BMJ Leader最新文献

{"title":"Evolving role of the health system CIO: perspectives from 33 health systems.","authors":"Dae Hyun Kim, Christy Lemak, Douglas Jones, Dalton Pena","doi":"10.1136/leader-2023-000969","DOIUrl":"https://doi.org/10.1136/leader-2023-000969","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores the evolving position of the health system chief information officer (CIO) by identifying new core roles for success.</p><p><strong>Methods: </strong>An advisory board of industry executives and system leaders guided the study. Purposeful sampling was used to invite chief executive officer and CIOs from 65 not-for-profit US health systems to participate. Interviews were conducted with 51 executives from 33 different systems, using a comprehensive interview topic guide. Interview transcripts were analysed using NVivo software, focusing on themes related to the evolving role of the health system CIO.</p><p><strong>Results: </strong>Analyses revealed three main themes, with the CIO as (1) enabler of strategic change and transformation, (2) strategic developer of technology and leadership talent and (3) driver of organisational culture.</p><p><strong>Discussion: </strong>The role of CIO has undergone transformation from technology and information system management to strategic leadership within the broader health system context. It highlights the importance of comprehensive business knowledge for CIOs and the need for other C-suite executives to have a deeper understanding of information and technology.</p><p><strong>Conclusion: </strong>As healthcare continues to evolve, the role of the CIO is expected to expand further, requiring a blend of technical and strategic business skills. This evolution presents opportunities for health systems to enhance their leadership development programmes, preparing leaders for the complexities of the contemporary health system sector.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876247","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":"Without medical education, a learning healthcare system cannot learn.","authors":"Michael A Barone, Carol Carraccio, Alison Lentz, Robert Englander","doi":"10.1136/leader-2023-000746","DOIUrl":"https://doi.org/10.1136/leader-2023-000746","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724575","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":"Digital innovative healthcare during a pandemic and beyond: a showcase of the large-scale and integrated Saudi smart national health command centre.","authors":"Muaddi F Alharbi, Mohammmed Senitan, Dalia Mominkhan, Sidney Smith, Maram ALOtaibi, Michal Siwek, Tim Ohanlon, Fahad Alqablan, Sarah Alqahtani, Mohammed K Alabdulaali","doi":"10.1136/leader-2023-000890","DOIUrl":"https://doi.org/10.1136/leader-2023-000890","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing frequency of pandemics, demand for healthcare and costs of healthcare services require efficient health systems with integrated care via a command centre that ensures a centralised and coordinated approach to exercise effective leadership.</p><p><strong>Description: </strong>We present a case study using the conceptual framework of Franklin to describe the novel system-based engineering approach of the Saudi National Health Command Centre (NHCC) including its features and outcomes measured.</p><p><strong>Discussion: </strong>The NHCC is structured into four departments and four zones with real-time data integration and visualisation on 88 dashboards. To empower leadership, it harnesses artificial intelligence affordances such as machine learning algorithms to enhance functionality, decision-making processes and overall performance. This allows for the rapid assessment of available resources and to monitor healthcare system efficiency at diverse levels of clinical and system indicators. Enhanced proactive capacity management has contributed to reducing lengths of stay, average supply chain lead time and surgery waiting list; early bending of the COVID-19 curve resulting in a low mortality rate; increasing bed capacity; deploying medical staff and mechanical ventilators rapidly; rolling out the COVID-19 vaccination programme and improving patient satisfaction.</p><p><strong>Conclusion: </strong>Integrating a healthcare system with a command centre provides healthcare leaders with the necessary infrastructure to create synergy between people, processes and technologies. This substantially improves both patient and service outcomes. It also allows for immediate care coordination and resource allocations and safeguards ease of access to care.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724574","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":"Evaluation of the first 5 years of the Next Generation GP leadership programme: balancing autonomy and accountability.","authors":"Steve Gulati, Judith A Smith","doi":"10.1136/leader-2024-000985","DOIUrl":"https://doi.org/10.1136/leader-2024-000985","url":null,"abstract":"<p><strong>Background: </strong>In 2017, a group of trainee general practitioners (GPs) came together to design and deliver a six-session leadership development programme for their peer trainee and early career GPs: the Next Generation GP programme. Over 2500 GPs took part in Next Generation GP between 2017 and 2022.</p><p><strong>Aim: </strong>To evaluate the origins and development of the Next Generation GP programme, its early impact on individuals and general practice, and what it reveals about GPs' needs for career and leadership development at a time of major workforce and demand pressures.</p><p><strong>Methods: </strong>A rapid review of evidence on general practice workforce and career trends informed the design of qualitative research interviews (n=28) with a purposive sample of programme participants, primary care leaders and educational experts. This was supplemented by analysis of secondary data from participant evaluations of programme workshops.</p><p><strong>Results: </strong>Many programme participants reported: improved competence in leadership skills, increased understanding of the health system, having new support networks and more energy for their GP role. Respondents pointed out the strengths of the programme, also highlighting ways in which it could be adapted to enable a transition to a more sustainable position within broader clinical and leadership career development.