BMJ Leader最新文献

{"title":"Impact and outcomes of the Emerging Leaders Programme: a mixed-methods evaluation of a leadership development programme for healthcare professionals.","authors":"Oscar Lyons, Juliette Phillipson, Mary Fenwick, Thomas Swinburn, Jacobus Charles Bender Kotze, Joao R Galante, Karandeep Nandra, Nicholas Fahy, Richard Canter","doi":"10.1136/leader-2024-001152","DOIUrl":"https://doi.org/10.1136/leader-2024-001152","url":null,"abstract":"<p><strong>Background: </strong>The significance of effective medical leadership in enhancing healthcare outcomes has been widely acknowledged. This study evaluates the Emerging Leaders Programme, a multidisciplinary leadership development initiative for healthcare professionals at a UK Hospital Trust.</p><p><strong>Methods: </strong>The evaluation spanned three cohorts (2017-2019) and a total of 54 participants, employing mixed methods to assess participant reactions, learning, behaviour changes and organisational impact. Quantitative pre-/post-measures included the Primary Colours Questionnaire (PCQ), Medical Leadership Competency Framework Questionnaire (MLCFQ) and Brief Resilience Scale (BRS), while qualitative data were gathered via free-text comments and long-term follow-up interviews.</p><p><strong>Results: </strong>The programme had high satisfaction ratings, with particularly positive feedback relating to the multidisciplinary cohort and experiential learning via Quality Improvement projects. Findings indicated improvements in participants' leadership skills, knowledge, confidence and job satisfaction. Organisational outcomes included increased organisational interest in quality improvement and individual career progression.</p><p><strong>Conclusion: </strong>The results highlight the value of a structured leadership programme in developing healthcare leaders and driving organisational improvements, with long-term effects. Recommendations for future programmes include multidisciplinary involvement, experiential learning, inspiring speakers and embedded mixed-methods evaluation.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217153","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":"Emergency Medical Commander: a multimethod case study applying the lens of Path-Goal leadership theory.","authors":"Adelaide Joan Fairweather Michael, Rachael Smithson","doi":"10.1136/leader-2024-001189","DOIUrl":"https://doi.org/10.1136/leader-2024-001189","url":null,"abstract":"<p><strong>Background and aim: </strong>In 2020, the Gold Coast University Hospital emergency department (ED) established a Medical Commander role; a medical leadership position with a focus on optimising patient flow. The objective of this study was to understand how the role executes leadership tasks to promote patient flow and its impact on staff working in and with the ED.</p><p><strong>Methods: </strong>A multimethod case study approach combined data from documents, observations staff interviews and surveys across a breadth of stakeholders. Data were deductively themed and triangulated through the analytical framework of Path-Goal leadership theory to provide a comprehensive analysis of the Medical Commander role functions and impact.</p><p><strong>Results: </strong>The Medical Commander role dynamically exhibits a combination of directive, supportive and participative leadership behaviours to enact and deliver patient flow leadership across a breadth of stakeholders. Path-Goal theory illuminates the environmental and personnel characteristics that have contributed to the role's perceived successes in patient flow and employee motivation. In addition, the application of this theory identifies several crucial enablers, including role characteristics (ie, clinical and service seniority, division-wide oversight and absence of clinical load) that support the dynamic use of leadership behaviours observed in this study and their effect on staff morale and patient flow.</p><p><strong>Conclusions: </strong>As rising demand and complexity increase the risks associated with delays to patient care coordination and flow, the senior-level oversight and enabling leadership behaviours provided by the Medical Commander role represent a viable and effective intervention to manage these gaps.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161156","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":"Diversity in leadership: analysing representation in global committees on climate and health.","authors":"Manish Barik, Kent Buse, Soumyadeep Bhaumik","doi":"10.1136/leader-2024-001146","DOIUrl":"https://doi.org/10.1136/leader-2024-001146","url":null,"abstract":"<p><strong>Background: </strong>Climate change is the greatest threat to global health. There are several working groups at the intersection of climate and health, which provide leadership in global governance around the issue-but their diversity has not been previously analysed.</p><p><strong>Objective and methods: </strong>We analysed 13 active committees, comprising 226 members. Committee members were analysed in terms of World Bank country income status, political grouping (G7 membership), climate vulnerability (being from Small Island Developing States (SIDS) and top 10 in the Global Climate Risk Index, 2021) and gender.</p><p><strong>Results: </strong>We found that 72.1% of the committee members are from high-income countries (HICs), 57.0% are from G7 nations, 2.2% are from SIDS nations, 5.3% are from the top 10 most vulnerable climate vulnerable countries and 45.6% are female. Only three committees exhibit a balanced representation in terms of country income status. Nine committees have more than half of their members from G7 countries. 