Date of Conferral

5-15-2025

Date of Award

May 2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Kourtney Nieves

Abstract

To orient children’s academic leaders to basic competency in quality improvement (QI) practices, academic children’s hospitals must overcome leadership diversity deficits and prepare for QI practice readiness. Leadership is a key factor in enhancing patients’ care outcomes, though practice models do not allow for organizational advancements. The distributed leadership (DL) theory on leadership applies in contexts where the leadership role in QI is not solely centralized to a single individual but is decentralized and spread to include all parties involved. This paper sought to determine the effects of leadership on QI in children’s hospitals and further establish the best leadership practices to enhance patient care. The Johns Hopkins Research and Non-Research Appraisal Tools were utilized to rate the quality of sources, and 13 articles met quality standards to answer the review question. The studies utilized a meta-synthesis of peer-reviewed articles on leadership types, QI methods, and current issues in pediatric health care. Ten major themes are examined in this integrative review to determine how leadership affects Quality Improvement (QI) in academic children’s hospitals: engagement; leadership effectiveness; leadership interventions; task-oriented leadership; empowering leadership; leadership development programs; healthcare improvement; QI initiatives; engagement; and barriers and facilitators. The review uses the Distributed Leadership (DL) concept to show how collaborative, role-driven, and inclusive leadership enhances clinical results, organizational culture, and QI sustainability in pediatric healthcare.

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