Journal of Healthcare Leadership最新文献

Purpose: Efficient leadership in healthcare requires actionable insights to improve both service quality and patient outcomes. This study aims to enhance outpatient service efficiency by applying a data-driven decision-support framework that integrates Discrete Event Simulation (DES) with Design of Experiments (DOE). The focus is on optimizing patient flow and reducing turnaround time in an internal medicine clinic of a Thai public hospital.

Methods: A hybrid DES-DOE model was developed to replicate the clinic's real-world processes and assess the impact of key operational factors. The DES model, built in Arena, captured detailed workflows and resource constraints. A full factorial DOE design evaluated five critical variables: patient arrival patterns, physician availability, consultation start-time delays, pre-appointment blood testing, and proportions of patient categories (eg, cardiovascular, neurological, endocrine). A total of 32 scenarios were tested and analyzed using ANOVA.

Results: All five factors significantly influenced turnaround time, with patient category proportions showing the strongest effect. The optimized scenario resulted in a 10.46% reduction in average turnaround time. These findings suggest that targeted, evidence-based adjustments can substantially improve patient throughput and clinic performance.

Conclusion: This research provides healthcare leaders with a validated, replicable framework for improving operational efficiency through simulation-based experimentation. It demonstrates how integrating DES and DOE can support strategic planning, workforce management, and service design, ultimately contributing to better patient experiences and more resilient healthcare systems.

The field of urology faces a projected workforce shortage, along with persistent gaps in rural care and underrepresentation of providers from diverse backgrounds. These challenges highlight the need to explore and identify strategies that may enhance diversity within the urologic workforce and ensure more equitable access to care across patient populations. This review examines the current landscape of inclusivity within urology, focusing on three key populations: osteopathic physicians, underrepresented minorities in medicine, and women. Each of these groups faces distinct obstacles in urology such as limited access to mentorship, disparities in residency program match rates, and underrepresentation in leadership positions. Despite these barriers, several targeted initiatives have demonstrated success in improving representation within urology and fostering a more inclusive professional environment. Mentorship programs such as the R. Frank Jones Urology Interest Group, Under Represented Trainees Entering Residency (UReTER) program, and the Michigan Urology Academy have shown encouraging match outcomes and positive participant feedback, underscoring the value of early engagement and structured guidance in supporting the success of individuals historically underrepresented in urology. The growth of professional affinity groups such as the Society of Women in Urology and Women in Urologic Oncology have meaningfully expanded mentorship networks, supported women in academic publishing, and propelled advocacy on key issues like parental leave and promotion equity. Furthermore, specific institutional pilot programs have been effective in addressing traditionally unrecognized departmental contributions and confronting gender-based bias and discrimination in the workplace. Altogether, current initiatives have illustrated the central role of structured mentorship, community-building, and institutional action in advancing workforce support systems and heterogeneity.

Introduction: Context plays a critical role in shaping how interventions are designed and implemented, and must therefore be considered prior to implementation. There is consensus that the relationship between contextual factors and intervention outcomes is best understood using qualitative and quantitative methods, the process for considering and incorporating context remains unclear. Drawing on a recently completed study focusing on building hospital management capacity, this paper describes and discusses the benefits and learning from the implementation of an integrative and co-design approach.

Methods: This sequential mixed-methods study included managers and clinicians from two district hospitals in China. Focus Group Discussions [FGD] are a critical step in guiding the adaptation of several validated tools in the local hospital context. Data collected from FGDs and online surveys provides a comprehensive understanding of the current state of hospitals.

Results: This study identified a wide range of difficulties faced by mid-level managers and clinical staff in two hospitals. While managers reported hospital-specific challenges, staff across both sites consistently cited issues such as inadequate support, lack of recognition, and lack of patient trust. Survey results also revealed low levels of psychological empowerment, job satisfaction, and perceived leadership effectiveness. Self-assessment using the MCAP tool highlighted significant competency gaps among mid-level managers, particularly in operations management and leading change.

Discussion: The use of a co-design approach broadly engaging relevant key stakeholders from the design and implementation of the project and formulation of improvement strategies is key to enabling project success and maximizing and sustaining project impact.

Background: Compassion is a critical component of effective, ethical healthcare, influencing patient care, provider well-being, and organizational culture. Its expression and support vary across cultures, yet little is known about how systemic and cultural factors shape compassionate care. This narrative review examines compassion's impact on healthcare practices across cultural contexts.

Methods: A narrative review of literature published since 2020, searching PubMed, PsycINFO, Scopus and Web of Science was performed. Fifteen studies met our inclusion criteria: peer-reviewed, English-language articles that explicitly examined compassion (or closely related constructs such as self-compassion or compassion fatigue) in healthcare settings and reported empirical, theoretical, or review evidence with attention to cultural or contextual factors. Excluded were articles published before 2020, non-English reports, conference abstracts, and opinion pieces lacking empirical or theoretical contribution.

