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Table 1 Influential Studies and Papers Exploring Political Skill within Healthcare Settings

From: The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

Author(s) Type Disciplinary Context Aims Methods Summary of Findings
Benton et al. [30] Review Nurses Integrative review of papers exploring nurses’ involvement in policy and political processes Integrative review methods to identify relevant studies in English between 1965 and 2015. Use of comparative thematic analysis. 45 studies identified, mostly in North America, mostly descriptive surveys with small sample sizes. Papers focused on developing nurses’ awareness of legislative and political processes. Literature ignores political awareness at team and organizational level and informal-politics largely ignored.
Berger [61] Conceptual Social workers To identify social workers’ power, including political acumen, within hospitals Not applicable Advocates for social workers developing political skills through awareness of power sources at individual and organizational level, particularly through maximizing their position within the hospital power network (e.g. through coordinating discharge and case management).
Byrd et al. [23] Empirical Nurses Assessing changes in nursing baccalaureate students’ participation in public policy learning activities Use of the Political Astuteness Inventory with 300 nursing students before and after completion in the learning activities Political astuteness scores significantly increased after participation in the learning activities. Active learning and increased political astuteness can increase knowledge of health policy.
Comber et al. [56] Empirical Physicians To understand physicians’ leadership of clinical and non-clinical roles through assessing their political skill (as defined by Ferris et al. (2005)). Sample of 209 Canadian physicians using the Political Skills Inventory Physicians in clinical roles had significantly lower PSI scores compared with those in non-clinical roles. Authors advocate for further training of political skills for physicians in clinical roles.
Crow and Hartman [34] Conceptual Managers Addressing the political skill gap for healthcare managers, with suggestions for how to acquire and improve political skill Not applicable The authors highlight that managers can feel intimated by those with higher education degrees and advocate the use of different powers, including the ability to read situations accurately and using coercion and influence.
Gilson [6] Theoretical, drawing on empirical Systems Reflections on everyday politics of healthcare systems, relevance for healthcare policy, and leadership skills required to navigate politics Not applicable Everyday politics within health systems involve multiple actors and agendas that frontline leaders must address that impacts upon how groups take action throughout the system. New forms of leadership training are required to develop political leadership skills.
Greer and Lillvis [73] Review Public health Joins Health in All Policies with political science literature to explore difficulties with coordinating initiatives across government sectors. Review is theoretically driven with few details on methods Two challenges identified: coordinating initiatives across different sectors and sustaining initiatives. Authors advocate not relying solely on political leadership but use outside ‘allies’ and networks to influence policy.
Hunter et al. [82] Empirical Systems Examination of the North East transformation system in the NHS, including its formation, progress and changes as result of government policy. Longitudinal 3.5 year study using mixed methods with 14 NHS Trusts in the North East, includes 68 interviews, observations and focus groups. Politics in system change is often ignored in research. Implementing whole system change is subject to changes in politics, especially the NHS which is itself influenced by wider government policies.
McAuliffe et al. [70] Empirical Systems Identify the factors associated with reforms and change of the Irish cancer service In-depth retrospective analytical case study exploring the implementation of the 8 Irish breast cancer services and interviews with stakeholders Key success to implement and sustain change include: timing, involvement of stakeholders/public support, framing the necessity for the change, clarifying scope of change, support of political leadership.
Montalvo and Byrne [25] Empirical Nurses To analyze the link between mentoring and political skill development with nurses who had earned, or were studying for, a PhD in nursing or doctorate of nursing practice. Web based survey, including the Political Skill Inventory (developed by Ferris and colleagues) with 222 nurses who had, or were working towards, a PhD in nursing or doctorate of nursing practice. Mentoring was significant for developing political skill and mentorship arrangements (formal or informal) benefit nurses for acquiring political skill.
Montalvo [5] Review Nurses Integrated analysis of political skill literature and relevance to nursing Literature reviews and empirical papers from 2000 to 2014 that defined political skill as the ability to influence others at work for personal development or achieving organizational goals Political skill helps individuals navigate organizational politics, influences their ability to network, manage stress, enhance their performance and increase interpersonal skills
Primomo [49] Empirical Nurses Assessing political astuteness of nursing students before and after a course on health policy Use of the Political Astuteness Inventory with 57 Masters of Nursing students before and after completion of the health policy course Political astuteness scores significantly increased after completion of the course. Primomo advocates health policy education in order for nurses to influence healthcare change
Smaltz et al. [66] Empirical Hospital Chief Information Officers (CIOs) Explores how CIOs can be effective in the healthcare sector Surveys with 185 CIOs (Phase 1) and surveys with 136 individuals from top management team members (Phase 2) Along with interpersonal skills and IT skills, political savvy had a significant positive relationship to the role effectiveness of a CIO. Developing trusting relationships with members of the top management team was significant.
Taylor [58] Conceptual Managers Focuses on the political skills required for managers and administrators working within Canadian health settings Not applicable The political skill for different levels of managers are outlined, including the need to be self-aware, the ability to influence others, knowledge of interorganizational policies, examining the internal/external environments to identify key issues
Turner et al. [71] Empirical Systems Identify factors that influence selection of acute stroke centralization models in London and Greater Manchester Analysis of 316 documents and 45 interviews with those leading the system change The combination of system and distributed leadership are most effective in implementing system change. Involving multiple stakeholders is crucial for those leading system change, along with a coordinating body with political authority to combine multiple interests.
Wilber and Coberly [59] Empirical Gerontologists Determine the desired educational policy requirements for gerontologists Surveys with 114 prospective gerontologist employers or those training gerontologists Communication and political skill are essential for gerontologists working in policy arenas. Internships were considered desirable to acquire these skills.