Conference Agenda

Staff wellbeing is decisive in public service organizations. For example, studies from the healthcare sector show that problems with employee mental health are associated with reduced patient safety, medical errors, and lower quality of patient care (Hall et al., 2016; Fahrenkopf et al., 2008; Panagioti et al., 2017). Frontline managers hold important roles for improving employee wellbeing in public organizations, but there has been much less focus on managers’ own mental health and wellbeing (Barling and Clautier, 2017). Protecting the wellbeing of managers is important for public organizations for several reasons. First, it is important since mental health problems can lead to long-term sickness absence, turnover, or early retirement (Kyndi et al, 2023) for managers. Second, lack of wellbeing among managers can affect employees both directly and indirectly. Directly, it can have negative spillover effects on employee wellbeing and productivity (Franke, Felfe & Pundt 2014), and indirectly it can harm managers’ leadership efforts, thereby potentially inducing negative consequences on employee motivation and job satisfaction (Backhaus and Vogel, 2022). As a result, manager wellbeing may not only have consequences for employees but also overall organizational performance (Montano et al., 2017).

The psychosocial work environment, comprised by factors such as organizational climate, culture, roles, relationships at work, and the design and content of work tasks (Rugulies, 2019), is a well-established antecedent of wellbeing (Niedhammer, Bertrais, and Witt, 2021). Particularly, Job Demands-Resources theory suggests that an appropriate balance between resources (e.g. social support or psychological safety) and demands (e.g. work without boundaries or a high work pace) in the psychosocial work environment is essential, as too high demands compared to resources can lead to reduced wellbeing. However, there is a lack of studies examining managers’ psychosocial work environment, well-being, and mental health. We therefore aim to investigate to which extent different factors in the psychosocial work environment are associated with wellbeing among frontline managers.

We use survey data from 504 frontline managers in hospitals and employ structural equation modeling to simultaneously investigate the relationships between selected psychosocial work environment factors and wellbeing among the managers, thus allowing the factors to covary. Qualitative insights from open-ended questions are included to further illustrate the investigated dynamics.

By understanding how different aspects of the psychosocial work environment are related to wellbeing among managers, this study contributes to knowledge about which factors public organizations should be aware of in their efforts to enhance wellbeing among frontline managers.

Interprofessional collaboration is essential for effective healthcare delivery, and leadership can play an important role in facilitating it. Professional development leadership (PDL) offers a framework for frontline managers to facilitate a shared understanding of professional quality and influence professionals to implement it, which can support interprofessional collaboration. However, more knowledge is needed about how PDL can be exercised in an interprofessional context, where diverse professional norms, knowledge and unequal power relationships exist among the different professions. By combining existing theoretical knowledge about PDL and in-depth analysis of interviews and field observations, I plan to examine what leadership behaviors contribute to facilitating and sustaining interprofessional collaboration in the healthcare sector. This article thus aims to contribute with knowledge about specific leadership behaviors formal frontline healthcare managers can exhibit to facilitate interprofessional collaboration in an interprofessional context in the healthcare sector.

INNOVATION IN ITALIAN HOSPITALS: THE ROLE OF MIDDLE MANAGERS

Gianluca Maistri, Stefano Landi, Gianluca Veronesi, Chiara Leardini, Luca Piubello Orsini

Innovation has been a hot topic in public administration for many years as a way to improve the delivery of public services (Chen et al., 2020; Walker, 2006). Innovation plays a particularly important role in the healthcare sector, where limited resources need to meet rapidly growing health needs in the face of increasing uncertainty and complexity (Boyne & Meier, 2009; Proksch et al., 2019). Amongst the burgeoning literature on innovation adoption, some scholars have focused on the environmental and organisational antecedents of innovation adoption at the organisational level (De Vries et al., 2016, 2018; Walker, 2014), with less attention paid to the individual characteristics of managers. Thus, only a limited number of studies have shown how managers’ characteristics, attitudes (Bertelsen et al., 2023; Damanpour & Schneider, 2009) and aspirations (Hong et al., 2020; Salge, 2011) can impact organisational adoption of innovation. In relation to the healthcare sector, previous research has also focused on the role of middle managers, demonstrating how their behaviours can facilitate the implementation of innovative solutions at the organisational level (Birken et al., 2012, 2013; Engle et al., 2017).

