Navigating healthcare leadership: Theories, challenges, and practical insights for the future (2025)

ABSTRACT

Effective healthcare leadership is essential to ensure high-quality patient care and foster a supportive work environment for healthcare professionals. This review aims to consolidate existing healthcare leadership literature to provide evidence-based insights that can guide leadership development, improve team performance, and enhance patient care outcomes. A systematic search of academic databases such as PubMed, Scopus, Web of Science, CINAHL, Embase, and Google Scholar was performed using keywords related to healthcare leadership. Studies were selected based on their relevance, peer-reviewed status, and focus on healthcare settings. Thematic analysis was employed to synthesize findings from the selected studies. The review explores various leadership theories, including Great Man, trait, behavioral, transactional, transformational, and contingency theories, highlighting their relevance and application in healthcare. Effective healthcare leaders must possess traits such as vision, emotional intelligence, adaptability, and ethical integrity to navigate the complexities of modern healthcare. The review categorizes different leadership styles, including authoritarian, transformational, transactional, servant, and participative, and discusses their application in specific healthcare contexts. Leaders face challenges such as balancing personal and professional responsibilities, adapting to technological advancements, managing financial constraints, and ensuring regulatory compliance. Healthcare leadership requires a dynamic and adaptable approach that integrates various leadership theories and styles to address the unique challenges of the healthcare environment. This review underscores the importance of leadership development programs and calls for further research to explore the practical implementation of leadership strategies in diverse healthcare settings. The findings provide actionable insights for healthcare leaders to tailor their leadership styles to the specific needs of their teams and organizational contexts, ultimately enhancing patient care and operational efficiency.

KEY WORDS: Adaptive leadership, healthcare challenges, healthcare leadership, leadership theories, patient outcomes, transformational leadership

Introduction

Effective healthcare leadership is critical as it significantly enhances patient clinical outcomes and fosters a supportive environment for healthcare providers, promoting workplace engagement and reducing burnout. This dual impact underscores the vital role of leadership in driving quality care and healthcare professionals’ well-being.[1,2,3]

Leadership has many interpretations. In many settings, it has been likened to “the abominable snowman whose footprints are everywhere but who is nowhere to be seen.”[4] In reality, it is a multifaceted concept with various definitions and interpretations. Warren Bennis, a notable authority on leadership, defines it as “a function of knowing yourself, having a vision that is well communicated, building trust among colleagues, and taking effective action to realize your leadership potential.”[5] Drucker’s definition, on the other hand, underscores the relational aspect of leadership, focusing on the presence of followers as the key indicator of a leader’s existence.[6]

What does leadership mean in healthcare settings? In healthcare settings, leadership takes on additional layers of complexity due to the unique challenges and high stakes involved.

Effective healthcare leaders must navigate a dynamic environment characterized by rapid technological advancements, complex patient needs, and evolving healthcare policies.

Healthcare leadership consequently refers to the practice of influencing and guiding individuals and teams within the healthcare sector toward achieving the collective goal of improving patient care, operational efficiency, and healthcare delivery.[7,8,9]

Healthcare leaders are crucial for fostering a positive work environment, enhancing team performance, and ensuring high-quality patient care. They must possess a diverse range of personal and professional traits to navigate the complexities of the modern healthcare landscape. The COVID-19 pandemic highlighted the need for leaders who can manage stress effectively, communicate with empathy and transparency, and adapt to rapidly changing situations.

Conducting this narrative review is crucial in the context of healthcare due to the evolving challenges faced by leaders in this field. With the ongoing transformation in healthcare delivery, driven by technological advancements, policy shifts, and changing patient needs, there is a pressing need to identify leadership models that can effectively address these dynamics. This review aims to consolidate existing knowledge, providing healthcare organizations with evidence-based insights that can guide leadership development, enhance team performance, and ultimately improve patient care outcomes.

Methodology

The methodology employed in this narrative review focused on synthesizing existing literature to offer a comprehensive understanding of healthcare leadership. A systematic search was conducted across multiple academic databases, namely PubMed, Scopus, web of Science, CINAHL, Embase, and Google Scholar, utilizing specific keywords such as “healthcare leadership,” “leadership theories,” “leadership development,” “effective leadership qualities,” “leadership challenges in healthcare,” “leadership models,” “adaptive leadership,” and “transformational leadership” to capture a wide range of relevant studies. After an initial screening based on titles and abstracts, full-text reviews were conducted to ensure the studies met the inclusion criteria, which required them to be peer-reviewed, available in full text, either quantitative or qualitative, relevant to healthcare, published in English, and within the last 20 years.

Key information was extracted from the selected studies, including effective leadership traits, leadership theories, leadership models and their role in healthcare settings, the process of effective leadership, leadership development, leadership matching matrix, reported outcomes, and any noted challenges. The extracted data were organized thematically, allowing the identification of common trends and gaps in the literature. The narrative synthesis emphasized the most frequently discussed leadership models and their effectiveness across different healthcare contexts. To enhance the review’s validity, expert consultations were conducted with senior faculty members and administrators, whose insights helped refine the practical recommendations.

This paper is grounded in the transformational leadership theory, which serves as the guiding theoretical framework for understanding effective leadership in healthcare settings. Transformational leadership theory posits that leaders who inspire, motivate, and foster positive change within their organizations are particularly effective in environments characterized by complexity and high stakes, such as healthcare. This framework is particularly relevant as it aligns with the dynamic nature of healthcare leadership, where adaptability, vision, and the ability to drive innovation are essential.

In conducting this review, we acknowledge the role of positionality, recognizing how our backgrounds, experiences, and roles within healthcare shape our perspectives on leadership. Our diverse team comprises junior faculty who bring insights from early career challenges, such as finding mentorship and navigating organizational hierarchies, alongside senior faculty members with extensive leadership experience. This combination allows us to analyze both the emerging issues faced by new leaders and the strategic insights gained from seasoned professionals.

By disclosing our positionalities, we aim to provide a balanced and comprehensive analysis, integrating a range of viewpoints. Throughout this review, we engaged in reflexive practice, continually questioning how our experiences and assumptions may influence our conclusions. Although our individual positions may introduce varying perspectives and potential biases, we have collectively worked to maintain objectivity by critically engaging with diverse literature and incorporating multiple perspectives. This approach ensures a multifaceted exploration of healthcare leadership, reflecting the challenges and insights from both those entering the field and those with established leadership roles.

For this narrative review, an ethical review was not deemed necessary because the study did not involve the collection of new data from human or animal subjects. Instead, the research synthesized and analyzed existing literature, which is already available in the public domain and typically undergoes its ethical review processes during publication. However, the study adhered to ethical standards of academic integrity by ensuring accurate citations, avoiding plagiarism, and acknowledging the contributions of original authors. The focus remained on maintaining high ethical standards throughout the research process, even in the absence of direct ethical review requirements.

This approach aimed to provide a robust framework for understanding leadership dynamics in healthcare, offering valuable insights for improving leadership practices and outcomes in medical institutions.

Results

Understanding leadership theories in healthcare

Leadership is a critical component of effective healthcare management, and over the years, various theories have been developed to explain what makes a successful leader. These theories offer insights into the traits, behaviors, and situations that contribute to effective leadership, particularly in the complex and dynamic field of healthcare. By understanding these theories, healthcare professionals can better navigate their roles, adapt to challenges, and foster environments that promote patient care, innovation, and team collaboration. The following sections delve into some of the most influential leadership theories, exploring their relevance and application in healthcare settings.

(i)
The Great Man theory
The Great Man theory, one of the earliest leadership theories, posits that leaders are inherently born with certain traits that make them natural leaders. According to this theory, these individuals possess extraordinary qualities such as charisma, intelligence, wisdom, and courage, which distinguish them from others and enable them to shape history and lead effectively. This theory suggests that leadership is not something that can be learned or developed; rather, it is a characteristic that individuals either possess at birth or do not. While influential in the past, this theory has been largely discredited in modern leadership studies, particularly in healthcare, where leadership is seen as a set of skills that can be learned and developed rather than innate traits that only a select few possess.[10,11]
(ii)
Trait theory
The Trait theory builds upon the foundation of the Great Man theory, proposing that certain personality traits are key indicators of leadership potential. This theory, developed in the early 20^th century, asserts that individuals who possess specific traits—such as self-confidence, decisiveness, integrity, and intelligence—are more likely to be effective leaders. Unlike the Great Man theory, which focuses on the inherent nature of leadership, the Trait theory suggests that these leadership traits can be identified and measured. However, like the Great Man theory, it has limitations, particularly in its assumption that leadership qualities are fixed and cannot be learned. In healthcare, where the ability to adapt and respond to complex, changing environments is crucial, this theory does not fully account for the dynamic nature of effective leadership.[12,13]
(iii)
Behavioral theory
Behavioral theory marks a shift from focusing on inherent traits to examining the behaviors and actions of leaders. According to this theory, leadership is not about who you are but what you do. Leaders can be made through learning and experience, and effective leadership is a result of specific behaviors that can be observed, taught, and replicated. This theory suggests that anyone can become a leader if they learn the right behaviors, such as effective communication, decision-making, and the ability to inspire and motivate others. In the context of healthcare, this theory is particularly relevant because it supports the idea that leadership can be developed through education, training, and practice.[13,14,15]
See Also
Promoting Health and Well-being in Healthy People 2030 The Role of Social Determinants of Health in Promoting Health Equality: A Narrative Review Health Promotion, Health Protection, and Disease Prevention: Challenges and Opportunities in a Dynamic Landscape A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviours
(iv)
Transactional leadership theory
Transactional leadership is based on a system of rewards and punishments to achieve desired behaviors and outcomes. It focuses on the exchanges between leaders and followers, where leaders provide resources or rewards in return for compliance and performance. This style is often associated with management rather than leadership and is most effective in situations where tasks are routine and goals are clear. In healthcare, transactional leadership might be used in environments that require strict adherence to protocols and guidelines, such as in administrative or operational settings. However, it may not be sufficient in environments that require innovation and adaptability.[16,17,18]
(v)
Transformational leadership theory
Transformational leadership is characterized by the ability of leaders to inspire and motivate followers to achieve more than what is expected of them. Transformational leaders focus on the big picture, articulating a vision that inspires others to work toward shared goals. They are often seen as change agents who encourage innovation, foster a positive organizational culture, and motivate followers to exceed their own expectations. In healthcare, transformational leadership is particularly valuable as it helps to navigate the complexities of healthcare delivery, drive improvements in patient care, and foster a collaborative and supportive work environment.[19,20,21]
(vi)
Contingency theory
Contingency theory posits that there is no one-size-fits-all approach to leadership. Instead, the effectiveness of a leadership style is contingent on various factors, including the situation, the tasks at hand, and the characteristics of the followers. This theory suggests that successful leaders are those who can adapt their style to the specific needs of the situation. In healthcare, where leaders often face a wide range of challenges, from managing crises to leading change initiatives, the ability to adapt their leadership approach based on the context is critical for success.[22,23,24]

The evolution of leadership theories reflects a shift from the idea that leadership is an inherent trait, as proposed by the Great Man and trait theories, to the understanding that leadership can be developed and adapted based on behaviors and situations. Over time, the emphasis moved to behavioral theories, which proposed that leadership is about actions and behaviors that can be learned. Further developments introduced transformational leadership, which focuses on inspiring and motivating change, and contingency theory, which highlights that effective leadership depends on context and adaptability. This progression shows a deeper understanding of leadership as a dynamic and learnable skill. These theories collectively provide a comprehensive framework for understanding leadership in healthcare. Each theory offers valuable insights into different aspects of leadership, highlighting the complexity and multifaceted nature of effective leadership in healthcare settings.

Essential qualities of effective healthcare leaders

Healthcare leadership is a multifaceted and complex responsibility, demanding a unique set of qualities that go beyond traditional managerial skills. In environments where the stakes involve both human lives and organizational efficiency, effective leaders must possess a blend of personal integrity, emotional intelligence, and the ability to inspire and guide diverse teams. These qualities are not just desirable but also crucial in navigating the challenges of modern healthcare settings. The following table highlights some of the key qualities that are essential for healthcare leaders to foster a positive work environment, improve patient care, and ensure the success of their organizations [Table 1].

Table 1.

Effective traits of healthcare leaders[4,13,19,20,21,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57]

Trait	Description
Vision	Ability to create a clear and compelling picture of the future.
Inspire, Influence, and Motivate	Encourages and energizes others toward achieving goals.
Decision-making	Capacity to make informed and effective decisions.
Emotional Intelligence	Recognizes and manages one’s own emotions and the emotions of others.
Adaptability and Resilience	Able to adjust to new conditions and recover quickly from difficulties.
Ethical	Adheres to moral principles and professional standards.
Transparent	Openness and honesty in communication and actions.
Team Player	Works effectively and cooperatively with others.
Business Skills	Understanding of business principles and practices.
Ability to Lead Change	Guides others through transitions and transformations.
Empowerment	Provides team members with the authority and confidence to make decisions.
Delegation	Assigns tasks and responsibilities effectively.
Mentorship	Guides and supports the development of others.
Humility	Possesses a modest view of one’s own importance.
Time Management Skills	Efficiently manages time to maximize productivity.
Organizational Skills	Plans and organizes tasks effectively.
Networking	Builds and maintains professional relationships.
Feedback Friendly	Open to giving and receiving constructive feedback.
Active Listener and Communicator	Engages in attentive listening and clear communication.
Prioritizes Team Wellbeing	Focuses on the health and satisfaction of the team.
Leads by Example	Demonstrates the behaviors and work ethic expected of others.
Instantaneous Reinforcement	Provides immediate feedback and recognition.
Continuous Learning	Commitment to ongoing education and self-improvement.
Stress Management	Effectively handles stress and maintains composure.
Conflict Management	Resolves disputes and manages disagreements constructively.
Advocate	Supports and promotes the interests of others.
Sponsor	Actively promotes the career development of others.
Collaboration	Works jointly with others to achieve shared goals.
Embraces Innovation and Technology	Adopts new technologies and innovative practices.
Fosters Leadership Qualities	Encourages and develops leadership skills in others.
Health Professional Education Research Skills	Proficient in healthcare professional education research.
Critical Thinking	Analyzes and evaluates information for sound judgment and problem-solving.

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Leadership styles and their application in healthcare

A diverse array of leadership styles can be applied in healthcare settings, each with its own set of advantages, challenges, and appropriate contexts for implementation. The table below provides a comprehensive overview of various leadership styles, detailing their characteristics, pros and cons, and the situations in which they are most effectively employed. This information serves as a valuable resource for understanding how different leadership approaches can be harnessed to foster a positive and productive healthcare environment [Table 2].

Table 2.

Leadership Styles and Their Application in Healthcare^{[16,23,58,59,60,61,62,63]}

Type	Description	Pros	Cons	When Required	Examples in Healthcare Settings
Authoritarian	Provides clear expectations for what needs to be done, when, and how. Decisions are made independently with little input from group members.	Clear direction. Quick decisions.	Can create a hostile environment and stifle creativity.	Best for situations requiring rapid decision-making and strict control.	A surgeon leading an emergency trauma team needs to make quick decisions to save a patient’s life.
Delegative (Laissez-Faire)	Offers little or no guidance to group members and leaves decision-making up to them. Effective when team members are highly skilled and motivated.	Encourages innovation and independence.	Can lead to a lack of direction and lack of accountability.	Effective with highly skilled and self-motivated teams.	A research team working on a complex project where members are experts in their fields and need freedom.
Transformational	Motivates and inspires followers to achieve extraordinary outcomes by focusing on the organization’s vision and values. Transformational leaders are energetic, enthusiastic, and passionate.	High performance, improved group satisfaction, and enhanced well-being.	Requires a lot of energy and commitment from the leader.	Ideal for driving change and innovation within the organization.	A hospital CEO inspiring staff to adopt new patient care technologies that improve outcomes.
Transactional	Focuses on the exchanges between leader and followers, emphasizing rewards and punishments based on performance.	Clearly defined roles and expectations; effective for routine tasks.	Can be perceived as rigid; lacks inspiration for long-term change.	Suitable for routine tasks and performance management.	A nurse manager enforcing protocols and rewarding compliance with infection control standards.
Servant	Prioritizes the needs of team members and helps them develop and perform as highly as possible. Demonstrates humility, empathy, and a commitment to serving others.	Builds trust, fosters collaboration, and enhances team satisfaction.	Can be time-consuming and may be seen as a lack of authority.	Best for environments that value collaboration and team development.	A department head who actively mentors junior doctors, focusing on their growth and professional development, not considering his own needs and interests.
Participative (Democratic)	Involves group members in decision-making, and encourages collaboration and creativity. The leader retains the final say but values input from others.	Higher quality contributions. Team members feel valued.	Slower decision-making process.	Useful when diverse input and creative solutions are needed.	A committee working to develop new hospital policies, including input from various healthcare professionals.
Authentic	Emphasizes building the leader’s legitimacy through honest relationships with followers based on ethical foundations. Authentic leaders are self-aware and genuine.	Builds trust, encourages open communication, and fosters loyalty.	Can be challenging in highly competitive environments.	Effective in creating trust and loyalty within the team.	A medical director who leads by example, demonstrating transparency in decision-making processes.
Complexity	Emphasizes adaptive, enabling, and administrative functions distributed across an organization. Healthcare organizations are seen as complex adaptive systems, where leadership emerges from interactions within the system.	Adaptive to changes, and encourages collaboration and innovative problem-solving.	Can be difficult to implement; requires cultural change.	Necessary in highly dynamic and complex environments.	A healthcare administrator managing a large hospital network, balancing various departments and functions.
Distributed	Shares leadership responsibilities among various individuals and teams, leveraging collective expertise and promoting collaboration and innovation.	Leverages collective expertise, promotes collaboration, and enhances innovation.	Can lead to confusion and requires strong communication.	Useful in collaborative environments requiring diverse expertise.	A multidisciplinary team managing patient care, with different leaders for medical, nursing, and support services.
Adaptive	Focuses on adapting to changing environments and challenges, promoting flexibility, continuous learning, and resilience within teams.	Flexible, promotes resilience, and encourages continuous learning.	Can be slow to respond and requires constant adjustment.	Ideal for environments with frequent changes and evolving challenges.	A public health leader adapting strategies to manage emerging health crises such as pandemics.
Contingency	Suggests that the effectiveness of a leader is contingent upon the match between the leader’s style and the situation, including the task, leader’s style, and group dynamics.	Tailored to situations, flexible, and effective in various contexts.	Can be complex to implement and requires situational analysis.	Effective when different situations require different leadership approaches.	A healthcare executive changing leadership style during different phases of a hospital merger.
Situational	Leaders must adjust their style to fit the development level of followers. The approach is adapted based on the task and the maturity or readiness of followers.	Flexible, adapts to follower needs, and encourages development.	Can be inconsistent and requires an understanding of follower needs.	Best when dealing with teams of varying skill levels and experience.	A senior nurse adjusting her leadership style when training new nurses versus experienced staff.

