BMJ Leader最新文献

{"title":"Psychological safety in the perioperative environment: a cost-consequence analysis.","authors":"Franklyn P Cladis, Mark Hudson, Joel Goh","doi":"10.1136/leader-2023-000935","DOIUrl":"10.1136/leader-2023-000935","url":null,"abstract":"<p><strong>Introduction: </strong>Psychologically unsafe healthcare environments can lead to high levels of staff turnover, and unwanted financial burden. In this study, we investigate the hypothesis that lower levels of psychological safety are associated with higher levels of turnover, within an anaesthesiology department and we estimate the cost attributable to low psychological safety, driven by turnover costs.</p><p><strong>Methods: </strong>Psychological safety was measured in one academic department. The psychological safety score was correlated with 'intention to leave' using linear regression and Pearson correlation and a cost-consequence analysis was performed.</p><p><strong>Results: </strong>One hundred and thirty-eight physician anaesthesiologists (MDs) and 282 certified registered nurse anaesthetists (CRNAs) were surveyed. The response rate was 67.4% (93/138) for MDs and 60.6% (171/282) for CRNAs. There was an inverse relationship between psychological safety and turnover intent for both MDs (Pearson correlation -0.373, p value <0.0002) and CRNAs (Pearson correlation -0.486, p value <0.0002). The OR of intent to turn over in the presence of low psychological safety was 6.86 (95% CI 1.38 to 34.05) for MDs and 8.93 (95% CI 4.27 to 18.68) for CRNAs. The cost-consequence analysis demonstrated the cost of low psychological safety related to turnover per year was $337, 428 for MDs and $14, 024, 279 for CRNAs. Reducing low psychological safety in CRNAs from 31.6% to 20% reduces the potential cost of low psychological to $8 876 126.03.</p><p><strong>Conclusion: </strong>There is a cost relationship between low psychological safety and turnover. Low psychological safety in an academic anaesthesiology department may result in staff turnover, and potentially high financial costs.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"305-311"},"PeriodicalIF":1.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We need more NHS Pirates.","authors":"Anna Yarlini Allan, Shehan Hettiaratchy","doi":"10.1136/leader-2023-000888","DOIUrl":"10.1136/leader-2023-000888","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824650","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":"Healthcare workers' well-being and perspectives on support during the COVID-19 pandemic: a systematic review and meta-synthesis of qualitative studies.","authors":"Siyuan Zhang, Xiuzhu Gu","doi":"10.1136/leader-2024-001041","DOIUrl":"10.1136/leader-2024-001041","url":null,"abstract":"<p><strong>Background: </strong>Since the outbreak of the COVID-19 pandemic, healthcare workers (HCWs) have faced multiple difficulties in their work and personal lives. However, most of the quantitative reviews have focused on the extent of the pandemic's impact on the HCWs and have thus failed to fully capture the HCWs' experiences and the complexity of the problems they encountered. Therefore, this qualitative systematic review elucidates the HCWs' challenges brought about by the pandemic, their perceptions of the existing support and the support that require further attention.</p><p><strong>Methods: </strong>The literature search spanned five databases: Scopus, PubMed, Web of Science, CINAHL and PsycInfo, targeting qualitative studies of HCWs' pandemic experiences from December 2019 to December 2023. These studies underwent strict quality and relevance assessment, emphasising critical appraisal and selection. Findings were unified through meta-synthesis, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was registered in PROSPERO.</p><p><strong>Results: </strong>This study analysed 29 qualitative studies on HCWs' experiences during the pandemic and their perceptions of support, identifying four themes of HCWs' physical and mental well-being, the impact of the pandemic on their professional and personal lives, their work environments and the support they received. These themes encompassed 8 main categories and 25 codes. The research revealed that the pandemic and work conditions negatively influenced their health, affecting their professional and personal lives. Current support has lessened the pandemic's effects on HCWs but should also address future requirements like long-term psychological support.</p><p><strong>Conclusion: </strong>The studies identified the challenges faced by HCWs during the pandemic, and the existing support. However, due to the complex interactions between the work and environmental factors, the effectiveness of the existing support remains challenging. To improve their effectiveness, the future support should target the interactions between the HCWs and the work system.</p><p><strong>Prospero registration number: </strong>CRD42023426238.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824649","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":"Research agenda for integrated care: supporting collaboration in turbulent times.","authors":"Sam van Elk, Kirsten Armit, Juan Baeza, Alec Fraser, Ruth Harris, Lorelei Jones, Jessica Lubin, Gerry McGivern, Justin Waring","doi":"10.1136/leader-2024-001078","DOIUrl":"10.1136/leader-2024-001078","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819633","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 competency training on medical administrators: an evaluation of medical management and leadership development programme.","authors":"Shuyuan Cheng, Fengying He, Xiaoxin Su, Yanxin Liu, Mingyen Cheung, Alastair P Mah","doi":"10.1136/leader-2024-001115","DOIUrl":"10.1136/leader-2024-001115","url":null,"abstract":"<p><strong>Background: </strong>China's healthcare sector is facing unprecedented challenges, placing substantial requirements on the competencies of medical administrators. Training programmes play a crucial role in enhancing the competencies of medical administrators to deliver high-quality healthcare services. This study aims to investigate the outcome of training on the competency of medical administrators and to use the findings to guide the development of future training content.