The aim of the study is, therefore, to investigate how middle managers’ individual characteristics, attitudes, and aspirations can directly or indirectly, through their influence on behaviours, impact the adoption of innovation. To measure individual behaviours, we adopt a construct previously used in innovation research: Innovative Work Behaviour (IWB), which is defined as intentional engagement in innovative activities (Janssen, 2003; Scott & Bruce, 1994). IWB can be a crucial factor in the organisation as it can be leveraged in support of change initiatives (Miao et al., 2018; Nicholson-Crotty et al., 2017). When adopted by middle managers, IWB has the potential to positively influence organisational-level innovation (Mustafa et al., 2022). Crucially, it is also acknowledged that IWB can be influenced by the individual characteristics of managers, such as age and tenure in the organisation (Ng & Feldman, 2013).

A mix of data sources is used to identify the specific mechanisms that drive innovation adoption while accounting for factors that are relatively immutable in the short term, such as experience and personal attitude of middle managers, and those that can also be influenced by organisational factors, such as their individual behaviours. First, to capture innovation adoption at the organisational level and middle managers’ IWB, attitudes, and aspirations, we administered a survey using validated instruments for each construct (Hurt et al., 1977; Janssen, 2000; Nicholson-Crotty et al., 2017). Second, to identify middle managers’ individual characteristics, we gathered information from their individual CVs, while secondary data was used to measure organisational-level control variables. The final sample consists of around 600 managers of Italian publicly owned hospitals. A pilot test has already been concluded with the participation of 73 managers, confirming the reliability and validity of the chosen constructs. The analysis relies on Structural Equation Modelling to evaluate the relationships between managers’ individual characteristics, innovation attitude, performance aspiration, and IWB with innovation adoption.

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Extensive research in public management focuses on the representation of groups and identities (Carrell and Mann 1995; Bishu and Kennedy 2020; Riccucci 2021). This research focus, coined representative bureaucracy, argues that public organizations can benefit from a representative workforce through different mechanisms (Riccucci and Van Ryzin 2017; Meier 2019). Studies focus primarily on whether and how representativeness is beneficial for public organizations. While empirical evidence indicates that representation elicits positive effects, several unanswered questions remain (Meier 2019). This study departs from one of these research gaps: research often considers gender representation at one separate organizational level, often overlooking other organizational levels and ignoring internal dynamics (e.g., Riccucci, Van Ryzin, and Li 2016; Van Ryzin, Riccucci, and Li 2017; Sievert 2021).

As such, we lack research on representation at different organizational levels and their interrelations . We specifically focus on the effects of representation on the top management level, an aspect generally understudied in public management research (McDougall 1996; Groeneveld 2011; Gould, Kulik, and Sardeshmukh 2017; Baekgaard and George 2018). We depart from prominent arguments in the field of human resource management. Here, scholars connected gender-diverse top management to an increase in gender representation at the lower managerial level, suggesting a trickle-down effect (Gould, Kulik, and Sardeshmukh 2018; Biswas, Roberts, and Stainback 2021; Gould, Kulik, and Sardeshmukh 2017). These arguments primarily build on the similarity-attraction paradigm and the homophily principle. Yet, insights from the public sector are scarce.

To approach this research focus and provide empirical evidence, we implement an empirical study using quantitative, longitudinal data from Italy. The data is derived from the national account of the Italian public sector workforce (2001-2021), which includes extensive information on the employment structure of around 8,000 Italian municipalities. The statistical analysis comprises a mixed-effect model, also known as a random intercept (Cnaan, Laird, and Slasor 1997), to account for within-subject and between-subject variability. The main outcome variable is the share of female employees in non-managerial and lower managerial levels, predicted by gender representation at the top managerial level in the previous year. Subsequent analysis will consider also a potential lag in the effect, up to five years. In addition, the model controls for politicians’ gender representation and other contextual and organizational factors.