BMJ Leader最新文献

{"title":"Effects of education based on ethical leadership on moral distress, perceived organisational justice and clinical competence among nurses.","authors":"Fatemeh Mansouri, Leili Rabiei, Reza Masoudi, Shahram Etemadifar, Soleiman Kheiri","doi":"10.1136/leader-2024-001081","DOIUrl":"10.1136/leader-2024-001081","url":null,"abstract":"<p><strong>Background and aim: </strong>Nurses encounter various ethical issues in their daily practice, and the inability to manage these challenges can adversely impact their care delivery. This study aimed to evaluate the effects of education based on ethical leadership (EL) on moral distress (MD), perceived organisational justice (OJ) and clinical competence (CC) among nurses.</p><p><strong>Methods: </strong>This study was conducted from 2020 to 2021 using a two-group pretest-post-test design. Eighty nurses were purposively selected from Hajar and Kashani teaching hospitals in Shahrekord, Iran and were randomly assigned to either a control group or an intervention group. Data were collected through a demographic questionnaire, the CC Assessment Questionnaire, the MD Scale and the OJ Scale. EL-based education focusing on trust, integrity, reciprocity, self-regulation and public service was delivered over 5-2-hour sessions. Statistical analyses were performed using SPSS software (V.24.0), employing tests such as mean, SD, median, IQR, χ², Fisher's exact test, independent sample t-test, Mann-Whitney U test and Friedman test.</p><p><strong>Results: </strong>No significant differences were observed between the groups regarding the scores of MD, perceived OJ and CC at pretest and immediately after the intervention (p>0.05). However, significant between-group differences were noted in the scores of MD, perceived OJ and CC 3 months postintervention (p<0.01).</p><p><strong>Conclusion: </strong>Education based on EL significantly reduces MD and enhances perceived OJ and CC among nurses. As a simple and safe intervention, EL-based education can effectively improve nurses' abilities to manage ethical issues and challenges.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"158-164"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235460","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":"Transformative leadership in physiotherapy education: breaking norms, embracing change.","authors":"Shahina Hanif, Helen Batty","doi":"10.1136/leader-2023-000966","DOIUrl":"10.1136/leader-2023-000966","url":null,"abstract":"<p><strong>Background: </strong>Leadership education is increasingly recognised as essential for preparing healthcare students to navigate complexity and drive change. Yet practice-based learning (placements) focusing on leadership in the Allied Health Professions remains underexplored and is often perceived as less relevant than those in clinical settings. This article presents a reflective account from a mature physiotherapy student from a minoritised ethnic background, whose cultural upbringing initially positioned education and leadership as inaccessible.</p><p><strong>Method: </strong>The student undertook a 6-week leadership-focused placement during her second year of study. Entering with apprehension and uncertainty about its value, she engaged in structured activities, including weekly presentations designed to reflect on learning from the previous weeks and to discuss progress on the placement's central project.</p><p><strong>Results: </strong>Drawing on personal experiences of navigating cultural and gender norms, the placement provided opportunities for significant personal and professional growth, including increased confidence, resilience and development of transferable skills in communication, digital literacy and teamworking. It enabled the student to challenge internalised limitations shaped by cultural expectations and recognise leadership as an integral aspect of physiotherapy practice. The impact of this leadership journey was demonstrated through a university leadership award and the opportunity to influence others via a national online presentation for the Chartered Society of Physiotherapy.</p><p><strong>Conclusion: </strong>This article illustrates how leadership-focused placements can be transformative by fostering inclusion, self-belief and professional adaptability. These placements align with workforce transformation goals and highlight the need to embed leadership as a core component of healthcare education.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"225-228"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670023","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":"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":"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":"145-150"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733658","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}

{"title":"Optimising doctor-administrator leadership dyads in healthcare organisations.","authors":"Vilert Loving","doi":"10.1136/leader-2024-001127","DOIUrl":"10.1136/leader-2024-001127","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"206-208"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805020","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}

