Table 2 Thematic Summary of Reviewed Literature

Nursing

35

Largely pre-dates work of Ferris et al. [19]

Nursing has legitimate role in health care decision making. But nurses lack formal power in relation to medicine and so require other approaches to influence (political skill as alternative to formal power). Definition rarely defined and is generalized.

Conceptual, surveys, some interviews, some ethnographies

Focus on nurses developing and using political skill or astuteness to secure greater influence in an organization, or more often to engage and have influence in legislative process

The concept of political skill linked to the macro- politics of nursing profession, especially the professionalization and politicizing agendas of US nursing. Some focus on workplace informal politics.

Healthcare Managers

9

Largely pre-dates work by Ferris et al. [19] Concept of political skill not always defined or explained theoretically.

Managers should be leading organizational change and require political skill to rise above inter-professional politics (political skill as change tactic).

Conceptual, surveys, some interviews

Focus on how hospital managers (can) use political skill or other forms of inter-personal influence to implement organization change, with some attention given to external policy relations

The concept of political skill linked to the informal politics of organizational change and broader politics of management reform, especially the difficulties of managing change in context of professional resistance.

Other Health Professionals (including public health)

13

Conceptualizations similar to nursing

Concept of ‘political skill’ not always defined or explained theoretically, exception of Hartley’s work on ‘political astuteness’

Conceptual, surveys, interviews

Focus on how non-nursing professionals use political skill to influence organization of work, especially in policy making processes, and through the professional leadership acting ‘politically’.

The concept of political skill seems to have been transferred from nursing with a focus on inter-personal influence or macro-influence on policy processes, dealing with professional dominance and more often influencing policy decisions.

System Leadership

5

Multiple stakeholders hold competing interests which need to be managed (political skill as form of negotiation)

Concept of ‘political skill’ not defined or explained theoretically but descriptive aspects of the concept are linked to conceptions of system leadership

Surveys, interviews, ethnographies

Focus on how system leaders understand and manage competing interests in the implementation of large-scale system change.

The concept is aligned close with ‘system leadership’ and reflects broader shifts in analysis from managers to leaders and a single organization to a system.