Journal of Healthcare Leadership最新文献

Purpose: The objective of this study is to evaluate whether the nationwide establishment and institutionalization of a peer-support program, is economically justified given the potential positive effects on the Second Victim Phenomenon (SVP) among healthcare professionals in Germany.

Methods: A comprehensive methodological approach was employed, using data from the SeViD studies to assess the prevalence and duration of SVP among physicians and nurses in Germany. Economic impact assessments were conducted to estimate the potential cost savings associated with implementing a peer-support program.

Results: The economic analysis reveals significant annual costs associated with SVP-induced absenteeism: approximately 1.56 billion euros for physicians and 1.87 billion euros for nurses. Implementing comprehensive peer-support programs could reduce these costs to approximately 0.85 billion (physicians) and 1.02 billion euros (nurses), respectively, demonstrating substantial potential economic benefits.

Conclusion: Investing in a structured peer-support program could yield annual savings exceeding 1.55 billion euros while enhancing workforce resilience and improving patient care. This underscores the economic rationale for scaling up peer support initiatives in healthcare settings.

Introduction: The well-being of healthcare workers (HCWs) is a critical concern. While healthcare leaders can play a crucial role in influencing employees' well-being, it remains unclear how leaders are leveraging this influence. This study aims to unravel the current perspectives and practices of healthcare leaders in supporting HCW well-being.

Methods: Semi-structured interviews were conducted with healthcare leaders at various levels within a university medical center. The interviews focused on exploring three key topics: factors influencing HCW well-being, data sources utilized for information gathering, and strategies leaders employ to influence HCW well-being. Our study design was grounded in constructionist epistemology and adopted a phenomenological approach. The methodology primarily involved a data driven, inductive thematic analysis to discern patterns and themes from the collected data.

Results: Fifteen interviews with healthcare leaders revealed a multitude of factors influencing HCW well-being, categorized into three domains: personal, socioeconomic, and work-related factors. Leaders reported a variety of data sources, including "contact data", data derived from regular and sporadic interpersonal interactions, and "investigation data", entailing formal inquiries conducted within the healthcare organization. Interestingly, while leaders acknowledge their potential to positively influence well-being, particularly in work-related aspects, there was a notable trend of deflecting responsibility, often redirecting it towards other leaders or placing it back on the individual employee.

Conclusion: Healthcare leaders show a comprehensive understanding of factors affecting employee well-being. However, healthcare leaders have a predominantly reactive approach to managing employees' well-being. Data collection is often sporadic, lacking consistency, and there is a tendency to redirect responsibility for well-being, revealing a discrepancy between acknowledgement of influence and its actual implementation. We argue that it is essential for leaders at all hierarchical levels to assume responsibility actively and collectively for employee well-being, transitioning to a proactive approach in promoting and safeguarding the well-being of HCWs.

Background: Nursing leadership is recognized as essential to fostering innovation in hospitals, while the precise relationship between them has yet to be established.

Aim: The objective of this study is to examine the association among leadership in nursing research, research motivation, perceived barriers, and innovation behavior of junior nurses who hold a master's degree or above in the hospital.

Methods: A cross-sectional survey was conducted and electronic questionnaires were distributed online. An online data analysis tool SPSSAU was adopted to conduct descriptive analysis, correlation analysis, and structural equation model construction. This study adhered to the STROBE guideline.

Results: A total of 1025 valid questionnaires were collected in this survey. The leadership in nursing research of head nurses affected nurses' innovation behavior via perceived barriers. The indirect effect accounted for 59.75% of the total response variance. Research motivation was identified as a moderator in the mediation model, revealing that leadership in nursing research did not significantly affect innovation behavior when nurses showed high motivation.

Conclusion: Leadership in nursing research of head nurses and research motivation of junior nurses with master's degree are crucial to enhancing nursing innovation behavior in the hospitals.

Background: The form of leadership that can positively influence nursing care performance and patient outcomes remains a crucial subject in the healthcare sector.

Aim: This study examines the effect of leadership style at different managerial levels on nursing care performance and patient outcomes.

Methods: A retrospective cohort study was conducted in a public hospital, focusing on two primary settings: the general ward and the critical care unit. The study sample included 60 nurses and 300 patients. The leadership style is a predictor of this study and was measured using a cross-sectional survey of Jordanian nurses using the Multifactor Leadership Questionnaire (MLQ). Nursing care performance and patient outcomes were measured by surveying patients, observing practice, and reviewing health records. The analysis involved descriptive statistics, chi-square tests, odds ratios, and multivariate regression analysis.