</p><p><strong>Conclusions: </strong>Next Generation GP has to date largely fulfilled its programme objectives. It now needs more tangible, longer-term objectives against which to assess outcomes. This evaluation has contributed to evidence about primary care leadership needing more policy attention, for the balance of autonomy and accountability within GP leadership needs careful and sustained support.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617303","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":"Building towards organisational resilience and complexity leadership: a case study of impacts and changes in a Dutch blood establishment during COVID-19","authors":"Praiseldy K Langi Sasongko, Mart Janssen, Martine de Bruijne","doi":"10.1136/leader-2024-001008","DOIUrl":"https://doi.org/10.1136/leader-2024-001008","url":null,"abstract":"Objectives This study examined how one large blood-related establishment coped and adapted during the first 1.5 years of the pandemic by evaluating the impacts and changes on its resources, communication, collaborations, and monitoring and feedback. Furthermore, we explored whether elements of complexity leadership emerged during this time. Design Duchek’s organisational resilience framework was primarily used. We followed a three-step sequential approach: (1) a document analysis of over 150 intranet, internet and internal reports; (2) 31 semistructured interviews with employees and (3) four feedback sessions. Setting Sanquin is known as the Dutch national blood bank and a large multidivisional expertise organisation in the Netherlands. Results Sanquin coped well. Respondents accepted the crisis and catalysed many collaborations to implement solutions, which were communicated to the public. There were many positive aspects related to internal collaborations, yet challenges remained related to its historical siloed structure and culture. Sanquin adapted partially. Many respondents experienced the organisation becoming more connected and flexible during the pandemic. However, Sanquin was not permanently changed due to significant leadership changes and organisational restructuring occurring simultaneously. Respondents reflected on lessons learnt, including the need for continual collaboration and improvements in Sanquin’s culture. An important driver in the successful coping was management’s enabling attitude and the adaptations occurring within and through the collaborative groups. Conclusions Sanquin improved its organisational resilience by exhibiting elements of adaptive spaces, enabling leadership and (temporary) emergence from complexity leadership. This illuminates how the organisation could continue benefiting from complexity leadership for non-crises and for future uncertainties. No data are available. The qualitative data are not publicly available due to the identifying nature of the transcripts and lack of consent from participants to publicly share this data.","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141588659","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":"Cultivating the next generation of healthcare leaders: reflections from an established healthcare leader.","authors":"Rakhshan Kamran, Andrea S Doria","doi":"10.1136/leader-2024-001037","DOIUrl":"https://doi.org/10.1136/leader-2024-001037","url":null,"abstract":"<p><strong>Background: </strong>Dr Andrea Doria is Professor and Vice-Chair of Radiology (Clinical Practice Improvement) at the University of Toronto, Research Director, Senior Scientist and Imaging Lead of Personalised Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada. Over the past few decades, Dr Doria has established a track record of healthcare leadership. Based on Dr Doria's extensive leadership experience, she believes it is essential for established healthcare leaders to be involved in cultivating emerging healthcare leaders.</p><p><strong>Methods: </strong>An interview was conducted with Dr Doria to learn about key lessons she believes are essential for healthcare leaders to help develop the next generation. Dr Doria reflected on her leadership style and experiences, sharing what has worked to improve the effectiveness of her teams.</p><p><strong>Results: </strong>Key messages were reflected upon, including practical ways for senior leaders to support the next generation; leadership insights gained from the pandemic; the importance of building diversity in teams and nurturing leaders from underrepresented minorities; challenges to be aware of for the future of healthcare leadership; finding inspiration from team members and essential traits for healthcare leaders.</p><p><strong>Conclusion: </strong>Through cultivating the next generation of healthcare leaders, established leaders can be involved in establishing a brighter future for healthcare. This article describes reflections and practical takeaways that can help established leaders support emerging leaders and build their leadership skills.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591635","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 development programmes in healthcare research: a systematic review, meta-analysis and meta-aggregation","authors":"Harry Kingsley-Smith, Christian E Farrier, Daniel Foran, Koot Kotze, Kamal Mahtani, Sarah Short, Anna Mae Scott, Oscar Lyons","doi":"10.1136/leader-2024-000976","DOIUrl":"https://doi.org/10.1136/leader-2024-000976","url":null,"abstract":"Background Academic institutions benefit from researchers adopting leadership positions and, subsequently, leadership development programmes are of increasing importance. Despite this, no evaluation of the evidence basis for leadership development programmes for healthcare researchers has been conducted. In this study, the authors reviewed leadership development programmes for healthcare researchers and aimed to identify their impact and the factors which influenced this impact. Methods The authors searched MEDLINE, EMBASE, CINAHL and PsycINFO between January 2000 and January 2023 for evaluations of leadership development programmes with healthcare