BMJ Leader最新文献

{"title":"Well-being initiatives for hospital employees provided by the Dutch University Medical Centres: an exploratory study.","authors":"Amber Boskma, Leontien Sturms, Arie Franx, Maarten van der Laan","doi":"10.1136/leader-2023-000891","DOIUrl":"https://doi.org/10.1136/leader-2023-000891","url":null,"abstract":"<p><strong>Background: </strong>Healthcare professionals (HCPs) face a range of sources of stress and dissatisfaction. Decreased well-being among HCPs is one of the causes of the caregivers' shortage and relates to poor patient outcomes. To improve well-being in the workplace, a variety of initiatives are offered. This inventory aims to give an overview of well-being initiatives provided by the university medical centres (UMCs) in the Netherlands.</p><p><strong>Methods: </strong>We conducted semi-structured video call interviews with all UMCs in 2021, employing a purposive sampling approach. An interview guide was used to ensure similar types of data from all informants were collected.</p><p><strong>Results: </strong>31 interviews were conducted among nurses, doctors, human resource personnel and occupational health department members. 203 initiatives were reported by the seven UMCs to improve or sustain employees' well-being. Initiatives concerned coaching, training, programmes, studies, apps and tools. The initiatives aim to improve physical fitness, mental fitness, personal development and balance, team collaboration, equip managers and function/context. Most of the initiatives are aimed at individual employees, and only a few focus on teams, organisations or the healthcare system. We also found that it is not evaluated if initiatives are effective to improve employees' well-being. Furthermore, HCPs' needs do not seem to be routinely evaluated upfront in the design of initiatives.</p><p><strong>Conclusion: </strong>The urgency of supporting the well-being of HCPs is recognised, given the extensive amount of provided initiatives. However, this collection of initiatives must be critically reviewed in order to have a balanced offer that is effective and fits the wishes of HCPs. These results should be taken into consideration when creating, implementing and coordinating well-being initiatives for employees in the healthcare field.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733658","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":"Hate rota gaps: I'm loving (Guardian) Angels instead - a successful standby initiative to prevent staffing gaps.","authors":"Nathanael Macdonald, Corina Palmaeda, Matthew Solan","doi":"10.1136/leader-2024-001138","DOIUrl":"https://doi.org/10.1136/leader-2024-001138","url":null,"abstract":"<p><strong>Background: </strong>Last-minute gaps in the rota are demoralising for those still at work and reduce the standard of patient care. Agency staff are the most common solution, but at peak times, it is often impossible to find a locum at the last minute. We present a novel solution that improves conditions for doctors, patients and rota coordinators.</p><p><strong>Methods: </strong>We implemented a standby system to prevent unfilled late notice gaps over 3 weekends. This was compared with previous weekends where cover was required. Additionally, we surveyed the junior doctors involved in the scheme.</p><p><strong>Results: </strong>In 2022-2023, 19 had late gaps. Only five of these were successfully covered.The following year, doctors volunteered to be Guardian's Angels for 29 standby shifts. Of the 25 filled standby slots, 4 (16%) were converted to full shifts.24 junior doctors responded to an online survey, 95% felt the scheme is beneficial.</p><p><strong>Conclusions: </strong>Staffing gaps result in poor morale, stressed staff which may lead to poor outcomes for patients. Doctors taking part in this scheme feel more valued and supported. Disadvantages of the scheme are the modest cost to the hospital (this may be offset by avoiding locum agencies with higher fees).</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691870","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":"Case for managerial academic careers.","authors":"Jenny Shand, Catherine French","doi":"10.1136/leader-2024-001191","DOIUrl":"https://doi.org/10.1136/leader-2024-001191","url":null,"abstract":"<p><p>This article highlights the need for a shift in how we view research and academic careers within healthcare management. By creating formal academic pathways for managers, we can better align operational and system-level improvements with evidence-based research, ultimately leading to better patient outcomes and a more resilient healthcare system.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643724","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":"Planetary health leadership to drive climate action across pharmaceutical supply chains: insights from qualitative research and a call to action.","authors":"Amy Booth, Liz Breen, Sietse Wieringa, Sara Elizabeth Shaw","doi":"10.1136/leader-2025-001253","DOIUrl":"https://doi.org/10.1136/leader-2025-001253","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmaceutical manufacture, delivery and use produces an estimated 10%-55% of national healthcare greenhouse gas emissions. Addressing pharmaceutical supply chain emissions is essential to mitigating healthcare's climate impact. Our research aimed to explore the constraints to pharmaceutical supply chain climate action and how planetary health leadership can overcome these challenges.