Explaining a Hybrid Competency-Meritocracy Model for Selection of Hospitals Executive Managers: A Scoping Review Publisher



Dargahi H¹ ; Khonsari MHK² ; Kooshkebaghi M² Show Affiliations
Source: Medical Journal of the Islamic Republic of Iran Published:2025

Abstract

Background: The successful improvement of health care system (HCS) efficiency in all countries hinges on the selection of effective leaders in the new century. Nevertheless, failing to notice the competency and meritocracy of managers still seems to be one of the major challenges drawn against Iran’s HCS, mainly at hospitals, to improve global knowledge and core skills. Methods: This scoping review was performed on the articles published on the Persian and English databases from June 2000 to September 2023, using the keywords “health care system, hospital executive manager, competency and meritocracy system.” The 6- stage framework developed by Arksey and O’Malley was applied to collect and present the findings. Moreover, the quality of the desired articles was evaluated via the Mixed Methods Appraisal Tool (MMAT). Results: In this study, there are 7 core categories—including effective leadership, comprehensive knowledge management, evidence, managerial tasks, personality traits, management intelligence, and management skills. Using a total of 105 references—including 47 articles for entry into the review and 58 articles added as other sources alongside 95 subcategories associated with the competency and meritocracy of hospital executive managers within the Management Competency Assessment Partnership (MCAP) framework—were extracted through open and deductive coding, and ultimately confirmed. Professionalism was correspondingly supplemented to the given categories based on the MCAP framework, and the final hybrid competency-meritocracy model for the selection of hospital executive managers was proposed. Conclusion: The hybrid competency-meritocracy model proposed in this scoping review can be exploited in the management of newcentury hospitals. As the administration of successful hospitals cannot be fulfilled individually, this hybrid model should incorporate all levels of clinical and executive management at hospitals to achieve the desired outcomes by synergizing them with each other. It is suggested to carry out further research on how to establish a competency-meritocracy system in the selection of hospital managers at senior, middle, and operational levels. © Iran University of Medical Sciences