BMJ Leader最新文献

{"title":"Kindness in healthcare: why it matters and why BMJ Leader will focus on it.","authors":"Robert Klaber, James Mountford, Dominique Allwood","doi":"10.1136/leader-2024-000991","DOIUrl":"10.1136/leader-2024-000991","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747498","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":"Incivility in healthcare: the impact of poor communication.","authors":"Joseph H Guppy, Hedda Widlund, Ross Munro, Jim Price","doi":"10.1136/leader-2022-000717","DOIUrl":"10.1136/leader-2022-000717","url":null,"abstract":"<p><p>Incivility is a common issue within healthcare in the UK and internationally. Experienced by at least one-third of staff within the UK National Health Service, incivility has been demonstrated to have significant negative implications on both patient care and healthcare staff. These include contributing to direct medical errors, diagnostic inaccuracy and team communication, with a large associated cost burden, while for staff it has significant negative impacts on retention, productivity and morale. Proposed methods do already exist to both prevent and address incivility, and it is in the interest of healthcare institutions, for their patients and staff, to investigate incivility and adopt these methods. This review explores existing literature on the effects of incivility, researched strategies to address it, as well as the proposed ways of integrating these. Through raising awareness and exploring these issues, our aim is to increase recognition of incivility, as well as inspire healthcare managers and leaders to collectively take efforts to reduce the rates of incivility.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9763916","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":"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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111709","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":"Striving for equity: exploring gender-inclusive medical leadership in India.","authors":"Kamal Gulati, Julie Davies, Angel Gonzalez de la Fuente, Angel Rajan Singh","doi":"10.1136/leader-2023-000970","DOIUrl":"https://doi.org/10.1136/leader-2023-000970","url":null,"abstract":"<p><strong>Introduction: </strong>There is a notable gap in studies examining the impact of gender within sociocultural norms in non-western professional settings, especially concerning the well-being of women physicians.</p><p><strong>Methods: </strong>Using purposive sampling and thematic data analysis, we recorded interviews with 30 physicians in India during May-July 2023. Participants were aged 34 to 65 years, with experience ranging from five to 35 years, in various clinical (37%), surgical (30%), paraclinical (23%) and hospital administration (10%) roles, 97% were postgraduates and 53% were women. The research questions explored how leadership roles happened, managing key challenges, barriers and enablers, and practical interventions to support women into medical leadership positions.</p><p><strong>Results: </strong>Findings revealed that the majority of interviewees believed gender-related barriers were obstructing women's progress and success in medical leadership roles in India. These barriers were identified within three overarching domains: (1) specialty, (2) organisational and (3) sociocultural. Interviewees commonly acknowledged the male-dominated landscape of medical leadership although some women stated that they did not perceive any barriers for women's advancement into leadership roles. Interestingly, some men surgeons held the perception that women might not be as effective in certain surgical disciplines, such as orthopaedics and neurosurgery. Some men physicians, however, considered women physicians in India to be highly effective multitaskers.</p><p><strong>Conclusion: </strong>We recommend structural reforms in medical education, leadership development, workplace systems and cultures, and improved implementation of equality, diversity and inclusion policies in the Indian context.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040566","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":"Can coaching advance medical leadership development?","authors":"Fiona Jane Day, Daljit Hothi","doi":"10.1136/leader-2023-000853","DOIUrl":"https://doi.org/10.1136/leader-2023-000853","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013447","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":"Faculty retention at a young medical school in crisis times and beyond: prospects, challenges and propositions from a mixed-methods study.","authors":"Vanda G Yazbeck Karam, Sola Bahous, Ghada M Awada, Nazih Youssef","doi":"10.1136/leader-2023-000900","DOIUrl":"https://doi.org/10.1136/leader-2023-000900","url":null,"abstract":"<p><strong>Background: </strong>Retention of faculty constitutes a significant challenge for higher education institutions, especially in times of crisis. Lebanon has been experiencing economic recession since the end of its civil war in 1990 until its complete collapse in 2019. This resulted in a massive faculty exodus, escaping the daily struggle with the sinking economy.</p><p><strong>Purpose: </strong>The purpose of this study was to empirically investigate the factors that precipitate faculty attrition and the measures that foster long-term commitment to the institution in a time of unprecedented crisis.</p><p><strong>Methods: </strong>An online anonymous survey, using a Likert scale, gathered responses from 92 faculty members. Quantitative findings were complemented by a qualitative exploration of emergent themes in comments. A team of three certified researchers conducted the analysis. Inductive analysis identified recurring themes, with steps like intercoder reliability checks and member-checking enhancing data validity. The researchers ensured methodological rigour, subject expertise, and overall reliability and validity of the thematic analysis.