BMJ Leader最新文献

There is increasing recognition in the field of health and social care research that community-engaged methods should include patients and the public throughout the research process. Therefore, individuals from all backgrounds should be involved in the research. We explored the public and patient engagement experience in research and how researchers and community groups can work together to make the research process more inclusive and sustainable. We carried out a rapid review and we present three themes from our results as a narrative summary. We found that partnerships and peer support was important for individuals, and it helped them to understand their role and the expectations of stakeholders. Also, using inclusive environments for diverse communities to participate helped individuals to access research training in their communities enabling them to co-create and co-design with facilitators and their community together. Trust was an important factor for diverse community participation in research and was linked to past experiences of taking part in research. We also found that partnerships, innovative methods of information sharing and context of the individual were important facilitators of inclusion. Analysis also indicated that the design of the studies and recruitment approaches such as using flyers, word of mouth, attending health fairs and partnering with nonprofit community, led to an increase in diverse population partcipation in research.

Background: China's healthcare sector is facing unprecedented challenges, placing substantial requirements on the competencies of medical administrators. Training programmes play a crucial role in enhancing the competencies of medical administrators to deliver high-quality healthcare services. This study aims to investigate the outcome of training on the competency of medical administrators and to use the findings to guide the development of future training content.

Methods: The Medical Management and Leadership Development Programme, grounded in the Royal Australasian College of Medical Administrators competency model, was implemented as a three-phase training programme for medical administrators at United Family Healthcare to assess the impact of training on their competency.

Results: The study's results revealed significant differences in participants' competencies across various domains between the pretest and post-test phases of the training programmes. These findings highlight parts where the training was effective and areas that may require further development to enhance overall competency.

Conclusions: The results indicate a positive impact of competency training on enhancing the skills of medical administrators. Additionally, the study offers valuable insights for optimising future training content.

Introduction: Strong hospital leadership is critical to navigating the challenges of the Canadian healthcare system. Currently, physicians and nurses tend to be selected to fulfil hospital executive roles. To date, we found only limited research exploring who else could or should be in these roles, or how more diverse groups of professionals navigate the journey into these roles. We sought to interview leaders from multiple professional backgrounds to understand how their career journey led them to their executive role.

Methods: We purposively sampled Canadian hospital executives with diverse professional and educational backgrounds. Through semistructured interviews, we explored their individual leadership journeys, and their experiences working with others along the way. Our team worked together to analyse data using a phenomenographic approach.

Results: Fourteen executive-level leaders from diverse professional backgrounds were interviewed. Overall, we noted three main trajectories for people to become hospital leaders: the achievement journey, the unexpected journey and the practical journey. These journeys corresponded to three main identities the champion leader, the discovered leader and the pragmatic leader, respectively. We found that some individuals had multiple trajectories and identities.

Conclusions: Improved diversity in executive hospital leadership may support transformational change in healthcare; however, this promise may not be automatically realised. Critical reflection on current hiring processes, career development and mentorship is warranted to support those with diverse and distinct backgrounds to enter and thrive in these roles.

Background: Changes in emergency departments are frequently implemented to improve efficiency and reduce costs. However, staff acceptance and adoption are crucial for the intended success of changes.

Objectives: This study explored staff perceptions of factors influencing the implementation of changes and any common themes linking changes and factors influencing changes in an emergency department at a university teaching hospital in the UK.

Methods: We used constructivist grounded theory methodology to perform a secondary analysis of 41 interview transcripts of physicians, nurses, support workers and managers involved in paediatric emergency care.

Results: Participants identified leadership, communication and education as factors impacting change management. They described many emotions associated with changes and with communication, leadership and education or the lack of any of them during changes. Both positive and negative emotions sometimes coexisted at individual, team or organisational levels. Negative emotions were due to real-life challenges and concern over compromised patient care. Professional values dictated the actions or inactions that transpired either because of these emotions or despite these emotions in health professionals.

Conclusions: Emotions to change should be acknowledged and addressed by credible leadership clear communication and education to improve the change process, its success and ultimately, patient care.

Background: Effective clinical leadership is required at every level, including in Foundation doctors. Most leadership programmes neglect self-awareness and personal growth aspects of leadership training. We modified the Basildon Leadership Hub to focus on these aspects and evaluated the new programme.

Methods: Large group sessions were led by speakers with varied leadership roles, interspersed by breakout sessions incorporating experiential and reflective learning. Attendees answered anonymous surveys before, immediately after, and 2 months after the workshop, with 5-point Likert-scale responses (1=strongly disagree to 5=strongly agree) designed around reaction, knowledge and behaviour levels of evaluation. We assessed differences in median responses using the Mann-Whitney U test with Bonferroni-Holm correction.

Results: The full-day workshop was attended by 27 trainees, 93% of whom considered it enjoyable and relevant. Attendees agreed more strongly to the statements 'I am a leader' and 'I know how I can demonstrate and develop my own leadership knowledge, skills and behaviours' in postcourse versus precourse surveys (p<0.001). The follow-up survey had a poor response rate of 26% with non-significant differences.

Conclusion: A full-day leadership workshop for Foundation doctors focusing on personal growth resulted in improvement in self-assessed precourse and postcourse knowledge and attitudes; however, poor follow-up response rate limited demonstration of sustained outcomes or changes in behaviour.

Background: Paediatric professional scarcity and uneven distribution is acute in underdeveloped regions, exacerbated by COVID-19's workload surge and burnout, highlighting the need for strengthened prevention and response measures.

Aim: Propose an effective talent management model to address the challenge of paediatric medical personnel shortage and lack of management experience in Underdeveloped cities of developing countries.

Methods: A crisis management plan has been implemented in a paediatric hospital in Henan, China, with a talent framework to ensure a skilled, stable workforce.

Results: An advanced talent management system is vital to address paediatric talent scarcity. Leveraging the national Children's Regional Medical Center, fostering international cooperation, sharing knowledge and harnessing regional policies are key to effective paediatric talent management through leveraging, promotion, and driving initiatives.

Conclusions: Efficient talent management methods have a significant positive impact on addressing the paediatric talent crisis, enabling departments and institutions to effectively manage medical talent through scientific strategies, ultimately contributing to the alleviation of medical resource deficiencies.

Background: Radical cystectomy has the potential to be a curative strategy for patients with aggressive bladder cancer. Emerging evidence over the last 20 years has shown that minimally invasive surgical approaches using robotics in performing this highly complex and morbid operation can achieve the same oncological outcomes while reducing complications for the patient.

Objective: This paper aims to present a managerial and leadership roadmap for change to robotic cystectomy for patients with advanced bladder cancer to achieve improved patient outcomes while embracing technological developments in the delivery of cancer care.

Methods: Using the Irish Health Service Executive guide for change, we propose and detail a three-stage plan (define, design and deliver) to guide the organisation from the concept of the transition to performing the first operative case.

Results: A walkthrough from identifying a vision for change for robotic cystectomy to designing a step-by-step process is discussed. By providing a template for success, this approach can be applied to any health jurisdiction worldwide and can be adapted as needed.

Conclusion: Although challenging, major change within the healthcare setting through a structured approach provides a valuable opportunity for a department to grow, develop and become a champion of patient care.