Journal of Healthcare Leadership最新文献

{"title":"Unleashing the Early Career Transition in Academic Medicine.","authors":"Daryn H David","doi":"10.2147/JHL.S519433","DOIUrl":"https://doi.org/10.2147/JHL.S519433","url":null,"abstract":"<p><p>In addition to advancing biomedical research and delivering cutting-edge clinical care, academic medical centers (AMCs) are tasked with training the next generation of physicians and scientists. This training is based on a competencies model, with emphasis given to the high-level acquisition of technical clinical and research skills. While this framework is appropriate for the learning years, once researchers and clinician-scientists transition from training to fuller career responsibilities, they are in need of an expanded psychological and psychosocial toolkit for holistic success. At present, academic medicine does not sufficiently support, address, or welcome the elements of this toolkit; in the early career phase, overemphasis is placed on the expression and expansion of independent technical competencies, to the neglect of the psychosocial facets necessary for academics' successful career progression and fulfillment. Delineating the legacy of the current training model for the early career period, this paper explicates the tension that exists between the conventional markers of success and adult psychosocial needs, with special attention paid to the potential consequences of this mismatch. The paper concludes with a series of suggestions for how leaders in academic medicine may help their research and clinician-scientist faculty flourish more fully in early career.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"133-140"},"PeriodicalIF":3.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033850","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":"Enhancing Belonging in Healthcare: A Commentary on Strategies for Organizational Leadership.","authors":"Elizabeth M Boland, Isabelle Martin, Barbara Jordan, Patrick Decker-Tonnesen, Anjali Bhagra","doi":"10.2147/JHL.S473636","DOIUrl":"https://doi.org/10.2147/JHL.S473636","url":null,"abstract":"<p><p>Belonging is a human necessity, fostering psychological safety and self-actualization. The importance and benefits of belonging are well documented, and there is a growing body of research emphasizing the role belonging plays in the workplace and its effects on employees and companies alike. Due to the unique stressors and barriers present in healthcare, a lack of belonging among employees is not uncommon. This paper explores how cultivating an inclusive environment transforms healthcare delivery and highlights tangible strategies leaders in healthcare can utilize to enhance belonging for staff and ultimately the patient populations they interact with. Because belonging is multifaceted and highly individualized, effective strategies include people-centered approaches that prioritize physical and mental well-being, career-advancing initiatives, empathetic leadership and robust support systems. The importance of analyzing systems that either promote or inhibit belonging, specifically by examining existing organizational policies and practices through an equity lens, is also discussed. By prioritizing diverse perspectives and implementing tailored interventions, healthcare organizations and committed staff can create a culture where both patients and professionals feel valued, leading to enhanced well-being, improved patient outcomes, and equitable healthcare delivery.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"117-121"},"PeriodicalIF":3.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005226","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":"Unveiling Patient Perspectives: A Multinational Cross-Sectional Analysis of Patient Experiences Undergoing Cleft Care by All-Women Surgical Teams.","authors":"Maria Fernanda Tapia, Hebah Daradkeh, Atenas Bustamante, Emily Marie Jones, Sonia Y Treminio, Marvee Turk, Mikyla Rata, Barbara Salazar, Ainaz Dory Barkhordarzadeh, Alyssa Caitlin Bautista, Laura Herrera Gomez, Greta L Davis, William Magee, Naikhoba C O Munabi, Allyn Auslander","doi":"10.2147/JHL.S508633","DOIUrl":"https://doi.org/10.2147/JHL.S508633","url":null,"abstract":"<p><strong>Background: </strong>Although women provide approximately 75% of healthcare globally, they are underrepresented in healthcare leadership, surgery, and anesthesia. Patient- provider gender concordance has been shown to improve patient experience in high-income settings; however, patients in low-and middle-income countries often lack the opportunity to choose the gender of their provider and there is a paucity of literature on the importance of women healthcare providers in these settings.</p><p><strong>Aim: </strong>To assess the experiences and provider gender preferences of patients with cleft and their caregivers before and after receiving care from an all-women surgical team in a Women in Medicine (WIM) surgical program.</p><p><strong>Methods: </strong>This cross-sectional study is based on an anonymous survey administered to patients 15 years or older or their caregivers after receiving care from an all-women surgical team during four distinct cleft surgery programs in Morocco, Peru, Malawi, and the Philippines throughout 2022. Analysis included quantitative, descriptive statistics, chi-squared and f-tests.</p><p><strong>Results: </strong>Before the program, 20% of participants had never received care from women physicians and only 35% preferred women as their healthcare provider. After the program, 66% preferred women as their healthcare provider (p<0.001) with the highest proportion in Morocco (90%) and lowest in Malawi and the Philippines (55%). Across all education levels, most participants preferred women after the program (64%) and 98% were satisfied or more than satisfied with the care received. The three most influential characteristics for preferring women were their understanding, patience, and communication.