</p><p><strong>Results: </strong>A total of 78 faculty participated in the survey (84.8%), with 79.5% reporting overall satisfaction, but a varying degree of satisfaction was noted across items. Faculty satisfaction was highest in areas such as respectful interactions (91.0%), belonging to the workplace (85.9%), communication from the Dean's office (85.9%), supportive environment and medical school leadership's commitment to retaining faculty (82.1%). Financial assistance, support for research and professional assistance were identified as important retention measures. Effective, transparent communication from leadership was highlighted as a critical factor during times of crisis.</p><p><strong>Conclusion: </strong>This study provides strategies for faculty retention in times of crisis that include ensuring timely salary payments, supporting research and professional development, fostering a positive work environment and implementing bonding programmes. Transparent communication from leadership is vital for faculty satisfaction and retention. These findings can aid medical schools and other institutions facing faculty attrition during crises.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991322","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":"Advancement, barriers and collaboration: the ABC's of addressing challenges and designing solutions between front-line physicians and business-oriented leaders.","authors":"Shayann Ramedani, Jeffery Miller, Jed D Gonzalo","doi":"10.1136/leader-2022-000651","DOIUrl":"https://doi.org/10.1136/leader-2022-000651","url":null,"abstract":"<p><strong>Background: </strong>The complexity of US healthcare has been increasing for many years, requiring clinicians and learners to understand care delivery systems in addition to clinical sciences. Thus, there has been a major push to educate faculty and trainees on healthcare functionality. This comes as hospitals expand into health systems requiring the help of more sophisticated expertise of departments such as operations excellence when problem-solving. As a medical student with a background in operations excellence, medical education leader and clinical administration leader all currently facilitating this transition, we wanted to reflect on the barriers we have experienced in clinical implementation of quality improvement projects and educating learners on the impact of operations excellence principles in their clinical education.</p><p><strong>Methods: </strong>The ideas presented in this article were the result of a several collaborative discussion between the authors, on the key challenges to adopting operations excellence principles into health system science education. In an effort to add context to this reflection through the current body of research present, they supplemented a literature review on the topic which included 86 studies published between 2013 and 2021 regarding health systems science and healthcare leadership engagement in the USA. The themes that intersected between the literature review and the discussions were then expanded on in this paper.</p><p><strong>Results: </strong>Through this process, we identified four challenges: (1) the difference in thinking styles, which we term, 'mental model differences'; (2) the strategic nature of process improvement projects and how that collides with physician priorities, or 'the chess game of stakeholder engagement'; (3) the language and precise methodology, or 'consistency of language and need for administrative resilience' and (4) the issue of teaching these concepts or bridging the learning gap.'</p><p><strong>Conclusion: </strong>In an increasingly complex healthcare landscape, physicians and trainee's need to bridge gaps between the mental models of administrative and clinical workflow.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991321","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":"Countercyclical approach to enhancing health and well-being in healthcare systems: strategies for economic resilience and sustainable care.","authors":"Benjamin Laker, Natalia Weisz, Roberto Vassolo","doi":"10.1136/leader-2023-000873","DOIUrl":"https://doi.org/10.1136/leader-2023-000873","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973843","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":"Balancing health and work: employees demand more flexibility in when, where and how they work.","authors":"Benjamin Laker, Rita Fontinha, James Walker","doi":"10.1136/leader-2023-000869","DOIUrl":"https://doi.org/10.1136/leader-2023-000869","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973842","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":"Nursing home managers' quality of work life and health outcomes: a pre-pandemic profile over time.","authors":"Tatiana Penconek, Yinfei Duan, Alba Iaconi, Kaitlyn Tate, Greta G Cummings, Carole A Estabrooks","doi":"10.1136/leader-2023-000876","DOIUrl":"https://doi.org/10.1136/leader-2023-000876","url":null,"abstract":"<p><strong>Aim: </strong>To examine trends in quality of work life and health outcomes of managers in nursing homes in Western Canada pre-pandemic.</p><p><strong>Methods: </strong>A repeated cross-sectional descriptive study using data collected in 2014-2015, 2017 and 2019-2020, in the Translating Research in Elder Care Programme. Self-reported measures of demographics, physical/mental health and quality of work life (eg, job satisfaction, burnout, work engagement) were administered and completed by nursing home managers. We used two-way analysis of variance to compare scores across times, controlling for clustering effects at the nursing home level.</p><p><strong>Results: </strong>Samples for data collection times 1, 2, 3, respectively, were 168, 193 and 199. Most nursing home managers were nurses by profession (80.63-81.82%). Job satisfaction scores were high across time (mean=4.42-4.48). The physical (mean=51.53-52.27) and mental (mean=51.66-52.13) status scores were stable over time. Workplace engagement (vigour, dedication and absorption) scores were high and stable over time in all three dimensions.</p><p><strong>Conclusions: </strong>Nursing home managers were highly satisfied, had high levels of physical and mental health, and generally reported that their work was meaningful over time pre-COVID-19 pandemic. We provided a comparison for future research assessing the impacts of the pandemic on quality of work life and health outcomes.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933332","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}