Leadership in Health Services最新文献

{"title":"Canadian medical faculty senior leaders: what skills do they need?","authors":"Mia Lang,&nbsp;Louanne Keenan","doi":"10.1108/LHS-03-2022-0023","DOIUrl":"https://doi.org/10.1108/LHS-03-2022-0023","url":null,"abstract":"<p><strong>Purpose: </strong>Many academic leaders have little formal leadership training, which can result in challenges to effective leadership, succession planning and burnout. This paper aims to explore the leadership skills needed to be an effective senior academic leader in a Canadian medical faculty.</p><p><strong>Design/methodology/approach: </strong>An anonymous voluntary survey of needed leadership skills and supports was sent to 60 senior academic leaders at the University of Alberta. This was followed by interviewing a purposive sample, using open-ended questions based on a multimodal needs assessment of senior academic leaders. The authors used an iterative process to analyze the data; anonymized transcripts were coded and categorized separately by two researchers, and themes were created.</p><p><strong>Findings: </strong>The \"ability to influence\" was the highest rated needed leadership skill in the survey. The interviewed leaders (<i>n</i> = 12) were unanimous that they felt unprepared at the start of the leadership role. The survey and interviews identified five major themes for leadership skills: Mentoring, Finances, Human Resources, Building Relationships and Protected Time. Networking and leadership courses were identified as major sources of support.</p><p><strong>Research limitations/implications: </strong>Although a single site study, the results were similar to another large Canadian medical faculty (University of Toronto, Lieff <i>et al.</i>, 2013). While the survey had a 42% response rate (25/60), the survey responses were echoed in the interviews. Although the purposive sample was small, the interviewed leaders were a representative sample of the larger leadership group.</p><p><strong>Originality/value: </strong>Academic leaders may benefit from a mentorship team/community of leaders and specific university governance knowledge which may help their ability to influence and advance their strategic initiatives.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40415080","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":"Shared accountability in distributed leadership for improved healthcare access: a study of a US dental institution.","authors":"A Erin Bass,&nbsp;Ivana Milosevic,&nbsp;Mary Uhl-Bien,&nbsp;Sucheta Nadkarni","doi":"10.1108/LHS-03-2022-0019","DOIUrl":"https://doi.org/10.1108/LHS-03-2022-0019","url":null,"abstract":"<p><strong>Purpose: </strong>Accountability within distributed leadership (DL) is critical for DL to drive positive outcomes in health services organizations. Despite this, how accountability emerges in DL is less clear. This study aims to understand how accountability emerges in DL so that distributed leaders can drive improvements in healthcare access - an increasingly important outcome in today's health services environment.</p><p><strong>Design/methodology/approach: </strong>The authors use an instrumental case study of a dental institution in the USA, \"Environ,\" as it underwent a strategic change to improve healthcare access to rural populations. The authors focused on DL occurring within the strategic change and collected interview, observation and archival data.</p><p><strong>Findings: </strong>The findings demonstrate accountability in DL emerged as shared accountability and has three elements: personal ownership, agentic actions and a shared belief system. Each of these was necessary for DL to advance the strategic change for improved healthcare access.</p><p><strong>Practical implications: </strong>Top managers should be cognizant of the emergence processes driven by DL. This includes enabling pockets of employees to connect, align and link up so that ideas, processes and practices can emerge and allow for shared accountability in DL.</p><p><strong>Originality/value: </strong>The overarching contribution of this research is identifying shared accountability in DL and its three elements: personal ownership, agentic actions and a shared belief system. These elements serve as a platform to demonstrate \"how DL works\" in a healthcare organization.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40695380","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":"A model of lived experience leadership for transformative systems change: Activating Lived Experience Leadership (ALEL) project.","authors":"Mark Loughhead,&nbsp;Ellie Hodges,&nbsp;Heather McIntyre,&nbsp;Nicholas Gerard Procter,&nbsp;Anne Barbara,&nbsp;Brooke Bickley,&nbsp;Geoff Harris,&nbsp;Lisa Huber,&nbsp;Lee Martinez","doi":"10.1108/LHS-04-2022-0045","DOIUrl":"https://doi.org/10.1108/LHS-04-2022-0045","url":null,"abstract":"<p><strong>Purpose: </strong>This discursive paper presents a lived experience leadership model as developed as part of the Activating Lived Experience Leadership (ALEL) project project to increase the recognition and understanding of lived experience leadership in mental health and social sectors. The model of lived experience leadership was formulated through a collaboration between the South Australian Lived Experience Leadership & Advocacy Network and the Mental Health and Suicide Prevention Research and Education Group.