Tuula Kivinen’s research while affiliated with University of Eastern Finland and other places

Purpose: The purpose of this study is to investigate public health care managers’ views on Knowledge Management (KM), and how managers’ individual and organisational factors are related to their views. Design/Methodology/Approach: Data was gathered through a survey of strategic, middle and first-line managers (n=406) in the public health care sector in Finland. The data were analysed using SPSS (version 28.0). Factor analysis was performed to formulate sum variables. The Kruskal-Wallis test and the Mann Whitney U test was used to determine the relationship between managers’ background and sum variables. Findings: Managers' views on knowledge management were quite positive. Organisational factors, such as management position in the organisation, the nature of the work and the organisation they work had more influence on managers’ views on KM than their individual characteristics. Health care managers expressed the most positive views about knowledge use in management. By contrast the creation of common managerial knowledge was considered as the weakest component of KM. In this study we found new KM component, which was named comprehensive knowledge about operations. Implications: These findings indicate the need to consider how to enhance creation shared knowledge among the health care managers, and development of organisational practices, culture, and strategy from knowledge management perspective. The results can be used developing KM in health care environments.

Knowledge management is intended to achieve organisational goals through effective management of knowledge resources and performance. This paper presents a review of knowledge management effects and performance in health care. Six databases were searched, the searches employing Boolean operators and combinations of key words. In total, 16 articles fulfilled the criteria set for inclusion. Data were analysed using inductive content analysis. The review shows that in health care knowledge management effects and performance have been viewed from various perspectives: it has been linked to health care functions such as management, finance, patient care, quality and safety, IT, continued improvement of clinical operations, and organisational culture. However, the effects of knowledge management extend also to employees’ work, job satisfaction, learning, knowledge distribution, and productivity. This review aims to summarise the recent research on knowledge management effects and performance in health care. Some of the effects are universal and some are context-specific.

Customer feedback information and its utilization in hospital management The aim of this study is to increase our comprehension of how customer feedback information is managed in the context of hospital management. The study is qualitative and built on case­study. Material were collected of two focus groups and it involved 13 leaders from different hospital management levels. Customer feedback information is collected simultaneously in several ways; oral feedback is not collected systematically. Customers provide feedback on service, care, friendliness and general hospital functioning. Customer feedback information is processed primarily by the unit attended by the customer. Physicians and nurses have a different role in customer feedback information processing. Hospital customer information processing is declarative and there is no uniform view on how to transfer customer feedback information between management levels. It is difficult to form a common conception of customer feedback information on the organizational level of this hospital

Purpose The purpose of this paper is to describe how Finnish experts perceive future (year 2030) hospital management and leadership. Design/methodology/approach A total of 33 experts participated in a three-round Argument Delphi process. Opposing views of management and leadership in 2030 were analyzed using inductive content analysis. Findings The experts’ perceptions were divided into two main categories: management and leadership orientation and future organization. Perceptions relating to management and leadership orientation were classified as relating to patient-centred, clinical dominance, professionally divided and management career options. Perceptions relating to future management and leadership organization were classified as representing shared, pair, team and the individual-centered leadership. The results highlighted the most distinctive issues raised by the participants. Research limitations/implications This qualitative study was conducted in the context of Finnish healthcare according to the principles of the Argument Delphi Method. The panel consisted of high-level experts representing a diverse set of roles. However, as suggested in previous literature, these experts may not be the most astute in predicting the future development of hospital organizations. Practical implications The findings can be used to develop and renew management and leadership training and management practices in hospitals. Social implications The findings can be exploited in discussions, planning and decision making regarding future management and leadership in hospitals. Originality/value Only a few studies have investigated perceptions of future management in hospitals. This study adopted the Argument Delphi Method to identify distinct perceptions on the future orientation and organization of management and leadership in hospitals.

Purpose: The purpose of this study is to elicit and analyze experts' perceptions of management and leadership competence (MLC) and likely MLC developments and requirements in hospital contexts by 2030. Design/methodology/approach: A three-round, web-based Argument Delphi process was used to gather critically discussed opposing perceptions of 33 Finnish experts, which were subjected to inductive content analysis to identify themes. Findings: Current deficiencies in MLC and several trends (e.g. an ongoing shift towards collaborative management) and required improvements (e.g. a need to adopt more holistic approaches) were identified. However, there were some conflicting perceptions, regarding for example the desirability of fixed-term positions for managers. Research limitations/implications: The findings provide qualitative indications of a group of Finnish experts' perceptions of MLC and requirements for its development, elicited using the Argument Delphi Method. Thus, they are subject to the usual limitations of the applied methodology and should be generalized to other contexts cautiously. Practical implications: The identification of current deficiencies and future requirements for MLC may facilitate the formulation of robust approaches for improving it in hospital contexts. Social implications: The findings may be useful for improving MLC in hospitals, thereby enhancing efficiency, teamwork, safety and client satisfaction in healthcare settings. Originality/value: The Argument Delphi Method has been rarely used in health management science studies and healthcare context. It is intended to develop relevant arguments and reveal reasons for differing views about focal issues, thereby providing deeper understanding of experts' perceptions of MLC and its likely development.