Results: The study found that transformational leadership was predominant in the general ward, while transactional leadership was more common in the critical care unit. Leadership styles significantly influence clinical nursing performance. Nurses under transformational leaders were more likely to follow generic policies like patient surveillance but less consistent with specific care standards. Nurses under transactional leaders were linked to higher adherence to standardized care protocols like fall risk assessment and medication rights. Patient outcomes were similar between units, except for higher readmission rates under transactional leadership.

Conclusion: The study's findings underscore the complexities of nurse leadership styles and clinical nursing performance. Nurse manager should adapt their leadership style to the particular setting and a one-size-fits-all approach to leadership may not be effective in healthcare.

Background: In many Indian states, public health programs are led by clinicians without formal training in leadership and management, limiting their effectiveness. To tackle this, Uttar Pradesh's Department of Medical, Health, and Family Welfare initiated a Public Health Management and Leadership (PHML) training program for the Level 4 (mid-career) medical officers. This program aims to enhance the leadership and management skills necessary for these officers to support them transitioning to administrative roles.

Methods: The training focused on essential competencies such as leadership, communication, team building, fiscal management, and public health problem-solving. It included in-person sessions and mentored practicum, utilizing experiential learning and problem-solving group projects. Kirkpatrick's model was used to evaluate participants' reactions, learning outcomes, and behavior change. Feedback was analyzed using descriptive statistics across 12 training domains, while pre- and post-training test scores were compared using paired t-tests in Stata 18 to measure learning improvements. Participant interviews provided additional insights.

Results: Participants reported high satisfaction with the learning environment and methods but faced challenges in applying management concepts, citing limited contextual input and faculty interaction. Learning outcomes showed moderate improvement, with average test scores rising from 53.3 to 59.6 (p = 0.003). They successfully applied a structured problem-solving framework in practicum projects and created action plans for public health challenges. Participants recommended adding topics on financing, procurement, human resources, and hospital management to support them in performing their core functions. Barriers to applying learned concepts included human resource constraints, limited autonomy, gender stereotypes, and lack of recognition.

Conclusion: Emphasizing leadership competencies, experiential learning, and mentored practicum holds promise. However, customizing the curriculum to UP's specific context, ensuring sufficient training time, focusing on core management functions, and addressing organizational barriers are vital. Integrating these recommendations into blended training that enhances core managerial skills and leadership development can strengthen workforce capabilities.

Introduction: Although the importance of leader-member relationships in teamwork is acknowledged in literature, a deeper understanding of this relationship is lacking, especially in rural areas. The impact of leader-member relationships on team outcomes is especially important in rural Chinese hospitals as improving teamwork forms a national health reform priority in these hospitals. This study investigates how leader-member relationships (ie leader-member perceived similarity and power distance orientation) influence team outcomes (ie perceived quality of care and job satisfaction) via speaking up and silence.

Methods: An online questionnaire was completed by 1017 team members (ie doctors, nurses and other healthcare professionals) of 300 teams in four rural Chinese hospitals in October 2022. The questionnaire measured leader-member perceived similarity, power distance orientation, speaking up, silence, perceived quality of care, job satisfaction and control variables. Multilevel mediation analysis was conducted to test the hypotheses.

Results: Leader-member perceived similarity and power distance orientation are positively related to speaking up (β=0.61, p<0.01; β=0.17, p<0.01 respectively) and to silence (β=0.41, p<0.01; β=0.63, p<0.01 respectively). Speaking up is positively related to the perceived quality of care (β=0.24, p<0.01; β=0.46, p<0.01) and job satisfaction (β=0.30, p<0.01; β=0.54, p<0.01), while the impact of silence is not significant. Finally, speaking up mediates the associations of both leader-member perceived similarity and power distance orientation with perceived quality of care (β=0.15, p<0.01; β=0.08, p<0.01 respectively) and job satisfaction (β=0.30, p<0.01; β=0.54, p<0.01 respectively).

Conclusion: Speaking up, rather than silence, contributes to team functioning by mediating the impact of leader-member relationships to team outcomes. Hospital management may therefore seek to stimulate speaking up by focussing on leader-member relationships: increasing leader-member similarity and promoting members' power distance orientation. However, any unintended effect of increased silence through these leader-member relationships is an important area of future research, which can adopt multidimensional models of speaking up and silence.

