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Eligible articles were those that described or tested managerial roles pertaining to quality and safety in the hospital setting.Part of the search strategy was based on guidance by Tanon .28 EMBASE, MEDLINE, Health Management Information Consortium (HMIC) and PSYCHINFO databases were searched.This present systematic literature review aims to identify empirical studies pertaining to the role of hospital managers in quality of care and patient safety.
doctors or nurses, who may have taken on further managerial responsibilities alongside their work but do not have a primary official role as a manager.
Those who have specifically taken on a role for quality of care, e.g. Distinction between senior, middle and frontline management was as follows: senior management holds trust-wide responsibilities26; middle managers are in the middle of the organisational hierarchy chart and have one or more managers reporting to them27; frontline managers are defined as managers at the first level of the organisational hierarchy chart who have frontline employees reporting to them. Although there are overlaps between senior managers and Boards (e.g.
Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria.
Data extraction and quality assessment were performed on 19 included articles.
This literature, made up of opinion articles, editorials and single participant experiences, present an array of insightful suggestions and recommendations for actions that hospital managers should take to improve the quality of patient care delivery in their organisation.13–17 However, researchers have indicated that there is a limited evidence base on this topic.18–21 Others highlight the literature focus on the difficulties of the managers’ role and the negative results of poor leadership on quality improvement (QI) rather than considering actions that managers presently undertake on quality and safety.22 23 Consequently, little is known about what healthcare managers are doing in practice to ensure and improve quality of care and patient safety, how much time they spend on this, and what research-based guidance is available for managers in order for them to decide on appropriate areas to become involved.
Due perhaps to the broad nature of the topic, scientific studies exploring these acts and their impact are likely to be a methodological challenge, although a systematic review of the evidence on this subject is notably absent.
A manager was defined as an employee who has subordinates, oversees staff, is responsible for staff recruitment and training, and holds budgetary accountabilities.
Therefore, all levels of managers including Boards of managers were included in this review with the exception of clinical frontline employees, e.g.
Results The majority of studies were set in the USA and investigated Board/senior level management.
The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices.