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      Impact of C-level positions on hospital performance: a scoping review protocol

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          Abstract

          Abstract
          Introduction

          The objective of this scoping review is to identify evidence of the impact of hospital managers in top management (c-suite) on hospital performance. Managers generally have various effects on organisational objectives of their organisations. In recent years, the healthcare sector has experienced alterations in hospital governance structures, together with the emergence of new c-suite positions, aligning more closely with those found in private organisations. Their impact on hospital performance (ie, quality of care) is not well known. This scoping review seeks to identify all the available evidence of their impact on the organisational objectives. This scoping review will include primary studies, reviews and commentaries that describe the impact of top management team members on organisational outcomes in a hospital setting.

          Methods and analysis

          The search strategy aims to locate both published and unpublished documents (ie, grey literature) using a three-step search strategy. An exploratory search of Medline and Google Scholar identified keywords and Medical Subject Headings terms. A second search of Medline (PubMed), Web of Science Core Collection, ScienceDirect, Business Source Premier (EBScoHost), JSTOR, BASE, Lens.org and the Google Search Engine will be performed. The scope of the search will cover 1990-present time using English search terms. Manual searching by two reviewers will be added to the search strategy. The identified documents will be independently screened, selected by two researchers and extracted by one researcher. The data are then presented in tables and graphics coupled with a descriptive summary.

          Ethics and dissemination

          As this study neither involves human participants nor unpublished secondary data, an ethics approval is not required. Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal.

          Trial registration number

          The protocol was registered on the Open Science Framework ( https://doi.org/10.17605/OSF.IO/EBKUP).

          Related collections

          Most cited references35

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

            Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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              Rayyan—a web and mobile app for systematic reviews

              Background Synthesis of multiple randomized controlled trials (RCTs) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions. Filtering of searches is time consuming, and no single method fulfills the principal requirements of speed with accuracy. Automation of systematic reviews is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making. We developed Rayyan (http://rayyan.qcri.org), a free web and mobile app, that helps expedite the initial screening of abstracts and titles using a process of semi-automation while incorporating a high level of usability. For the beta testing phase, we used two published Cochrane reviews in which included studies had been selected manually. Their searches, with 1030 records and 273 records, were uploaded to Rayyan. Different features of Rayyan were tested using these two reviews. We also conducted a survey of Rayyan’s users and collected feedback through a built-in feature. Results Pilot testing of Rayyan focused on usability, accuracy against manual methods, and the added value of the prediction feature. The “taster” review (273 records) allowed a quick overview of Rayyan for early comments on usability. The second review (1030 records) required several iterations to identify the previously identified 11 trials. The “suggestions” and “hints,” based on the “prediction model,” appeared as testing progressed beyond five included studies. Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements. The survey respondents reported 40% average time savings when using Rayyan compared to others tools, with 34% of the respondents reporting more than 50% time savings. In addition, around 75% of the respondents mentioned that screening and labeling studies as well as collaborating on reviews to be the two most important features of Rayyan. As of November 2016, Rayyan users exceed 2000 from over 60 countries conducting hundreds of reviews totaling more than 1.6M citations. Feedback from users, obtained mostly through the app web site and a recent survey, has highlighted the ease in exploration of searches, the time saved, and simplicity in sharing and comparing include-exclude decisions. The strongest features of the app, identified and reported in user feedback, were its ability to help in screening and collaboration as well as the time savings it affords to users. Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of reviewers.
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                Author and article information

                Contributors
                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2024
                11 July 2024
                : 14
                : 7
                : e085655
                Affiliations
                [1 ]departmentInstitute for Management in Medicine and Health Sciences , University of Bayreuth , Bayreuth, Bavaria, Germany
                [2 ]Robert Bosch Medical Research , Stuttgart, Baden-Wuerttemberg, Germany
                [3 ]Robert Bosch Hospital , Stuttgart, Baden-Wuerttemberg, Germany
                Author notes

                Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

                None declared.

                Author information
                http://orcid.org/0000-0002-8032-3883
                http://orcid.org/0000-0002-6992-2885
                Article
                bmjopen-2024-085655
                10.1136/bmjopen-2024-085655
                11243285
                38991677
                2ae49c0c-433e-4397-90c9-8ec615ca1491
                Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 22 February 2024
                : 25 June 2024
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001646, Robert Bosch Stiftung;
                Award ID: NA
                Categories
                Protocol
                Medical Management
                1710
                1506

                Medicine
                clinical governance,organisational development,hospitals,organisation and administration

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