BMJ Leader最新文献

Background: Leadership education is increasingly recognised as essential for preparing healthcare students to navigate complexity and drive change. Yet practice-based learning (placements) focusing on leadership in the Allied Health Professions remains underexplored and is often perceived as less relevant than those in clinical settings. This article presents a reflective account from a mature physiotherapy student from a minoritised ethnic background, whose cultural upbringing initially positioned education and leadership as inaccessible.

Method: The student undertook a 6-week leadership-focused placement during her second year of study. Entering with apprehension and uncertainty about its value, she engaged in structured activities, including weekly presentations designed to reflect on learning from the previous weeks and to discuss progress on the placement's central project.

Results: Drawing on personal experiences of navigating cultural and gender norms, the placement provided opportunities for significant personal and professional growth, including increased confidence, resilience and development of transferable skills in communication, digital literacy and teamworking. It enabled the student to challenge internalised limitations shaped by cultural expectations and recognise leadership as an integral aspect of physiotherapy practice. The impact of this leadership journey was demonstrated through a university leadership award and the opportunity to influence others via a national online presentation for the Chartered Society of Physiotherapy.

Conclusion: This article illustrates how leadership-focused placements can be transformative by fostering inclusion, self-belief and professional adaptability. These placements align with workforce transformation goals and highlight the need to embed leadership as a core component of healthcare education.

Background: Transitioning into a new chief executive role within a large national health and social care provider prompted a period of systematic observation and deliberate reflection. Drawing on Schön's concept of the reflective practitioner, I kept a journal during my first months to capture critical moments that tested my assumptions and revealed how organisational culture shapes leadership behaviour.

Reflection: This autoethnographic account integrates observation, intentional listening and reflective journaling to explore how leadership meaning is constructed in everyday practice. Six anonymised vignettes are presented, spanning board discussions, governance meetings and frontline encounters. Each vignette illustrates tensions such as silence vs intervention, urgency vs empathy and authority vs collaboration, analysed through frameworks including adaptive, situational and collective leadership, as well as psychological safety, motivation and organisational culture.

Conclusion: The reflections show that leadership is not confined to formal authority but emerges in presence, tone and everyday interactions. They demonstrate how listening, humility and adaptive behaviour foster psychological safety and collective leadership. While situated in health and social care, the insights are transferable to leaders at all levels and across sectors facing complexity and uncertainty.

Introduction: In their 2024 editorial, Yassaie and Garman called on health professionals to be planetary health leaders. Responding to their call for articles, this submission reflects my COVID-19 'planetary health' epiphany during the Australian lockdowns while curating sustainable healthcare and climate change education submissions. COLLECTIVE COVID-19 LEARNINGS: As a global collective, we could have learnt much from the pandemic. Despite our broken relationship with Nature, during lockdown, most of us spent considerable time in Nature. This should have heightened our awareness of our interdependence with our natural environment. The United Nations has asked us to Make Peace with Nature and be the #GenerationRestoration in the 2021-2030 Decade of Restoration. A PERSONAL COVID-19 EPIPHANY: My COVID-19 epiphany happened while curating sustainable healthcare education articles for a medical education journal. An article reflecting Indigenous perspectives introduced me to Natural and First Laws. My newfound awareness of Indigenous communities' deep spiritual connection to and stewardship of Country or Land changed the lens with which Planetary Health was integrated across our curriculum.

Advancing planetary health: This 'epiphany' also led to advocacy for advancing planetary stewardship in health professions education, such as the development of a Consensus Statement on Planetary Health and Education for Sustainable Healthcare, and contributing to the revision of the Australian Medical Council's Accreditation Standards.

Restoration of the planet: Individually and collectively, as health professionals and health professions educators and as #GenerationRestoration, current and yet unborn generations of all 'beings' are relying on us to be inclusive eco-ethical leaders and planetary stewards.

Objective: The aim of this review article is to comprehensively examine and analyse the studies and research conducted in the field of succession planning in nursing management.

Introduction: Succession planning, through the identification and appointment of qualified managers to key leadership positions, helps improve the quality of nursing services.

Methods: The present study is a scoping review that was conducted using Arksey and O'Malley's framework. We used English-language databases such as Web of Science, PubMed, Scopus, ProQuest and the Google Scholar search engine. Additionally, for searching Persian-language sources, databases such as the Islamic World Science Citation Center, the Jihad University Journals Bank, Iran-Doc, Elm-Net and the Ministry of Health's of Iran Theses System were employed.

Results: 30 documents were selected based on the evaluation for data extraction, aligning with the objectives of the study. The results of the data analysis identified six main categories related to succession planning: barriers, facilitators, requirements, contextualisation, cyclical succession planning and potential succession planner organisation.

Conclusion: Based on the importance of succession planning in nursing management, we recommend using the study's findings to plan and carry out thorough and practical research, formulate guidelines and managerial policies, define hospital goals and missions, and shape the organisational vision.

Objectives: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Aims: To identify the range of internal specialist management expertise providers in the NHS and explore their blending with external organisations to address complex organisational challenges.

Methods: Ongoing quantitative and qualitative research (e.g. interviews) and a national networking event and workshop organised by the University of Bristol with NHS partners.

Findings: There is a diverse NHS ecosystem of what we term internal consultancies where strategic benefits can result from combining their contextual insight with the specialist skills of external providers. Effective blending can build sustainable management capacity, deliver better value and reduce over-reliance on external consultants.

Conclusion: There is a need for coordinated action across policy, procurement and workforce development to support a network of internal consultancy/expertise and its periodic blending with other partners, including external organisations.

Background: Founded in 1925 as a 'reverse Rhodes Scholarship', the Harkness Fellowship was designed to foster international collaboration through transatlantic academic exchange. Over a century, it has evolved into a leadership programme uniting mid-career professionals from nine countries and a range of professional backgrounds to improve health systems through a year of immersion in the USA. As the fellowship marks its centennial, we reflect on what its history reveals about leading and learning across borders.

Methods: This centennial reflection draws upon archival research, programme documentation, alumni interviews and individual case studies. The analysis synthesises historical shifts, strategic pivots and leadership development outcomes over the programme's 100-year history.

Results: Three core lessons emerged: (1) challenge assumptions-fellows consistently innovated by questioning entrenched practices and applying cross-cultural insights; (2) harness the power of fellowship-sustained relationships and a shared mission drive collaborative outcomes across borders and (3) embrace a multidisciplinary mindset-fellows from diverse fields have advanced more holistic approaches to healthcare reform. Real-world examples illustrate the fellowship's tangible impact and provide practical lessons for healthcare leaders across countries and sectors.

Conclusions: The Harkness Fellowship demonstrates that leadership in healthcare demands curiosity, humility and sustained collaboration. The fellowship's story is a reminder that the ability to learn across differences remains one of the most powerful tools for change. As the programme enters its second century, its relevance will rest on staying true to its core values: shared purpose, openness to difference and collaboration across borders to drive systemic change.