BMJ Leader最新文献

{"title":"When work harms: how better understanding of avoidable employee harm can improve employee safety, patient safety and healthcare quality.","authors":"Aled Jones, Adrian Neal, Suzie Bailey, Andrew Cooper","doi":"10.1136/leader-2023-000849","DOIUrl":"10.1136/leader-2023-000849","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"59-62"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10210624","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":"Integrating health leadership and management perspectives: the MESH framework for culturally informed food design thinking and well-being promotion.","authors":"Jack S Tillotson, Vito Tassiello, Shona Bettany, Benjamin Laker","doi":"10.1136/leader-2023-000838","DOIUrl":"10.1136/leader-2023-000838","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the social and cultural life of food innovations to inform food design thinking. The authors explore this through wellness regulating functional foods, foods scientifically modified for health benefits based on medical and nutritional claims, as a materialisation of food innovation in the marketplace.</p><p><strong>Design/methodology/approach: </strong>Drawing on affordance theory, where affordance relations enable potential for consumer food well-being regulation, the authors gathered in-depth interview data from diverse consumer groups across three illustrative exemplar functional foods.</p><p><strong>Findings: </strong>The research reveals how consumers engage in meaningful actions with functional foods in the experiences of their everyday lives. Four analytical themes emerge for consumer wellness regulation through functional foods: morality judgements, emotional consequences, social embedding and historicality.</p><p><strong>Originality: </strong>Analytical themes emerging from the findings are conceptualised as MESH, a useful acronym for the social and cultural life of food innovations within the design thinking arena. The MESH framework includes dichotomous cultural affordances that overlap and entangle different cultural themes weaving together consumers' perceived possibilities for food well-being regulation. These cultural affordances reveal distinct paths that link consumer experiences and food design thinking.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"25-31"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123707","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":"Navigating role conflict: one professional's journey as a new clinician leader.","authors":"Christopher Wiedman","doi":"10.1136/leader-2022-000715","DOIUrl":"10.1136/leader-2022-000715","url":null,"abstract":"<p><p>Transitioning from full-time clinical work to a leadership position can be a difficult transition for healthcare professionals. Competing demands, new responsibilities and changes in how one measures success in this new role often leave new clinician-leaders feeling lost, stymied or ineffectual.Role conflict is one phenomenon which can impact a healthcare professional's transition into leadership. Role conflict occurs when the clinician turned leader experiences a sense of dissonance between a highly valued identity as a clinician and a developing identity as a new leader.This article shares my personal experience as a new clinician leader in the field of physical therapy. I offer reflections on the impact of professional role identity conflict during my transition into leadership, and how this role identity conflict led to early leadership failures, but also how addressing role conflict contributed to leadership success later on.More importantly, this article offers advice to the new clinician leader for navigating role identity conflict during a clinical to leadership transition. This advice is based on my personal experience in physical therapy and on the growing body of evidence on this phenomenon in all healthcare professions.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"6-8"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9723021","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":"Listening campaigns: engaging clinicians to assess system factors contributing to burnout.","authors":"Sarah E Richards, Victoria Kennel, Jana Wardian, Kristy Carlson, Bethany Lowndes","doi":"10.1136/leader-2022-000701","DOIUrl":"10.1136/leader-2022-000701","url":null,"abstract":"<p><strong>Background: </strong>Even prior to the pandemic, many US physicians experienced burnout affecting patient care quality, safety and experience. Institutions often focus on personal resilience instead of system-level issues. Our leaders developed a novel process to identify and prioritise key system-related solutions and work to mitigate factors that negatively impact clinician well-being through a structured listening campaign.</p><p><strong>Methods: </strong>The listening campaign consists of meeting with each clinician group leader, a group listening session, a follow-up meeting with the leader, a final report and a follow-up session. During the listening session, clinicians engage in open discussion about what is going well, complete individual reflection worksheets and identify one 'wish' to improve their professional satisfaction. Participants rate these wishes to assist with prioritisation.</p><p><strong>Results: </strong>As of January 2020, over 200 clinicians participated in 20 listening sessions. One hundred and twenty-two participants completed a survey; 80% stated they benefited from participation and 83% would recommend it to others.</p><p><strong>Conclusion: </strong>Collecting feedback from clinicians on their experience provides guidance for leaders in prioritising initiatives and opportunities to connect clinicians to organisational resources. A listening campaign is a tool recommended for healthcare systems to elicit clinician perspectives and communicate efforts to address systemic factors.