10 committees do not have representation from SIDS, and 7 lack members from the 10 most climate-vulnerable countries. Eight committees have good gender representation. Most chairs and co-chairs (only six committees reported them) are from HICs (83.3%), with good gender representation. Half of these chairs and co-chairs are from G7 nations, 16.7% are from SIDS and none are from the 10 most climate vulnerable nations.</p><p><strong>Conclusions: </strong>We call on committees to develop policies that are grounded in intersectionality to improve diversity among their members, including for Indigenous/Adivasi people (which we did not analyse) to improve global governance of climate and health.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018343","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":"Developing nursing and allied health professional leaders: the wider impact of a professional development initiative on leadership.","authors":"Gemma Phillips, Claire Armitage, Katherine Hawker, Kelly Barber, Deanne Rennie, Lizelle Bernhardt","doi":"10.1136/leader-2024-001111","DOIUrl":"https://doi.org/10.1136/leader-2024-001111","url":null,"abstract":"<p><strong>Background: </strong>Effective leadership is necessary across healthcare systems to ensure person-centred safe and effective care delivered by a workforce that is empowered to flourish. Similarly, research is essential to underpin evidence-based clinical practice to optimise the quality of care provided. It is important to develop the capacity and capability of the healthcare workforce to become effective clinical and research leaders; however, there are challenges. The creation of fellowship programmes such as the Director of Nursing and Allied Health Professions (AHPs) Fellowship was inspired by this need to support the skill development of these clinicians.</p><p><strong>Aims: </strong>To report the experiences of nurses, midwives and AHPs (NMAHPs) completing the Director of Nursing and AHP Fellowship programme; a 1-year development programme focussing on leadership, research and quality improvement. To describe the broader impact of the fellowship on NMAHP leadership. To consider the implications of the fellowship on the fellows and the wider organisation and healthcare system.</p><p><strong>Methods: </strong>The evaluation consisted of surveys and focus groups with fellows and mentors supporting them. These included clinical mentors, academic mentors, quality improvement advisors and improvement partners.</p><p><strong>Findings: </strong>The following four themes were identified from the survey and focus group data: leadership development, networking and relationships, collaborative working and communication.Fellows' development within the programme translated into multiple clinicians securing new job roles in clinical leadership positions, and key learning has been incorporated into future iterations of the programme.</p><p><strong>Conclusion: </strong>High-quality patient care relies on the support of research and implementation of evidence-based practice. Investment in the leadership of clinicians is key to promoting a culture of high-quality patient care and evidence-based practice. The Director of Nursing and AHP fellowship contributes to the development of nurses and AHPs implementing national priorities optimising patient care.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022469","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":"Huddles for unprofessional behaviours in the healthcare setting that may require immediate investigation, inquiry or intervention.","authors":"Cynthia A Baldwin, Thomas F Catron, Gerald B Hickson, Scott Aberson, Rebecca M Anderson, Sandy Bledsoe, Michael Brodman, Jeremy Cauwels, Roger Dmochowski, Thomas Hemmen, Brian Hoenerman, Rochelle Johnson, Sonam Kapoor, Daniel Lee, Dustin Lillie, Kristen Mekeel, Steven Meranze, Diane Moate, William Perry, Shira L Robbins, Thomas J Savides, Brijen J Shah, Kimberly Thillman, Craig Uthe, Christian Tomaszewski, Britney Wade, Lynn Webb, William O Cooper","doi":"10.1136/leader-2024-001134","DOIUrl":"https://doi.org/10.1136/leader-2024-001134","url":null,"abstract":"<p><strong>Background: </strong>Some unprofessional behaviours, including allegations of discrimination, hostile work environment, violent behaviour, sexual boundary violations, potentially impaired clinicians, professional integrity and retaliation, require healthcare organisations to have a timely and reliable process to guide investigation, inquiry and/or interventions. Failure to have a consistent approach creates extraordinary risk for organisations, their team members and their patients.</p><p><strong>Methods: </strong>Descriptive study of five health systems that participate in a national professionalism collaborative through the Vanderbilt Health Center for Patient and Professional Advocacy (CPPA) and implemented a huddle process to guide the initial disposition of event reports describing unprofessional behaviours that might warrant investigation, inquiry or intervention. Each site applied lessons learnt over the study period to refine the huddle participants, the process for the huddle and the tracking of information based on their experience.