Health management and leadership competencies: The most important factor

Health management and leadership competencies: The most important factor
The terms ‘competency’ and ‘competence’ are often used interchangeably and inconsistently in health management and leadership literature. However, both terms are distinct concepts. Competency refers to the knowledge, skills, and attitudes which health leaders require for effective performance in roles , and can be improved with training and development interventions . Knowledge has been described as a demonstration of the awareness or understanding of the concepts, theories, guidelines, or principles required to successfully perform a task . Skill, on the other hand, refers to the possession of the capacity to successfully carry out physical or cognitive tasks to achieve a specific outcome , while an attitude refers to “a relatively enduring organisation of beliefs, feelings, and behavioural tendencies towards socially significant objects, groups, events or symbols “. Certain competencies are considered as crucial for successful performance of organisations; such competencies are known as ‘core competencies’, a concept first advocated by Prahalad and Hamel .
Core competencies have also been described as common competencies which overlap and complement one another and are shared by health managers in a wide range of positions and settings . Although the concept of core competencies engenders understanding and collaboration among individuals, it has been criticised for not taking into consideration the specific needs of each manager in line with his or her dominant management or leadership role . Thus, in addition to identifying core competencies, it may also be useful to identify specific competencies required by certain individuals or members of a professional body for effective performance .
Competence is the ability to consistently produce the outcomes (of behaviour) required for effective achievement of organisational goals . In other words, a competent health man ager or leader possesses the requisite knowledge, skills and attitudes that enable him or her to manage or lead effectively. The term ‘proficiency’, or ‘competence level’, refers to the level of expertise for a particular competency. A ‘competency model’ is a framework which contains competency statements in which essential knowledge, skills and attitudes desirable for specific roles are described , or a collection of competencies required for successful performance .
A ‘competence model’, on the other hand, refers to a framework which describes the process and work outputs required to achieve the set goals of specific roles . Other terms commonly associated with competency are ‘capability’ and ‘capacity’. Capability refers to the process which allows individuals to demonstrate or express the required com petencies on their jobs; it is the ease with which the required competencies can be accessed, deployed, or applied by individuals .
Capacity, on the other hand, refers to the power or ability of individuals to hold or possess the required competencies at a level considered suf ficient for a role . As pointed out earlier, several studies have been conducted on health management and leadership. The majority of these focused on identification and/or assessment of essential competencies required by health managers and leaders for effective performance in management and leadership roles. The focus on competencies has been informed by the need to develop strong and competent health management and leadership workforces, given the pivotal roles of leaders from health management and clinical backgrounds in driving changes and leading development in health care organisations. This much has also been recognised by the World Health Organisation, which has advocated the need to strengthen management and leader ship capabilities at all levels of the health system .
Different approaches are being used to identify and assess essential competencies required by health management and leader ship workforces. These approaches include literature review, position description analysis, the Delphi technique, surveys, interview of job incumbents and focus groups. The optimal approach recommended for identification and assessment of competencies involves the use of multiple methods to improve the credibility of findings .
A major point of contention in health management and leadership is whether competencies are similar across countries and organisational contexts, or are contextually sensitive. While some authors have argued that certain ‘core’ competencies are applicable to most health contexts , others have advocated for more contextually compatible competencies based on the premise that competencies may be influenced by contextual factors such as demographic characteristics of personnel, as well as the size, culture and needs of organisations .
Notwithstanding the argument, certain domains of competencies have been identified across several studies as important for health management and leadership roles, regardless of the con texts in which those relationships, business skills, knowledge of the health care environment, professionalism, and leadership . A close look at these domains of competencies shows that some, including communication, interpersonal relationships, professionalism and leadership, are people and relationship centred. This is not surprising, given the fact that health care orgaisations are comprised of human systems where people of diverse backgrounds interact with one another for successful management of the health care system , and provision of safe, effective, and high-quality patient care .
Although certain competencies may be common to most health contexts, in practice they are likely to be demonstrated differently, depending on certain factors such as management levels and sectors . In other words, while some competencies may be similar across most health contexts, the competence level (proficiency) required to demonstrate them will vary from one management level or organisational setting to another. Thus, in addition to identifying the essential competencies required by health management and leadership work forces generally, the health care sector should also focus on the competencies required by specific groups and organisations.