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"79-82"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9766442","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":"Workplace-based knowledge exchange programmes between academics, policy-makers and providers of healthcare: a qualitative study.","authors":"Stephanie Kumpunen, Jake Matthews, Thuvarahan Amuthalingam, Greg Irving, Bernadeta Bridgwood, Luisa M Pettigrew","doi":"10.1136/leader-2023-000756","DOIUrl":"10.1136/leader-2023-000756","url":null,"abstract":"<p><strong>Background: </strong>Workplace-based knowledge exchange programmes (WKEPs), such as job shadowing or secondments, offer potential for health and care providers, academics, and policy-makers to foster partnerships, develop local solutions and overcome key differences in practices. Yet opportunities for exchange can be hard to find and are poorly reported in the literature.</p><p><strong>Objectives: </strong>To understand the views of providers, academics and policy-makers regarding WKEPs, in particular, their motivations to participate in such exchanges and the perceived barriers and facilitators to participation.</p><p><strong>Methods: </strong>A qualitative study involving semistructured interviews with 20 healthcare providers, academics and policy-makers in England. Rapid data collection and analysis techniques were employed. Interviews formed part of a wider scoping study that mapped the characteristics and existing literature related to WKEPs.</p><p><strong>Results: </strong>Interviewees reported being motivated to develop, sponsor and/or participate in WKEPs with a clear purpose and defined outcomes that could demonstrate the value of the time out of work to their organisations. Perceived barriers included competitive application processes for national fellowships, a lack of knowing how to identify with whom to undertake an exchange (varying 'tribes'), and the burdens of time, costs and administration regarding arranging exchanges. WKEPs were reported to work best where there was a perceived sense of shared purpose, long-standing relationship and trust between organisations. Facilitators included existing confidentiality agreements and/or shared professional standards, as well as funding.</p><p><strong>Conclusion: </strong>WKEPs were reported to be valuable experiences but required significant organisational buy-in and cooperation to arrange and sustain. To benefit emerging partnerships, such as the new integrated care systems in England, more outcomes evaluations of existing WKEPs are needed, and research focused on overcoming barriers to participation, such as time and costs.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"15-19"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9766443","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":"Effective clinical nursing leadership in hospitals: barriers from the perspectives of nurse managers.","authors":"Abdullah Algunmeeyn, Majd T Mrayyan, Wafika A Suliman, Hamzeh Y Abunab, Saleem Al-Rjoub","doi":"10.1136/leader-2022-000681","DOIUrl":"10.1136/leader-2022-000681","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this study was to identify barriers to effective clinical nursing leadership in Jordanian hospitals from the perspectives of nurse managers (NMs).</p><p><strong>Background: </strong>Clinical leadership is about expertise in specialised fields and involving professionals in clinical care. Even though leadership terminology has been used in nursing and healthcare business literature, clinical leadership is still misunderstood, including its barriers.</p><p><strong>Method: </strong>This study adopted a qualitative narrative approach and recruited a purposive sample of 19 NMs and two associate executive directors of nursing from two hospitals. Data were collected through two focus group discussions and in-depth interviews and were analysed using content analysis. The study was guided by the 'Consolidated Criteria for Reporting Qualitative Research'.</p><p><strong>Result: </strong>Four themes emerged regarding barriers to effective clinical nursing leadership: (1) power differential, (2) inconsistent connectedness with physicians, (3) lack of early socialisation experiences and (4) clinical practice reform is a mutual responsibility.</p><p><strong>Conclusion and relevance to clinical practice: </strong>Barriers are detrimental to effective clinical leadership; they are associated with interdisciplinary and professional socialisation factors. Managers and academicians at all levels should immediately consider these barriers as a priority. Innovative clinical leaders should identify barriers to effective clinical leadership at the early stages. Thus, innovative clinical leadership programmes are warranted.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"20-24"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9895317","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":"Thematic analysis of tools for health innovators and organisation leaders to develop digital health solutions fit for climate change.","authors":"Lysanne Rivard, Pascale Lehoux, Robson Rocha de Oliveira, Hassane Alami","doi":"10.1136/leader-2022-000697","DOIUrl":"10.1136/leader-2022-000697","url":null,"abstract":"<p><strong>Objectives: </strong>While ethicists have largely underscored the risks raised by digital health solutions that operate with or without artificial intelligence (AI), limited research has addressed the need to also mitigate their environmental footprint and equip health innovators as well as organisation leaders to meet responsibility requirements that go beyond clinical safety, efficacy and ethics. Drawing on the Responsible Innovation in Health framework, this qualitative study asks: (1) what are the practice-oriented tools available for innovators to develop environmentally sustainable digital solutions and (2) how are organisation leaders supposed to support them in this endeavour?</p><p><strong>Methods: </strong>Focusing on a subset of 34 tools identified through a comprehensive scoping review (health sciences, computer sciences, engineering and social sciences), our qualitative thematic analysis identifies and illustrates how two responsibility principles-environmental sustainability and organisational responsibility-are meant to be put in practice.