</p><p><strong>Design/methodology/approach: </strong>As one of the outcomes of the ALEL research project, this model incorporates findings from a two-year research project in South Australia using participatory action research methodology and cocreation methodology. Focus groups with lived experience leaders, interviews with sector leaders and a national survey of lived experience leaders provided the basis of qualitative data, which was interpreted via an iterative and shared analysis. This work identified intersecting lived experience values, actions, qualities and skills as characteristics of effective lived experience leadership and was visioned and led by lived experience leaders.</p><p><strong>Findings: </strong>The resulting model frames lived experience leadership as a social movement for recognition, inclusion and justice and is composed of six leadership actions: centres lived experience; stands up and speaks out; champions justice; nurtures connected and collective spaces; mobilises strategically; and leads change. Leadership is also guided by the values of integrity, authenticity, mutuality and intersectionality, and the key positionings of staying peer and sharing power.</p><p><strong>Originality/value: </strong>This model is based on innovative primary research, which has been developed to encourage understanding across mental health and social sectors on the work of lived experience leaders in seeking change and the value that they offer for systems transformation. It also offers unique insights to guide reflective learning for the lived experience and consumer movement, workers, clinicians, policymakers and communities.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40596601","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":"Nurse leaders' changing roles over 25 years: a qualitative study.","authors":"Frøydis Vasset,&nbsp;Lisbeth Fagerstrøm,&nbsp;Marianne Louise Frilund","doi":"10.1108/LHS-03-2022-0025","DOIUrl":"https://doi.org/10.1108/LHS-03-2022-0025","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to emphasise nurses' experiences of nurse leaders' changing roles over 25 years.</p><p><strong>Design/methodology/approach: </strong>A qualitative study was performed with individual interviews of eight nurse managers. From Norway and Finland, all nurse managers with more than 25 years of experience and working in specialist health care and primary health care were included in the study.</p><p><strong>Findings: </strong>These nurse managers have a lot of knowledge and resolved conflicts using improved methods and have experienced continuous change. The role of nurse manager ranges from bedside to exclusive administrative work. The organisations have become more extensive, and the staff has grown. These changes have led to many challenges and more complex organisations.</p><p><strong>Research limitations/implications: </strong>Nurse managers who have worked for over a 25-year period had useful experience and could handle many new challenges. They can change themselves and their organisation tasks over time and follow the development of society.</p><p><strong>Originality/value: </strong>Based on their experiences as novices at the beginning of their career, the informants demonstrate their development to the level of expert manager.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40576963","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":"More I than we - the effect of organisational identification in the Australian aged care workforce.","authors":"Richard Olley","doi":"10.1108/LHS-05-2022-0049","DOIUrl":"https://doi.org/10.1108/LHS-05-2022-0049","url":null,"abstract":"<p><strong>Purpose: </strong>This paper aims to determine the effects of leadership style (LS) on organisational identification (OID) in aged care provider organisations to inform talent management strategies for the sector, which has quite severe workforce shortages.</p><p><strong>Design/methodology/approach: </strong>This paper reports on a mixed-methods study. Study 1 was quantitative in approach that measured responses to an online questionnaire containing the Multifactor Leadership Questionnaire and the Identification with a Psychological Group scale. The analytical strategy provided results that demonstrated the socio-demographic characteristics of the sample, the reliability and distributions of data and calculated the correlations between the factors of the deployed tools. The relationship between the factors that comprise both tools was measured, and any differences between the two natural groups were labelled leaders and raters. Study 2 was qualitative in approach, using interpretive phenomenological analysis to provide an in-depth analysis of phenomena.