BMJ Leader最新文献

Background: Shared decision-making (SDM) is a cornerstone of patient-centred care, yet it has been underused in radiology.

Objective: To translate research into innovative strategies to empower radiology leaders to apply SDM and outline the cultural and structural changes required for meaningful integration into clinical practice.

Methods: This article synthesises case examples and evidence across imaging scenarios, evaluates emerging innovations and highlights leadership levers that can embed SDM as a core practice in radiology.

Results: Leadership interventions can transform radiology's contribution to SDM. Cases such as incidental pulmonary nodules, breast MRI in familial risk and Li-Fraumeni syndrome illustrate how radiologists can engage directly in preference-sensitive decisions. Key strategies include improving access to imaging data, using patient-friendly summaries, expanding opportunities for direct communication and incorporating patient-reported outcome measures, patient-reported experience measures and artificial intelligence (AI)-driven tools to support patient understanding. Barriers such as workflow demands, medicolegal uncertainty and lack of incentives can be addressed through leadership-driven reforms.

Conclusions: Radiology plays a central role in care pathways, offers clinical and technical expertise and increasing patient-facing innovation. Leaders who embed SDM into training, workflows and systems can enhance radiology as a model of cutting-edge, patient-centred care. Clear actions include training, protected time, incentives, strategic application of AI and transformational leadership.

Background: This article evaluates the impact of the allied health professions (AHPs) leadership within the Oxleas NHS Foundation Trust AHP Preceptorship Programme on early career professionals. Preceptorship, defined as structured support during career transitions, is recognised as crucial for developing confidence and autonomy among healthcare workers. While extensive research supports the benefits of preceptorship in nursing, limited evidence exists for AHPs.

Aim: To explore the effects of the Oxleas AHP Preceptorship Programme on early career AHPs.

Method: Using a mixed-methods approach, the study surveyed AHPs enrolled in the programme to explore its effects on retention, confidence, continuing professional development and AHP leadership support.

Findings: Key findings include the positive influence of a community of practice in reducing feelings of isolation and creating a sense of belonging, with 92.3% of participants reporting that the programme contributed to their retention. The leadership of AHP-specific preceptorship leads, external to clinical teams, was identified as pivotal in providing tailored support.

Conclusion: Despite its limitations, including a small sample size, the study highlights the value of a dedicated AHP preceptorship programme in improving early career support and development. The findings emphasise the importance of structured support for AHPs and suggest that further research is needed to explore the broader impact of such programmes across different healthcare settings.

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.