PURPOSE The purpose of this study is to examine, in healthcare institutions, the mediating role of top management team (TMT) cohesion in the relationship between the CEO's transformational leadership (TL) and the efficacy of the TMT, positioning these three elements as dynamic managerial capabilities (DMC) that enable the organisation to better align with its environment. DESIGN/METHODOLOGY/APPROACH A structural equation model is used based on a survey conducted in public hospitals in the Valencian Community (Spain), with a total of 87 executives from 19 participating hospitals, covering almost all hospitals in the Valencian Community (20 hospitals). FINDINGS The results indicate that TMT cohesion plays an important mediating role in the relationship between TL and TMT efficacy. PRACTICAL IMPLICATIONS The findings suggest that CEO TL is associated with greater TMT cohesion, which is in turn associated with higher team efficacy. In healthcare organisations, where decision-making involves high professional diversity and uncertainty, cultivating a cohesive leadership climate supports more integrated decision-making and improves management effectiveness and organisational adaptability. ORIGINALITY/VALUE This study contributes to healthcare leadership research by examining how CEO TL, TMT cohesion and TMT efficacy are interrelated within the public hospital context, and by explaining why CEOs' TL does not always translate directly into higher TMT efficacy. The findings indicate that TMT cohesion plays a mediating role in this relationship. It further conceptualises these constructs as interrelated DMC with distinct but complementary adaptive functions, offering a novel perspective on how their interaction may support organisational adaptability and alignment with environmental demands.
Purpose This study aims to investigate the role of servant leadership in fostering a collaborative culture within healthcare organizations in the United Arab Emirates (UAE), examining the mediating roles of trust in leaders and perceived organizational support (POS) through the lens of Social Exchange Theory (SET) as the study’s central organizing framework. The UAE’s multicultural healthcare workforce provides the empirical context for this study; cultural diversity is theorized as a factor that may plausibly strengthen the proposed mechanisms, though this proposition is not directly tested in the present design. Design/methodology/approach The study employs a quantitative, cross-sectional survey design, collecting data from 312 healthcare professionals across six healthcare organizations (three public, three private) in the UAE. Structural equation modeling is used to test hypothesized direct and indirect relationships among servant leadership, trust in leaders, POS and collaborative culture, with full measurement model validation, bias-corrected bootstrapping (5,000 resamples), common method bias testing, and assessment of organizational clustering via intraclass correlations and cluster-robust standard errors. Findings The findings reveal that servant leadership has a significant positive association with collaborative culture, both directly and indirectly through trust in leaders and POS, with both mediators supporting partial mediation. Practical implications Theoretically, the study specifies how two distinct SET pathways – relational (trust) and organizational (POS) – jointly link servant leadership to collaborative culture. Practically, it suggests specific leadership-development practices organizations can adopt to enhance teamwork and organizational effectiveness. Originality/value The study contributes to theory by specifying the dual-pathway mechanism through which servant leadership fosters collaborative culture and by conducting this investigation in a multicultural, high-stakes UAE healthcare setting in which cultural diversity is a plausible – though here theorized rather than tested – amplifier of these mechanisms.
PURPOSE This study aims to examine the association between specific nurse manager leadership behaviors and the job satisfaction levels of registered nurses in Trinidad. DESIGN/METHODOLOGY/APPROACH A quantitative, descriptive correlational design was employed. A convenience sample of 100 registered nurses from two major public hospitals completed an online survey incorporating the Leader Behavior Description Questionnaire (LBDQ-XII) and a researcher-developed Job Satisfaction Scale (Cronbach's a = 0.835). Data were analyzed using Spearman's rho correlations and Chi-square tests. FINDINGS Behaviors reflecting Consideration (relationship-orientation) were significantly and positively correlated with satisfaction (r = 0.341, p < 0.001). However, the prevalent leadership approach was perceived as high in Initiating Structure (task-orientation) but deficient in relational support. This behavioral imbalance was associated with high levels of nurse dissatisfaction, particularly regarding the work environment (78 % disagreement). PRACTICAL IMPLICATIONS Healthcare organizations may consider viewing leadership not as an isolated solution, but as an organizational resource embedded within broader work environment strategies. While competency-based training in relational behaviors (such as active listening and constructive feedback) and balanced promotion criteria may support nurse managers, sustainable improvements in job satisfaction and retention likely require multi-pronged initiatives that concurrently address staffing adequacy, operational workloads and the escalating complexity of clinical care. ORIGINALITY/VALUE First empirical evidence linking specific managerial behaviors to nurse satisfaction in Trinidad and Tobago. Moving beyond broad leadership styles, it utilizes the LBDQ-XII to identify a specific behavioral imbalance, high task-orientation versus low relational support, as a primary factor associated with workforce dissatisfaction in the Caribbean context.
Purpose This study aims to map emotional competence in nurse managers and examine how it is conceptualised, assessed and developed, including how it is differentiated from related constructs. Design/methodology/approach A scoping review followed Joanna Briggs Institute methodology and was reported in accordance with PRISMA-ScR. Fourteen information sources were searched up to 13 August 2026. Findings Emotional competence was frequently invoked but rarely operationalised as such. Only 12 sources met the criteria for emotional competence, compared with 71 on emotional intelligence, with two represented in both groups (81 distinct sources). Across the emotional-competence literature, ten domains were identified, but 11 of 20 domain attributions concerned managers regulating, containing or expressing their own emotions, with substantially less attention to emotional skill directed towards others. No source assessed emotional competence against an explicit behavioural standard for the nurse-manager role. Emotional intelligence entered the competence literature through three recurring routes: competency-labelled frameworks, instruments bearing competence terminology and claims that emotional intelligence itself constitutes a leadership competence. Research limitations/implications Most quantitative evidence concerns emotional-intelligence abilities, traits or self-perceptions rather than demonstrated emotional performance in role. Research should define the behavioural attributes of emotional competence and develop context-sensitive assessment approaches. Practical implications Emotional-intelligence scores should not be treated as evidence of demonstrated emotional competence. Organisations should define and directly assess expected role behaviours. Originality/value The review separates emotional competence from emotional intelligence at the level of operationalisation and identifies how frameworks, instruments and claims about emotional intelligence can blur that distinction.
Purpose Telemedicine offers a promising avenue for improving healthcare access in low-resource settings, yet its adoption in Uganda remains uneven. Leadership is pivotal in shaping the successful implementation and management of telemedicine programs, influencing infrastructure development, staff engagement, policy adherence and patient trust. Therefore, this study aims to explore the leadership strategies, challenges, and contextual factors that influence the implementation and sustainability of telemedicine and remote patient care services in Ugandan healthcare clinics. Design/methodology/approach This qualitative study explored the strategies, challenges and contextual factors affecting telemedicine implementation in Ugandan healthcare clinics. Using a phenomenological approach, semistructured in-depth interviews were conducted with 24 healthcare leaders, including clinic managers, IT leads and senior medical officers, from public and private clinics in Kampala, Mbarara and Gulu. Thematic analysis following Braun and Clarke’s (2006) method was used, with NVivo software facilitating coding and data management. Findings Findings reveal how leadership practices, such as strategic planning, staff capacity building and stakeholder engagement, influence the adoption and sustainability of telemedicine services. Contextual factors, including infrastructural limitations, policy gaps and cultural considerations, were found to shape decision-making processes. Originality/value Insights from this study provide valuable guidance for national eHealth policy formulation, leadership development programs and scalable digital health interventions in Uganda and similar Sub-Saharan African contexts.
