Journal of Healthcare Leadership最新文献

Purpose: To develop healthcare professionals as clinical leaders in academic medicine and learning health system; and uncover organizational barriers, as well as pathways and practices to facilitate career growth and professional fulfillment.

Methods: The Department of Medicine strategic plan efforts prompted the development of a business of medicine program informed by a needs assessment and realignment between academic departments and the healthcare system. The business of medicine leadership program launched in 2017. This descriptive case study presents its 5th year evaluation. Competencies were included from the Physician MBA program and from specific departmental needs and goals.

Results: The program hosted a total of 102 clinical faculty. We had a 37% response rate of those retained at Indiana University School of Medicine. Overall, responses conveyed a positive experience in the course. Over 80% of participants felt that they gained skills in professional reflection, professional socialization, goal orientation, critical thinking, and commitment to profession. Financial literacy was overwhelmingly the skill that was reported to be the most valuable. Finance and accounting were mentioned as the most difficult concepts to understand. Familiar concepts included communication, LEAN, and wellness related topics. One hundred percent of participants said they are utilizing the skills gained in this program in their current role and that they would recommend the course to others.

Conclusion: Business of medicine courses are more common now with programs describing elements informed by health system operations. However, few programs incorporate aspects of wellness, equity, diversity, inclusion, and health equity. Our program makes the case for multiple ways to develop inclusive leaders through a focused five-month program. It also recognizes that to really impact the learning health system, health professionals need leadership development and leaders suited to work alongside career administrators, all aiming towards a common goal of equitable patient-centered care.

Purpose: Little is known about the long-term efficacy of virtual leadership training for physicians. This study compares two highly similar groups of Obstetricians-Gynecologists' (OB-GYN) 6-month post-program changes in competency and skills after experiencing equity-centered leadership training in a virtual or in-person format.

Participants and methods: Using a retrospective pre- and post-test method, we collected 6-month post-program data on 14 competencies for knowledge gains and skills use, comparing the virtual cohort (2021, n = 22) to the in-person cohort (2022, n = 33) in 55 total participants. Qualitative data from open-ended feedback questions informed on skills relevancy and professional impact since program participation.

Results: Data indicate strong, statistically significant knowledge and skills retention in both cohorts, with 63% of the virtual and 85% of the in-person participants responding. Data indicate participants report the course having a positive impact on their healthcare provision and nearly all report they made changes to their communication and leadership approaches in the 6-months after the program. 59% of the virtual and 55% of the in-person cohorts report new leadership opportunities since their participation and that the course helped prepare them for those roles. Qualitative data support the need for the training, specific elements of the training these physicians found particularly helpful, and that the learning was "sticky", in that it stayed with them in the months post-program. There was a clear stated preference for in-person experiences.

Conclusion: Either virtual or in-person leadership training can result in long-term (6-month) significant retention and application of knowledge and skills in physicians. While limited in size, this study suggests that in-person experiences seem to foster more effective bonds and also greater willingness to participate in post-program follow-up. Physicians find equity-centered leadership training to impact their subsequent communication and leadership practices and they report career benefits even in 6-month follow-up.

Purpose: Leadership is increasingly becoming a priority in the forms of higher education associated with the Fourth Industrial Revolution; however, few studies have examined it in the context of pharmacy education. This study investigated the levels of communication competence, critical thinking disposition, problem-solving ability, and leadership of pharmacy students, and identified factors related to leadership.

Methods: This study was conducted using a nationwide cross-sectional online survey with a self-administered questionnaire. A total of 416 third-to-sixth-year pharmacy students from all 35 pharmacy schools in South Korea, completed the survey from September 1 to 15, 2019. Data were analyzed using descriptive statistics, t-tests, Pearson's correlations, and multiple regression analysis. We verified construct validity by performing an exploratory factor analysis.

Results: The pharmacy students revealed a moderate level of communication skills, critical thinking disposition, problem-solving ability, and leadership. Significant positive correlations were found among communication competence (r=0.724, p<0.001), critical thinking disposition (r=0.615, p<0.001), problem-solving ability (r=0.599, p<0.001), and leadership. After adjustment for control variables, communication competence (β=0.319, p<0.001) was found to be the most significant predictor of leadership (F=104.12, p<0.001, R²=0.756).

Conclusion: This study showed that the students' leadership was influenced by their competence in communicating effectively, thinking critically, and solving problems. Pharmacy educators should acknowledge and implement innovative curriculum and assessment approaches in preparing pharmacy students for their professional paths.

Background: Understanding the factors influencing work engagement among nurses is crucial for ensuring high-quality care and positive patient outcomes. Despite numerous factors associated with nurse work engagement, many were explored before the pandemic, potentially overlooking aspects relevant to the current context.