Healthcare leaders are responsible for creating an environment where their staff can maintain their resilience and well-being. However, there is a crisis of burnout among healthcare workers. The resulting increased turnover, diminished morale and performance, safety risks, and decreased worker engagement produces a vicious cycle of burnout. A strategic intervention is needed that focuses on worker wellbeing. This paper describes how the Johns Hopkins Resilience In Stressful Events (RISE) peer support program has helped healthcare leaders support their workers and strengthen the resilience of their organization. It explains the crucial role that leaders play in the success of the program. RISE peer was established at Johns Hopkins Hospital in 2011 to provide timely peer support for stressful patient and work-related situations. RISE helps break the cycle of healthcare worker burnout by providing peer support for stresses at work 24 hours a day, 7 days a week. This program structure also supports leaders by sharing the responsibility of emotional support and by providing them with new skills to do their job in a way that generates personal and professional satisfaction. The program has been implemented globally in over 140 healthcare organizations. Leaders are essential to integrate support and serve as role models. Institutions that successfully launch peer support programs engage leaders to participate in program design, participate in the program themselves, and adapt the program to meet the needs of their staff and organization. Peer support programs broaden the base of support for all healthcare workers by providing an employee-focused resource. Implementation of a RISE support model demonstrates an institution's commitment to the overall health of the people it employs. Operational integration of the model conveys a positive impact on resilience at all levels of the organization, especially in institutions that broadly engage organizational leaders.

Digital technologies are now integral to daily life. However, their applications for the health of populations remain largely untapped. Increasing cancer incidence, and it being the leading cause of death in every country in the world, justifies the need for increasing healthcare. Digital health technology is a promising field. Digital health means different things to different people. Thus, the need for a concrete, distinctive, comprehensive action plan. Conceptual frameworks represent ways of thinking about a problem and how complex things work. We elaborate on the latest evidence with examples for the role of Digital Health Technology (DHT) as a comprehensive multi-faceted 'Conceptual Framework -5Ps' comprising: (i) DHT for Proper assessment: right from history taking to digital biopsies. (ii) DHT for Pertinent treatment: including genomic data analysis for precision treatment. Artificial Intelligence-based digital pathology approaches are practical and are increasingly improving selective cancer treatments. Digital self-management interventions improve symptom outcomes in adult cancer patients. Digital health can help cancer patients gain more autonomy, self-acceptance, and personal growth. (iii) DHT for Progress monitoring: comprehensively and remotely. The concept "hospital at home" feasible with DHT. (iv) DHT for Prevention applications: reaching all rewardingly. (v) DHT for Professional standards: education excellence. Proficiency is desirable when using DHTs fast-advancing applications. Doctors may not have the information they need to use a given DHT. General Medical Council, UK, and Medical Council India have been proactive in technology training. Regulations & ethics rigour are required energetically. All new technologies must meet the same bar for clinical evidence as other clinical interventions. Digital Health Academy is required to meet the highest standards, energizing and ensuring excellence. In the current state of healthcare and growing demands, good developments in DHT seem the solution. A conceptual framework is a good start for generous success. We hope our work progresses mindsets, practices, and policies majorly.

Background: Gender inequity persists in high-level leadership within academic medicine. Understanding the perspectives of early career women faculty could clarify how to recruit and support women who pursue high-level leadership. This study explored the specific priorities and concerns that may influence the recruitment of women leaders in the future.

Methods: Twenty-five assistant professors (mean: 1.8 years at rank) completed the Early Career Women's Leadership Program and participated in semi-structured, in-depth interviews in 2023. Data were analyzed using an iterative, thematic constant comparison process informed by constructivist grounded theory.

Results: The authors identified four themes. In theme one, participants described the importance of being seen and valued as a whole person, with consideration of their personal and professional lives. They sought mentorship and leadership positions that supported their work-life integration. In theme two, women balanced an interplay between the individual and the collective when considering themselves as future leaders. From the individual perspective, participants prioritized personal values like humility and compassion when discussing preferred leadership styles. From the collective perspective, they prioritized inclusivity and teamwork. Theme three showed discomfort with the unknown with a desire to fully understand a leadership position and its impact on personal and professional life. Participants wondered about having the authority and resources to realistically make meaningful change and whether they could adequately prepare to lead. The fourth theme was representation mattered. Participants valued having women leaders who have experienced similar challenges as themselves. These leaders inspired participants to believe that they could also achieve and succeed in high-level leadership.

Conclusion: Early career women balanced numerous factors when considering whether to pursue high-level leadership in academic medicine. Understanding women's priorities and concerns can enable institutions to prepare women faculty to lead and ultimately recruit and retain them in high-level leadership.