BMJ Leader最新文献

{"title":"Global nature of Planetary Health: leadership through diversity of stories.","authors":"Jelena Malogajski, Mubinat Olohunkemi Lawal, Teddie Potter, Jennifer Rasmussen, Hina Shan","doi":"10.1136/leader-2026-001567","DOIUrl":"https://doi.org/10.1136/leader-2026-001567","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this project is to invite people across communities and disciplines to consider both the systemic drivers of the Earth crisis and their own potential to lead and contribute to meaningful change, while exploring shared narratives that deepen understanding of global interdependence and nurture leadership grounded in equity, care and inclusion.</p><p><strong>Methods: </strong>Grounded in the Movement Building and Systems Change domain of the Planetary Health Education Framework, this qualitative, participatory storytelling initiative gathered diverse global narratives that illuminate lived experiences of environmental change and action.</p><p><strong>Insights: </strong>Shared stories foster empathy, collective identity and hope, demonstrating how leadership often begins with personal awakening and expands towards a sense of shared responsibility. Indigenous, local, community-based and academic examples illustrate leadership expressed through everyday stewardship, community initiatives and institutional change, challenging narrow or hierarchical definitions of success.</p><p><strong>Conclusions: </strong>These narratives show that effective Planetary Health leadership is context-dependent, often incremental and strengthened by recognising diverse pathways to action rooted in equity, inclusion and care.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798947","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":"How clinical expertise drives job satisfaction in Danish hospitals.","authors":"Agnes Bäker, Amanda H Goodall, Christian Bøtcher Jacobsen, Lars Dahl Pedersen, Mickael Bech","doi":"10.1136/leader-2025-001405","DOIUrl":"https://doi.org/10.1136/leader-2025-001405","url":null,"abstract":"<p><strong>Purpose: </strong>Hospital physician job satisfaction is critically low, leading to turnover and compromising patient care. This study examines how clinical directors' clinical expertise influences subordinate physicians' job satisfaction and intention to stay, exploring the mechanisms through which expert clinicians become effective managers.</p><p><strong>Methods: </strong>We analysed multisource survey data from 184 clinical directors and 803 subordinate physicians in Danish public hospitals. Clinical expertise was measured through experience, education and peer recognition. We examined how expertise relates to human resource management (HRM) practices, perceived expertise and leader identity, and their effects on subordinates' job satisfaction and retention intentions.</p><p><strong>Results: </strong>Directors with higher clinical expertise implement better HRM practices, which significantly mediate the relationship between expertise and subordinate job satisfaction (β=0.03, p<0.05) and intention to stay (β=0.03, p<0.05). Clinical expertise correlates positively with leader identity (β=0.18, p<0.05), contradicting expectations that expert clinicians make reluctant managers. Perceived expertise showed weaker relationships than actual expertise.</p><p><strong>Practical implications: </strong>The findings challenge assumptions that outstanding clinicians resist leadership roles, suggesting that clinical excellence and leader identity can coexist and are both important. Organisations should focus on developing HRM capabilities alongside leadership identity among expert clinicians to maximise subordinate satisfaction and retention.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798973","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":"Reconceptualising hospital performance management as a socio-organisational system: a scoping review.","authors":"Olga Schibli, Norbert Seyff, Doris Brandenberger, Thomas Ehrlich, Yiannis Kyratsis","doi":"10.1136/leader-2026-001576","DOIUrl":"https://doi.org/10.1136/leader-2026-001576","url":null,"abstract":"<p><strong>Background: </strong>Hospital performance management is frequently framed as a technical challenge centred on indicators, dashboards and analytics. Despite growing measurement infrastructures, many hospitals struggle to translate performance data into strategic leadership, effective governance and value-based improvement, suggesting that hospital performance management is a socio-organisational process shaped by leadership practices, institutional contexts and organisational dynamics. No review has systematically mapped how these socio-organisational dimensions are conceptualised across the hospital performance management literature.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews guidance, we conducted a scoping review across PubMed, Web of Science, Scopus and CINAHL. From 2612 records identified, 1749 unique titles and abstracts were screened. Of these, 50 met inclusion criteria; a purposive subsample of 40 studies presenting system-level or integrative frameworks underwent in-depth conceptual analysis. Findings were inductively organised into four thematic domains: tools & data; people & change; policy & governance and value-based healthcare.</p><p><strong>Results: </strong>Hospital performance management emerges as a multidimensional, context-dependent and socially embedded phenomenon. In the included literature, performance measurement and performance management were frequently conflated, with implicit assumptions that indicator availability would translate into improvement. Technical solutions-including balanced scorecards, dashboards and analytics platforms-produced meaningful improvements only when embedded within supportive governance arrangements, engaged leadership and learning-oriented cultures. The balanced scorecard, while widely adopted, was selectively enacted according to dominant value orientations-functioning variably as a control, efficiency, learning or innovation tool depending on organisational context. Misalignment across technical tools, workforce dynamics, governance structures and value-based ambitions contributed to symbolic compliance and fragmented initiatives. A performance management architecture map and competing values framework interpretation are proposed to explain cross-study variation.