BMJ Leader最新文献

{"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":"10.1136/leader-2023-000746","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"190-193"},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","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":"Transforming safety culture in neonatal intensive care teams.","authors":"Zheng Jing Hu, Gerhard Fusch, Enas El Gouhary, Jennifer Twiss, Amneet Sidhu, Elias Chappell, Emmeline Sheehan, Zoe El Helou, Robert Robson, Kemi Salawu Anazodo, Lehana Thabane, Peter Lachman, Salhab El Helou","doi":"10.1136/leader-2024-001033","DOIUrl":"10.1136/leader-2024-001033","url":null,"abstract":"<p><strong>Background: </strong>Healthcare organisations face widespread challenges in optimising their safety culture, especially amid conflicting stakeholder needs, staffing shortages and increasing acuity of patients. McMaster University Children's Hospital Neonatal Intensive Care Unit developed a safety culture programme that prioritises the needs of patients, hospital staff and learners altogether.</p><p><strong>Methods: </strong>The safety culture programme and activities revolve around six primary drivers: psychological safety, provider well-being, equity, diversity and inclusion, teamwork and communication, organisational learning and leadership. We describe how these drivers influence safety culture, the ongoing activities being implemented, stakeholder feedback and contextual factors. We evaluated the maturity of our safety culture using the Manchester Patient Safety Framework (MaPSaF) questionnaire.</p><p><strong>Results: </strong>MaPSaF assessments were conducted three times over 4 years. Most domains of safety culture in MaPSaF maintained their position despite COVID-19 while some indicators declined or have been maintained.</p><p><strong>Conclusions: </strong>We provide a framework for implementing a safety culture programme that addresses the needs of diverse stakeholders. Transformation of the safety culture takes time and the failure to improve the patient safety measures over the period may be attributed to rapidly increasing workload and worsening patient acuity. These challenges underscore the imperative of balancing transactional and transformational projects to preserve a safety culture.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"202-205"},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802568","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":"NHS needs managers and leaders: a brief report from the Faculty of Medical Leadership and Management conference 2024.","authors":"Daniel Jones, Hannah Son, Zoe Howard","doi":"10.1136/leader-2024-001185","DOIUrl":"https://doi.org/10.1136/leader-2024-001185","url":null,"abstract":"<p><strong>Introduction: </strong>Effective management and leadership are needed for the successful running and improvement of National Health Service (NHS) organisations and enhance the ability of these organisations to improve. However, NHS managers are often undervalued, and there are serious shortfalls in management capacity. We hosted a workshop with a diverse audience of health professionals, to explore this issue in depth.</p><p><strong>Description: </strong>The workshop took place at the annual Faculty of Medical Leadership & Management conference 2024 with five panellists and roughly 40 delegates, lasting for over 90 minutes. It consisted of individual presentations, panel discussions, questions and answers and online polling and commentary. The results were analysed using thematic analysis.</p><p><strong>Discussion: </strong>We identified four themes. The first included an overall lack of management capacity in the NHS, with fewer managers compared with other sectors and countries. Difficulties in interprofessional relationships was a second theme, for example, the lack of understanding or appreciation for the management role. Significant variation in development, training and career opportunities was the third theme. Discussions on potential regulation for NHS managers was the final theme.</p><p><strong>Conclusion: </strong>The workshop report identified important challenges affecting managers and leaders in the NHS. Addressing these will be crucial to sustaining and improving high-quality care.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486349","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":"Perceptions of artificial intelligence in healthcare: a qualitative study among healthcare professionals in Jordan.","authors":"Ahmad F Klaib, Tasneem N AlHosanie, Ladees W Mahadin, Enas J Altatar","doi":"10.1136/leader-2024-001093","DOIUrl":"https://doi.org/10.1136/leader-2024-001093","url":null,"abstract":"<p><strong>Purpose: </strong>While there are studies on this topic, there may be a relative scarcity of research focusing on specific regions, such as Jordan. So, this study aims to gather insights from healthcare providers in Jordan concerning the advantages of integrating artificial intelligence (AI) into practices, their perspectives on AI applications in healthcare, and their views on the future role of AI in replacing key tasks within health services.</p><p><strong>Method: </strong>An online questionnaire was used to collect data on demographics, attitudes towards using AI for tasks and opinions on the benefits of AI adoption among healthcare professionals. For healthcare professionals with restricted internet access or older people, soft copies of the questionnaire were provided to them, and then their responses were collected. A one way analysis of variance (ANOVA) was used to determine the associations between the determinants and the outcomes. Any test with a p value ≤0.05 was considered significant.</p><p><strong>Results: </strong>A total of 612 healthcare professionals participated in the survey, with females comprising a majority of respondents (52.8%). The majority of respondents showed optimism about AI's potential to improve and revolutionise the field, although there were concerns about AI replacing human roles. Generally, physical therapists, medical researchers and pharmacists displayed openness to incorporating AI into their work routines. Younger individuals aged <40 seemed accepting of AI in the domain. A significant portion of participants believed that AI could negatively impact job opportunities.</p><p><strong>Conclusion: </strong>To conclude, the results of this study suggest that healthcare professionals, in Jordan, hold receptive views on incorporating AI in the medical field, similar to their counterparts in developed nations. However, there is a concern about the implications of AI on job stability and potential replacements.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486350","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 training in healthcare: a systematic umbrella review.","authors":"Juliette Phillipson, Alexandra Cardoso Pinto, Harry Kingsley-Smith, Nick Krachler, Gerry McGivern, Oscar Lyons","doi":"10.1136/leader-2025-001269","DOIUrl":"https://doi.org/10.1136/leader-2025-001269","url":null,"abstract":"<p><p>The importance of effective clinical leadership has been reflected in an increase in leadership development programmes. However, there remains a lack of consensus regarding the optimal structure, content and evaluation of such programmes. This review synthesised evidence from reviews of leadership development interventions for healthcare professionals published prior to October 2024, including content, methods, evaluation strategies and impact. Title, abstract and full-text screening were conducted in duplicate by two reviewers. Data extraction was piloted by two reviewers and conducted by a single reviewer. Quality appraisal was conducted using the Risk of Bias in Systematic Reviews tool by a single reviewer, with generative artificial intelligence serving as the second reviewer. 