</p><p><strong>Findings: </strong>The results and findings of this study are that OID was not evident in the quantitative or qualitative samples. There are recommendations for future research relating to the social capital of organisations and the use of social media to determine how these could be harnessed in support of workforce recruitment and retention strategies.</p><p><strong>Research limitations/implications: </strong>This research was conducted in Australia with participants from the workforces of aged care providers in three eastern states of Australia. The results and findings may be limited to the Australian aged care context. The researcher evaluated the limitations of this research relating to: Methodology: There may be an overstatement of the strength of the relationships between variables among those motivated to participate in the survey in the quantitative study; Transferability: The qualitative study required the researcher to be thorough in describing the research context, and it may be that those who wish to transfer the results of this study to a different context are responsible for making the judgement on the suitability of the transfer; Credibility: The qualitative analysis was not designed to directly reflect a relationship between each leader and their direct report raters' experiences; and Confirmability: The researcher maintained an awareness and openness to the dynamism of the results. Frequent reflection and self-criticism about preconceptions that may have affected the research were recorded in field notes after each interview.</p><p><strong>Practical implications: </strong>Aged care providers who must compete in the labour market for staff may use the results and findings of this research to inform recruitment and retention strategies relating to brand recognition and loyalty and social capital strategies.</p><p><strong>Social implications: </strong>Provi","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40551525","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":"Women's career progression to management positions in Jordan's health sector.","authors":"Yousef Khader,&nbsp;Aida Asim Essaid,&nbsp;Mohammad S Alyahya,&nbsp;Rowaida Al-Maaitah,&nbsp;Muntaha K Gharaibeh,&nbsp;Abeer Bashier Dababneh,&nbsp;Raeda F AbuAlRub","doi":"10.1108/LHS-05-2022-0047","DOIUrl":"https://doi.org/10.1108/LHS-05-2022-0047","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to identify and explore experiences, perspectives, barriers and enablers to women's career progression to management positions in the health-care sector and to assess women's and men's perceptions of the policies and practices of the health-care system concerning gender equality and nondiscrimination between women and men.</p><p><strong>Design/methodology/approach: </strong>A cross-sectional survey was conducted among health-care professionals in ten selected hospitals, including physicians, registered nurses/midwives and pharmacists with or without managerial positions.</p><p><strong>Findings: </strong>This study included a total of 2,082 female and 1,100 male health-care professionals. Overall, 70% of women and men reported that opportunities for advancement are based on knowledge and skills in their institution. However, 58.9% of women (<i>p</i> < 0.001) reported that women are more likely to face barriers to career advancement than men do in their workplace. Lack of women in general/line management and discrimination against women by supervisors at the point of promotion were the main barriers to women's career progression, as they were reported by two-thirds of women. The main barrier, as perceived by men (62.3%) was that women have family and domestic responsibilities.</p><p><strong>Practical implications: </strong>To overcome barriers in women's career progression, there is a need to establish a career planning and capacity-building program for women in the health sector.</p><p><strong>Originality/value: </strong>Jordanian female health-care professionals face different barriers that affect their career progression, including inequity and discrimination in the workplace, negative views about women's abilities, lack of qualifications and training, hostile cultural beliefs and family responsibilities.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40536166","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":"Family physician leadership during the COVID-19 pandemic: roles, functions and key supports.","authors":"Maria Mathews,&nbsp;Dana Ryan,&nbsp;Lindsay Hedden,&nbsp;Julia Lukewich,&nbsp;Emily Gard Marshall,&nbsp;Judith Belle Brown,&nbsp;Paul S Gill,&nbsp;Madeleine McKay,&nbsp;Eric Wong,&nbsp;Stephen J Wetmore,&nbsp;Richard Buote,&nbsp;Leslie Meredith,&nbsp;Lauren Moritz,&nbsp;Sarah Spencer,&nbsp;Maria Alexiadis,&nbsp;Thomas R Freeman,&nbsp;Aimee Letto,&nbsp;Bridget L Ryan,&nbsp;Shannon L Sibbald,&nbsp;Amanda Lee Terry","doi":"10.1108/LHS-03-2022-0030","DOIUrl":"https://doi.org/10.1108/LHS-03-2022-0030","url":null,"abstract":"<p><strong>Purpose: </strong>Strong leadership in primary care is necessary to coordinate an effective pandemic response; however, descriptions of leadership roles for family physicians are absent from previous pandemic plans. This study aims to describe the leadership roles and functions family physicians played during the COVID-19 pandemic in Canada and identify supports and barriers to formalizing these roles in future pandemic plans.