthodologie : les chercheurs de cette étude transversale qualitative ont fait appel à des groupes de travail pour explorer les connaissances des physiothérapeutes à l’égard des MLPP de leur établissement, le rôle des physiothérapeutes au sein des MLPP, les répercussions des leaders en pratique professionnelle sur l’exercice de la physiothérapie, les répercussions des MLPP sur la satisfaction au travail des physiothérapeutes et les éléments d’un MLPP idéal. Ils ont codé les transcriptions à l’aide de logiciels qualitatifs et ont utilisé une approche inductive de l’analyse de données pour dégager les thèmes. Résultats :  les chercheurs ont tenu huit groupes de travail avec des physiothérapeutes de six établissements du TAHSN (quatre organisations). Cinq caractéristiques clés des MLPP émergent des perspectives des participants : le réseau d’entraide, la structure organisationnelle, les possibilités de perfectionnement professionnel, l’influence du leader en pratique professionnelle et l’équilibre des charges de travail et des responsabilités. Chaque caractéristique clé comprenait un groupe d’éléments interreliés, soit les éléments des MLPP qui influaient sur l’exercice de la physiothérapie. Conclusions :  la présente étude est la première à explorer les éléments et les caractéristiques clés des MLPP utilisés en physiothérapie dans les établissements du TAHSN. Les chercheurs proposent cinq recommandations pour améliorer les MLPP en physiothérapie.

Research Shared (core) Facilities (RSF) operate as centers of expertise and help to accelerate basic and translational science. A centralized platform for unified ordering, equipment reservation, and the billing of services using an integrated software system is a valuable resource that many academic institutions should consider. This paper discusses considerations for best practices and identifies lessons learned from the implementation of two different software systems for RSF. After implementing two different centralized billing systems for RSF, this paper identifies considerations for best practices and discusses lessons learned.