Purpose The organisational level and leadership development are crucial elements in advancing patient safety, because patient safety weaknesses are often caused by system failures. However, little is known about how frontline leader and director teams can be supported to develop patient safety practices. The purpose of this study was to describe the patient safety development process carried out by nursing leaders and directors. The research questions were: 1) how the chosen development areas progressed in six months’ time, and 2) how nursing leaders view the participatory development process. Design/methodology/approach Participatory action research was used to engage frontline nursing leaders and directors into developing patient safety practices. Semi-structured group interviews (N= 10) were used in data collection at the end of a six-month action cycle, and data was analysed using content analysis. Findings The participatory development process enhanced collaboration and gave leaders insights into patient safety as a part of the hospital system and their role in advancing it. The chosen development areas advanced to different extents, with the greatest improvements in those areas with simple guidelines to follow and in which the leaders were most participative. The features of high-reliability organisation were moderately identified in the nursing leaders’ actions and views. For example, acting as a change agent in order to implement patient safety practices was challenging. Participatory methods can be used to support leaders into advancing patient safety. However, it is important that the participants are familiar with the method and there are enough facilitators to steer development processes. Originality/value Research brings more knowledge of how leaders can increase their effectiveness in advancing patient safety and promoting high-reliability organisation features in the health care organisation.

Purpose – The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment. Health-care leaders and managers in this study were both nursing and physician managers. Competence was assessed by evaluating the knowledge, skills, attitudes and abilities that enable management and leadership tasks. Design/methodology/approach – A systematic literature review was performed to find articles that identify and describe the characteristics of management and leadership competence. Searches of electronic databases were conducted using set criteria for article selection. Altogether, 13 papers underwent an inductive content analysis. Findings – The characteristics of management and leadership competence were categorized into the following groups: health-care-context-related, operational and general. Research limitations/implications – One limitation of the study is that only 13 articles were found in the literature regarding the characteristics of management and leadership competence. However, the search terms were relevant, and the search process was endorsed by an information specialist. The study findings imply the need to shift away from the individual approach to leadership and management competence. Management and leadership need to be assessed more frequently from a holistic perspective, and not merely on the basis of position in the organizational hierarchy or of profession in health care. Originality/value – The authors’ evaluation of the characteristics of management and leadership competence without a concentrated profession-based approach is original.

Accessible summary Communication is important for safe and quality health care. The study provides needed insight on the communication elements that support patient safety from the psychiatric care view. Fluent information transfer between the health care professionals and care units is important for care planning and maintaining practices. Information should be documented and implemented accordingly. Communication should happen in an open communication culture that enables discussion, the opportunity to have debriefing discussions and the entire staff can feel they are heard. For effective communication, it is also important that staff are active themselves in information collecting about the essential information needed in patient care. In mental health nursing, it is important to pay attention to all elements of communication and to develop processes concerning communication in multidisciplinary teams and across unit boundaries. Abstract The study aims to describe which communication elements support patient safety in psychiatric inpatient care from the viewpoint of the nursing staff. Communication is an essential part of care and one of the core competencies of the psychiatric care. It enables safe and quality patient care. Errors in health care are often connected with poor communication. The study brings needed insight from the psychiatric care view to the topic. The data were gathered from semi‐structured interviews in which 26 nurses were asked to describe the elements that constitute patient safety in psychiatric inpatient care. The data were analysed inductively from the viewpoint of communication. The descriptions connected with communication formed a main category of communication elements that support patient safety; this main category was made up of three subcategories: fluent information transfer, open communication culture and being active in information collecting. Fluent information transfer consists of the practical implementation of communication; open communication culture is connected with the cultural issues of communication; and being active in information collecting is related to a nurse's personal working style, which affects communication. It is important to pay attention to all the three areas and use this knowledge in developing patient safety practices and strategies where communication aspect and culture are noted and developed. In mental health nursing, it is important to develop processes concerning communication in multidisciplinary teams and across unit boundaries.