Intro content below is a good start. Need to include more rational on why you think the research should be undertaken (include research question the systematic review -research proposal is trying to answer – IN A PRIVATELY RUN HOSPITAL, WHAT LEADERSHIP QUALITIES ARE ASSOCIATED WITH POSITIVE OUTCOMES?).  Need to reference what others have said about the research question/problem.


NOTE: expected to discuss the construction / development of research question in the context of PICO, PEO/PIO or similar framework in the introduction


In this section you will need to provide the reader with the context to your research including the reason why you think the research should be undertaken (rationale) as well as some background to help the reader understand the relevance of your proposed study. These reasons for the study are likely to be work related but you will also need to place the research problem within a wider socio-political context. Some discussion of how you envisage your research being used in terms of developing policy and practice within your area of work should also be included in this section. For example, if you were proposing to carry out research on drug abusers you may wish to use the results to develop more effective treatment programmes.  Use references in introduction.


In Intro write about the following:


  1. What is the context of your research question/problem? It is expected to discuss the construction / development of research question in the context of PICO, PEO/PIO or similar framework in the introduction to your proposal in the undertaking of a Systematic Review.
  2.  What have others said about your research question/problem? – This section will not provide the depth of your literature review but you may find it useful to refer to one or two key sources which have helped you to identify your research question.
  3.  Where, when and who are you studying? (Your research population – this is normally interpreted as people, but could be documentary sources or types of equipment).
  4.  Is your research question identified as an issue within contemporary policy and practice developments?
  5.  How will your research help to improve practice? write about why is this study important and why now? What impact might it have on practice?


It is extremely important for Systematic Reviews to the development and precise framing of research question is particularly important as this will drive the whole of the project so make sure you spend some time getting this right.  


Leadership is among the most important functions that are connected to the performance of organisations in different sectors. Whether a profitable or a not-for-profit institution, there is need for high-quality leadership for positive performance. Leaders are the face of their organisations and hence the manner in which they execute their duties determines the direction that the institutions take. Privately owned hospitals are business organisations like any other in different industries and hence they seek to maximize profitability and shareholder wealth. In this way, managers have to possess strong leadership qualities that will facilitate a smooth running of the hospitals. Positive outcomes in hospitals include factors such as high levels of customer satisfaction, revenue maximisation, compliance with different administrative provisions, and so forth. Leaders are tasked with ensuring that these positive outcomes of operations are realised in the long run. without the possession of high-quality leadership skills, it is hard or impossible for them to lead their institutions to the realisation of the desired and positive results.

Background and significance

I like your writing style.  This paragraph should focus more on stating the research problem and give more detailed explanation about the purpose of the study than what was stated in the introduction.  This is particularly important if the problem is complex or mulitifaceted, which healthcare leadership is.


In totality, the quality of healthcare services in the United States is relatively high but has a large room for improvement going forward into the future (how do we know healthcare is high quality in U.S. and how do we measure the room for improvement – what did the research show about this statement). The US has the highest rates of deaths that are amenable to healthcare in comparison to other developed countries around the world (Is there statistics we can reference?). Further, disease burden is higher and potential years of life have gone down in America as compared to other developed economies (Is there a reference for this from literature review?). . Also, there are different medical and laboratory errors experienced in the United States healthcare system which are absent in other comparable countriesIs there a reference for this from literature review?). . In this way, it is evident that the system in the country requires significant improvement in a bid to offer up to standard services to the citizens (this sentence is not clear how you came to this conclusion?). It is in this sense that considering the qualities of leadership required in running hospitals is vital in attempts to improve healthcare services offered to the larger society.

The writing is good but the content in this paragraph needs to be structure in a way that shows why are we talking about governance, managerial ideologies.  Structure this paragraph by presenting the rational of proposed study and clearly indicate why it is worth doing.  Answer the “So what? question (i.e. why should be people care this study is proposed to be done)


Over the past three decades, hospitals have increasingly assumed models of governance that are substitutes of the ancient professional bureaucracy influenced by managerial ideologies. In both the public and private sectors, the changes have indicated a corporatisation of the health care facilities toward assuming a business-like arrangement. The aim of the changes is to extend independence of decision-making and the long run accomplishment of positive outcomes in service delivery. The shift has inferred the introduction of important structural changes in leadership of hospital more so the creation of the CEO role and the establishment of boards of directors (Lega, Prenestini and Spurgeon 2013, p.49). Following the vital underlying assumptions of corporate governance that lead to great effectiveness and efficiency, the adoption of business ways of doing things in the hospitals has come as a crucial influencer on performance of both private and public hospitals.

