BMJ Leader最新文献

{"title":"Physician burn-out, transformational and servant leadership.","authors":"Aston Wan","doi":"10.1136/leader-2024-001060","DOIUrl":"https://doi.org/10.1136/leader-2024-001060","url":null,"abstract":"<p><strong>Background: </strong>Physician burn-out was associated negatively with physicians' health, patient outcomes and healthcare system performance. Reducing physician burn-out may potentially benefit physicians and patients, improve healthcare performance and reduce societal healthcare costs.</p><p><strong>Aim: </strong>The purpose of this study was to clarify the relationship between transformational and servant leadership behaviours and physician burn-out.</p><p><strong>Methods: </strong>A cross-sectional, non-experimental quantitative correlation study was conducted using scores on the Maslach Burnout Inventory, Global Transformational Leadership Scale and Servant Leadership Behaviour Scale-6-item Short Form. The data were obtained by an online survey of physicians working at a metropolitan hospital in Australia.</p><p><strong>Results: </strong>82 physicians participated in the study. The result showed significant correlations between transformational and servant leadership and lower physician burn-out, particularly in supporting fellow physicians' personal accomplishments, a burn-out construct (Pearson r=0.42 and 0.32, respectively). Among the constructs of transformational leadership, leaders who are clear about their values and demonstrate them in their actions correlate strongly with the constructs of burn-out. In servant leadership behaviours, helping subordinates generate meaning out of everyday work was the most influential factor in fellow physicians' burn-out. The finding may be related to the effects of observing the positive values and actions of their supervisor and the physicians' own understanding of the value of their work.</p><p><strong>Conclusions: </strong>A positive role model and the meaning of everyday work could be protective against physician burn-out. Positive role modelling and mentorship may be relevant in physician supervisor training. Encouraging physicians to discover meaning from their everyday work may help to promote physician well-being.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of humble leadership on attitudes to error disclosure: the mediating role of psychological safety and safety climate in Australian veterinary practices.","authors":"Luiz C P Santos, Wendy Goodwin, Michelle McArthur","doi":"10.1136/leader-2024-001149","DOIUrl":"https://doi.org/10.1136/leader-2024-001149","url":null,"abstract":"<p><strong>Background: </strong>Medical errors, while prominent in healthcare as one of the leading causes of mortality, remain a relatively unexplored area in veterinary medicine. The nature and frequency of such errors in this field are rarely reported or discussed, presenting a significant gap in understanding and improvement of veterinary practices. It is in this context that the importance of leadership styles emerge. Humble leadership involves acknowledging one's own limitations, actively seeking feedback and learning from it, and appreciating others' strengths and contributions. Such a leadership style has been linked to increased openness and error disclosure in various fields - a crucial step in mitigating medical errors.</p><p><strong>Purpose: </strong>This study investigates the association between humble leadership and error disclosure in veterinary medicine, with a particular focus on the mediating role of psychological safety and safety climate.</p><p><strong>Methods: </strong>A total of 669 responses were collected from veterinary staff across Australia to analyse the impact of leadership style on error disclosure. Model 4 of Hayes' PROCESS macro in SPSS was employed to analyse the effect of humble leadership on staff's attitudes towards error disclosure and the mediating effects of psychological safety and safety climate.</p><p><strong>Results: </strong>Humble leadership had a positive influence on psychological safety (β 0.66, p<0.001) and safety climate (β 0.48, p<0.001). Furthermore, both psychological safety and safety climate significantly impacted staff's attitudes towards error disclosure (β 0.07, p<0.001; β 0.22, p<0.001, respectively). The study showed that humble leadership did not influence staff's attitudes towards error disclosure directly. Rather, the influence of humble leadership appears to be channelled through its positive effects on psychological safety and the safety climate.</p><p><strong>Conclusion: </strong>Humble leadership fosters a safe environment and encourages a mindset of psychological safety among staff, which in turn leads to more positive attitudes towards error disclosure.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's in a leader? Association of perceived leadership effectiveness and psychological safety among clinical physician faculty.","authors":"Celestine He, Eleonore de Guillebon, Saadia Akhtar, Robert H Pietrzak, Jonathan Ripp, Lauren Peccoralo","doi":"10.1136/leader-2024-001163","DOIUrl":"https://doi.org/10.1136/leader-2024-001163","url":null,"abstract":"<p><strong>Objective: </strong>To identify leadership qualities associated with psychological safety among physician faculty in a large medical centre in New York City.</p><p><strong>Patients and methods: </strong>An anonymous, institution-wide cross-sectional survey was sent to all physician faculty with clinical responsibilities between July and September 2022. Demographic and occupational characteristics were assessed. Perceived leadership effectiveness was measured with the nine-item Mayo Leadership Index and psychological safety was measured using the seven-item Fearless Organisation Questionnaire. Multivariable logistic regression analyses were conducted to determine associations between leadership, psychological safety, and demographic and occupational correlates of psychological safety.