Abstract
BackgroundThe implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature.MethodsThe article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in healthcare services.ResultsSixty-two papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is comprised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through five dimensions of leadership: personal performance; contextual awareness; inter-personal influence; stakeholder engagement, networks and alliances; and influence on policy processes.ConclusionThere is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.
Highlights
The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations
Structure of the literature The review found that the health services research literature was structured along four lines when deploying the concept of political skill in the study of health services change, each reflecting different policy and professional contexts that have been the focus of research over the last four decades (Table 2)
The thematic review described below details the different dimensions and qualities of political skill as deployed within the health services research literature to understand the implementation of health services change
Summary
The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Growing recognition of the informal politics of healthcare services has led to corresponding calls for health and care leaders to acquire and utilise a distinct set of skills and capabilities tailored to understanding and dealing with the ‘political arenas’ of health service change. Gilson [6] calls for greater attention to organisational politics and political skill in healthcare leadership development so that leaders are better equipped to understand the multiple agendas and interests that impact on everyday service organisation. Such ideas have become integral to formal leadership development programmes. Reviews in the nursing field provide some evidence for these skills in terms of nursing objectives and agendas, there is wide variation in the definition and conceptualisation of political skill, astuteness, savvy and intelligence, as well as variations in how such concepts can help inform or explain the implement of health service change
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