{"title":"Blending internal and external consultancy in the NHS: towards smarter use of management expertise.","authors":"Andrew Sturdy, Kirsten Armit, Ian Kirkpatrick","doi":"10.1136/leader-2025-001401","DOIUrl":"10.1136/leader-2025-001401","url":null,"abstract":"<p><strong>Aims: </strong>To identify the range of internal specialist management expertise providers in the NHS and explore their blending with external organisations to address complex organisational challenges.</p><p><strong>Methods: </strong>Ongoing quantitative and qualitative research (e.g. interviews) and a national networking event and workshop organised by the University of Bristol with NHS partners.</p><p><strong>Findings: </strong>There is a diverse NHS ecosystem of what we term internal consultancies where strategic benefits can result from combining their contextual insight with the specialist skills of external providers. Effective blending can build sustainable management capacity, deliver better value and reduce over-reliance on external consultants.</p><p><strong>Conclusion: </strong>There is a need for coordinated action across policy, procurement and workforce development to support a network of internal consultancy/expertise and its periodic blending with other partners, including external organisations.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"200-202"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496647","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":"4Ps framework: practical actions to protect individual health in the current climate crisis.","authors":"Hugh Montgomery, Amir Baniassadi, Wenjia Cai, Ali Kubba, Li Li, Rossella Nappi, Amanda Stucke","doi":"10.1136/leader-2025-001262","DOIUrl":"10.1136/leader-2025-001262","url":null,"abstract":"<p><p>Climate change driven by anthropogenic greenhouse gas (GHG) emissions represents an immediate and grave threat to human health and survival. Sea level rise, altered weather patterns and increasingly frequent and severe extreme weather events can damage health directly (eg, injury, heat stress, altered aeroallergen and particulate exposure). They also bring indirect health impacts through altered patterns of zoonotic and vectorborne diseases, disruption of food systems and downstream social consequences (economic collapse, mass migration and conflict).Healthcare providers and healthcare workers all need to take immediate action to drive and deliver reductions in GHG emissions, and to help patients in better managing the health impacts brought about by climate change. Here, we propose the '4Ps framework' (Personal, Professional, Pathway-specific and Policy) to empower and facilitate such action.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"131-136"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001567","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}

{"title":"Proposed model of empathic leadership to address crises in contemporary management.","authors":"Jeremy Howick, Sean Heneghan, Jodi Halpern, Sue Carr, Sheona MacLeod, Rich Withnall","doi":"10.1136/leader-2024-001203","DOIUrl":"10.1136/leader-2024-001203","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"183-186"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765623","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}

{"title":"Investigating the relationship between nurse managers' leadership style and predicted nurses' turnover.","authors":"Kawthar Alsaleh, Taibah Mohammed Ali, Fatimah Alhalafi, Faten Ali, Mashael Alfotais, Olfat Salem","doi":"10.1136/leader-2024-001021","DOIUrl":"10.1136/leader-2024-001021","url":null,"abstract":"<p><strong>Aim: </strong>Nurse turnover presents a significant challenge globally, impacting healthcare costs, patient outcomes and quality of care. This profound issue is very alarming in Saudi Arabia, necessitating an urgent need for effective strategies to mitigate such challenges. Effective management and leadership styles have emerged as pivotal determinants influencing nurse turnover and the intention to leave the profession. This research seeks to explore the relationship between the impact of three distinct leadership styles, transformational, transactional and passive-avoidant leadership, as implemented by nurse managers and the anticipated turnover among nurses, as well as investigate the relationship between the demographic characteristics and anticipated nurse turnover.</p><p><strong>Methods: </strong>This study used a quantitative cross-sectional correlational design. Using a convenience sampling method, nurses from a tertiary governmental hospital in Makkah Province, Saudi Arabia, were included. The self-administered questionnaire consists of participant demographic inquiries, the Multifactor Leadership Questionnaire and the Anticipated Turnover Scale (ATS).</p><p><strong>Results: </strong>The study involved a total of 192 nurses. The study analysis showed a significant positive relationship between passive-avoidant leadership and the predicted nurse turnover. The proximity in mean scores of both transactional and transformational leadership styles indicated a relatively balanced prevalence of the two leadership styles among nurse managers, whereas the passive-avoidant leadership style was the least prevalent leadership style. Markedly, the data indicated that 77.6% of the participants had high ATS scores, signalling high turnover intentions. The results also revealed that two demographic variables, nationality and qualification level, have a statistically significant relationship with anticipated turnover.</p><p><strong>Conclusion: </strong>The investigation concluded that the leadership style implied by nurse managers has a significant relationship with the predicted turnover level of nurses. This study suggests fostering the growth of transformational leaders while discouraging the passive-avoidant style. Implementing targeted leadership development programmes can empower nurse managers to adopt effective leadership approaches and ultimately mitigate turnover rates.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"151-157"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761663","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}

