L’hybrid management nel processo di ammodernamento della pubblica amministrazione. I risultati di una revisione strutturata della letteratura

The public administration reform of the 1990s highlighted the principles of efficiency and sound management. The reform enhanced the rewarding logics of recruitment, and career advancement progressively, renewing the accounting, planning, and management and control tools. Actions were taken on the qualification and skills of the new managers. This framework has introduced the hybrid manager (Hm) professionals within the public administration, especially in the healthcare sector. Such Hm professionals feature a high level of technical-specialist competence, and they are assigned organizational and managerial responsibilities. Typical examples of Hm are the medical directors of departments, nursing heads, laboratory coordinators, or coordinators of the health professions. The assignment of management tasks to Hm has represented one of the most significant aspects of this innovation, but the outcomes produced versus the desired results are little known and remain controversial. The goal of this paper is to fill this knowledge gap through a structured review of the scientific literature of the last 30 years. This is the period in which the various public administration reforms should have produced their effects. The results of the study reveal an articulated, sometimes contradictory picture, which in some cases identifies the Hm as a resource for change, in others an obstacle, a sort of specialized enclave of resistance to innovation. However, the common feature is represented by low investments in training. These topics should stimulate local and international health policies to address the knowledge gaps in the years to come.