Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

Personal and organisational attributes that support transformational leadership in acute healthcare: scoping review

Julie Considine https://orcid.org/0000-0003-3801-2456 A B * , Jenny Dempster https://orcid.org/0009-0007-5237-4863 C , Nga Man Wendy Wong C , Noelleen Kiprillis https://orcid.org/0000-0002-0052-2701 C and Leanne Boyd https://orcid.org/0000-0001-9957-6357 C
+ Author Affiliations
- Author Affiliations

A School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Vic., Australia.

B Centre for Quality and Patient Safety Research – Eastern Health Partnership, Box Hill, Vic., Australia.

C Eastern Health, Box Hill, Vic., Australia.

* Correspondence to: julie.considine@deakin.edu.au

Australian Health Review 48(3) 274-282 https://doi.org/10.1071/AH23179
Submitted: 24 August 2023  Accepted: 13 February 2024  Published: 7 March 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Objective

Transformational leadership benefits both patients and staff. The objective of this scoping review was to explore personal and organisational attributes that support transformational leadership in acute health care.

Methods

A scoping review was undertaken using Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Medline Complete, PsycInfo and Emerald Insight databases. Search terms were related to transformational leadership and acute care hospitals.

Results

A total of 18 studies were included: 14 reported personal attributes and 8 reported organisational attributes supporting transformational leadership. The most common personal attributes were manager educational preparation (n = 5), years of management experience (n = 4), age (n = 3) and emotional intelligence (n = 3). The most common organisational attributes reported were larger organisational size (n = 2) and culture (n = 2). Personal (manager) attributes were synthesised into the following categories: demographics, role characteristics, leadership preparation and traits. Organisational attributes were categorised as manager support, organisational characteristics and organisational processes.

Conclusions

Despite the beneficial outcomes of transformational leadership for patients, staff and organisations, the personal and organisational attributes supporting transformation leadership are not well understood.

Keywords: health services management, health services research, human resource, leadership, management, performance and evaluation, scoping review, transformational leadership, workforce.

References

Bass BM. Two decades of research and development in transformational leadership. Eur J Work Organ Psychol 1999; 8: 9-32.
| Crossref | Google Scholar |

Burns J. Leadership. New York: Harper & Row; 1978.

Bass BM. Leadership and performance beyond expectations. New York: Free Press; 1985.

Gabel S. Transformational Leadership and Healthcare. Med Sci Educ 2013; 23: 55-60.
| Crossref | Google Scholar |

Alanazi NH, Alshamlani Y, Baker OG. The association between nurse managers’ transformational leadership and quality of patient care: A systematic review. Int Nurs Rev 2023; 70: 175-184.
| Crossref | Google Scholar | PubMed |

Sfantou DF, Laliotis A, Patelarou A, et al. Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare 2017; 5: 73.
| Crossref | Google Scholar | PubMed |

O’Donovan R, Rogers L, Khurshid Z, et al. A systematic review exploring the impact of focal leader behaviours on health care team performance. J Nurs Manag 2021; 29: 1420-1443.
| Crossref | Google Scholar | PubMed |

Specchia ML, Cozzolino MR, Carini E, et al. Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review. J Environ Public Health 2021; 18: 1552.
| Crossref | Google Scholar | PubMed |

Hussain MK, Khayat RAM. The Impact of Transformational Leadership on Job Satisfaction and Organisational Commitment Among Hospital Staff: A Systematic Review. J Health Manag 2021; 23: 614-630.
| Crossref | Google Scholar |

10  Kim S, Jeong SH. A meta-analytic path analysis on the outcome variables of nursing unit managers’ transformational leadership: Systemic review and meta-analysis. J Korean Acad Nurs 2020; 50: 757-777.
| Crossref | Google Scholar | PubMed |

11  Cummings GG, Lee S, Tate K, et al. The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership. Int J Nurs Stud 2021; 115: 103842.
| Crossref | Google Scholar | PubMed |

12  Figueroa CA, Harrison R, Chauhan A, et al. Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC Health Serv Res 2019; 19: 239.
| Crossref | Google Scholar | PubMed |

13  Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med 2018; 169: 467-473.
| Crossref | Google Scholar | PubMed |

14  Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005; 8: 19-32.
| Crossref | Google Scholar |

15  Campbell M, McKenzie JE, Sowden A, et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ 2020; 368: l6890.
| Crossref | Google Scholar |

16  Covidence. Covidence systematic review software. 2023 Available at www.covidence.org [accessed August 2023].

17  Dunham-Taylor J. Nurse executive transformational leadership found in participative organizations. J Nurs Adm 2000; 30: 241-250.
| Crossref | Google Scholar | PubMed |

18  Gowen III CR, Henagan SC, McFadden KL. Knowledge management as a mediator for the efficacy of transformational leadership and quality management initiatives in U.S. health care. Health Care Manage Rev 2009; 34: 129-140.
| Crossref | Google Scholar | PubMed |

19  Kelly LA, Wicker TL, Gerkin RD. The relationship of training and education to leadership practices in frontline nurse leaders. J Nurs Adm 2014; 44: 158-163.
| Crossref | Google Scholar | PubMed |

20  Leach LS. Nurse executive transformational leadership and organizational commitment. J Nurs Adm 2005; 35: 228-237.
| Crossref | Google Scholar | PubMed |

