BACKGROUND: Hybrid professionalism is one of the most effective ways to involve clinicians in management practices and responsibilities . With this study we investigated the perceptions of doctors and nurses on hybridization in clinical directorates (CDs) in hospitals .
METHODS: We investigated the attitudes of healthcare professionals (doctors and nurses) towards eight hospital CDs in the Local Health Authority (LHA) of Bologna (Emilia Romagna, Italy) 6 years after their implementation . We used a validated questionnaire by Braithwaite and Westbrook (2004). Drawing on Palmer et al . (2007), we added a section about the characteristics of department heads . In all , 123 healthcare professionals in managerial roles completed and returned the questionnaire . The return rate was 47.4% for doctors and 31.6% for nurses .
RESULTS: Doctors reported an increase in clinical governance, interdisciplinarity collaboration, and standardization of clinical work . Hybridization of practices was noted to have taken place . While doctors did not see these changes as a threat to professional values, they felt that hospital managers had taken greater control . There was a large overlap of attitudes between doctors and nurses: inter-professional integration in CDs fostered alignment of values and aims . The polarity index was higher for responses from the doctors than from the nurses .
CONCLUSION: The study findings have implications for policy makers and managers: mission and strategic mandate of CDs; governance of CDs, leadership issues; opportunities for engaging healthcare professionals; changes in managerial involvement during the COVID-19 pandemic . We also discuss the limitations of the present study and future areas for research into hybrid structures.