A study to determine the relationship between healthcare employees' behaviors towards quality studies and their clinical leadership characteristics

Quality management in healthcare services is among the effective and important factors in enhancing the strength of institutions in today's competitive environment. It is also a process-oriented management approach that centers on patients and employees, values teamwork, highlights the leadership aspects of employees, and provides opportunities for them to develop these aspects. The complex nature of healthcare services, their non-deferrable nature, and zero tolerance for errors, along with increasing patient expectations and the emphasis on patient safety, necessitate the provision of quality services. However, implementing quality in healthcare services is a challenging process. This difficult process, managed by interdependent teams, requires enhancing employees' knowledge and skills, improving their decisionmaking and problem-solving abilities, and particularly, clinicians embracing quality efforts and focusing on rapid change, innovation, and continuous improvement. Quality in healthcare services is divided into different components, and leadership serves as an essential bridge connecting these components. In this context, a strong leadership practice is needed to initiate and sustain quality efforts that include these applications. This is because healthcare institutions have a complex structure that includes different organizations and individuals and requires all of them to work synchronously. Furthermore, recognizing and reflecting the innovations and changes in healthcare systems onto institutions is not easy. It is important to have leaders who can see these innovations and changes and integrate them into their institutions. Moreover, initiating, sustaining, and turning quality efforts into a culture will be easier with clinicians who can demonstrate clinical leadership competence. In this case, clinical leaders are healthcare professionals who take responsibility in line with their institutions' goals and play a significant role in quality and continuous improvement efforts. In this thesis study, it is aimed to determine the behaviors and perceptions of clinicians who are working in a private hospital towards quality studies, as well as their clinical leadership characteristics, and to research whether there is a relationship between the clinicians' clinical leadership characteristics and their behaviors and perceptions of quality. The first section of the study provides information about the concept of quality in healthcare services, the importance and characteristics of quality, the principles of quality management, and applications related to quality in healthcare services. The second section discusses the concept of leadership, leadership approaches, the importance of leadership in healthcare institutions, clinical leadership, and the model of clinical leadership competencies. The third section covers the research methodology, the fourth section presents the findings obtained from the research, and the final section includes information related to the results and discussion. This research was conducted on professional groups (physicians, nurses, midwife, therapists, psychologists, technicians, etc.) working as clinicians in a private hospital located in the Southeastern Anatolia Region. The study was applied to all employees (251 people) working at the related hospital who volunteered to participate. IBM SPSS Statistics 29 package program was used for data analysis. Analysis methods were determined after performing reliability and normality tests, and descriptive statistical methods (number, percentage, mean, standard deviation), MannWhitney U test, Kruskal-Wallis H test, and Spearman correlation test were used. It was found that clinicians had a high level of positive behaviors and perceptions towards quality studies and clinical leadership characteristics. A positive and low-level relationship was found between the behaviors and perceptions of the clinicians towards quality studies and their clinical leadership characteristics. According to the analysis results of the differences in clinicians' behaviors and perceptions towards quality studies based on socio-demographic characteristics, there was no significant difference in terms of gender, age, marital status, education level, professional group, total working years in the profession, and whether they were educated on healthcare quality. However, it was found that there was a difference according to whether they had received clinical leadership training, but it was not found significant difference based on gender, age, marital status, education level, profession, and total working years in the profession according to the analysis results of the differences in clinicians' clinical leadership characteristics based on socio-demographic characteristics.