Paragraph 3 – Third paragraph under “Background” should address the following:  Describe the major issues or problems to be addressed by your research. Be sure to note how your proposed study builds on previous assumptions about the research problem – reference literature review common theme you read about major issues.


The content below (highlighted) can be moved, added and simplified to first paragraph under “Background” to answer why are we doing the study –  to see whether leaders are born with traits or can be taught?


Reforms are supported in relation to enhancing organisational autonomy and great independence in strategic planning and decision-making. In this sense, the most effective skills and expertise of the institutions’ senior leadership qualities remain an open issue of discussion and deliberation in the long run. Different practitioners and scholars have questioned if hospital CEOs as the senior leaders together with the boards of directors are supposed to be clinically trained to be top managers. However, the extent to which clinicians are involved in managerial and leadership positions in hospitals tend to be different across different countries around the world. Also, there is the question of whether leaders are born or trained to assume the leadership positions in their institutions of running. Leadership qualities are individual possessions or skills that can be acquired over time. Such queries open forum for discussions with regard to the extent to which leadership qualities affect performance of health care facilities.


Paragraph 4 – Fourth paragraph needs to explain how you plan to go about conducting your research.  Clearly identify the key sources you intend to use and explain how they will contribute to your analysis of the topic. Provide key concepts and/or terms.


Content below is more descriptive writing as I need more critical writing (please write as per paragraph 4 instructions).


The aim of sound leadership and management practices in healthcare is to offer high-quality services to the community sustainably, appropriately, efficiently, and equitably. The service delivery can only be accomplished where key resources for the purpose such human resources, funding, hardware, and others are brought together and synchronized. Critical leadership considerations for planning and evaluation, interacting with the community, and managing information are critical aspects that determine the performance of the hospitals. Leaders should have the knack of integrating and synchronizing different inputs into a single unit that is geared towards high quality delivery of healthcare services to the society. Failure to incorporate different inputs implies that there is a sense of weak leadership and it is possible that the hospital is unable to serve clients competently. For this reason; looking into leadership qualities of the senior management in hospitals becomes an important thing.

Research and objectives

Content below is overly descriptive.  Depending on the research you’ve done (aims and objectives must fall in-line with research themes and analysis). I have written example below but don’t use my content as I don’t know if they fall in line with what you have researched.


The aims should be as following:


The aim to proposing research on leadership qualities that coorilate with positive outcomes is to identigy, describe and produce analysis of the interacting factors which influence the successful leadership of a privately run hospital and show that more reseach needs to be done to help future healthcare endevours.


Objective content should look something like this:


The research seeks to determine the nature, extent and affect of leadership traits on decision making that deliver positive outcomes in privately run hospital.  Summarize the end goal of this research proposal. (Objectives needs to tie in with what you said in intro and background and literature review).


Aims and Objectives section shouldn’t be more than 100 words.


Recent research studied have emphasized the significance of management and leadership in the healthcare industry. Positive correlations are identified between high-quality leadership and positive outcomes of operations. There is still controversy regarding the kind of leadership and senior management team should assume in leading hospitals and this research has interesting evidence to analyse. Beginning with a systematic review of literature, the research paper discusses different streams of knowledge regarding the manner in which leadership qualities can influence the outcomes of operations of the healthcare organisations.

The research study aims at looking into different leadership qualities as important factors that facilitate the accomplishment of positive results of operations. First, the study will assess the way the aspect of listening as a leadership quality positively impacts on the outcomes accomplished in health care facilities. Effective leaders and managers are known to be good communicators and attentive listening is among the key aspects of sound communication. Without the ability of listening to other people, it becomes impossible to be a high-quality leader because there is the development of unawareness with regard to the ongoing events. Also, leaders need to be visionary in the process of managing healthcare facilities endeavours. The research paper will investigate how visionary leaders in healthcare achieve higher results as compared to their counterparts who are not specific in defining the organisational direction of their hospitals.

Further, integrity comes with the accomplishment of positive results both in healthcare and other industries in the global economy. In this regard, the research study aims at looking into the element of integrity as leadership quality with the manner in which it comes with positive accomplishments in service delivery. Additionally, empathy is a leadership quality which will be instrumental in developing this paper. It is also associated with positive outcomes in service delivery and hence it is important to look into it as a leadership aspect in the healthcare industry. Finally, the research study will investigate optimism as a leadership quality which is vital in realising positive results in delivering services to clients. In hospitals, patients at times experience their worst days and without the trait of optimism and patience, healthcare leaders may fail to guide the clients through these difficult times. In totality, the paper will investigate leadership qualities on the grounds of these five elements and the manner in which they come with positive impacts on healthcare service delivery.