</p><p><strong>Results: </strong>During the study, the participating sites held 219 huddles, which represented <1% of reports processed by CPPA during the study period. The most common type of reports resulting in a huddle included allegations of discrimination (30% of huddles) or hostile work environment (29%). Other common reasons for huddles included violent or aggressive behaviour (15%) or potential sexual boundary violations (13%). Additional reasons for huddles included concerns for an impaired clinician (3%), integrity (2%) or retaliation against a reporter for a previous electronic safety event report (2%).</p><p><strong>Conclusions: </strong>Implementing a huddle to review and guide next steps for reports including allegations of serious behaviours provided the healthcare organisations a process to reduce the variability of response to such reports and fostered increased communication and trust among organisational key stakeholders.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019431","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":"Community, courage, culture and care: a qualitative study exploring the experiences of planetary health leadership in the UK health context.","authors":"Rammina Yassaie, Carrie Stephenson","doi":"10.1136/leader-2024-001171","DOIUrl":"https://doi.org/10.1136/leader-2024-001171","url":null,"abstract":"<p><strong>Background: </strong>Planetary health and the delivery of planetary healthcare are growing concerns for health and health institutions globally. While the leadership required to navigate this evolving arena is an area of increasing study, little research exists exploring the experience and perceptions of leaders in this field.</p><p><strong>Aim: </strong>This study aimed to explore the experiences and perceptions of leaders working towards planetary health in the UK health context, with a view to making recommendations on leadership and leadership development in this field.</p><p><strong>Methods: </strong>A qualitative study with 25 participants with experience of planetary health and/or planetary healthcare leadership. Virtual semistructured interviews were used for data collection and thematically analysed.</p><p><strong>Results: </strong>Six themes were identified: creating community; managing the scale of the challenge; morality; creating consensus; shaping culture and identity (as leader and/or as activist).</p><p><strong>Conclusions: </strong>This study highlights the relational, collaborative and moral aspects of leadership as central to the experience of planetary health leadership, offering recommendations for leadership educators to strengthen leadership development in this field. It also identified the critical need for the well-being needs of leaders navigating this emotive and uncharted territory to be appreciated and responded to, along with the importance of legitimising and professionalising action and leadership in this field.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031882","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":"Attention-based view of leadership.","authors":"Amit Nigam, Zuhur Balayah","doi":"10.1136/leader-2024-001156","DOIUrl":"https://doi.org/10.1136/leader-2024-001156","url":null,"abstract":"<p><strong>Background: </strong>Healthcare leaders' attention is stretched in healthcare organisations due to the large number of issues that they must respond to. Effectively attending to legitimate attentional demands, which involves deprioritising less important demands, is a defining feature of competent leadership.</p><p><strong>Method: </strong>This piece summarises key findings from research in the attention-based view, integrating its key findings with insights from conversations with healthcare leaders in executive education settings.</p><p><strong>Findings: </strong>The attention-based view develops three premises that explain how organisations structure and channel attention in ways that shape what organisations do: (1) given the scarcity of attention, where leaders focus their attention shapes what they do, (2) people's attention is situated (eg, in the work they do and the meetings they attend) and (3) organisations structure roles and communication channels in ways that shape who pays attention to what. Five lessons drawn from these premises are that leaders should: create an architecture that will address critical issues; be mindful of attentional networks; cultivate opportunities for voice; create attentional capacity and embrace creating attentional coherence as perhaps the core task of leadership.</p><p><strong>Conclusion: </strong>Given the diverse issues, people and demands that characterise contemporary healthcare organisations, effectively focusing attention on what matters is essential if organisations are to function well. A critical task for leaders is to prioritise for themselves and for everyone in their organisation the key issues that should be fundamental to, and hence merit attention from, everyone.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022852","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 of medical leadership in the age of artificial intelligence.","authors":"Vincent Q Sier","doi":"10.1136/leader-2024-001155","DOIUrl":"https://doi.org/10.1136/leader-2024-001155","url":null,"abstract":"<p><p>In the dynamic landscape of modern healthcare, the rise of artificial intelligence (AI) is revolutionising leadership roles by challenging established skill sets. Effective integration of AI relies heavily on adept balancing of rapid technological advances and ethical concerns, ensuring patient welfare and equitable access to care. In this context, strategies such as continuous learning, ethical prioritisation, leadership development and inclusive AI adoption are essential. By adopting a human-oriented approach, healthcare leaders can effectively harmonise technological progress and advance societal well-being.