</p><p><strong>Results: </strong>Of 3086 eligible clinical faculty members, 867 (28.1%) physicians with clinical responsibilities participated. On average, 57.6% of physicians reported that their workplace was psychologically safe and the majority agreed with items on the Mayo Leadership Index (60.0%-84.5%), the most prevalent being 'treats me with respect and dignity,' 'employs me to do my job' and 'encourages employees to suggest ideas for improvement.' In a multivariable model, higher overall leadership index scores were positively associated with psychological safety scores.</p><p><strong>Conclusions: </strong>Greater perceived leadership effectiveness was positively associated with psychological safety among clinical physician faculty at a large, urban hospital. These results suggest that organisational investment in promoting leadership effectiveness may have positive downstream effects on healthcare delivery, burn-out and attrition rates.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practice leadership: an extension of the consultation.","authors":"Andy Brooks","doi":"10.1136/leader-2024-001058","DOIUrl":"https://doi.org/10.1136/leader-2024-001058","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leading across healthcare silos: why relational leadership matters?","authors":"Rachel Hawley, Tony Wall","doi":"10.1136/leader-2023-000859","DOIUrl":"10.1136/leader-2023-000859","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"1-3"},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future-ready healthcare leadership: the revised International Hospital Federation competency model.","authors":"Sylvia Basterrechea, Jan C Frich, Andrew N Garman","doi":"10.1136/leader-2023-000925","DOIUrl":"10.1136/leader-2023-000925","url":null,"abstract":"<p><strong>Background: </strong>Major global trends are reshaping health services delivery, and preparing current and future healthcare leaders requires an understanding of these trends. A well-designed leadership competency model can provide guidance for individuals, as well as for system-level leadership development and integration programmes.</p><p><strong>Objective: </strong>To describe the process of updating the International Hospital Federation's (IHF) Global Healthcare Management Competency Directory.</p><p><strong>Methods: </strong>Revisions were informed by a recent foresight study of major trends in health services delivery, and an evidence-informed framework of leadership competencies. The original framework competencies were reviewed by 45 subject-matter experts from 30 countries and regions, who provided feedback through electronic surveys and online interviews. We incorporated this iterative feedback to revise the framework design, competencies within the framework and their associated behavioural descriptions.</p><p><strong>Results: </strong>A total of 45 subject-matter experts from 30 countries and regions participated in 1 or more phases of the survey process. The resulting leadership competency model includes 32 competencies organised into a framework of 6 domains: values, self-development, execution, relations, context management and transformation.</p><p><strong>Conclusion: </strong>The updated IHF Leadership Model provides a robust, evidence-based and up-to-date resource for assessing and developing future-ready healthcare leaders.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"80-82"},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital innovative healthcare during a pandemic and beyond: a showcase of the large-scale and integrated Saudi smart national health command centre.","authors":"Muaddi F Alharbi, Mohammmed Senitan, Dalia Mominkhan, Sidney Smith, Maram ALOtaibi, Michal Siwek, Tim Ohanlon, Fahad Alqablan, Sarah Alqahtani, Mohammed K Alabdulaali","doi":"10.1136/leader-2023-000890","DOIUrl":"10.1136/leader-2023-000890","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing frequency of pandemics, demand for healthcare and costs of healthcare services require efficient health systems with integrated care via a command centre that ensures a centralised and coordinated approach to exercise effective leadership.</p><p><strong>Description: </strong>We present a case study using the conceptual framework of Franklin to describe the novel system-based engineering approach of the Saudi National Health Command Centre (NHCC) including its features and outcomes measured.</p><p><strong>Discussion: </strong>The NHCC is structured into four departments and four zones with real-time data integration and visualisation on 88 dashboards. To empower leadership, it harnesses artificial intelligence affordances such as machine learning algorithms to enhance functionality, decision-making processes and overall performance. This allows for the rapid assessment of available resources and to monitor healthcare system efficiency at diverse levels of clinical and system indicators. Enhanced proactive capacity management has contributed to reducing lengths of stay, average supply chain lead time and surgery waiting list; early bending of the COVID-19 curve resulting in a low mortality rate; increasing bed capacity; deploying medical staff and mechanical ventilators rapidly; rolling out the COVID-19 vaccination programme and improving patient satisfaction.</p><p><strong>Conclusion: </strong>Integrating a healthcare system with a command centre provides healthcare leaders with the necessary infrastructure to create synergy between people, processes and technologies. This substantially improves both patient and service outcomes. It also allows for immediate care coordination and resource allocations and safeguards ease of access to care.