</p><p><strong>Design/methodology/approach: </strong>This study conducted semi-structured qualitative interviews with family physicians across four regions in Canada as part of a multiple case study. During the interviews, participants were asked about their roles during each pandemic stage and the facilitators and barriers they experienced. Interviews were transcribed and a thematic analysis approach was used to identify recurring themes.</p><p><strong>Findings: </strong>Sixty-eight family physicians completed interviews. Three key functions of family physician leadership during the pandemic were identified: conveying knowledge, developing and adapting protocols for primary care practices and advocacy. Each function involved curating and synthesizing information, tailoring communications based on individual needs and building upon established relationships.</p><p><strong>Practical implications: </strong>Findings demonstrate the need for future pandemic plans to incorporate formal family physician leadership appointments, as well as supports such as training, communication aides and compensation to allow family physicians to enact these key roles.</p><p><strong>Originality/value: </strong>The COVID-19 pandemic presents a unique opportunity to examine the leadership roles of family physicians, which have been largely overlooked in past pandemic plans. This study's findings highlight the importance of these roles toward delivering an effective and coordinated pandemic response with uninterrupted and safe access to primary care.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9595102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622522","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 effects of a dilemma management training program on mental health: a prospective study with mid-level executives in hospitals.","authors":"Marieke Born,&nbsp;Janna Küllenberg,&nbsp;Antonia Drews,&nbsp;Ulrike Bossmann,&nbsp;Julika Zwack,&nbsp;Harald Gündel,&nbsp;Jochen Schweitzer","doi":"10.1108/LHS-03-2022-0024","DOIUrl":"https://doi.org/10.1108/LHS-03-2022-0024","url":null,"abstract":"<p><strong>Purpose: </strong>Mid-level executives are confronted with many dilemma situations, in which they are forced to decide between conflicting options, none of them leading to the desired result. If they fail to cope with them constructively, their individual risk for mental strains increases (Gerlmaier and Latniak, 2013). Initial findings focusing on executives in industry (Bossmann, 2020) show that fostering effective dilemma management in executives is a preventive factor against stress-related diseases. Yet, there is little empirical research that evaluates the contribution of dilemma management training on leadership's mental health prevention in hospitals. This study aims to examine whether such a training program, adapted to current working conditions in German hospitals, promotes mid-level executives' mental health.</p><p><strong>Design/methodology/approach: </strong>A 10-month training program was administered to N = 69 senior physicians, senior nurses and senior service and administrative staff in four hospitals. To evaluate training effects on perceived stress reactivity, on cognitive and emotional irritation over time as well as the effects of the training dose on these results, participants' self-reported measures were collected at four points in time: before (t0), during (t1), immediately after (t2) and three months after the intervention (t3).</p><p><strong>Findings: </strong>Overall, participants showed less cognitive irritation and perceived stress reactivity over time. However, their emotional irritation did not change significantly. The dose of training participation did not moderate these results.</p><p><strong>Originality/value: </strong>This paper contributes to the prevention of stress-related diseases and the promotion of sensemaking in mid-level executives' dilemma management routine in the face of increasingly aggravating working conditions due to financial restrictions in the German health-care system. Findings of this study are explained in greater depth using previously reported qualitative data from the same research project.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40623973","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":"Embedding coproduction in organisational culture and practice: a case study.","authors":"Julie Repper,&nbsp;Julian Eve","doi":"10.1108/LHS-04-2022-0039","DOIUrl":"https://doi.org/10.1108/LHS-04-2022-0039","url":null,"abstract":"<p><strong>Purpose: </strong>This paper aims to explore the challenges of coproduction at individual, team, service, organisational and system level and critically describes the work of one organization to describe ways in which coproduction can be facilitated.