Aim: To explore and update factors related to nurse work engagement in the new normal era.

Design: Systematic review.

Data sources: The search was restricted to articles published from 2019 to 2024 in CINAHL, PubMed, Scopus, ScienceDirect, Web of Science, and ProQuest, with full English text. The search was conducted from September 13th to 15th, 2023. Quantitative research articles that examined factors related to work engagement were included.

Review methods: Data extraction, quality appraisal, and data analysis were performed in all included studies. Manual content analysis method was used to classify and group the factors.

Results: Sixty-one research articles were included in the final review. Five key groups of factors were generated from content analysis, including 1) individual-related factors, 2) organizational-related factors, 3) job and role-related factors, 4) work-life balance, and 5) work environment.

Conclusion: Understanding and addressing these multifaceted factors holistically is essential to develop strategies to sustain optimal engagement levels among nursing staff and improve overall patient care outcomes. Further studies are needed to confirm the findings.

Purpose: Broad evidence points out that women workers in Saudi Arabia face a range of inequitable work practices despite continued efforts for gender equality. The study aims to assess the satisfaction of Saudi women working in the health sector among certain factors in the work environment, factors that enable them to gain opportunities and benefits and make decisions.

Patients and methods: This is a cross-sectional study, which involved the use of closed-ended surveys on 261 Saudi women working in the healthcare sector.

Results: Most of the females were aged between 25 and 34 years (59%) and more than half of them worked in the governmental sector (53%). Fifty-eight percent of the females hold clinical jobs, 25% of the administrative jobs were 37% of them have more than 19 years of working experience. The finding showed a significant association between female workers in health sector satisfaction with factors related to the workplace environment, training, and development, and their involvement in decision-making.

Conclusion: Most women felt empowered when they received equitable tasks and were able to reach managerial-level positions in their organizations. Establishing a positive work environment characterized by opportunities has the potential to enhance women workers' satisfaction.

Introduction: Leadership is increasingly recognized as a crucial competency in medicine, with physicians expected to provide leadership skills throughout their careers. This study explores the perceptions, attitudes, and interests of medical students and interns in Saudi Arabia regarding medical leadership. Medical graduates are expected to "provide leadership skills that enhance team functioning, the learning environment, and the healthcare delivery system", according to the Association of American Medical Colleges (AAMC).

Methods: A cross-sectional study was conducted from January to July 2023, involving 519 medical students and interns in Saudi Arabia. An online survey covered demographic data, perceptions, attitudes, interests, and self-perceived leadership skills. A pilot study was conducted to ensure the questionnaire's validity and reliability. Data were analyzed using SPSS 26, employing descriptive statistics and inferential tests.

Results: Most participants had a positive perception of leadership (38.3%), with higher scores associated with medical specialties as a career choice (p < 0.001). The majority expressed average interest in medical leadership (29.1%). Communication and organizational skills were highly self-rated leadership attributes. Barriers to leadership implementation included lack of interest (49.3%), inadequate training (45.1%), and time constraints (43.2%). Only 14.6% rated leadership education in medical school as "very good".

Conclusion: This study underscores the importance of leadership in medical education. Integrating comprehensive and structured leadership programs into medical curricula, addressing barriers, and promoting awareness can foster future medical leaders. Continuous evaluation and adaptation are essential for ensuring the relevance and effectiveness of leadership training.

Purpose: Organizational approaches to physician burnout are limited. Training physician leaders to influence the organizational environment is a growing area of study. This study explored perceived physician leadership behaviors in response to burnout from the viewpoint of faculty physicians not in formal leadership positions. Understanding physician leadership behaviors from the viewpoint of those faculty being led can inform organizational strategy and leadership training to address physician burnout.

Subjects and methods: Interview requests were sent to 70 randomly identified faculty physicians from a roster containing all 1145 physician faculty that excluded the Pediatric Department, at an academic health care institution in Southern California. The first ten respondents were asked to participate in a 30-to-40-minute semi-structured virtual interview via Zoom. The interviewees were asked two questions pertaining to burnout and their perception of how leadership responded. The two questions were "What has leadership done to address burnout?" and "If you had five minutes to advise your leaders on burnout, what would you say?" The recorded interviews were transcribed, redacted, and then sent to two reviewers. Thematic analysis through iterative coding was completed, and categories were constructed that aligned with the two interview questions.

Results: Overall, five themes were identified. These themes were organized according to the interview questions and broadly categorized as physician leadership behaviors observed that corresponded to the interview question of what leadership had done to address burnout and physician leadership behaviors desired corresponding to the second interview question of what advice should be given. Leadership behaviors observed in the context of burnout included three themes; referral to individual wellness programs, increased number of meetings and events, and a lack of agency in addressing wellness issues. The two themes of leadership behaviors desired were the obtainment of more resources and the granting of greater appreciation and recognition for work done through enhanced communication.

