BMJ Leader最新文献

Background: Healthcare leadership and management impacts every patient journey and every staff experience. Good leadership results in positive outcomes. Kindness is an understudied and underused leadership strategy. The research questions addressed in this study are the following: (1) Does kindness in healthcare leadership and management currently meet the criteria of a mature concept?; (2) Using concept analysis methodology, can we develop our understanding of kindness within this context?

Methods: A systematic search of the peer-reviewed literature was conducted to inform a concept evaluation, followed by a concept analysis. Search terms consisted of 'leader*' or 'manage*' and 'kindness'; databases searched comprised MEDLINE, HMIC, SPP, APA PsycInfo and CINAHL. Data extraction and thematic analysis of the data were performed manually according to concept analysis principles.

Results: The 10 papers included from the search suggested that within healthcare leadership and management, kindness is an 'emerging' rather than a 'mature' concept. Concept analysis demonstrated a cluster of recurring attributes, allowing a theoretical definition to be put forth.

Conclusions: Despite being a commonly used lay term, kindness in the context of healthcare leadership and management is not yet a mature concept. Work developing this concept is needed to validate the proposed theoretical definition. Observational studies and systematic review of the grey literature are recommended.

Introduction: Return to practice is one mechanism for recruiting and retaining allied health professionals (AHPs) within the health and care workforce in England. It is not known how this affects persons with protected characteristics.

Aim: To understand experiences of AHPs with protected characteristics of returning to the workforce through a return to practice programme.

Method: A QUAL (semistructured interviews) + qual (focus group interviews) mixed-methods study. 12 online semistructured interviews with return to practice AHPs, followed by 2 online focus groups.

Results: Our research identifies a new type of returners who have to use the return to practice programme as a vehicle to step into health and social care as they have not been able to find employment. A main driver to return to practice was financial reason.

Conclusion: To date there, is little evidence of leaders understanding the complexities of AHPs in a return to practice programme, the considerable contribution they can make to the workplace and the current inequities that exist.

Background: The COVID-19 pandemic presented unprecedented challenges for leaders in healthcare requiring decision-making and crisis response that can often be tricky without the right level of trust. Trust is fostered and facilitated with emotional intelligence (EI); thus, a critical examination of medical leaders' reflections was essential to understand how leaders perceived their leadership responses during the initial response to COVID-19. This exploratory study used an EI lens to investigate leaders' perceptions of their decision-making during COVID-19.

Methods: A purposeful sample of seven leaders in medicine who experienced leading during COVID were invited to participate in semi-structured interviews.

Results: Four themes around leadership response during the uncertain times of the COVID-19 were identified. The themes included communication, interprofessional collaboration including decision-making and strategic planning, internal and external awareness, and finally, trust and psychological safety.

Conclusions: Incorporating EI competencies into crisis leadership education for healthcare professionals could enhance medical leaders' preparedness to adapt, collaborate and communicate effectively in a crisis.

Background: Like other fields in medicine, medical education relies on collaboration and cooperation between countries and regions of the world, although no single institution or position unifies the global medical education community in the way that the WHO does in public health, for example. Recent research in medical education has drawn attention to many injustices that exist in the field, where power and influence is held in relatively few Global North countries, although most practice happens in Global South countries.

Methods: In this article, we examine three positions that hold global prominence in medical education, including the presidents of the World Federation for Medical Education and the Association for Medical Education in Europe, and winners of the Karolinska Institutet Prize for Research in Medical Education.

Findings: We highlight that these positions have problematic histories and have perpetuated the current power disparities in the field. We argue that an alternative model for global leadership is required that should be determined democratically by those involved in medical education all around the world. Such a model should prioritise diversity and inclusivity, empowering leaders from countries who have previously been peripheral to the decision-making platforms in the field.

Conclusion: Given the shortcomings of existing leadership positions and organisations, we suggest that a new institution is required to realise this new vision, and that the principles that govern it should be determined through debate and democracy, with a focus on inviting those voices that have not previously been heard in global medical education circles.

Introduction: Healthcare organisations work better with an engaged workforce, and staff-engagement campaigns offer a method to build this engagement. Leeds Teaching Hospitals NHS Trust (LTHT), one of the UK's largest Trusts, provides an example of where an organisation-wide engagement intervention has been used in a healthcare setting. This study aimed to understand why staff participate, or do not participate, in staff-engagement campaigns, supporting healthcare leaders to increase participation in future campaigns.

Methods: Scenario-based focus groups were carried out across five different organisational units within LTHT. The data from these were transcribed, coded and analysed using reflective thematic analysis.

Results: Participation in staff-engagement campaigns is dependent on campaign awareness, staff perceptions of the campaign and the practicalities associated with participation. Perceptions of the campaign are further subdivided into the campaign's perceived effectiveness, purpose and relevance.

Conclusions: Staff engagement was a powerful driver of participation, which presents a conundrum: how do you encourage participation in staff-engagement campaigns, if engagement is a prerequisite for participation? The answer lies in taking advantage of organisational belongingness and visible leadership, supported by communications that take control of the narrative around the campaign. Behavioural science models may guide leaders across the organisation in mapping where these approaches can have the greatest impact within their existing spheres of influence. Further, considering inequalities around participation across different groups may help target action to the areas of greatest need. Accordingly, the research provides pragmatic guidance for leaders in thinking about how to use staff-engagement campaigns more effectively.

Purpose: To examine the consequences of broader spans of control for well-being outcomes among frontline managers.

Method: Healthcare managers were surveyed in collaboration with the Central Denmark Region. The response rate was 74.5%. Using regression analysis, we investigate how span of control is associated with outcomes related to well-being understood as perceived stress, burnout, job satisfaction, satisfaction with the work environment, intention to quit their current job and work-life balance.

Findings: Span of control may be an important factor in establishing well-being among frontline managers in the Danish hospital sector on several parameters. Span of control is associated the strongest with work-life balance and intention to quit, least but significantly with perceived stress and not significantly with burnout.

Practical implications: We recommend that healthcare organisations consider whether it could be more optimal to reduce the span of control for some managers. Furthermore, we recommend that future studies pay attention to span of control and provide stronger causal evidence about its impact on healthcare workers.

Aim: The identification and development of managerial talents for nursing manager succession in the future should be a concern for organisations, as the concept of succession planning has not been seriously addressed in nursing. This study aimed to explore managers' perceptions of the concept of succession planning in nursing management.

Design: This qualitative study used a conventional content analysis approach.

Methods: Participants included 15 nursing managers, who were purposively selected based on predetermined inclusion and exclusion criteria. After obtaining ethical approval, data were collected through semistructured interviews. MAXQDA software was used for data management, and data analysis was performed using the seven-stage method by Graneheim and Lundman. The credibility and dependability of the data were assessed using Guba and Lincoln's criteria.

Results: The main categories identified in this study were barriers to succession planning, facilitators, succession planning requirements, contextualisation, succession planning cycle, the dynamism of the successor organisation and consequences of lack of succession planning. Based on the findings of this study, it is recommended that organisations plan and adopt policies to develop qualified personnel management in nursing organisations and appoint these individuals to critical managerial positions.