A conceptual framework for health-promoting leadership in healthcare inspired by the Okanagan Charter

PURPOSE: The wellbeing of healthcare workers is increasingly recognized as foundational to high-quality care and sustainable health systems. While various leadership frameworks promote wellbeing, there remains a gap in system-wide strategies that integrate equity, psychological safety and health promotion into leadership practice. This paper aims to address that gap by adapting the Okanagan Charter, originally developed for health-promoting universities, into a novel framework for health-promoting leadership in healthcare. DESIGN/METHODOLOGY/APPROACH: This conceptual paper reinterprets the principles of the Okanagan Charter through the lens of inclusive, distributed and compassionate leadership. The authors adapt an established six-domain model to the health leadership context: embed health in all policies, adapt spaces to promote wellbeing, create thriving communities and cultures, support meaningful personal and professional development, promote engagement with health services and collaborate in continuous improvement and evaluation. For each domain, they provide theoretical rationale, leadership strategies and practice-based illustrations. FINDINGS: This paper critically examines the applicability of the Okanagan Charter within healthcare leadership, highlights practical implementation challenges and presents a revised leadership case study grounded in real-world complexity. The findings demonstrate the utility of the six-domain model in guiding leaders to embed wellbeing into everyday practice. ORIGINALITY/VALUE: This paper advances existing scholarship by explicitly extending Okanagan Charter-aligned work into the domain of healthcare leadership. It offers a clear, theory-informed roadmap for leaders to integrate wellbeing, equity and health promotion into the fabric of organizational life, positioning health-promoting leadership as a strategic imperative for resilient, inclusive and high-performing health systems.