Results: Compassion-focused interventions reduced fatigue and improved self-compassion and satisfaction. Cultural and systemic factors influenced how compassion was understood and applied, from Buddhist-informed to Western models. Institutional culture, leadership, workload, and spiritual care affected practice, while mental health and community care showed benefits but faced systemic barriers.

Conclusion: Compassion in healthcare is shaped by individual, cultural, organizational, and systemic factors. Embedding compassion across all these levels is essential for delivering effective, person-centered care. This review contributes by synthesizing recent cross-cultural evidence, highlighting how cultural, structural, and spiritual dimensions influence compassionate care, and identifying gaps in global research. Cross-cultural awareness and structural reform are critical for sustaining compassionate healthcare. Future research should explore underrepresented cultural contexts and evaluate systemic interventions that promote compassion in diverse health systems.

Purpose: This study aimed to assess the effect of the Pathways to Leadership for Health Transformation Programme (PLHTP) by World Health Organization Regional Office for Africa (WHO AFRO) on the leadership practices of its participants at their workplaces in Benin and Niger.

Participants and methods: The study was conducted among leaders of healthcare facilities in Benin and Niger who had participated in the WHO PLHTP. Missions were deployed to Benin and Niger to observe changes in the leadership behaviors and healthcare outcomes at the workplaces of the PLTHP participants. Qualitative data were collected through observations, interviews, and document analysis. The data from the various methods were triangulated thematically to assess the effectiveness of PLHTP.

Results: PLHTP improved the leadership caliber and enhanced effective decision-making among the trained leaders in both Benin and Niger. The healthcare leaders in Niger applied the acquired leadership knowledge and skills better as evident in pragmatic resource management, innovation, and staff empowerment compared to Benin where excess resource wastage, suboptimal resource mobilization, poor external communication, and challenges in conflict management and team cohesion neutralized the program's positive effects. Niger has more participative cultures, accommodative health policies, and investments in healthcare compared to Benin, hence PLHTP had better outcomes in Niger than in Benin. Resistance to change by experienced colleagues of the trained healthcare leaders hindered the introduction of changes in the healthcare facilities in both Benin and Niger.

Conclusion: PLHTP improved the leadership capabilities of the participants in both Benin and Niger. Application of the leadership skills had better effect in Niger than Benin since its culture, policies and health systems are more accommodative. Integrating context-specific scenarios in the modules of PLHTP and leveraging digital technologies to make it freely accessible by all healthcare workers can enhance its effectiveness.

Patient-centred care is the foundation for safe and high-quality care that enhances patient health outcomes, with multidisciplinary team-based care (MTBC) being a key enabling factor. MTBC is an integrated approach in care provision involving health professionals with different skillsets working in collaboration. Shared goals, clarity of roles, mutual trust, effective communication, and the evaluation of team functions are important for MTBC success. No reviews were identified on the system or cross-organisational approaches that support MTBC in primary care settings. A scoping review was conducted between October and December 2024 to identify international innovations in operationalising MTBC in primary care and the factors that impact its success. The databases searched were CINAHL, ProQuest Central, PubMed, Scopus, and Web of Science, in October 2024. The search terms were informed by two central concepts: MTBC (concept 1) and primary care (concept 2). Concepts of design (concept 3) and factors (concept 4) were added to refine the scope of the search. Following the Arksey and O'Malley framework, the scoping review included 58 articles on data extraction, and confirmed 14 key success factors and 14 barriers that could affect the implementation and adoption of MTBC. The strengths of MTBC in the primary care setting are summarised by six themes: patient-centred benefits, teamwork and collaboration, decision-making and clinical care, communication and coordination, improved access and performance management, and supportive infrastructure. This review further confirms six core benefits and 11 core components of the MTBC model, providing important guidance for MTBC development. A multidisciplinary team-based care model was designed to deliver comprehensive patient-centred care by integrating expertise from various disciplines. By integrating the key elements identified in this review into a specific primary care context, successful implementation of an adaptable MTBC model may lead to improved service delivery and outcomes in primary care.

Purpose: Rising healthcare costs have intensified the need for innovation within healthcare systems, with organizational innovation being seen as a key enabler for the development of strategies to improve affordability and accessibility for long-term sustainable health care delivery. While research has long examined innovation among physicians and nurses, studies focusing on Allied Health Professionals (AHPs) and pharmacists are nascent. This study investigates the innovation culture among AHPs and pharmacists in Singapore's largest healthcare cluster. It specifically examines how components of the Innovation Quotient model-Values, Behaviors, Climate, Processes, Resources, and Success-predict perceived changes in innovation.

Methods: A cross-sectional survey was distributed via Email to 4413 AHPs and pharmacists, yielding 620 complete responses. The survey instrument, the InnoQuotient, comprised 54 items categorized into 18 factors that correspond to six building blocks of innovation. Structural equation modeling (SEM) in R Studio evaluated model fit and the relationships between these factors and self-reported change in innovation. Complementing the quantitative analysis, a thematic analysis was conducted using MAXQDA on 65 verbatim responses.