</p><p><strong>Methods: </strong>We conducted 21 narrative interviews with representatives from pharmaceutical companies and industry and health system stakeholders. Interviews explored perspectives on climate action across pharmaceutical supply chains. Analysis was informed by argumentative discourse analysis, enabling the identification of key storylines.</p><p><strong>Results: </strong>Climate action across pharmaceutical supply chains is sporadic and insufficient to achieve health system climate goals. Critical constraints to climate action include (a) structural constraints, particularly complex, fragmented, global supply chains as well as limited renewable energy infrastructure in some countries where supply chains operate and (b) conceptual constraints, the 'patient-profit-planet dilemma', where climate action is perceived to conflict with patient well-being and financial considerations.Planetary health leadership can help overcome these constraints in three key ways. First, planetary health leadership can help reconceptualise healthcare delivery, and the role of pharmaceuticals, to align patient and planetary well-being while meeting financial pressures. Second, planetary health leadership can mobilise collective climate action across pharmaceutical supply chains, reframing climate change as a shared problem and challenging issues of transparency, competition and blame. Third, planetary health leadership can challenge wider systems that constrain climate action, leveraging the economic and political power of pharmaceutical supply chains to drive global decarbonisation efforts.</p><p><strong>Conclusion: </strong>Planetary health leadership must confront considerable constraints to embed planetary health considerations across pharmaceutical supply chains. Leaders in this space must be willing to go against the status quo and challenge entrenched norms and systems to enable wider spread and support for sustainable healthcare delivery.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609859","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":"Novel approach to improving teamwork in healthcare.","authors":"Christopher A Collura, Jane E Brumbaugh, Megan M Misgen, Raymond C Stetson, Stephanie C Mavis, Tami K Omdahl, Claire E Reeve, Christopher E Colby","doi":"10.1136/leader-2024-001159","DOIUrl":"https://doi.org/10.1136/leader-2024-001159","url":null,"abstract":"<p><strong>Background: </strong>Excellence in healthcare delivery is dependent on individuals working together on a team.</p><p><strong>Objective: </strong>We sought to enhance team performance by partnering with human resources (HR) to identify opportunities unrecognised by unit leadership.</p><p><strong>Methods: </strong>100 individuals representing a cross-section of the multidisciplinary team participated in an interview focused on teamwork conducted by an HR representative. Action plans were then developed and implemented. Press Ganey Survey results for the question, \"Staff worked together to care for you/your baby?\" were tracked to assess patient perception of teamwork.</p><p><strong>Results: </strong>Between 2022 and 2024, we observed improvement in the per cent of patients who assigned the highest rating of teamwork, culminating in 100% of patients reporting the highest score in the final quarter.</p><p><strong>Conclusion: </strong>The model of HR facilitated discussions with work unit team members identified barriers to optimal teamwork, led to the implementation of action plans and resulted in an improvement in our teamwork rating by patients.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609858","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":"American healthcare workforce is not indestructible: treating it as such is a mistake.","authors":"Daniel Marchalik, Tait Shanafelt","doi":"10.1136/leader-2025-001316","DOIUrl":"https://doi.org/10.1136/leader-2025-001316","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585072","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":"Beyond the numbers: redefining quality in the boardroom.","authors":"Ashifa Trivedi, Benjamin Moxley-Wyles, Christine Blanshard, Jim Gardner, Venu Harilal, Nikki Stevenson, Kate Wood","doi":"10.1136/leader-2024-001099","DOIUrl":"https://doi.org/10.1136/leader-2024-001099","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561414","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":"Contemporary diversity trends among matched ophthalmology residents in the USA.","authors":"Camryn Thompson, Pratap Challa, Sandra S Stinnett, Sharon Fekrat","doi":"10.1136/leader-2024-001204","DOIUrl":"https://doi.org/10.1136/leader-2024-001204","url":null,"abstract":"<p><strong>Background: </strong>Ophthalmology remains one of the least diverse medical specialties, despite ongoing efforts to promote inclusion. To address the gap in recent literature and understand the demographic trajectory of this specialty, this study analyses current demographic trends among ophthalmology residents in the USA.</p><p><strong>Methods: </strong>US ophthalmology residents enrolled with the Accreditation Council for Graduate Medical Education between 2008 and 2022 were included. Racial trends were analysed over the period of 2012-2022, and sex trends were analysed across 2008-2022, according to data availability.