{"title":"Emergence of complexity leadership in a national rehabilitation hospital through cooperative inquiry.","authors":"Áine Carroll, Jane McKenzie, Claire Collins","doi":"10.1136/leader-2025-001347","DOIUrl":"https://doi.org/10.1136/leader-2025-001347","url":null,"abstract":"<p><strong>Background: </strong>Healthcare systems are increasingly characterised by complexity, uncertainty and the need for adaptive leadership. This study reports on a cooperative inquiry conducted with senior medical professionals in an Irish public rehabilitation hospital during the COVID-19 pandemic and a concurrent hospital relocation. The inquiry aimed to explore how reflective practice and collaborative learning could support leadership, well-being and organisational change in this dynamic context.</p><p><strong>Methods: </strong>The cooperative inquiry involved six iterative cycles with 4-12 participants per session over an 18-month period. Participants engaged in structured reflection, collective dialogue and co-designed actions. Qualitative data were drawn from meeting notes, reflective journals and outputs such as action plans and feedback loops. Analysis focused on emergent themes across the cycles and evaluation of enacted changes. The process was informed by complexity leadership theory and action research methodology.</p><p><strong>Results: </strong>Key themes that were generated across cycles included trust, connection, psychological safety, professional isolation and adaptive leadership. Actions included establishing new communication platforms (eg, WhatsApp groups), embedding reflective practice, engaging with executive decision-making structures and initiating governance innovations. Participants reported increased capacity for navigating complexity, improved collegial support and expanded organisational influence. Reflective practice and relational leadership emerged as core mechanisms of change.</p><p><strong>Conclusion: </strong>The inquiry demonstrated how cooperative, reflective processes can support the emergence of adaptive and relational leadership and enable organisational learning in complex healthcare settings. Even under conditions of crisis and constraint, participants cultivated a learning community that contributed to meaningful professional and systemic development. The study provides an empirical account of the mechanisms through which cooperative, reflective processes support the emergence of adaptive and relational leadership in complex healthcare settings.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333500","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":"Fable Hospital 3.0: the business case for building better healthcare facilities.","authors":"Ashley Dias, Leonard Berry, Elly Hall, Kirk Hamilton, Blair Sadler, Phaedra Svec, Judah Auld, Marcelo Bernal","doi":"10.1136/leader-2025-001522","DOIUrl":"https://doi.org/10.1136/leader-2025-001522","url":null,"abstract":"<p><strong>Objectives: </strong>Fable Hospital 3.0 aims to demonstrate the economic return on investment (ROI) of high-performing design strategies towards regenerative healthcare. Building on the legacy of Fable Hospitals 1.0 (2004) and 2.0 (2011), this third iteration seeks to refute the persistent myth that high performance is unaffordable while addressing current healthcare challenges, including financial pressures, workforce burnout, climate resilience and technological integration.</p><p><strong>Setting: </strong>Fable Hospital 3.0 is a cost-benefit analysis of a hypothetical 300-bed, 750 000-square-foot community hospital located in 'Anywhere, USA'.</p><p><strong>Interventions: </strong>The design incorporates more than 20 high-performance and healing strategies, ranging from biophilic design and energy-efficient systems to flexible infrastructure and community integration.</p><p><strong>Primary and secondary outcome measures: </strong>Each strategy is evaluated for its construction cost and potential operational benefits. Excluding the cost of the land, the analysis uses conservative cost estimates based on national averages and industry benchmarks, quantifying ROI reductions in medical errors, energy and water consumption, staff turnover, renovation costs and inpatient length of stay, along with improvements in operational resiliency, material first costs and speed to market.</p><p><strong>Results: </strong>The study demonstrates that an estimated additional investment of $25-30 million (approximately 3% of total construction costs) can be recovered within the first 2 years of operation. Key annual savings include: a major contribution of ~$7.25 million from reduced inpatient length of stay, ~$1.0 million from fewer medical errors, ~$1.2 million from improved staff retention, ~$500 000 from maintaining operations during emergencies, ~$250 000 from energy savings, ~$1.5 million from lowered renovation costs, ~$5.4 million from lower material first costs and ~$100 000 from water use reduction.</p><p><strong>Conclusions: </strong>Fable Hospital 3.0 proposes a model for analysing the impact of adopting high-performance design strategies in healthcare and demonstrates that this approach is environmentally and socially responsible and financially wise, aligning with healthcare's mission to promote health and resilience within and beyond hospital walls.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228712","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}