21  Newhouse RP, Mills MEC. Enhancing a professional environment in the organized delivery system: lessons in building trust for the nurse administrator. Nurs Admin Q 2002; 26: 67-75.
| Crossref | Google Scholar |

22  Prado-Inzerillo M, Clavelle JT, Fitzpatrick JJ. Leadership Practices and Engagement Among Magnet R Hospital Chief Nursing Officers. J Nurs Adm 2018; 48: 502-507.
| Crossref | Google Scholar | PubMed |

23  Spano-Szekely L, Quinn Griffin MT, Clavelle J, et al. Emotional Intelligence and Transformational Leadership in Nurse Managers. J Nurs Adm 2016; 46: 101-108.
| Crossref | Google Scholar | PubMed |

24  Jankelová N. The Key Role of Strategically and People-Oriented HRM in Hospitals in Slovakia in the Context of Their Organizational Performance. Healthcare 2021; 9: 01.
| Crossref | Google Scholar | PubMed |

25  Jankelová N, Joniaková Z. Communication Skills and Transformational Leadership Style of First-Line Nurse Managers in Relation to Job Satisfaction of Nurses and Moderators of This Relationship. Healthcare 2021; 9: 18.
| Crossref | Google Scholar | PubMed |

26  Ferreira VB, Amestoy SC, Silva G, et al. Transformational leadership in nursing practice: challenges and strategies. Rev Bras Enferm 2020; 73: e20190364.
| Crossref | Google Scholar | PubMed |

27  Pereira MV, Spiri WC, Spagnuolo RS, et al. Transformational leadership: journal club for emergency and intensive care nurse managers. Rev Bras Enferm 2020; 73: e20180504.
| Crossref | Google Scholar | PubMed |

28  Mohtady Ali H, Ranse J, Roiko A, et al. Enabling Transformational Leadership to Foster Disaster-Resilient Hospitals. Int J Environ Res Public Health 2023; 20: 22.
| Crossref | Google Scholar | PubMed |

29  Stordeur S, Vandenberghe C, D’Hoore W. Leadership styles across hierarchical levels in nursing departments. Nurs Res 2000; 49: 37-43.
| Crossref | Google Scholar | PubMed |

30  Stuber F, Seifried-Dubon T, Tsarouha E, et al. Feasibility, psychological outcomes and practical use of a stress-preventive leadership intervention in the workplace hospital: the results of a mixed-method phase-II study. BMJ Open 2022; 12: e049951.
| Crossref | Google Scholar | PubMed |

31  Apore GN, Asamoah ES. Emotional intelligence, gender and transformational leadership among nurses in emerging economies. Leadersh Health Serv 2019; 32: 600-619.
| Crossref | Google Scholar | PubMed |

32  Khrais H, Alsadi M. Traits of transformational leaders in nursing: emotional intelligence counts? Br J Health Care Manag 2021; 27: 1-6.
| Crossref | Google Scholar |

33  Alfadhalah T, Elamir H. Exploring leadership styles in government hospitals in Kuwait. Leadersh Health Serv 2019; 32: 458-476.
| Crossref | Google Scholar | PubMed |

34  Duygulu S, Kublay G. Transformational leadership training programme for charge nurses. J Adv Nurs 2011; 67: 633-642.
| Crossref | Google Scholar | PubMed |

35  Echevarria IM, Patterson BJ, Krouse A. Predictors of transformational leadership of nurse managers. J Nurs Manag 2017; 25: 167-175.
| Crossref | Google Scholar | PubMed |

36  Kim H, Kim T. Emotional Intelligence and Transformational Leadership: A Review of Empirical Studies. Hum Resour Dev Rev 2017; 16: 377-393.
| Crossref | Google Scholar |

37  Gómez-Leal R, Holzer AA, Bradley C, et al. The relationship between emotional intelligence and leadership in school leaders: a systematic review. Camb J Educ 2022; 52: 1-21.
| Crossref | Google Scholar |

38  Salovey P, Mayer JD. Emotional intelligence. Imagin Cogn Pers 1990; 9: 185-211.
| Crossref | Google Scholar |

39  Seidman G, Pascal L, McDonough J. What benefits do healthcare organisations receive from leadership and management development programmes? A systematic review of the evidence. BMJ Leader 2020; 4: 21-36.
| Crossref | Google Scholar |

40  McGowan E, Hale J, Bezner J, et al. Leadership development of health and social care professionals: a systematic review. BMJ Leader 2020; 4: 231-238.
| Crossref | Google Scholar |

41  Sun R, Henderson AC. Transformational Leadership and Organizational Processes: Influencing Public Performance. Public Admin Rev 2017; 77: 554-565.
| Crossref | Google Scholar |

42  Aronsson G, Theorell T, Grape T, et al. A systematic review including meta-analysis of work environment and burnout symptoms. BMC Public Health 2017; 17: 264.
| Crossref | Google Scholar | PubMed |

43  Hall LH, Johnson J, Watt I, et al. Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PLoS One 2016; 11: e0159015.
| Crossref | Google Scholar | PubMed |

44  Rudolph CW, Murphy LD, Zacher H. A systematic review and critique of research on “healthy leadership”. Leadersh Q 2020; 31: 101335.
| Crossref | Google Scholar |