Literature review – Literature Review Intro should be no more 250 -300 words summarizing the below.


The intro paragraph to literature review should frame how the proposal’s literature review will be approached.


Discuss primary focus on the literature pertinent to your research problem.

Give summary of compared various arguments, theories, methodologies, and findings expressed in the literature: what do the authors agree on? Who applies similar approaches to analyzing the research problem?


Give summary of contrast the various arguments, themes, methodologies, approaches, and controversies expressed in the literature: what are the major areas of disagreement, controversy, or debate?


Discuss the critique the literature: Which arguments are more persuasive, and why? Which approaches, findings, methodologies seem most reliable, valid, or appropriate, and why? Pay attention to the verbs you use to describe what an author says/does [e.g., asserts, demonstrates, argues, etc.].


Connect the literature to your own area of research and investigation: how does your own work draw upon, depart from, synthesize, or add a new perspective to what has been said in the literature?


A key pillar of healthcare reform around the world is the measurement and reporting of hospital performance with the aim of motivating quality enhancement and enforcing transparency and accountability. If associations between positive results and hospital operations are understood, they may define the targets of quality improvement and designs operation which are both cost-effective. Leaders in the hospital setting, be they clinical or otherwise, are supposed to be aware of the associations which are pertinent to their context, are under their control, and are amenable to alteration. Different factors are attributed for positive performance including and not limited to organisational culture, physician engagement, resource availability, strategic plans, effective communication, and sound leadership. The purpose of this literature review is to critically appraise and reflect on quantitative studies that investigate the association between leadership qualities and outcomes in healthcare services provision in hospitals.

Scoping review – This should be no more than 150 – 200 words. First few sentence to talk about the quick and unsystematic search done to ensure that there will be sufficient research to include in the review and not so much that that review will become unmanageable.  Next few sentences discussion is to ensure that research question has not already been answered using an up-to-date and valid systematic review.  Next few sentences should discuss how scoping review enabled you to determine the nature of the research approach adopted in the field i.e. qualitative/quantitative/mixed methods and identification and discussion of the weaknesses and limitations in current literature and research will be particularly important in strengthening the rationale for a Systematic Review.


The content is descriptive writing need more critical writing (need more explanation, rational behind the statements).


The purpose of a scoping for a Systematic Review is to ensure the question has not been answered and that there is enough research already undertaken so you can extract enough data from it for your own purposes. This will help to justify the need for your study and to strengthen your rationale.


The literature search for an SR requires that you should also, in addition to the above, include a scoping review. This involves a quick and unsystematic search of an electronic database to ensure that there will be sufficient research to include in the review and not so much that that review will become unmanageable.


The identification and discussion of the weaknesses and limitations in current literature and research will be particularly important in strengthening the rationale for a Systematic Review.  


During the scoping review it is also important to ensure that research question has not already been answered using an up-to-date and valid systematic review. Part of your scoping review should enable you to determine the nature of the research approach adopted in the field i.e. qualitative/quantitative/mixed methods.


In the modern healthcare practice, both nursing and evidence-based medicine are broadly acknowledged as tools that establish effective hospitals of high-quality care and productivity. Leadership and management of healthcare facilities are critical elements for strengthening the integration and quality of care. In healthcare, leadership comes as the relationship between the top management team and the subordinates who have to follow. It is all about coordinating and directing the activities of a group of people towards the accomplishment of a common objective. There are different types of leadership that are known to come with positive accomplishments both in the healthcare sector and other industries across the global economy.

Transformational leadership involves the creation of motivation and relationships among members of staff and senior management team in an organisation. Transformational leaders inspire confidence in their subordinates, respect the members of staff, communicate a shared vision, and manage to achieve higher productivity over time. On the other hand, transactional leaders inspire change and exchange ideas with the subordinates in such a way that is geared towards improving productivity in the long run. Autocratic approach to leadership is where the top management makes all the decisions and it is widely applicable in emergency situations that do not provide room for consultations and consideration of different inputs. In the laissez-faire form of leadership, leaders do not make decisions; rather members of staff make decisions without direct supervision but there it works with a hands-off approach which result in rare changes (Daimler 2016, p.12). There is the task-oriented leadership style which involves the prior planning of work activities. Further, the approach includes classifying roles in a team and setting objectives and continuing to monitor the performance of processes. Finally, the relationship-oriented kind of leadership style involves support, development, and recognition of employees input in the ultimate productivity in organisational processes. The various leadership styles are applicable to different situations that are unique to specific organisations. In this way, one hospital may be using the transformational kind of leadership whereas another one utilises the autocratic approach depending on unique circumstances and leadership requirements of the facility in question. It is important to note that the two hospitals are using different approaches but both are applying them to their operational benefits and positive impacts on the results of their operations.