</p><p><strong>Conclusion: </strong>Participation in the WIM program provided some patients with their first opportunity to experience receiving care from a woman. This exposure may influence their preference for a healthcare provider, which has been shown to enhance patient experience. Programs like this are imperative to increasing visibility of women in surgical and healthcare leadership roles, improving patient experience, and increasing access to care.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"123-132"},"PeriodicalIF":3.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001127","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":"Exploring Ethical, Cultural, and Transnational Competence Among International Healthcare Management Students: An Australian Perspective.","authors":"Matylda Howard, Kuan Liung Tan, Rasika Jayasekara","doi":"10.2147/JHL.S506361","DOIUrl":"https://doi.org/10.2147/JHL.S506361","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare leaders face complex ethical challenges that can impact patient care and organizational integrity. For international healthcare management students pursuing leadership roles in Australia, these challenges are heightened by ethical, cultural, and transnational differences. This exploratory study examined the challenges faced by these students to establish foundational understanding of the competencies needed for effective ethical decision-making, cultural integration, and transnational readiness in diverse healthcare environments.</p><p><strong>Methods: </strong>Using a composite theoretical framework incorporating Cultural Relativism, Ethical Climate Theory, Institutional Theory, and Transnationalism, a 35-item instrument was adapted from three validated sources. A cross-sectional survey of 35 international postgraduate health services management students collected quantitative and qualitative data. Quantitative data were summarized using descriptive statistics, while thematic analysis, informed by the Gioia methodology, was applied to qualitative responses.</p><p><strong>Results: </strong>Key ethical challenges identified included healthcare inequity, resource allocation, and patient safety. Effective leadership practices emphasized fostering supportive work environments and promoting diversity. Participants demonstrated strong cultural competence, particularly in cultural awareness and cross-cultural communication, but highlighted the need for enhanced preparation in ethical decision-making and navigating transnational healthcare systems.</p><p><strong>Conclusion: </strong>The findings underscore the importance of transnational training programs that integrate cultural orientation, healthcare-specific language support, and ethical decision-making simulations. The Ethical, Cultural, and Transnational framework developed in this study provides a practical guide for embedding these competencies into leadership curricula, equipping international students to navigate the complexities of globalized healthcare systems effectively.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"97-115"},"PeriodicalIF":3.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651119","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":"Making Hospitals More Dementia Friendly: An Inclusive, User-Centered Approach.","authors":"Diane L Farsetta, Sarah E Endicott, Paula Woywod, Lisa C Bratzke","doi":"10.2147/JHL.S496288","DOIUrl":"10.2147/JHL.S496288","url":null,"abstract":"<p><strong>Purpose: </strong>People living with dementia and their care partners identify interactions with the healthcare system as among their greatest challenges. Many hospital staff do not feel prepared to care for people living with dementia. This contributes to poor outcomes for patients living with dementia, frustration and confusion for care partners, and distress for hospital staff.</p><p><strong>Patients and methods: </strong>An academic project team with expertise in education, geriatrics, simulation, and community engagement, who had previously developed dementia-friendly training materials for classroom and community use, designed a dementia-friendly hospital toolkit. Applying principles of user-centered design, the project team consulted with care partners of people living with dementia, hospital staff, hospital leadership, and advocates from communities disproportionately impacted by dementia to identify and address the needs of patients, care partners, hospital staff, and hospital leadership.</p><p><strong>Results: </strong>The project team developed a dementia-friendly hospital toolkit, which includes training materials for hospital staff across roles and an organizational guide to facilitate uptake by a wide range of hospitals. In multiple rounds of pilot testing, hospital staff rated toolkit training activities highly, reporting new insights and applying the knowledge or skills gained in their professional roles. Five hospitals, ranging from large academic centers to rural critical access hospitals, used the toolkit to assess needs, develop plans, and organize training sessions for staff. All hospitals reported receiving positive feedback from staff, meeting staff learning objectives, and intending to continue using the toolkit to meet their dementia-friendly goals.</p><p><strong>Conclusion: </strong>Following an inclusive, user-centered approach to developing dementia-friendly training materials allowed the project team to address the needs of key partners: people living with dementia, their care partners, hospital staff, and hospital leadership. Based on the positive responses from hospital pilot partners, the project team is supporting wider dissemination of the dementia-friendly hospital toolkit.