Abstract
BackgroundWithin contemporary health care, many of the decisions affecting the health and well-being of patients are not being made by the clinicians or health professionals, but by those involved in health care management. Existing literature on organizational ethics provides insight into the various structures, processes and strategies - such as mission statement, ethics committees, ethical rounds … - that exist to create an organizational climate, which fosters ethical practices and decision-making It does not, however, show how health care managers experience their job as being intrinsically ethical in itself. In the present article, we investigate the way in which ethical values are present in the lived experiences and daily practice of health care management. What does it imply to take up a managing position within a health care institution and to try to do this in an ethically inspired way?MethodWe carried out a qualitative study (Grounded Theory Approach) to explore the essence of values-based leadership in health care. We interviewed 15 people with extensive experience in health care management in the fields of elderly care, hospital care and mental health care in the various regions of Flanders, Belgium.ResultsSix predominant themes, presented as metaphors, illustrate the essence of values-based leadership in health care management. These are: (1) values-based health care management as managing a large garden, (2) as learning and using a foreign language, (3) going on a trekking with an ethical compass, (4) embodying integrity and authenticity in a credible encounter with everyone, (5) being a present and trustworthy leader during sun and storm, and (6) contributing to human flourishing by giving people wings to fly.ConclusionsNotwithstanding the importance of organizing a good ethics infrastructure, values-based leadership in health care entails much more than that. It is about the co-creation of an integrated and comprehensive ethical climate of which community-model thinking and authentic leadership are essential components. As a never-ending process, the six metaphors can help leaders to take substantive proactive steps to shape a fruitful ethical climate within their organization.
Highlights
Within contemporary health care, many of the decisions affecting the health and well-being of patients are not being made by the clinicians or health professionals, but by those involved in health care management
Notwithstanding the importance of organizing a good ethics infrastructure, values-based leadership in health care entails much more than that. It is about the co-creation of an integrated and comprehensive ethical climate of which community-model thinking and authentic leadership are essential components
The increasing awareness that many of the decisions affecting the health and well-being of patients are not made by the clinicians or health professionals, but by those involved in health care management and policy, gradually raised new and specific ethical questions in contemporary health care [3,4,5,6,7]
Summary
Many of the decisions affecting the health and well-being of patients are not being made by the clinicians or health professionals, but by those involved in health care management. The increasing awareness that many of the decisions affecting the health and well-being of patients are not made by the clinicians or health professionals, but by those involved in health care management and policy, gradually raised new and specific ethical questions in contemporary health care [3,4,5,6,7]. The organizational ethics concern is institutionalized through various formal and informal structures, processes, and strategies [7, 12, 18], such as: mission discernment and value statement [6, 16, 17, 19], ethics committees [20, 21], ethics codes or guidelines, such as codes of conduct or professional codes of ethics [22, 23], ethical rounds, administrative case rounds or ethical roundtables [7, 24, 25], ethics case reflection and moral case deliberation [26,27,28,29,30], ethical decision-making frameworks [15, 31,32,33], organizational ethics programs [13, 34, 35], accreditation standards and organizational ethics policies [21, 35,36,37]
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