Quality of care is an important element for the achievement of high productivity levels in hospitals. Quality comes as the extent to which the possibility of achieving the expected health results is enhanced and is in tandem with the updated professional skills and knowledge in healthcare. According to the Institute of Medicine (OM) there are six traits that show high-quality care services and they encompass effectiveness, safety, reliability, equitability, efficiency, and patient-oriented. The measurement of health outcomes is a key element of evaluating the healthcare quality offered in hospitals. Quality metrics include the process, structure, results, and client satisfaction. The National Quality Measures Clearing House in the United States suggest that a clinical result makes reference to the health status of a patient as a result of services administered by healthcare organisations. Metrics on patient outcomes and satisfaction include hospital mortality levels, shorter patient length of admission, healthcare associated ailments, medication errors, use of restraint, failure to rescue ratio (Clay-Williams et al. 2017, p.27). Poor outcomes are also founded on inadequate management of pain, patient fall rate, falls with injuries, urinary tract infections, medical errors, and so forth.

Different publications recognize leadership styles and qualities as vital elements for the delivery of high-quality healthcare services in hospitals. Effective leadership is amongst the most important elements which lead an organisation to successful and effective outcomes. Significant positive relationships between effective approaches to leadership and high client satisfaction levels comes with a reduction in reported adverse effects of the treatment process. Additionally, different research studies have considered the significance of leadership qualities of the provision of healthcare within nursing homes. The transformational approach to leadership is strongly associated with the implementation of sound management functions which creates a culture of patient safety and satisfaction. The literature suggests that empowering leadership is associated with patient outcomes through promoting great nursing expertise through enhanced staff ability, and suppressed labour turnover. Effective leadership comes with an indirect effect on decreasing the magnitude of mortality rates through inspiring, supporting, and retaining the experienced members of staff (Sfantou et al. 2013, p.73). Although there are numerous published studies looking into vitality of leadership, only a few of them have attempted to correlate different leadership qualities to patient results and healthcare quality indicators.

Literature review (2000 words) This section is very important and must show understanding of topic and show critical analysis of literature and write about your conclusions of research read).


The first paragraph needs to include a systematic literature search content and keyword (see sample below) Your literature review should begin with a brief outline of your literature search indicating how you located and selected your sources including what search methods / locations you used and why?  This is different to scoping review.


This is sample please don’t draw a table like below.  I need content describing the below.


A good literature review is far more than a critical appraisal of a series of articles; it should create a structure in which you legitimise carrying out your proposed study.


Paragraph 2,3,4,5 – After first paragraph based on research break each paragraph into common themes of your research i.e.  Leadership can be taught/Emotional Intelligence/ Communication Skills : then in each theme there need to discussions, critical analysis of the literature review. Need to write concisely to explore those works which have a direct bearing on your proposed study and set out what is already known in the area. You will need to try and develop some conclusions of your own based on your evaluation of the work of others.  Also need to tie in themes with research question/aims and objectives.


Point to discuss under each themes critical analysis of literature review:


What are the strengths and weaknesses of the literature you have reviewed?

What are the similarities and differences in the literature?

Are there any inconsistencies in the literature?

Are there any gaps in the literature, which your research would be addressing?

Have you identified the interrelationships between previous literature and your proposed study?

Have you justified any constraints in the review of the literature?

Who is the information aimed at?

What are, or might be, the reasons for its existence?

Who is providing the information?

What are their sources?

Do you think what is being said is correct and why?

Are the arguments supported?

Is any supportive evidence credible?

How valid is any research underpinning the information?

Can you identify any omissions and what might be their significance?

How selectively is the information presented?

Does it take into account a variety of perspectives?

Is it balanced?

Is there any obvious bias; what is it and why might it exist?

Do you think that what is being said contains a ‘hidden agenda’; what do you think this may be?


Here is a sample of themes categories (Headline) and common theme the research showed under this theme (bullet points).