researchers. The authors synthesised results through exploratory meta-analysis and meta-aggregation and used the Medical Education Research Study Quality Instrument (MERSQI) and Joanna Briggs Institute (JBI) Checklist for Qualitative Studies to identify higher-reliability studies. Results 48 studies met inclusion criteria, of which approximately half (22) met the criteria for higher reliability. The median critical appraisal score was 10.5/18 for the MERSQI and 3.5/10 for the JBI. Common causes of low study quality appraisal related to study design, data analysis and reporting. Evaluations principally consisted of questionnaires measuring self-assessed outcomes. Interventions were primarily focused on junior academics. Overall, 163/168 categorised programme outcomes were positive. Coaching, experiential learning/project work and mentoring were associated with increased organisational outcomes. Conclusion Educational methods appeared to be more important for organisational outcomes than specific educational content. To facilitate organisational outcomes, educational methods should include coaching, project work and mentoring. Programmes delivered by external faculty were less likely to be associated with organisational outcomes than those with internal or mixed faculty, but this needs further investigation. Finally, improving evaluation design will allow educators and evaluators to more effectively understand factors which are reliably associated with organisational outcomes of leadership development. Data are available on reasonable request.","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":"36 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141587226","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":"Improvisation versus protocol: navigating the benefits and pitfalls of leadership jazz in healthcare settings.","authors":"Maximilian Kalyuzhnov, Olena Khlystova, Benjamin Laker","doi":"10.1136/leader-2024-001016","DOIUrl":"https://doi.org/10.1136/leader-2024-001016","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564686","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 compassionate leadership of senior hospital leaders help retain trainee doctors?","authors":"Wen Wang, Jennifer Creese, Maria Karanika-Murray, Kevin Harris, Mark McCarthy, Christopher Leng, Christopher King","doi":"10.1136/leader-2024-001010","DOIUrl":"10.1136/leader-2024-001010","url":null,"abstract":"<p><strong>Background: </strong>High burnout and low retention rates among trainee doctors threaten the future viability of the UK medical workforce. This study empirically examined factors that can sustain trainee doctors.</p><p><strong>Method: </strong>A total of 323 trainee doctors from 25 National Health Service (NHS) Trusts in England and Wales completed an online survey on their training and employment experiences. A mixed method approach was employed.</p><p><strong>Results: </strong>Structural equation modelling revealed that perceived compassionate leadership of hospital senior leaders (CLSL) (i.e., doctors in senior clinical and management positions, and senior managers) is directly and negatively associated with trainee doctors' burnout and intention to quit. We propose the associations may be indirectly strengthened through two mediating pathways: increased psychological contract fulfilment (PCF) of training/organisational support and reduced worry about the state of the NHS; however, only the former is supported. The model can explain a substantial 37% of the variance in reported burnout and 28% of intention to quit among trainee doctors. Being a Foundation Year (FY) trainee was significantly associated with poor PCF and burnout. Rich qualitative data further elaborated on their experiences in terms of senior leaders' awareness of their training/working experiences, listening to and acting on.</p><p><strong>Conclusions: </strong>Active and demonstrable CLSL plays a vital role in trainee doctors' retention. It has both direct (through support) and indirect effects through improving trainee doctors' PCF to reduce burnout and intention to quit. This seems particularly valuable among FY doctors. Implications for the development and management of the medical workforce are discussed.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471294","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":"Accelerated transformation programme for healthcare services: structure, function and the lessons learnt.","authors":"Anthony J Riley, Sami A AlShammary, Yacoub Abuzied, Rasmieh Al-Amer, Ibrahim Bin-Hussain, Mesfer Alwaalah, Khalil Alshammari, Khalid I AlQumaizi","doi":"10.1136/leader-2023-000851","DOIUrl":"10.1136/leader-2023-000851","url":null,"abstract":"<p><p>The Kingdom of Saudi Arabia's (KSA) Ministry of Health's (MOH) healthcare transformation strategy aims to improve the quality of life of Saudi citizens in line with the 'Vision 2030<i>'</i> strategic objectives. The MOH is reforming the way healthcare will be managed in the future and is in the process of transferring healthcare service delivery responsibilities to clusters with ratified boards, while also moving the MOH from a provision of service model to a regulatory one. Several early pathfinding clusters were initiated in the eastern central and western regions. To ensure northern and southern regions were not left behind, the early innovation, while awaiting cluster nomination status, the northern and southern business units of Health Holding Company implemented the accelerated transformation programme (ATP). The ATP's remit was to develop capabilities and stimulate local engagement and ownership in the healthcare transformation process. This paper summarises the process of healthcare transformation undertaken in the northern and southern regions of KSA to date. It reviews the success in engaging with local healthcare professional communities in a standardised way and the learning from previous clusters, and elaborates on emerging implementation issues and how we may overcome them and introduce the lessons learnt from this journey.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"102-110"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41157449","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}