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The effective application of diverse leadership styles can play a pivotal role in improving patient outcomes by directly influencing team dynamics, communication, and overall morale within healthcare settings. Transformational leadership fosters innovation and team engagement, leading to a more motivated workforce and continuous improvement in clinical processes that enhance patient care. Transactional leadership emphasizes adherence to protocols and performance metrics, which helps reduce errors and ensures compliance with safety standards. Servant leadership focuses on team empowerment, leading to increased patient satisfaction and better coordination of care through a more cohesive team approach. Situational leadership allows leaders to adapt their style based on the scenario, providing directive support in emergencies and coaching new staff to develop their competencies. Authentic leadership fosters a culture of transparency and safety, which encourages open communication and builds patient trust. Lastly, adaptive leadership proves essential in managing change and driving innovation, particularly during public health crises, where flexibility and resilience are crucial for maintaining quality care. By leveraging these varied leadership approaches, healthcare leaders can enhance care quality, ensure patient safety, and ultimately contribute to better patient satisfaction and health outcomes.

Choosing the best leadership style in healthcare is complex and multifaceted as there is no single style that fits all situations. The most effective healthcare leaders are those who can adapt their style to meet the needs of their team and the situation, inspire and motivate their followers toward a common vision, and uphold high ethical standards. Effective healthcare leadership therefore often involves a combination of adaptive, situational, transformational, and ethical leadership styles that create a resilient and responsive healthcare environment, ultimately leading to better patient care and organizational success.

Leaders must be cautious of adopting certain negative traits as these can significantly undermine their effectiveness and the overall team environment. Traits such as being controlling, judgmental, critical, bad-tempered, bad-mannered, rude, volatile, belittling, derogatory, and unappreciative can create a toxic atmosphere, reducing morale and hindering collaboration among team members. The distinction between a boss and a leader is crucial in this context. While a boss tends to exercise authority, focusing on giving orders and maintaining control, a leader is someone who inspires, guides, and motivates the team toward achieving common goals. Moreover, while management focuses on producing order and consistency, organizing resources, and maintaining structure, leadership is about driving change, setting direction, influencing others, and managing transitions. The absence of the aforementioned negative qualities is vital for leadership that not only directs but also inspires and motivates others to achieve collective goals.[64]

Process of effective leadership

In healthcare settings, leadership plays a critical role in ensuring effective management and improved patient outcomes. The sequence of events provided below outlines a comprehensive system for effective leadership, starting from identifying leadership needs to continuous improvement.

