Leadership effectiveness of hospital managers in Iran: a qualitative study.

Purpose: The purpose of this paper is to investigate the factors influencing the leadership effectiveness of hospital managers in Iran. Design/methodology/approach: Top managers (15), middle managers (10) and operational managers (5) of public, private or social security hospitals in Tehran participated in a qualitative study using semi-structured in-depth interviews. Data were recorded, transcribed and then analyzed via MAXQDA 10 software. Findings: The findings were categorized into two main themes of internal and external factors with eight sub-themes. The most important internal factors that had an influence on the leadership of the hospital managers were intra-organizational relations, manager's personality traits, knowledge, attitude and skills of the manager. The most important external factors included extra-organizational relations, macro-level health policies, access to special financial resources, and social, economic and political factors. Research limitations/implications: The results call for a need to understand and analyze the socioeconomic factors influencing managers' leadership while adopting appropriate strategies. Practical implications: The results of the current study can help design training programs for hospital managers, and suggest criteria for appointing hospital managers across the country and this can enhance the effectiveness of their leadership. Health sector policymakers and decision makers should reform the programs that target training and empowerment of hospital managers so that the right people with the right competencies will hold such positions. Social implications: The results of this study showed that leadership effectiveness is also influenced by social and external factors. On the other hand, the effectiveness of management leadership can play a significant role in the quality of care provided to the community, patient satisfaction and in hospital social performance through the appropriate management of all hospital resources. Such factors should also be considered in training and appointing hospital managers. Originality/value: Although there are several studies on hospital managers' leadership worldwide, this study is the first to investigate the leadership effectiveness of hospital managers in Iran. [ABSTRACT FROM AUTHOR]