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Aim: The aim of this study was to describe first‐line managers’ thoughts on and motives for leaving their position. Introduction: The turnover rate of first‐line managers impacts healthcare organizations’ overall performance. Burnout, dissatisfaction, and desired career advancement contribute to the intention to leave. High turnover negatively impacts patient care and has financial consequences. Involving managers in decision‐making, providing support, and addressing workload and resource challenges are known to be crucial factors in retaining managers. Method: Sixteen semistructured interviews were conducted with first‐line managers. Qualitative content analysis was used to analyze the data. Findings: Our study showed that some first‐line managers experience difficulties at work, leading them to reach a breaking point and leave. These difficulties stem from a lack of influence, feeling unheard, and having inadequate support. Some first‐line managers reach a point where they feel the need to move on, often due to personal reasons or a lack of motivation. Upon deciding to leave, managers commonly have a plan to ensure a smooth transition for their successor, aiming to help both the new manager and the unit’s staff. Conclusion: First‐line managers can perceive their work situation as challenging and frustrating when they lack authority and support. This can lead to them leaving their role for reasons such as retirement, seeking more time for family, or seeking new work challenges. It is important for healthcare management to empower and support first‐line managers. Smooth transitions for successors and staff are crucial, regardless of why a manager leaves.

In recent years, increasing attention has been paid to digital human resource management (HRM) practices. Nonetheless, the impact of digital HRM practices is not yet fully understood by practitioners and researchers. Drawing from adaptive structuration theory (AST), we suggest that HRM capability maturity is a key boundary condition for understanding the effectiveness of digital HRM practices. By employing a path analysis approach on a sample of 1770 enterprises in China, this study found that the use of digital HRM practices impacts HRM effectiveness through the internal consistency of HR practices and external social networking of HR managers with line managers. The positive or negative effects of digital HRM practices depend on the enterprise’s HRM capability maturity. While the majority of previous studies have explored the impact of digital HRM on organizations, including the effects on cost reduction and organizational performance, our study expanded the focus on the outcomes of digital HRM to include employees’ perceptions of HRM effectiveness, which can further influence employees’ attitudes and organizational behaviors. The implications of our findings for research and practice are discussed.

Background and aim Common mental disorders are common reasons for long-term sick leave, especially among women. Return to work is often complex and unsuccessful, why more knowledge is needed regarding women’s health and psychological well-being in the return-to-work process. Therefore, the aim was to describe women’s health and psychological well-being in the return-to-work process, from women’s and first-line managers’ perspectives. Methods Individual interviews were conducted with 17 women and 16 first-line managers. Qualitative content analysis was performed based on the content areas “Women’s health (i.e. overall well-being, both physical and psychological) throughout the whole RTW process” and “Women’s psychological well-being (happiness, meaning and a sense of being significant) at work after work resumption” Themes and categories were created. Results Women and managers had similar descriptions, i.e. that women’s health and psychological well-being depend on the individual characteristics of women themselves, their private life, work and other stakeholders. However, women described relational work tasks (e.g. meeting patients) as beneficial for health, and highlighted small stressors in the work environment, which the managers did not. Having work that was compatible with private life, being in good health, having stimulating work tasks and strengthening relationships at work were important for the women’s psychological well-being. Conclusions Based on women’s and first-line managers experiences, promotion of women’s health and psychological well-being during the return-to-work process requires individually adapted assessments and actions involving women’s entire life situation. First-line managers should know that relational work tasks (e.g., meeting patients) can be beneficial for women’s health as well as that minor stressor in the work environment can put their health at risk.