</p><p><strong>Conclusions: </strong>Hospital performance management failures stem less from inadequate indicators than from misalignment across measurement, governance, workforce and value-creation domains. Leaders should focus on aligning socio-organisational architectures, making value trade-offs explicit and using performance information to support organisational sense-making, coordination and learning rather than treating performance management as a compliance exercise.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799007","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":"Leadership for climate-resilient healthcare: insights from an ATACH technical meeting.","authors":"Bhavini Gohel, Thomas Dakin, Sonia Roschnik, Andrew N Garman","doi":"10.1136/leader-2026-001578","DOIUrl":"https://doi.org/10.1136/leader-2026-001578","url":null,"abstract":"<p><strong>Introduction: </strong>Climate change is increasingly recognised as both a public health emergency and a systemic stressor on healthcare systems. While many healthcare organisations have articulated ambitious climate and sustainability commitments, progress is frequently constrained by gaps in leadership capacity, governance and decision-making frameworks. Understanding what forms of leadership are required to move healthcare systems from climate ambition to operational readiness is a critical priority.</p><p><strong>Approach: </strong>This article draws on insights from two global technical meetings convened by the WHO's Alliance for Transformative Action on Climate Change and Health (ATACH), codesigned and cochaired by the Canadian Coalition for Green Healthcare and the International Hospital Federation's Geneva Sustainability Centre. The meetings brought together healthcare leaders from multiple levels within diverse resource settings. Leadership competencies were used as a guiding scaffold for the discussion.</p><p><strong>Reflections: </strong>Participants highlighted that climate-resilient healthcare requires system-oriented, value-informed and relational leadership exercised across frontline, organisational and community levels. Effective leadership was characterised by the ability to embed sustainability into routine decision-making, align climate action with quality, safety, equity and stewardship and create enabling structures beyond individual champions. These insights underscore that investing in leadership capacity is essential for delivering equitable, sustained and system-wide climate action in healthcare.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760747","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":"Visible, vulnerable and vital: leadership lessons from building belonging in healthcare.","authors":"Abby Sirisegaram-Cole","doi":"10.1136/leader-2025-001322","DOIUrl":"https://doi.org/10.1136/leader-2025-001322","url":null,"abstract":"<p><strong>Background: </strong>Newcomers to healthcare organisations often experience unspoken barriers to belonging, including cultural dissonance, microaggressions and systemic exclusion. As a visible minority and female leader, I frequently became a point of cultural reassurance for new staff seeking both guidance and recognition.</p><p><strong>Reflection: </strong>One interaction in particular, a question about where to find biryani spices locally, illustrated that newcomer staff were often seeking more than orientation to organisational processes. Many were also searching for connection, cultural familiarity and a sense of belonging within both the workplace and the broader community. This moment inspired the development of an open forum for internationally trained and newcomer staff to share experiences of exclusion, cultural adjustment and emotional labour.</p><p><strong>Insight: </strong>This experience reinforced the importance of leadership grounded in empathy, authenticity and community-building. It also highlighted how representation can help create environments where staff feel comfortable sharing their experiences. Attention to team readiness, intentional facilitation and the use of facilitators without direct supervisory authority appeared to encourage participation and open discussion.</p><p><strong>Implications: </strong>Belonging cannot be mandated by policy alone; it emerges through relationship-based practices. Leaders must assess when teams are ready for equity-focused conversations, create accessible spaces for lived experience and resource psychological safety. As a result of this session, an employee resource group was launched, and broader discussions about equity have gained momentum.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707596","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":"Physician oath, followership and leadership.","authors":"Vishal Shelat","doi":"10.1136/leader-2026-001644","DOIUrl":"https://doi.org/10.1136/leader-2026-001644","url":null,"abstract":"<p><p>Physician oaths are often treated as ceremonial relics or ethical ornaments of graduation. I have come to think they are something more demanding: early leadership texts. They declare what a profession publicly promises to protect. Yet modern healthcare is delivered not only through individual virtue but also through teams and systems with increasing reliance on checklists and technology. This raises a leadership question: what do physician oaths still teach us, and what do contemporary leaders need to add? This essay offers a reflective comparative reading of major oath and pledge traditions, together with later professionalism and governance literature. The aim is not to produce a systematic history of every oath variant but to read the tradition through a leadership-and-followership lens. The oath tradition has moved from sacred craft morality to public professionalism and then towards system and technology governance. Modern texts have become stronger on dignity, autonomy, equality and accountability. However, unnecessary blood or imaging tests, sleep disruption while in hospital, convenience-based restraint, fractured handovers within teams, documentation burden and electronic record bloat, defensive medicine and opaque use of artificial intelligence are endemic issues that require administrative, educational and clinical leadership attention. Newly graduated doctors usually enter practice first as followers, not formal leaders. Oath-taking should therefore be read not only as a promise of private virtue but also as an initiation into ethical followership, culture-building and responsible systems participation. A modern leadership reading of the oath should connect bedside morality with stewardship, trust, empathy, teamwork and accountable human oversight of technology.