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"85-96"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574323","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":"Managing Resilience and Exhaustion Among Health Care Workers Through Psychological Self-Care: The Impact of Job Autonomy in Interaction With Role Overload.","authors":"Francis Maisonneuve, Anaïs Galy, Patrick Groulx, Denis Chênevert, Colleen Grady, Angela M Coderre-Ball","doi":"10.2147/JHL.S501193","DOIUrl":"10.2147/JHL.S501193","url":null,"abstract":"<p><strong>Purpose: </strong>Drawing on the conservation of resources theory, we explore how job autonomy affects resilience and emotional exhaustion through psychological self-care (PSC). In addition, we study the impact of role overload as a boundary condition which dampens the beneficial effects of job autonomy.</p><p><strong>Methods: </strong>Cross-sectional data was collected through an online survey among Canadian health care workers (HCWs) across multiple organizations. We performed structural equation modeling (SEM) to test the proposed hypotheses (N=860).</p><p><strong>Results: </strong>Job autonomy had a positive relationship with resilience and negative with emotional exhaustion, both through PSC. However, high role overload hinders these relationships.</p><p><strong>Conclusion: </strong>Job autonomy combined with reasonable workload allows HCWs to invest in themselves in the form of PSC, which in turn alleviates their emotional exhaustion and fosters their resilience. Accordingly, this helps HCWs in overcoming both current and future adverse events at work. Valuing autonomy and PSC through communication and contextualized human resource management practices will help support HCWs and health care organizations in turn. Indeed, nurturing resilience and reducing emotional exhaustion will provide and protect the needed individual resources to face future disruptive events, consequently leading to strengthen health care organizations.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"63-73"},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543892","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":"Physician Leadership and Its Effect on Physician Burnout and Satisfaction During the COVID-19 Pandemic.","authors":"Edward G Spilg, Kylie McNeill, Melanie Dodd-Moher, Johanna Suzanne Dobransky, Elham Sabri, Jerry M Maniate, Kathleen A Gartke","doi":"10.2147/JHL.S487849","DOIUrl":"10.2147/JHL.S487849","url":null,"abstract":"<p><strong>Purpose: </strong>Physician burnout is a global issue associated with low job satisfaction, decreased quality of patient care, reduced productivity, and early retirement from clinical practice. We sought to evaluate the impact of the leadership qualities of direct physician supervisors on the burnout and professional satisfaction of the physicians they supervise.</p><p><strong>Methods: </strong>An online survey was distributed by Email to all staff physicians practicing at a large Canadian academic tertiary care hospital. The primary outcome was the prevalence of burnout and professional satisfaction, assessed using the 2-item Maslach Burnout Inventory and a single item 5-point Likert scale rating, respectively. The secondary outcome was the relationship between composite leadership score and burnout/satisfaction, with leadership assessed by the 12-item Mayo Clinic Participatory Management Leadership Index.</p><p><strong>Results: </strong>Out of the 1176 physicians surveyed, 383 (32.6%) responded (51.2% male; 41.5% female). Overall, 41.7% of physicians reported at least one symptom of burnout (40.0% reported high emotional exhaustion; 15.3% reported high depersonalization). 40.1% of physicians reported being satisfied with the organization, 26.3% were neutral, and 33.6% were dissatisfied. On multivariate analysis adjusting for age, sex, duration of employment at the institution, and specialty, each one-point increase in composite leadership score was associated with a 3.1% decrease in the likelihood of burnout (<i>p</i> = 0.0017), and a 6.6% increase in the likelihood of satisfaction (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Physician burnout is prevalent and positive leadership qualities of direct supervisors decreases the likelihood of burnout in physicians and increases the likelihood of their satisfaction with the organization.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov; Identifier: NCT04896307.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"49-61"},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543895","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":"Exploring Trust and Engagement: A Qualitative Evaluation of the Relationship Between Clinicians and Healthcare Leaders at Academic Medical Centers.","authors":"Eric J Keller, Niraj Sehgal, Robert K Ryu, Howard Chrisman, Robert K Vogelzang, Tait D Shanafelt","doi":"10.2147/JHL.S503086","DOIUrl":"10.2147/JHL.S503086","url":null,"abstract":"<p><strong>Background: </strong>Dynamics between clinicians and healthcare leaders are critical in determining the culture and success of Academic Medical Centers (AMCs). These dynamics are complex, making it challenging to develop effective means of improving these relationships. This study sought to characterize and compare relationships between clinicians and healthcare leaders at three AMCs to develop more effective means of improving healthcare organization cultures.</p><p><strong>Materials and methods: </strong>The authors interviewed clinicians, clinician leaders, and operational leaders at three AMCs about their role, perceived dynamics between clinicians and healthcare leaders, and ideal leadership. Interviews continued until additional interviews stopped revealing new information at each organization, requiring a total of 92 participants (49% male, 54% clinicians, 22% clinician-leaders, 24% operational leaders). Interview transcripts were systematically analyzed based on constructivist grounded theory and content analysis for key themes.