Challenges in leadership in healthcare

In the rapidly evolving landscape of healthcare, leaders face a myriad of challenges that require a delicate balance between personal, organizational, and external demands. The complexities of managing both clinical and academic responsibilities, adapting to technological advancements, and navigating financial constraints are just a few of the pressing issues. Furthermore, healthcare leaders must maintain compliance with regulatory standards, foster a diverse and inclusive workforce, and shift the focus toward patient-centered care. These challenges are compounded by the need to stay informed about broader healthcare and educational agendas, all while promoting innovation and driving interprofessional collaboration. The table below provides a detailed overview of these challenges, highlighting the multifaceted nature of leadership in healthcare settings [Table 3].

Table 3.

Key Issues Faced by Healthcare Leaders and Potential Solutions[65,66]

Current Healthcare Leadership Challenges	Potential Solutions
Personal Issues Maintaining an appropriate work-life balance, and the dual demands of clinical and academic careers pose significant challenges.	1. Encourage flexible working hours and remote work options where feasible.
	2. Provide access to wellness programs and mental health resources.
Organizational and Cultural Issues Understanding and navigating the organizational culture is critical for success. Certain healthcare disciplines may better accommodate both clinical and academic demands.	1. Implement mentorship programs to help new leaders understand the organizational culture.
	2. Foster an inclusive culture that values diverse perspectives.
Balancing competing agendas Managing the dual demands of the higher education sector and the rapidly evolving healthcare system can be stressful	1. Use project management tools to organize and prioritize tasks effectively.
	2. Encourage time management training and set realistic goals.
The Wider Agenda Leaders must stay informed about broader healthcare and educational agendas, including interprofessional learning, diversity, and leadership innovation.	1. Establish a leadership development program focused on current trends and issues.
	2. Engage in continuous professional development activities.
Technological Adaptation Leaders must adapt and integrate new technologies into healthcare practices, which requires continuous learning and can face resistance from staff.	1. Provide training programs for new technologies to reduce resistance.
	2. Implement change management strategies to facilitate smooth transitions.
Financial Constraints Healthcare leaders often face budget limitations while trying to improve patient care and operational efficiency.	1. Focus on cost-effective care models, such as value-based care.
	2. Foster partnerships for shared resources and collaborative funding opportunities.
Regulatory Compliance Navigating healthcare regulations and ensuring organizational compliance with privacy laws, safety standards, and accreditation requirements is challenging.	1. Establish a dedicated compliance team for regular audits.
	2. Offer training on regulatory requirements relevant to each role within the organization.
Workforce Diversity Leading a diverse workforce requires understanding various cultural backgrounds and fostering an inclusive environment.	1. Provide cultural competency training for staff.
	2. Implement policies that promote diversity, equity, and inclusion within the organization.
Patient-Centered Care Shifting from provider-centered to patient-centered care requires leaders to prioritize patient experience, which can be challenging in large organizations.	1. Encourage the use of patient feedback to guide improvements.
	2. Implement patient-centered communication training for healthcare providers.

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Discussion

The debate over whether leadership qualities are innate or can be developed—”Are Great Leaders Born?”—has long been a point of discussion in both academic and practical circles. On one side, theories such as the Great Man and trait theories suggest that leadership is an inherent quality, with leaders being born with certain traits that predispose them to effective leadership. However, contemporary perspectives increasingly emphasize that leadership qualities can indeed be cultivated.

Leadership development is now seen as an essential component of professional growth, particularly in healthcare. This development involves reading about leadership theories, attending workshops, participating in mentorship programs, and taking on more responsibilities as opportunities arise. These activities help in embedding leadership qualities, promoting leadership practice, and building professional networks.