86 systematic and non-systematic reviews met inclusion criteria. Regarding educational methods, leadership training effectiveness was associated with experiential learning, mixed-methods approaches, coaching or mentoring, longitudinal designs, goal-setting, and 360-degree feedback. Group learning and interprofessional education were noted for fostering teamwork. Programmes tailored to participants' needs and organisational contexts showed better outcomes. Content reported to be effective included interpersonal skills, self-awareness, emotional intelligence, leadership theory, communication and teamwork. Evaluations primarily relied on self-reported measures. Training outcomes were largely positive at the individual level, with participants reporting increased confidence and competence. Organisational and clinical outcomes were less frequently assessed. The long-term impact on patient outcomes and return on investment remains uncertain. Leadership development programmes were found to enhance individual competencies. However, evidence supporting long-term, system-wide impact remains limited due to reliance on self-reported evaluations and a lack of standardised evaluation approaches.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318209","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":"Hermeneutic clinical leadership.","authors":"Jo-Anne Johnson, Rupal Shah, Bob Clarke, Sanjiv Ahluwalia","doi":"10.1136/leader-2024-001209","DOIUrl":"https://doi.org/10.1136/leader-2024-001209","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259077","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":"Association between incident occurrence and bed configuration: a retrospective observational study in a Japanese academic hospital during the COVID-19 pandemic.","authors":"Mutsuko Moriwaki, Mikayo Toba, Chihiro Takahashi, Michiko Tanaka, Masayuki Kakehashi, Satoshi Obayashi, Kenji Wakabayashi, Atsushi Kudo, Kiyohide Fushimi","doi":"10.1136/leader-2024-001187","DOIUrl":"https://doi.org/10.1136/leader-2024-001187","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines the relationship between the diversification and complexity of ward operations (DCWO) during the COVID-19 pandemic and incident occurrence. Our hospital faced significant changes in ward management during the pandemic. Typically, each ward accommodates two to four clinical departments, with department assignments remaining relatively fixed. However, to free up beds for patients with COVID-19, the number of general wards was reduced, forcing a more fluid allocation of patients across various departments. This shift resulted in a more complex and diverse departmental mix within each ward, complicating ward operations.</p><p><strong>Methods: </strong>This study retrospectively examined patients admitted to a university hospital in Japan from 1 April 2020 to 31 March 2022. We analysed incident occurrences by ward (including all inpatients within the target ward) and assessed the relationship between nurse-related incidents and DCWO.</p><p><strong>Results: </strong>We selected records for 7030 ward days from 21 559 patients admitted (10 336 in 2020 and 11 233 in 2021). No significant difference in average age was observed between fiscal year (FY) 2020 and FY 2021 (62.5±16.6 years vs 62.3±16.8 years, respectively; p=0.69). However, the average length of stay differed (13.6±23.9 days vs 12.9±17.5 days, respectively; p<0.01). Logistic regression analysis revealed an OR for DCWO of 1.008 (95% CI 1.002 to 1.015; p=0.007), indicating that an increase in DCWO was associated with the occurrence of mild incidents (where treatment was not necessary). Multiple regression analyses also revealed the association between DCWO and drug-related incidents (p=0.011) and mild incidents (treatment was not necessary; p=0.010).</p><p><strong>Conclusions: </strong>Changes in departmental configurations during the COVID-19 pandemic influenced patients' conditions and the frequency of mild incidents, highlighting the importance of patient safety considerations in hospital ward operations.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250091","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: essential personal characteristics for addressing the planetary crisis.","authors":"Elizabeth Cerceo, Lisa Patel, Cecilia Sorensen","doi":"10.1136/leader-2025-001250","DOIUrl":"https://doi.org/10.1136/leader-2025-001250","url":null,"abstract":"<p><p>The climate crisis presents a defining challenge for our generation, demanding leaders who can navigate the complexities of planetary health on an ailing planet while inspiring meaningful action across diverse sectors from public health to industry to government. Effective planetary health leadership requires a unique blend of attributes to identify and address the structural causes driving planetary crises, foster interdisciplinary collaboration and overcome the resistance that often accompanies transformative change. The authors represent the perspectives of three leaders in planetary health: CS, the medical director of a global planetary health education organisation, LP, the executive director of a national organisation which represents planetary health interests of >56 medical societies, and LC who chairs two committees under LP and works with CS. The ideas presented in this article result from several collaborative and iterative discussions among the authors who have worked together on prior projects. No patients were involved. Through this process, we identified seven key skills important in planetary health leadership. Resilience, emotional intelligence, creativity, interdisciplinary fluency, effective communication skills, lifelong learning, an unwavering commitment to equity and boldness are critical traits for leaders seeking to make a difference in this space. These seven attributes are for some innate but can and should also be cultivated among those aspiring to planetary health leadership. While no single individual can completely master all these qualities, and each of us is on a journey of growth and self-actualisation, this non-exhaustive list highlights key attributes that can foster the development of effective planetary health leaders. Next steps involve creating training programmes to foster the development of these important qualities.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235461","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-05","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":"Chief residency: challenges and future directions.","authors":"Beret Amundson, Derek Ross Soled","doi":"10.1136/leader-2025-001240","DOIUrl":"https://doi.org/10.1136/leader-2025-001240","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227016","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}