Results: SEM analysis indicated that three innovation building blocks of Behaviors, Processes, and Success were significantly associated with reported innovation change. Specifically, positive innovation change correlated with enhanced Behaviors and Success, whereas a negative relationship between innovation change and Processes suggested that overly centralized and top-down initiatives may impede grassroots innovation. The thematic analysis reinforced these findings by highlighting the pivotal role of leadership in driving effective innovation while also revealing concerns regarding the unilateral implementation of innovation initiatives and the challenges of fostering interdisciplinary collaboration.

Conclusion: The findings advocate for a balanced approach that synergizes leadership direction with organic, collaborative efforts to cultivate a robust innovation culture. Future studies should focus on refining strategies to bolster less effective innovation components and include perspectives across different organizational levels.

The World Health Organization Regional Office for Africa (WHO AFRO) is committed to mainstreaming gender equality in its systems and operations through its transformation agenda. This literature review discusses the steps that the WHO AFRO has taken to mainstream gender equality in its systems, programs, and activities, while highlighting successes and opportunities. A narrative literature review methodology was applied, whereby information relevant to the objective was synthesized from 28 publications that were retrieved after searching keywords combined using Boolean operators in WHO AFRO, PubMed, Google Scholar, and Google search engines. WHO AFRO's Department of Gender, Women, and Health addresses gender issues. A Gender, Equity, and Rights unit in the WHO AFRO ensures gender considerations in institutional processes and health programs in both regional and country offices in the commitment to "leave no one behind." It aligns with Sustainable Development Goals 3, 5, and 8 since it extracts gender policies from international statutory instruments and initiatives. The WHO's gender and parity policies guide the WHO AFRO in gender mainstreaming. WHO AFRO's initiatives and mechanisms prioritize female representation and present gender considerations and equity as values of human resources for health policies. Its zero tolerance to sexual harassment and an anonymous reporting system for sexual abuse or exploitation, as well as protection from retaliation and assistance, protects against gender-based harassment by WHO workers. The mandatory shortlisting of at least one qualified female in all recruitments in the WHO AFRO, as stipulated in the transformation agenda, creates room for gender balance in the workforce. Mandatory training, advocacy, and projects on the prevention and response to sexual abuse, inclusion, and diversity also constitute the WHO AFRO's efforts in gender mainstreaming. Empowerment programs have also been initiated for female leaders. The finalization of the WHO AFRO gender policy and the development of its sexual harassment policy will further steer gender mainstreaming toward achieving gender equality and inclusion in the health sector.

Introduction: Effective leadership communication is essential in healthcare, particularly for mid-level managers who serve as a bridge between frontline staff and institutional leadership. Despite its importance, leadership communication training may be deficient in healthcare education. These descriptive statics aimed to evaluate the implementation and impact of a structured leadership communication program designed to enhance mid-level managers' skills in communication, psychological safety, and team dynamics at the Mayo Clinic.

Methods: A series of leadership development courses were developed and facilitated by the Experience Training, Education, and Coaching (XTEC) unit, focusing on evidence-based communication strategies. Three primary courses-CORE Communication Skills for Leaders, Navigating Team Dynamics, and Psychological Safety and Transparency-were conducted virtually. Participants completed post-course surveys assessing the effectiveness of training, confidence in skill application, and overall satisfaction. Additionally, an individual coaching program was evaluated using participant feedback. Data was collected from January 2021 to October 2023 using voluntary, anonymous surveys, with descriptive statistics used for analysis.

Results: From September 2019 to October 2023, a total of 2,297 healthcare managers participated in at least one leadership course, with 189 attending all three. Survey results were recorded starting in January 2021 and demonstrated high satisfaction and confidence in applying learned skills. 95% of CORE course participants reported achieving the learning objectives, while 97% of Navigating Team Dynamics attendees and 93% of Psychological Safety and Transparency participants stated they would recommend the training. One-on-one coaching was well received, with 97% of participants expressing confidence in maintaining learned strategies.

Conclusion: The findings highlight the need for leadership communication training among mid-level healthcare managers. High participation rates and positive feedback indicate substantial demand and perceived value. The study underscores the importance of experiential learning and guided practice in leadership development. Expanding training opportunities, integrating advanced topics, and exploring technological engagement strategies can further support leadership growth.

The strength of Academic Medical Institutions (AMIs) is founded on their academic departments, both clinical and basic science. The evolving role of the departmental chair is dictated by multitude of influences including the tectonic changes in the terrain of US healthcare and academic medicine with wanning revenue sources, complexity of administrative constructs in AMIs, situational needs, and regional competitive market trends. These subtleties underscore the importance of rigorous screening and recruitment of a departmental chair whose stance will be congruent with an AMI's mission, vision, values in alignment with the institutional leadership, in addition to possessing the requisite professional qualifications and personal attributes. Success of a departmental chair is determined by meeting expectations as a manager, leader, and scholar with performance metrics for the role against benchmarks in specific domains of academic medicine. This descriptive treatise expounds on the important implications of numerous elements and anticipated challenges contributing to the inexorable evolution of the departmental chair's role in US AMIs.