Leadership in the healthcare sector is vital because doctors best relate with their counterparts and subordinates in a hospital setting. Further, the physicians can learn administrative aspects of running a healthcare facility and overcome some of the persistent challenges facing the industry. Many doctors also turn out to be natural problem solvers and hence assuming executive roles and trying to enhance the delivery of healthcare services in hospital an appealing endeavour. They can easily manage to shift from their routine technical works to more leadership-based operations in the hospital (Sarto and Veronesi 2016, p.169). In this section of the research study, there is the reflection of literature with regard to how other scholars draw an association between health outcomes and different leadership qualities.

Participative leadership is highly productive in an organisational setting because it allows the leaders to consistently seek out opinions of teams. After collecting the team’s thought patterns, the leaders still retain the ultimate authority to make the final decisions. In the end, the team feels engaged and appreciated while at the same time learn to respect the leader. Members of staff who are actively involved in decision-making and projects tend to have greater job satisfaction, high commitment to the organisation, and immense respect for the administration team. The participative approach of leadership provides a chance for more voices to be heard and this implies that the most viable ideas are implemented in the long run. In the end, there is the enhancement of output and entire productivity.

Sound communication skills are important for any effective leader but communication comes as a two-way traffic affair. Frequently, communication entails less talking and assumes more of a listening role and the aspect does not come easily to healthcare practitioners. For this reason; doctors who take their time to extensively listen to both the clients and subordinate members of staff can make a potentially excellent leader. Through asking questions and taking time to hear the responses, effective leaders become more aware of the operating situation in the hospital. Leaders who listen are therefore likely to have a lot of information and acquaintance with data sets and trends as compared to the ones who do not take time to listen. The large volume of information obtained by the leaders will assist them in devising improved ways and remedies of handling patients in the hospital.

Leaders who wish to establish positive patient outcomes need to be visionary in their ways of managing the healthcare facilities. It is vital for leaders to have a clear vision in the healthcare sector since the industry has many challenges and setbacks and it is easy to get hindered and frustrated and end up losing focus. A sound leader manages current challenges and the daily operations while at the same time to focus on the bigger picture of running the hospital’s affairs. The logic of the direction taken by the hospital is supposed to be in the range of five to six years of operations. It is impossible to steer an organisation into the future successfully if the leadership team is unprepared for what the future may bring. Successful leaders have the knack of juggling the now and here and develop goals, a mission, and overall enhancement of operations (Brand et al 2017, p.24). In this way, visionary leaders come up with a strategic corporate culture that guides members of staff on how they are supposed to handle clients.

Different medical leaders working at lean facilities conduct frequent lean meeting to discuss what is going right, wrong from the previous meeting and how to achieve improvements in the future. They consider current metrics and devise rational goals and objectives and the metrics that will be used in a month, six months, or a year from that particular point. If there is the development and accomplishment of the reasonable goals, for a hospital, there is a show of effective leadership (Aij and Teunissen 2017, p.74). In this point, there is the illustration of how visionary leaders always seek improvement in the manner in which operations are run in the organisation. The constant enhancement in operations means that high-quality care services are delivered to the clients. High-quality services will come with positive outcomes such as customer satisfaction, high and fast recovery rates, and other forms of admissible responses accorded by the patients.


Aij, K.H. and Teunissen, M., 2017. Lean leadership attributes: a systematic review of the literature. Journal of health organization and management, 31(7/8), pp.73-79.

Brand, C.A., Barker, A.L., Morello, R.T., Vitale, M.R., Evans, S.M., Scott, I.A., Stoelwinder, J.U. and Cameron, P.A., 2012. A review of hospital characteristics associated with improved performance. International Journal for Quality in Health Care, 24(5), pp.483-494.

Clay-Williams, R., Ludlow, K., Testa, L., Li, Z. and Braithwaite, J., 2017. Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?. BMJ open, 7(9), p.e014474.

Daimler, M. (2016). Listening Is an Overlooked Leadership Tool. [online] Harvard Business Review. Available at: [Accessed 3 Aug. 2018].

Lega, F., Prenestini, A. and Spurgeon, P., 2013. Is management essential to improving the performance and sustainability of health care systems and organizations? A systematic review and a roadmap for future studies. Value in Health, 16(1), pp.S46-S51.

Sarto, F. and Veronesi, G., 2016. Clinical leadership and hospital performance: assessing the evidence base. BMC health services research, 16(2), p.169.

Sfantou, D.F., Laliotis, A., Patelarou, A.E., Sifaki-Pistolla, D., Matalliotakis, M. and Patelarou, E., 2017, October. Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. In Healthcare (Vol. 5, No. 4, p. 73). Multidisciplinary Digital Publishing Institute.