This study investigated the impact of electronic human resource management (e-HRM) implementation on the effectiveness of HRM system. The framework of this study was guided by three theories: unified theory of acceptance and use of technology, the social exchange theory, and the leader-member exchange theory. Covariance-based structural equation modelling was used to test the proposed model and hypotheses. The sample consisted of 282 responses from the employees of two telecommunications companies in Jordan. The research findings suggested that performance expectancy had a significant positive effect on behavioural intention to use an e-HRM system, whereas effort expectancy did not. Facilitating conditions had a positive significant impact on e-HRM system usage. Top management support and the HRM role of line managers positively affected behavioural intention to use e-HRM and actual usage of e-HRM, whereas the effect of HR professionals on e-HRM usage was negative. Finally, the actual usage of e-HRM had a significant impact on HRM system effectiveness.

Common mental health and musculoskeletal disorders (CMDs and MSDs) are two of the most significant causes of non-participation in employment amongst working age adults. Background: This case study fills an important gap in the scientific literature on reintegration back to work after sickness absence due to CMDs and MSDs. It particularly examines the return to work (RTW) experiences of sick-listed employees to understand the facilitators and barriers of sustainable RTW. Methods: Using a realist evaluation approach within a qualitative inquiry, perceptions of employees were explored to provide in-depth understanding of what, how and under what circumstances sustainable RTW can be enabled for employees absent on a short- or long-term basis. Repeat face-to-face semi-structured interviews were conducted with 22 participants (15 women and 7 men, aged 30–50 years and sick-listed with MSDs and CMDs) who were recruited using purposive sampling. Data was thematically analysed. Results: A total of 2 main codes and 5 subcodes were developed and grouped into three theoretical abstractions. As a result of validating the context, mechanism, and outcome configurations with accounts of participants, all three initial theories explaining the most prominent mechanisms that either facilitates or impedes a sustainable RTW for people with CMDs and MSDs were justified. Conclusions: Our findings reveal the active role of line managers on the RTW outcomes of returning employees. However, line-manager’s competence and ability to effectively support and implement appropriate RTW strategies suited to employees’ hinges on working in alignment with key stakeholders and returning employees.

Purpose As a low-cost and effective way to maintain good interpersonal relations, gratitude expression has moved into the public glare of organizational management arena. Nonetheless, leader gratitude expression and its impact on employees’ behavior have received scarce attention. This study aims to elucidate the mechanisms underlying the effect of line manager gratitude expression on employees’ negative behaviors, that is, knowledge hiding and unethical pro-supervisor behavior (UPSB). Design/methodology/approach The authors conducted an experiment study and a field study. Study 1 invited full-time students from a Chinese university (n = 210) to participate a scenario-based experiment, then used SPSS 29.0 to conduct independent sample t-tests. Study 2 involved a time-lagged design with two waves of data collection over two months from employees in China (n = 550). The authors used Mplus 8.3 for confirmatory factor analysis and structural equation modeling to test the hypotheses. Findings An experimental study (Study 1) finds that line manager gratitude expression positively correlates with UPSB/rationalized hiding while negatively correlates with evasive hiding and playing dumb. Field study (Study 2) confirms the results and further finds that emotional expression authenticity moderates the relationship between line manager gratitude expression and employees’ negative behaviors (i.e. UPSB, evasive hiding and playing dumb). Originality/value Based on signaling theory, this study provides novel evidence on how line manager gratitude expression affects employee negative behaviors, thereby adding a new perspective to the literature on gratitude. The findings of this study contribute to the understanding of whether and when employees exhibit negative behaviors (i.e. UPSB and knowledge hiding) after they perceive line manager gratitude expression.

The purpose of this study is to examine line manager perspectives on two workplace-based efforts to reduce sickness absence (uniform procedures for managing sickness absence and initiating preventive actions), two components from an intervention to reduce sickness absence in public sector workplaces in Denmark. We performed 19 semi-structured interviews with line managers from four public sector workplaces. The interviews were analysed using thematic analysis (TA). Normalization Process Theory (NPT) was used as theoretical framework. Uniform sickness absence procedures are meaningful and provide clear expectations for line managers and employees about roles and responsibilities during sick leave. Line managers expressed a desire for flexibility in adjusting the procedures to the individual needs of the employees. They also reported a need for proactive preventive actions that prevent sickness absence from occurring in the first place. The line managers reported lacking competencies to ensure appropriate sick leave management and that their own well-being was often overlooked. Future interventions should focus on improving the work environment instead of focusing solely on absenteeism. It is essential to consider the well-being of the line managers and provide adequate training, as this can affect their capability to ensure the well-being of, and reduce sickness absence, among their employees.