Initiatives such as Lord Darzi’s Next Stage Review and ongoing programs by the NHS Leadership Academy underscore the importance of developing leadership in healthcare. These initiatives advocate for structured leadership programs that equip clinicians with the necessary skills, further supporting the argument that leadership can be developed rather than being an exclusively innate ability. In summary, while some aspects of leadership might be influenced by inherent traits, the current consensus leans toward the idea that effective leadership can be cultivated through dedicated education, training, and practical experience.[67,68]

This review underscores the critical importance of tailoring leadership styles to the specific contexts and team dynamics within healthcare settings. An adaptive leadership approach is essential for enhancing patient outcomes, improving staff well-being, and fostering a resilient healthcare environment. As the healthcare sector continues to evolve, particularly with the integration of advanced technologies, the role of leadership in navigating these changes becomes increasingly vital. Effective management of technological adoption, coupled with a deep understanding of organizational culture, will be key to ensuring smooth transitions and sustained improvements in healthcare delivery.

Future research should focus on the practical implementation of leadership theories across various healthcare environments, exploring their direct impacts on clinical outcomes and workforce morale. In addition, there is a pressing need to assess the long-term efficacy of leadership development programs in healthcare, with a particular emphasis on identifying the most effective components of these initiatives. Understanding the interaction between organizational culture and leadership practices across diverse settings will provide valuable insights into how leadership can be optimized to meet the unique challenges of modern healthcare.

Strengths of the review

Comprehensive Literature Synthesis: The review incorporates a broad range of leadership theories, models, and practical insights, offering a holistic view of leadership in healthcare settings. It draws from a variety of sources, ensuring a well-rounded analysis of the topic.

Relevance to Current Healthcare Challenges: The review addresses the contemporary challenges faced by healthcare leaders, such as technological advancements, regulatory compliance, and workforce diversity, making the findings highly relevant to current healthcare environments.

Practical Recommendations: By focusing on the applicability of leadership theories and models, the review provides actionable insights for healthcare professionals. This includes practical advice on matching leadership styles to team members’ development levels, which can be directly implemented in healthcare settings.

Ethical Consideration: Although the review did not require formal ethical approval, it maintained high ethical standards by ensuring the proper citation of sources and adherence to academic integrity. This adds to the credibility and reliability of the findings.

Expert Consultation: The inclusion of insights from senior faculty members and administrators adds depth to the review, ensuring that the recommendations are grounded in practical, real-world experience.

Limitations of the review

Potential Bias in Literature Selection: Despite efforts to be comprehensive, the review may be subject to selection bias as it only includes studies published in English and within the last 20 years. This may exclude relevant older studies or non-English research, potentially limiting the scope of the findings.

Lack of Original Data: The review synthesizes existing literature without collecting new empirical data. While this approach provides valuable insights, it may miss out on current, unpublished trends or emerging issues that are not yet reflected in the literature.

Variability in Study Quality: The studies included in the review vary in their methodologies and quality, which could affect the consistency and reliability of the synthesized findings. The review relies on the assumption that all included studies have undergone rigorous peer review, which may not always be the case.

Generalizability: The review focuses on leadership in healthcare settings, which may limit the generalizability of the findings to other sectors. In addition, the specific context of healthcare in different countries may affect the applicability of the recommendations in diverse global settings.

Conclusion

In conclusion, this paper underscores the importance of applying the transformational leadership theory as a lens through which healthcare leadership can be understood and developed. By focusing on the attributes of inspiration, motivation, and positive organizational change, this framework provides a robust foundation for addressing the unique challenges inherent in healthcare settings. This exploration highlights the critical role of effective leadership in advancing both patient care and professional development within healthcare institutions, offering a roadmap for current and future leaders striving to navigate the complexities of this field.

Ethical approval

We did not obtain ethical approval for this narrative review as it involved synthesizing and analyzing existing literature rather than conducting original research involving human or animal subjects. This review relies on previously published data and information, which are already in the public domain and have typically undergone their respective ethical review processes. However, we ensured that all sources were accurately cited and that the review process adhered to ethical standards of academic integrity, including avoiding plagiarism and appropriately acknowledging the contributions of all original authors.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil

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Navigating healthcare leadership: Theories, challenges, and practical insights for the future (2025)

ABSTRACT

Introduction

Methodology

Results

Understanding leadership theories in healthcare

Essential qualities of effective healthcare leaders

Table 1.

Leadership styles and their application in healthcare

Table 2.

Process of effective leadership

Figure 1.

Challenges in leadership in healthcare

Table 3.

Discussion

Strengths of the review

Limitations of the review

Conclusion

Ethical approval

Conflicts of interest

Funding Statement

References