Conclusion: This small study of faculty physician perceptions of leadership behaviors identified several themes that had been identified in previous studies of leadership and burnout; need for relationship building through communication, need for resources to address work issues, and referral to wellness programs. However, the identification of a lack of agency in addressing factors in the wellness environment has not been identified in the previous burnout and physician leadership literature. Further study into the causes of this perceived lack of agency should be explored. Understanding the root causes of physician leaders' lack of agency can further inform physician leadership education as an organizational approach to burnout.

Background: Awareness and development of nurse executives' leadership competencies has been considered a key strategy for the success of healthcare organizations. However, only a few studies about nurse executives' leadership competencies are available in the literature, and no study has been conducted about the topic within Saudi Arabian context. The aim of this study was to assess the leadership competencies of nurse executives and the predictors of these competencies.

Methods: This quantitative study used a descriptive, cross-sectional, and correlational design. The study recruited a total convenience sample of 136 nurse executives who voluntarily consented to participate. The respondents self-rated the online survey, "Leadership Competency Assessment Tool: Self-Assessment." Data collection was conducted between September 2022 and November 2022. Test of correlation and multiple regression analyses were conducted.

Results: The overall mean score of nurse executives' leadership competencies was 3.38 out of 5.0, which was below the level of having excellent leadership competencies. Four dimensions had mean scores below the level of having excellent leadership competencies, namely, communication and relationship building (3.48), knowledge of the healthcare environment (3.29), leadership (3.45), and business skills (3.15), while nurse executives had excellent leadership competencies only in the professionalism dimension (3.51). Age (p=0.04), highest educational attainment (p=0.01), current role (p<0.01) and length of experience (p=0.02) as nurse executive, monthly salary (p=0.03), nationality (p=0.04), and having seminars/trainings in leadership and management (p=0.01) were considered predictors of the leadership competencies of nurse executives.

Conclusion: Nurse executives reported a low level of leadership competencies, thus implying necessary actions for improvement. There were personal factors that influenced the level of nurse executives' leadership competencies. To achieve quality outcomes and maintain a high level of nursing care in hospital organizations, these findings must be considered in planning strategies related to the improvement of the leadership competencies of nurse executives.

Background: Despite the large amount of leadership and implementation theories and recommendations, healthcare services continue to struggle with efficiently incorporating new knowledge. The questioning of conventional leadership approaches in healthcare organizations prompted us to investigate how frontline leaders comprehend their own implementation intentions and actions, and how these intentions and actions may impact the implementation of clinical guidelines in mental healthcare in Norway.

Methods: Employing a theory-driven qualitative design, we conducted nine semi-structured interviews with frontline leaders who had recently led implementation of clinical guidelines for the treatment of psychosis in mental health. We employed Systematic Text Condensation, informed by Normalization Process Theory, to structure and analyze the data and used fidelity scales to measure the degree of implementation and distinguish between leaders' levels of success in implementation.

Results: Frontline leaders in units that achieved high success in implementation described their intentions and actions differently, from those with less success. The former group's actions aligned more closely with the constructs of the Normalization Process Theory compared to the latter group when describing their actions. Frontline leaders leading units with a high degree of implementation success describe relation-orientation, trust, and providing adaptive space for staff members to take initiative. In contrast, those leading units with less implementation success describe more control and guidance of co-operators and place more emphasize on information and knowledge.

Conclusion: Differences in how frontline leaders describe their actions and intentions to achieve clinical guideline implementation suggest that the leadership approach of these frontline leaders is an important factor to consider when planning and conducting implementation. To better understand the implementation process, it is important to pay attention to how frontline leaders customize their leadership approaches to the dynamics of complex organizations, and how they interact with their team and superiors.

Navigating the healthcare conundrum in the Blue Zone of Loma Linda, California, requires understanding the unique factors that make this region stand out in terms of health and longevity. But more important is understanding the healthcare system sustaining the Blue Zone in Loma Linda, California. In an era marked by soaring healthcare costs and diminishing reimbursement rates, hospitals and physicians face an unprecedented challenge: providing excellent patient care while maintaining financial sustainability. This leadership perspective publication paper delves into the multifaceted struggles encountered by healthcare and hospital leaders, exploring the root causes, implications, and potential solutions for this complex issue. As we examine the evolving healthcare landscape, we aim to shed light on the critical need for innovative approaches to sustain the future of healthcare excellence in one of the five original Blue Zones.