</p><p><strong>Results: </strong>Over the study period, the percentage of female ophthalmology residents remained stable from 41% in 2008 to 41.8% in 2022 (compared with 54.6% of US medical students). The least represented racial group from 2012 to 2022 was American Indian/Alaskan Native (ranging 0%-0.35%) followed by black/African American (ranging 1.42%-3.01%) and Hispanic/Latin/Spanish origin (ranging 2.05%-7.50%). The year with the greatest proportion of under-represented in medicine (URiM) ophthalmology residents was 2021-2022, with 10.5% URiM residents (0% American Indian/Alaskan Native, 3.01% black/African American, 7.50% Hispanic/Latin/Spanish). The summed proportions of URiM ophthalmology residents were significantly less before 202 (5.4%) compared with after (10%) (p<0.001).</p><p><strong>Conclusions: </strong>Overall, female and URiM residents are under-represented in ophthalmology. The proportion of female residents remained constant between 2008 and 2022, highlighting a need for additional recruitment efforts. The proportion of URiM residents increased over the same period, highlighting a time period of interest for future research on recruitment strategies.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555240","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":"Importance of modern bedside manners.","authors":"Rakesh Patel, Elizabeth Wyse","doi":"10.1136/leader-2024-001113","DOIUrl":"https://doi.org/10.1136/leader-2024-001113","url":null,"abstract":"<p><p>A doctor's ability to demonstrate compassion and empathy-the essence of bedside manners-remains as crucial today as ever. Yet modern medical training does not prepare doctors to meet the social and emotional demands of a rapidly changing clinical environment. Prompted by Debrett's reframing of 'modern manners', the authors explore how social protocols for manners apply in the healthcare setting. They identify three key areas where better etiquette could make a tangible difference for patients and carers: digital communication, day-to-day interactions on wards, authentically apologising. They note that graduating healthcare professionals often lack structured guidance on sustaining face-to-face empathy in an increasingly digital world. Similarly, small acts of politeness and genuine acknowledgement of a patient's reality during day-to-day interaction (such as timely updates or warm personal greetings) can significantly defuse anxiety. They also point out that a well-placed, heartfelt apology can restore trust when things go wrong, a skill rarely discussed in formal training. The authors argue that embedding these simple, modern manners into everyday practice is not just an optional extra; it is a vital professional competency. By explicitly teaching and modelling interpersonal skills alongside clinical or technical training, they suggest medical educators can better equip the next generation to address patients' emotional needs and enhance the overall care experience.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545201","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":"Mixed-methods evaluation of targeted leadership development training to support the career progression of the black and minority ethnic NHS workforce.","authors":"Holly Blake, Keir Scarlett, Sala Kamkosi Khulumula, Niki Chouliara","doi":"10.1136/leader-2024-001175","DOIUrl":"https://doi.org/10.1136/leader-2024-001175","url":null,"abstract":"<p><strong>Introduction: </strong>Black and minority ethnic (BME) workers within the National Health Service (NHS) experience barriers to attainment of senior leadership roles. The NHS Leadership Academy delivered two Leadership Programmes addressing barriers to progression among the BME workforce, the Stepping Up (middle managers) and Ready Now (senior leaders) programmes.</p><p><strong>Methods: </strong>Mixed-methods evaluation involving an online survey (n=39; 20m/19f, identifying with 10 ethnic groups) and qualitative interviews (n=8; 5m/3f) with programme participants investigating barriers and the extent to which targeted leadership programmes impacted their career progression. Analysis included descriptive statistics and thematic analysis of qualitative data.</p><p><strong>Results: </strong>Participants reported institutional barriers to career progression and experiences of structural racism. Evaluation of targeted leadership programmes was consistently positive, providing a 'safe space' for shared experiences, while building self-confidence and motivation to apply for career development opportunities or positions. Most participants secured meaningful career development following programme completion.</p><p><strong>Conclusions: </strong>Targeted career development programmes are highly valued by BME healthcare workers and are perceived to contribute to addressing workforce inequalities in career progression relating to ethnic disparity in the attainment of senior NHS leadership roles. However, the broader impact of such programmes remains limited without addressing wider institutional barriers to progression and tackling racialised workplace inequities.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545202","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}