</p><p><strong>Results: </strong>Guidance to make environmentally sustainable digital solutions is found in 11 tools whereas organisational responsibility is described in 33 tools. The former tools focus on reducing energy and materials consumption as well as pollution and waste production. The latter tools highlight executive roles for data risk management, data ethics and AI ethics. Only four tools translate environmental sustainability issues into tangible organisational responsibilities.</p><p><strong>Conclusions: </strong>Recognising that key design and development decisions in the digital health industry are largely shaped by market considerations, this study indicates that significant work lies ahead for medical and organisation leaders to support the development of solutions fit for climate change.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"32-38"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9755992","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":"Five hats of effective leaders: teacher, mentor, coach, supervisor and sponsor.","authors":"Richard C Winters, Teresa M Chan, Bradley E Barth","doi":"10.1136/leader-2022-000733","DOIUrl":"10.1136/leader-2022-000733","url":null,"abstract":"<p><strong>Background/aim: </strong>Teaching, mentoring, coaching, supervising and sponsoring are often conflated in the literature. In this reflection, we clarify the distinctions, the benefits and the drawbacks of each approach. We describe a conceptual model for effective leadership conversations where leaders dynamically and deliberately 'wear the hats' of teacher, mentor, coach, supervisor and/or sponsor during a single conversation.</p><p><strong>Methods: </strong>As three experienced physician leaders and educators, we collaborated to write this reflection on how leaders may deliberately alter their approach during dynamic conversations with colleagues. Each of us brings our own perspective and lens.</p><p><strong>Results: </strong>We articulate how each of the 'five hats' of teacher, mentor, coach, supervisor and sponsor may help or hinder effectiveness. We discuss how a leader may 'switch' hats to engage, support and develop colleagues across an ever-expanding range of contexts and settings. We demonstrate how a leader might 'wear the five hats' during conversations about career advancement and burn-out.</p><p><strong>Conclusion: </strong>Effective leaders teach, mentor, coach, supervise and sponsor during conversations with colleagues. These leaders employ a deliberate, dynamic and adaptive approach to better serve the needs of their colleagues at the moment.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"9-14"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9672773","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":"What makes for a 'Top Doc'? An analysis of UK press portrayals of so-called top doctors.","authors":"Paul Keeley, Mark Taubert, Emma Wardle, Simon Tavabie, Ollie Minton","doi":"10.1136/leader-2022-000735","DOIUrl":"10.1136/leader-2022-000735","url":null,"abstract":"<p><strong>Objective: </strong>To determine the characteristics of medical practitioners designated 'top doctor' or 'Top Doc' in the UK press.</p><p><strong>Design: </strong>Observational study of news stories related to the term top doctor (or Top Doc) with analysis using data from publicly available databases.</p><p><strong>Setting: </strong>News reports in the UK press accessed via a database from national newspapers from 1 January 2019 to 31 December 2019, prior to the COVID-19 pandemic. Stories relating to disciplinary/criminal matters were analysed separately.</p><p><strong>Main outcome measures: </strong>Results were cross-referenced with the General Medical Council register of medical practitioners for gender, year of qualification, whether on the general practitioner (GP) or the specialist register, and if on the specialist register, which specialty.</p><p><strong>Results: </strong>There was a gender divide, with 80% of so-called top doctors being male. National top doctors had been qualified for a median time of 31 years. Top doctors are widely spread among specialties; 21% of top doctors were on the GP register. Officers of the British Medical Association and the various Royal Colleges are also well represented. 'Top doctors' facing disciplinary proceedings are more overwhelmingly male, working in hospital specialties and less obviously eminent in their field.</p><p><strong>Conclusion: </strong>There is no clear definition of a 'top doctor', nor are there objective leadership criteria for journalists to use when applying this label. Establishing a definition of 'top doctor', for instance, via the UK Faculty for Medical Leadership and Management, which offers postnominals and accreditation for high-achieving medical professionals, may reduce subjectivity.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"39-42"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9764563","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":"Evidence behind the exhortation? A rapid review of servant leadership's influence and claims in healthcare over the last decade.","authors":"Lee Yung Wong, Sen Sendjaya, Samuel Wilson, Andrew Rixon","doi":"10.1136/leader-2023-000796","DOIUrl":"10.1136/leader-2023-000796","url":null,"abstract":"<p><p>Servant leadership is an other-oriented approach to leadership with multiple positive outcomes. However, its influence in the context of medicine, particularly on healthcare leaders, is less clear. We conducted a rapid review to examine the impact of servant leadership in healthcare over the last decade. We included a total of 28 articles, 26 of which described beneficial organisational, relational and personal outcomes of servant leadership. However, most of these were either conceptual or opinion-based articles. Moreover, most quantitative studies were cross-sectional, precluding causal inferences. Our review demonstrates that the purported positive association between servant leadership and healthcare outcomes lacks a strong evidence base. We conclude by calling for more rigorous empirical research to examine the effects and potential challenges of implementing servant leadership in healthcare contexts.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"88-92"},"PeriodicalIF":2.7,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9873288","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}