Healthcare organizations face increasing challenges in retaining first-line managers, who play a key role in operational stability and patient care. Studies indicate that approximately half of all first-line managers intend to leave their position within 5 years. This highlights the need for updated knowledge about conditions under which they work. A qualitative descriptive design was used to explore first-line managers’ perceptions of what is important for them to remain in the managerial role. Data were collected through 20 individual semi-structured interviews with first-line managers from a medium-sized healthcare organization in Sweden between March and June 2022. The data were analyzed using qualitative content analysis. The results are presented through the overarching theme Empowered through support, responsibility, and meaningful contribution. This theme describes how first-line managers sustain their motivation and commitment by developing confidence in their ability to lead, influence others, and create meaningful change. Their confidence is grounded in support, responsibility, and role clarity. The theme also shows how first-line managers handle challenges, make decisions, and act to improve staff well-being and patient care. Through these actions, they contribute to the development of their units. Trust from their manager, autonomy in decision-making, and support from colleagues enhance first-line managers’ sense of purpose and motivation, encouraging them to remain in their role. Moreover, balanced workloads and opportunities to make a meaningful impact strengthen their commitment. By recognizing and addressing these aspects, healthcare organizations can better support long-term engagement of first-line managers, fostering sustainable leadership and stability.

Purpose Sustainable return to work remains challenging for workers returning after long-term sick leave due to common mental disorders (CMDs): stress, anxiety and depression. Line managers play a significant role in supporting returned workers. Therefore, the purpose of this qualitative study was to examine the supportive behaviors of line managers in supporting returned workers.Design/methodology/approach The authors conducted a longitudinal study with up to three semi-structured interviews with 20 line managers with experience managing returned workers. In these interviews, the authors asked questions about the supportive behaviors line managers enacted to support workers and the role of the context. The authors conducted reflexive thematic analysis.Findings The analyses revealed five key strategies, including managing workload, flexible working time arrangements, location of work, mental health check-ups and long-term support. The interviewed line managers reported their own lived experiences and that being aware of the limitations of their role, together with training and support from senior management and human resources (HR), enabled them to provide appropriate support.Practical implications The five strategies and the barriers and facilitators to implementing these may enable HR to develop policies and procedures to support line managers, including training of line managers.Originality/value This is the first study in the UK on line managers’ behaviors to support workers who have returned to work after a period of long-term sickness absence due to CMDs. The identification of such behaviors is paramount to developing organizational policies and practices. The question, however, remains whether employees see these behaviors as effective.

Background Safety culture can be described and understood through its manifestations in the organization as artefacts, espoused values and basic underlying assumptions and is strongly related to leadership-yet it remains elusive as a concept. Even if the literature points to leadership as an important factor for creating and sustaining a mature safety culture, little is known about how the safety work of first line managers’ is done and how they balance the different and often conflicting organizational goals in everyday practice. The purpose of this study was to explore how health care first line managers perceive their role and how they promote patient safety and patient safety culture in their units. Methods Interview study with first line managers in intensive care units in eight different hospitals located in the middle of Sweden. An inductive qualitative content analysis approach was used, this was then followed by a deductive analysis of the strategies informed by constructs from High reliability organizations. Results We present how first line managers view their role in patient safety and exemplify concrete strategies by which managers promote patient safety in everyday work. Conclusions Our study shows the central role of front-line managers in organizing for safe care and creating a culture for patient safety. Although promoted widely in Swedish healthcare at the time for the interviews, the HSOPSC was not mentioned by the managers as a central source of information on the unit’s safety culture.