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019463","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 landscape and future directions: a cross-sectional study of diversity among dermatology leadership in Canada.","authors":"Grace Xiong, Ted Zhou, Reetesh Bose, Monica Li, Boluwaji Ogunyemi, Mohannad Abu-Hilal","doi":"10.1136/leader-2024-001130","DOIUrl":"https://doi.org/10.1136/leader-2024-001130","url":null,"abstract":"<p><strong>Background/objectives: </strong>Medical leadership and education which reflects the diversity of patient populations are crucial to equitable healthcare experiences and outcomes. This study aims to assess the current landscape of diversity in dermatology leadership and educational curricula in Canada. We also sought to collect and summarise recommendations made by current dermatology leaders about how to improve diversity in the field.</p><p><strong>Methods: </strong>This cross-sectional study assessed the self-reported racial/ethnic backgrounds and Fitzpatrick skin types of Canadian dermatology leaders. Individuals who held one or more leadership positions in the past 10 years were identified and sent an anonymous, online survey. Respondent's demographic information and perspectives on diversity in dermatology were analysed with proportions and thematic analysis, respectively.</p><p><strong>Results: </strong>The survey response rate was 50.0% (55/110). 65.5% (36/55) of respondents identified as White/Caucasian. More respondents identified as having Fitzpatrick skin types 1-2 (65.5%) compared with Fitzpatrick skin types 3-6 (34.5%). More respondents (68.9%) holding leadership positions in national, provincial or regional societies identified as White/Caucasian compared with leaders in academic or research roles (56.5%). Most respondents believed that Black, Indigenous and people of colour are not sufficiently represented in Canadian dermatology leadership and that skin of colour is not adequately represented in dermatology educational curricula.</p><p><strong>Conclusions: </strong>Our study suggests a potential underrepresentation of racial and ethnic minorities in Canadian dermatologists in national, provincial and regional society leadership positions. Most Canadian dermatologists previously or currently holding leadership roles believe that further efforts are necessary to improve equity, diversity and inclusion in the field.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047617","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":"Teaching health systems leadership and innovation to physicians.","authors":"Savithiri Ratnapalan, Abi Sriharan, Geoffrey Anderson, Isser Dubinsky, Benjamin Tb Chan, Tina Smith, Sara Allin, Devrim Sen, Christina Lopez, Zoe Downie-Ross, Ajantha Nadarajah, Audrey Laporte","doi":"10.1136/leader-2024-001098","DOIUrl":"https://doi.org/10.1136/leader-2024-001098","url":null,"abstract":"<p><strong>Background: </strong>A master's programme in Health Systems Leadership and Innovation was launched in 2016 to integrate health systems science and innovation management within the medical education continuum.</p><p><strong>Objectives: </strong>To identify faculty and staff perceptions of tailoring the programme to accommodate potential future learning needs as a continuous quality improvement initiative of the programme.</p><p><strong>Methods: </strong>A combination of two qualitative research methodologies was used: (1) a situational analysis to explain context and (2) a collaborative autoethnographic approach to understand the evolution of the programme and future directions. Faculty and staff involved with the programme were invited to participate after obtaining institutional research ethics approval. In conducting a collaborative autoethnography, all authors are participants who narrate, analyse and theorise about their individual and or collective experiences.</p><p><strong>Results: </strong>Nine faculty and three staff members narrated their perceptions of the programme. The situational analysis identified major internal and external actors, major processes and external actants relevant to the programme. It also outlined the multiple overlapping social arenas where the students, faculty and staff were situated through a social world map and differing positions of the authors with respect to the programme's future learners. The master narrative identified an urgent need for internal and external communications about the programme and to revisit course delivery methods. The authors were divided in their opinion as to whether the programme should continue to cater to undergraduate medical students or focus on physicians or have learners from multiple educational levels in the same class.</p><p><strong>Conclusions: </strong>The programme needs marketing, continuous course assessments and revisions to ensure visibility and relevance. The programme offers a flexible pathway for students at different stages in the career path from novice medical students to consultant physicians, and tensions related to the level of medical education hierarchy in the class are being managed by the faculty.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056698","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}