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"83-87"},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotionally intelligent themes in medical leaders' decision-making during COVID-19.","authors":"Bobbie Ann Adair White, Heather Valenova Dayag, Erin S Barry, Joann Farrell Quinn","doi":"10.1136/leader-2023-000936","DOIUrl":"10.1136/leader-2023-000936","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic presented unprecedented challenges for leaders in healthcare requiring decision-making and crisis response that can often be tricky without the right level of trust. Trust is fostered and facilitated with emotional intelligence (EI); thus, a critical examination of medical leaders' reflections was essential to understand how leaders perceived their leadership responses during the initial response to COVID-19. This exploratory study used an EI lens to investigate leaders' perceptions of their decision-making during COVID-19.</p><p><strong>Methods: </strong>A purposeful sample of seven leaders in medicine who experienced leading during COVID were invited to participate in semi-structured interviews.</p><p><strong>Results: </strong>Four themes around leadership response during the uncertain times of the COVID-19 were identified. The themes included communication, interprofessional collaboration including decision-making and strategic planning, internal and external awareness, and finally, trust and psychological safety.</p><p><strong>Conclusions: </strong>Incorporating EI competencies into crisis leadership education for healthcare professionals could enhance medical leaders' preparedness to adapt, collaborate and communicate effectively in a crisis.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"76-79"},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical education needs a new model for global leadership.","authors":"Mohammed Ahmed Rashid, Thirusha Naidu","doi":"10.1136/leader-2024-001011","DOIUrl":"10.1136/leader-2024-001011","url":null,"abstract":"<p><strong>Background: </strong>Like other fields in medicine, medical education relies on collaboration and cooperation between countries and regions of the world, although no single institution or position unifies the global medical education community in the way that the WHO does in public health, for example. Recent research in medical education has drawn attention to many injustices that exist in the field, where power and influence is held in relatively few Global North countries, although most practice happens in Global South countries.</p><p><strong>Methods: </strong>In this article, we examine three positions that hold global prominence in medical education, including the presidents of the World Federation for Medical Education and the Association for Medical Education in Europe, and winners of the Karolinska Institutet Prize for Research in Medical Education.</p><p><strong>Findings: </strong>We highlight that these positions have problematic histories and have perpetuated the current power disparities in the field. We argue that an alternative model for global leadership is required that should be determined democratically by those involved in medical education all around the world. Such a model should prioritise diversity and inclusivity, empowering leaders from countries who have previously been peripheral to the decision-making platforms in the field.</p><p><strong>Conclusion: </strong>Given the shortcomings of existing leadership positions and organisations, we suggest that a new institution is required to realise this new vision, and that the principles that govern it should be determined through debate and democracy, with a focus on inviting those voices that have not previously been heard in global medical education circles.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"4-6"},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making evaluations useful for healthcare leadership development programmes.","authors":"Oscar Lyons, Juliette Phillipson, Joao R Galante, Timothy Jahn","doi":"10.1136/leader-2024-001129","DOIUrl":"https://doi.org/10.1136/leader-2024-001129","url":null,"abstract":"<p><strong>Background: </strong>Effective healthcare leadership has been linked to improved individual and organisational outcomes globally. However, evaluations of healthcare leadership development programmes have often been of low quality. This study investigates the evaluation and decision-making needs of stakeholders for the Oxford Emerging Leaders Programme and aims to redesign its evaluation approach.</p><p><strong>Methods: </strong>Drawing from Michael Quinn Patton's utilisation-focused evaluation approach, semistructured interviews were conducted with 12 key programme stakeholders. Interviews were thematically analysed to identify key areas for useful and impactful evaluation.</p><p><strong>Results: </strong>Three main themes were identified: impact on patients, impact on healthcare organisations and individual outcomes. Individual outcomes were further divided into skills and qualities. Stakeholders emphasised the importance of measuring improvements in organisational culture, as well as from the perspectives of patients and individual leaders. The need for a multifaceted and longitudinal evaluation approach was highlighted.</p><p><strong>Conclusions: </strong>The study underscores the importance of aligning evaluation methods with stakeholder needs. Tailoring evaluations to specific programme aims and incorporating both qualitative and quantitative measures can enhance their utility. These insights contribute to the broader literature on healthcare leadership development and programme evaluation.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}