WHAT DOES IT MEAN LEADERSHIP IN ITALIAN HEALTHCARE: A RESEARCH ACTION

This research is part of a wider project called CompAct (Compassionate Leadership: an Italian model) funded by the Veneto Region (Italy) as part of its strategic initiatives to improve healthcare workforce retention, explores the meaning and practice of leadership within the Italian healthcare system. The present study involved healthcare managers (physicians and nurses) from two public hospitals, focusing on three key departments: Emergency, Internal Medicine, and Primary Care. This phase of the project aimed to investigate how healthcare leaders interpret their roles and responsibilities, particularly in supporting their teams. Through a series of participatory meetings following the Participatory Action Research approach (Kemmis et al., 2014), participants were encouraged to reflect on their leadership experiences, challenges, and strategies. The qualitative data collected revealed a shared understanding of leadership as a relational and supportive function, rather than a purely managerial or directive one. One of the most significant findings was the emphasis placed on the concept of compassion as a central dimension of effective leadership, involving the capability of noticing, understanding, empathizing, helping (Dutton et al., 2006). However, the way the support is enacted varies considerably depending on the department and professional role. In Emergency departments, leadership is often expressed by a close synergy between the two leaders (physician and nurse) supporting each other to manage the whole team. In Internal Medicine, two different approaches between physician and nurse arose: physicians focus more their leadership on clinical supervision, and managing complex patient care pathways; nurse leaders are more oriented to create mutual trust and collaboration, as a family. In Primary Care, leadership takes on a more distributed and delegative form, emphasizing the need to understand situation where they cannot be physically present. Overall, the research underscores the need for healthcare organizations to recognize and invest in leadership development as a key factor in workforce retention. By fostering a culture of support and compassion (West, 2021), healthcare leaders can contribute significantly to psychological well-being, job satisfaction, and retention. These results represent a first step toward understanding and enhancing leadership practices in Italian healthcare, offering insights that can inform future policies and training programs aimed at strengthening the healthcare workforce