</p><p><strong>Results and discussion: </strong>The perceived most pressing issues at each AMC varied across three key cultural levels: organization, department, and practice. When interventions targeted levels distinct from the level perceived most pressing, they tended to exacerbate existing issues and further undermine trust and engagement between clinicians and healthcare leaders. Clinicians and healthcare leaders across AMCs described similar traits of ideal leadership but exhibited different understandings of what those traits meant in application. Cultural dynamics were also challenged by professional cultural differences between the three groups and barriers such as differences in status, location, and background. Limitations of this study included its cross-sectional nature and potential sampling bias.</p><p><strong>Conclusion: </strong>The level of organizational culture where the greatest tension exists between clinicians and healthcare leaders varies by three key levels. Discerning which level of organizational culture represents the greatest local opportunity can inform the design of more targeted interventions to improve dynamics between clinicians and healthcare leaders seeking to foster more constructive partnerships.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"75-83"},"PeriodicalIF":3.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568462","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":"Rethinking Healthcare: Why Paradox Science Is Core to the Future of Health and Health Leadership.","authors":"Laura Desveaux","doi":"10.2147/JHL.S512053","DOIUrl":"10.2147/JHL.S512053","url":null,"abstract":"<p><p>Solutions to healthcare's most persistent and pervasive challenges remain elusive because we approach them as navigating oppositional tensions: the need to drive efficiency versus improve quality, to leverage cutting-edge technology versus maintain human compassion, to address population health versus providing care to the patient in front of you. The key to transforming healthcare lies in the ability of healthcare leaders to recognize when oppositional tensions are in fact paradoxes at play, to increase the capability and collective capacity to navigate them. Paradox science contends sustainable solutions to intractable challenges come not from eliminating the tensions that operate within the complexity but from the ability of those involved to hold opposing ideas in productive balance. It empowers leaders and their teams to find innovative paths by engaging with tensions directly. This perspective piece outlines three steps healthcare leaders can take to apply paradox science in practice, providing descriptions and example actions for each: 1) Clarify the paradox, 2) Encourage experimentation, and 3) Adopt a dynamic view. Moving forward, health leaders must leverage paradox science to drive forward innovation agendas in order to truly transform the healthcare experience for patients, populations, and the health workforce that serves them.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"45-48"},"PeriodicalIF":3.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504656","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":"The Erosion of Healthcare and Scientific Integrity: A Growing Concern.","authors":"Björn L D M Brücher","doi":"10.2147/JHL.S506767","DOIUrl":"10.2147/JHL.S506767","url":null,"abstract":"<p><strong>Background: </strong>Tremendous achievements in healthcare and science over the past 200 years have enhanced life expectancy in parallel with a shift from dogma to humanistic liberal education. Advancements in cancer have included vaccines treating causes of cancer (eg, hepatitis C- induced liver cancer and human papillomavirus-induced cervical cancer) along with improved cancer survival in children. In contrast, developments in cancer, frequently touted as \"discoveries\" or \"breakthroughs\" in media headlines, have been demonstrated to be ephemeral rather than game changers. In reality, cancer incidences are increasing, and relapse and mortality rates have not changed substantially. By this, we are experiencing today similar challenges to those before the so-called Humboldt reform. The trend towards managerialism with a focus on quantity in health care and science endangers their integrity.</p><p><strong>Methods: </strong>Due to the complexity of integrity of healthcare and science, in-depth contemplation of this review contains foundations of actions in healthcare and science, information regarding cancer, as an example, quantity focus of healthcare, technology, publishing, marketing and media, predatory publishers, followed by psychologic and sociologic aspects which influence our perception.</p><p><strong>Results: </strong>A complex paradoxical transformation has occurred, in which quality and humanism have been replaced by quantity, revenue, and marketing, together with \"citation silence\", (ignoring original findings), and increased corruption and misconduct. This shift explains why the integrity of healthcare and science is being eroded.</p><p><strong>Conclusion: </strong>Countries and societies are only as strong as their healthcare and science, both of which are only as strong as their emphasis on quality and integrity. Awareness of this situation may represent a first step toward a renewed focus on accountability.</p>","PeriodicalId":44346,"journal":{"name":"Journal of Healthcare Leadership","volume":"17 ","pages":"23-43"},"PeriodicalIF":3.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504727","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}