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686213","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":"Unlocking the potential of genomics: a co-designed toolkit for hospital implementation and governance.","authors":"Belinda Dawson-McClaren, Cate Kelly, Trang Thu Do, Katie Arkell, Clara Gaff","doi":"10.1136/leader-2026-001534","DOIUrl":"https://doi.org/10.1136/leader-2026-001534","url":null,"abstract":"<p><strong>Background: </strong>Genomics is increasingly part of routine clinical care. However, hospital leaders face a range of organisational challenges in implementing safe, effective genomic care including: insufficient resources, rapidly evolving practices, gaps in genomic literacy, data infrastructure demands and limited governance frameworks. Good clinical governance can overcome these barriers by aligning leadership, resources, workforce development, monitoring and accountability to enable structured, reliable adoption.</p><p><strong>Objective: </strong>To describe our iterative co-design processes and final outputs in developing a resource for hospital executives. This toolkit resource applies clinical governance principles to support organisation-wide implementation and oversight of evidence-based genomic care in hospitals.</p><p><strong>Methods and analysis: </strong>A co-design implementation science-informed approach was adopted, following the updated Medical Research Council guidance for complex interventions. This involved 85 individuals from 14 healthcare organisations across Victoria (Australia) participating in a concept testing workshop, usability testing and content advisory groups.</p><p><strong>Results: </strong>A maturity self-assessment tool was initially designed. Interested organisations could map their current state of maturity in the identified domains. The tool was assessed for feasibility, usability and potential value to stakeholders and revised through three major co-design steps. The evaluation of feedback and learnings led to the decision to transition the self-assessment prototype to the <i>Genomics and Your Hospital Toolkit</i> (the 'toolkit'). This comprised seven key action domains and a suite of resources designed for any hospital undertaking genomic care, irrespective of their maturity. The key action areas are as follows, with supporting resources developed for each: (1) form a genomics leadership group; (2) define models of care; (3) understand and mitigate risks; (4) check workforce skills and support; (5) support and monitor quality and value; (6) review new genomic practice and (7) involve consumers in genomic medicine services.</p><p><strong>Conclusion: </strong>The toolkit is designed to lower the barriers to hospital executives embedding high-quality genomic care across their organisation. Although developed specifically for genomics, the toolkit addresses common challenges in the implementation and oversight of care that includes large-scale emerging technologies intended to make individual care more precise.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632231","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 social justice in healthcare publishing: a call to action.","authors":"Nagina Khan, Sian Reece, Janice St John-Matthews, Ming-Ka Chan","doi":"10.1136/leader-2026-001540","DOIUrl":"https://doi.org/10.1136/leader-2026-001540","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621656","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":"Exploring the lived experience of allied health professionals (AHPs) with disability, difference, long-term conditions and neurodivergence (DDLTCN): insights for inclusive leadership.","authors":"Alice Fiona Gair, Ripal Patel","doi":"10.1136/leader-2025-001517","DOIUrl":"https://doi.org/10.1136/leader-2025-001517","url":null,"abstract":"<p><strong>Aim: </strong>To examine the lived experiences of allied health professionals (AHPs) with disability, difference, long-term conditions and neurodivergence (DDLTCN), identify barriers and enablers in their career journeys and generate insights to inform leadership and workforce strategy.</p><p><strong>Method: </strong>A pragmatic mixed-methods approach was employed across a single Integrated Care System (ICS) in the National Health Service (NHS), combining quantitative survey data (n=132) and qualitative focus group data (n=24). The survey included 22 multiple-choice questions and optional free-text responses. Focus groups were segmented by career stage and supplemented with written submissions.</p><p><strong>Key findings: </strong>Ableism, stigma and inconsistent understanding of DDLTCN were identified as key barriers to disclosure and progression. Where allyship and compassionate leadership were present, participants reported improved psychological safety, well-being and productivity.</p><p><strong>Implications: </strong>Inclusive leadership must embed equity into workforce structures and culture. System-level change is needed to normalise disclosure, foster belonging and ensure visible representation of AHPs with DDLTCN in leadership roles. The findings offer transferable lessons for healthcare systems seeking to build an inclusive, resilient workforce.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585298","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":"Towards equity in healthcare workforce well-being: a framework for leaders to improve well-being and retention.","authors":"Shannon Satterwhite, Brianna Lombardi, Warren McKinney, Timothy J Usset, Mark Linzer, Emily C O'Brien","doi":"10.1136/leader-2025-001404","DOIUrl":"10.1136/leader-2025-001404","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550885","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}