Experiences of organizational practices that advance women in health care leadership

Mousa, M., Garth, B., Boyle, J. A., Riach, K. and Teede, H. J. (2023) Experiences of organizational practices that advance women in health care leadership. JAMA Network Open, 6(3), e233532. (doi: 10.1001/jamanetworkopen.2023.3532) (PMID:36939704) (PMCID:PMC10028487)

Abstract

Importance: Women are underrepresented in health care leadership positions. Organizational practices and culture play a key role in mitigating this disparity. Objective: To explore the experiences of women in leadership roles and inform how health care organizations can support the advancement of women into leadership. Design, Setting, and Participants: This qualitative study used a constructivist grounded theory approach applied over a 1-year period (May 1, 2021, to May 31, 2022) in a large private health care network in Australia. Women were eligible if they had been in leadership positions for more than 5 years. Purposive and theoretical sampling guided recruitment of 28 women, representing medical, nursing, and allied health specialties. Interviews lasted 1 hour, producing 500 pages of transcripts for analysis. Main Outcomes and Measures The primary outcome was a model of organizational practices and conditions that advance women in health care leadership, extrapolated from the collective experiences of women in leadership. Key elements pertained to organizational patterns of interaction and group norms and behaviors that contributed toward women’s experiences of career advancement. Results: Overall, 28 women (23 [82%] White; 3 [11%] Southeast Asian) participated in the study, 10 (36%) of whom were in nursing, 9 (32%) of whom were in allied health, and 9 (32%) of whom were in medical disciplines. Organizational practices that advance women in health care leadership were highly dependent on conducive organizational culture enhancing women’s credibility and capability as leaders. Four interrelated elements were identified that create the necessary conditions for an organizational culture to advance women in health care leadership, including (1) identifying and actively addressing systemic barriers, (2) challenging gendered assumptions and expectations of leadership behaviors, (3) providing mentorship to shape career opportunities, and (4) determining how these conditions all contribute toward raising women’s credibility to enable internalizing a leadership identity. For women, advancing to leadership involved organizations moving away from ad hoc, inconsistent applications of gender equity practices and generating supportive practices that reinforced a workforce culture of credibility, collaboration, and continuous improvement to support women. Conclusions and Relevance: In light of persisting inequity in health care leadership, women’s experiences were captured in this qualitative study to identify organizational practices that support their advancement. Insights into factors that influence efficacy of these practices, including building a supportive culture and mentoring, are discussed. This research informs a National Health and Medical Research Council initiative with international collaborators to support organizations in advancing women in health care leadership.

• Item Type: Articles
• Additional Information: This work was supported by grant 82038 from the Epworth Medical Foundation Fund; a scholarship from Epworth Healthcare and Monash University (Ms Mousa); a fellowship from the NHMRC (Dr Teede); and grant 1198561 Advancing Women in Healthcare Leadership Partnership from the NHMRC.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Riach, Professor Kathleen
• Authors: Mousa, M., Garth, B., Boyle, J. A., Riach, K., and Teede, H. J.
• College/School: College of Social Sciences > Adam Smith Business School > Management
• Journal Name: JAMA Network Open
• Publisher: American Medical Association
• ISSN: 2574-3805
• ISSN (Online): 2574-3805
• Published Online: 20 March 2023
• Copyright Holders: Copyright © 2023 Mousa M et al.
• First Published: First published in JAMA Network Open 6(3): e233532
• Publisher Policy: Reproduced under a Creative Commons License