</p><p><strong>Design/methodology/approach: </strong>This is a case study of the approaches developed (coproduced) within an independent not-for-profit mental health consultancy organization to facilitate coproduction at every level.</p><p><strong>Findings: </strong>Although much is published about coproduction in research, there is relatively little guidance relating to coproduction in practice. This paper describes the meaning, purpose and impact of coproduction at different levels and gives examples of how it can be achieved. The learning from his work is drawn together to present a series of findings with recommendations including: inclusion, managing power difference, accommodating difference, generating new ways forward rather than debating and selecting existing options.</p><p><strong>Originality/value: </strong>The literature on coproduction in practice is replete with guidance rather than examples of good practice. It is also apparent that the ambition for coproduction has progressed rapidly from coproduction between service providers and people using services to coproduction with all relevant stakeholders. This paper provides contemporary examples of coproduction in different forms and at different levels with attention to ways of overcoming challenges.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40623976","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":"Implementing the HEART score in an NHS emergency department: can identity leadership combined with quality improvement promote racial equality?","authors":"Rangani Handagala,&nbsp;Buddhike Sri Harsha Indrasena,&nbsp;Prakash Subedi,&nbsp;Mohammed Shihaam Nizam,&nbsp;Jill Aylott","doi":"10.1108/LHS-04-2022-0035","DOIUrl":"https://doi.org/10.1108/LHS-04-2022-0035","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to report on the dynamics of \"identity leadership\" with a quality improvement project undertaken by an International Medical Graduate (IMG) from Sri Lanka, on a two year Medical Training Initiative (MTI) placement in the National Health Service (NHS) [Academy of Medical Royal Colleges (AoMRC), 2017]. A combined MTI rotation with an integrated Fellowship in Quality Improvement (Subedi <i>et al.</i>, 2019) provided the driver to implement the HEART score (HS) in an NHS Emergency Department (ED) in the UK. The project was undertaken across ED, Acute Medicine and Cardiology at the hospital, with stakeholders emphasizing different and conflicting priorities to improve the pathway for chest pain patients.</p><p><strong>Design/methodology/approach: </strong>A social identity approach to leadership provided a framework to understand the insider/outsider approach to leadership which helped RH to negotiate and navigate the conflicting priorities from each departments' perspective. A staff survey tool was undertaken to identify reasons for the lack of implementation of a clinical protocol for chest pain patients, specifically with reference to the use of the HS. A consensus was reached to develop and implement the pathway for multi-disciplinary use of the HS and a quality improvement methodology (with the use of plan do study act (PDSA) cycles) was used over a period of nine months.</p><p><strong>Findings: </strong>The results demonstrated significant improvements in the reduction (60%) of waiting time by chronic chest pain patients in the ED. The use of the HS as a stratified risk assessment tool resulted in a more efficient and safe way to manage patients. There are specific leadership challenges faced by an MTI doctor when they arrive in the NHS, as the MTI doctor is considered an outsider to the NHS, with reduced influence. Drawing upon the Social Identity Theory of Leadership, NHS Trusts can introduce inclusion strategies to enable greater alignment in social identity with doctors from overseas.</p><p><strong>Research limitations/implications: </strong>More than one third of doctors (40%) in the English NHS are IMGs and identify as black and minority ethnic (GMC, 2019a) a trend that sees no sign of abating as the NHS continues its international medical workforce recruitment strategy for its survival (NHS England, 2019; Beech <i>et al.</i>, 2019). IMGs can provide significant value to improving the NHS using skills developed from their own health-care system. This paper recommends a need for reciprocal learning from low to medium income countries by UK doctors to encourage the development of an inclusive global medical social identity.</p><p><strong>Originality/value: </strong>This quality improvement research combined with identity leadership provides new insights into how overseas doctors can successfully lead sustainable improvement across different departments within one hospital in the NHS.<","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40606308","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}