</p><p><strong>Methods: </strong>The Medical Management and Leadership Development Programme, grounded in the Royal Australasian College of Medical Administrators competency model, was implemented as a three-phase training programme for medical administrators at United Family Healthcare to assess the impact of training on their competency.</p><p><strong>Results: </strong>The study's results revealed significant differences in participants' competencies across various domains between the pretest and post-test phases of the training programmes. These findings highlight parts where the training was effective and areas that may require further development to enhance overall competency.</p><p><strong>Conclusions: </strong>The results indicate a positive impact of competency training on enhancing the skills of medical administrators. Additionally, the study offers valuable insights for optimising future training content.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819630","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":"Quiet effect of lacking leadership in healthcare education.","authors":"Nithya Arigapudi","doi":"10.1136/leader-2024-001020","DOIUrl":"10.1136/leader-2024-001020","url":null,"abstract":"<p><strong>Background: </strong>In the landscape of Indian healthcare, the role of leadership in addressing disparities and driving change is often overlooked, particularly within medical education. Through the lens of the author journeying from a volunteer to ultimately a leader of a student-led non-profit organisation, this article explores the reason, rhyme and possible resolutions to the quiet effect of lacking leadership in healthcare education.</p><p><strong>Methods: </strong>Drawing from personal experience and reflections, the article highlights the profound impact of grassroots initiatives in reaching underserved populations and how inadequate leadership hindered their ability to scale effectively. Insights into the challenges encountered and the barriers that needed to be overcome have been elaborated to unravel the possible origins of this problem and address potential solutions throughout various levels of health education.</p><p><strong>Results: </strong>Although there is rarely a simple solution to a complex challenge, building adequate mentorship and support can help sustain leadership efforts in leadership by providing a pillar to lean on without diminishing individualised effort for growth. Cultivating collaborative networks can further provide opportunities to kindle the flame of leadership among young doctors.</p><p><strong>Conclusions: </strong>By fostering a culture of leadership, medical education can produce professionals who are skilled clinicians and innovative leaders capable of driving change in the community.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819631","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":"Advancing racial equity within an academic medical centre: a model of strategic planning to make change happen.","authors":"Douglas V Easterling, Goldie S Byrd, Julie Ann Freischlag, Laura McDuffee, Amy J McMichael, Sabina B Gesell","doi":"10.1136/leader-2024-001001","DOIUrl":"10.1136/leader-2024-001001","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808277","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":"Why <i>BMJ Leader</i> is focusing on healthcare leadership in Africa.","authors":"Mumta Hargovan, Shrikant Maurice Peters, Jamiu O Busari","doi":"10.1136/leader-2024-001164","DOIUrl":"10.1136/leader-2024-001164","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808278","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":"Current state and future directions for improvement science: reflections from the 2024 International Forum on Quality and Safety in Healthcare.","authors":"Amar Shah, James M Hoffman, Nana Twum-Danso, Jonathan Burlison, Pierre Barker","doi":"10.1136/leader-2024-001061","DOIUrl":"10.1136/leader-2024-001061","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802564","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":"Distinct journeys and unique stories: how individuals from multiple professions cultivate careers in healthcare leadership.","authors":"Sarah Gregor, Alannah Delaine Mulholland, Ryan Brydges, Beverly Bulmer, Emilia Kangasjarvi, Betty Onyura, Susan Lieff, Stella Ng","doi":"10.1136/leader-2024-001051","DOIUrl":"10.1136/leader-2024-001051","url":null,"abstract":"<p><strong>Introduction: </strong>Strong hospital leadership is critical to navigating the challenges of the Canadian healthcare system. Currently, physicians and nurses tend to be selected to fulfil hospital executive roles. To date, we found only limited research exploring who else <i>could</i> or should be in these roles, or how more diverse groups of professionals navigate the journey into these roles. We sought to interview leaders from multiple professional backgrounds to understand how their career journey led them to their executive role.</p><p><strong>Methods: </strong>We purposively sampled Canadian hospital executives with diverse professional and educational backgrounds. Through semistructured interviews, we explored their individual leadership journeys, and their experiences working with others along the way. Our team worked together to analyse data using a phenomenographic approach.</p><p><strong>Results: </strong>Fourteen executive-level leaders from diverse professional backgrounds were interviewed. Overall, we noted three main trajectories for people to become hospital leaders: the achievement journey, the unexpected journey and the practical journey. These journeys corresponded to three main identities the champion leader, the discovered leader and the pragmatic leader, respectively. We found that some individuals had multiple trajectories and identities.</p><p><strong>Conclusions: </strong>Improved diversity in executive hospital leadership may support transformational change in healthcare; however, this promise may not be automatically realised. Critical reflection on current hiring processes, career development and mentorship is warranted to support those with diverse and distinct backgrounds to enter and thrive in these roles.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792577","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}