Journal of Healthcare Leadership最新文献

Since the middle of the 20th century, the American food environment has become increasingly ultra-processed. As a result, the prevalence of chronic, diet-related disease in the United States has skyrocketed. Meanwhile, physicians are still poorly trained in nutrition. A recent innovation that aims to address this is "culinary medicine" programming taught by teams of physicians, chefs, and registered dietitian nutritionists. Culinary medicine is an evidence-based, interprofessional field of medicine that combines culinary arts, nutrition science, and medical education to prevent and treat diet-related disease. It employs hands-on learning through healthy cooking and is typically taught in a teaching kitchen, either in-person or virtually. It can be dosed either as a patient care intervention or as experiential nutrition education for students, medical trainees, and healthcare professionals. Culinary medicine programs are effective, financially feasible, and well-received. As a result, healthcare systems and medical education programs are increasingly incorporating culinary medicine, teaching kitchens, and interprofessional nutrition education into their patient care and training models.

Oral, dental and craniofacial (ODC) health has a profound impact on general health and welfare throughout life, yet US dentists and physicians operate across misaligned silos. This protracted division limits access to optimal health, supports fee for services, and exacerbates health disparities. Early in the 20th century, the most frequent dental therapy was tooth extraction: removed infected teeth were substituted by prosthetic appliances - commonly, dentures or nothing. Most adults assumed becoming edentulous was a normal corollary of aging. With the discovery of penicillin and other antibiotics, healthcare professionals and policy makers predicted infectious diseases would become irrelevant. However, given numerous health threats, including SARS-CoV-2, HIV, multidrug-resistant bacteria, Zika virus, Ebola virus, and now monkeypox, public and professional awareness of transmissible infectious diseases has never been more evident. Ironically, little attention has been paid to unmet transmissible, infectious, common oral diseases - dental caries and periodontal diseases. Therefore, these persist within "the silent and invisible epidemic". The preventable death of a young boy in 2007 from an infected untreated tooth that produced bacterial meningitis is a profound reminder that our nation has vast inequities in education, health, and welfare. The impact of oral infections on hospital-acquired pneumonia, post-operative infection in cardiac valve surgery, and even academic performances of disadvantaged children displayed through sociodemographic characteristics and access to care determinants also are profound! This paper asserts that current and emerging ODC health knowledge and science will inform health policies and advance equity in access to care, affordable costs, and optimal healthcare outcomes. We recommend that legal and regulatory systems and public health programs be required to ensure health equity. A fair healthcare system that addresses holistic healthcare must be transparent, accessible, integrated and provide a standard of oral healthcare based upon scientific evidence for all people across the lifespan.

Purpose: The Division Chief at an academic health sciences centre has many leadership roles and responsibilities. There are no data on leadership training needs for Division Chiefs, and so we sought to design and implement a needs assessment for pediatric Division Chiefs at CHEO, a pediatric academic health sciences centre in Eastern Ontario, Canada.

Methods: A needs assessment survey was developed with the aim to document demographics, preparedness for the role of Division Chief and desired leadership training for the role. This survey was piloted, revised and then distributed to all the Division Chiefs at our institution. The results of each question were collated, and simple descriptive statistics were calculated.

Results: The survey was completed by 22 of 31 Division Chiefs. The majority of respondents were from the Department of Pediatrics (63.6%), followed by Surgery (20%), Psychiatry (3.3%) and Laboratory Medicine (3.3%). Their mean length of time as Division Chief was 5.5 years. Seventy-seven percent had concurrent leadership roles in addition to the role of Division Chief. None felt they were very well prepared for the role, five felt they were somewhat well prepared, nine were neutral, five were somewhat unprepared and three were very unprepared for the role. Half of the respondents received mentoring, either formal or informal, for their role and all but one felt that formal mentoring would have been useful. In terms of desired training, the Division Chiefs felt they had the most knowledge and skills in patient safety. All wanted training in developing divisional budgets, and many desired training in supporting the academic mission of the Division.

Conclusion: Overall, this needs assessment identified an unmet need for leadership training and development among Division Chiefs. The findings are being used to optimize onboarding of Division Chiefs and an ongoing leadership development program targeted at this group.

Purpose: The COVID-19 pandemic caused a disruption of in-person workforce development programs. Our immersive physician-oriented leadership institute suspended in 2020, resumed in 2021 with a virtual program, and in 2022 reconvened in-person training. We used this opportunity to compare the participant experience, including reported knowledge acquisition and ability gains, between these nearly identical curricula delivered in vastly different circumstances and formats.

Participants and methods: We describe the differences in immersive leadership training implementation and adaptations made for virtual vs in-person engagement of two cohorts of OB-GYN physicians. Data were collected from virtual (n=32) and in-person (n=39) participants via post-session surveys. Quantitative data reported includes participant ratings for knowledge gain and ability gain. Qualitative data were obtained via open-ended feedback questions per session and the overall experience.

Results: Knowledge and ability scores indicated strong, statistically significant gains in both formats, with some reported learning gains higher in the virtual training. Qualitative data of participant feedback identified a number of positive themes similar across the in-person and virtual settings, with virtual participants noting how construction of the virtual program produced highly effective experiences and engagement. Constructive or negative feedback of the virtual setting included time constraint issues (eg, a desire for more sessions overall or more time per session) and technical difficulties. Positive comments focused on the effectiveness of the experience in both formats and the surprising ability to connect meaningfully with others, even in a virtual environment. However, there were also many comments clearly supporting the preference for in-person over virtual experiences.

Conclusion: Immersive physician leadership training can be effectively delivered via virtual or in-person methods, resulting in significant reported gains of knowledge and skills. These programs provide valuable interpersonal connections and skills to support physician leadership. While both formats are effective, participants clearly prefer in-person leadership development experiences and interpersonal learning.

Psychiatry chief residents have diverse leadership roles within psychiatry residency programs. Chief residents have historically been viewed as "middle managers", and other leadership roles include administrative work, teaching, and advocacy for residents. Chief residents also help in managing the logistics of complex healthcare systems and mediating between many groups with conflicting needs and perspectives. The COVID-19 pandemic has changed the functioning of psychiatry residency programs, and this has also led to the evolution of the roles of the chief residents in psychiatry. During the COVID-19 pandemic, the chief residents had to help with adapting to the changes in teaching and clinical work with residents and faculty. They had to liaison with various healthcare providers in making decisions related to COVID-19 in residency programs. Along with these changes, chief residents also had to advocate for the wellbeing and needs of their fellow residents. This perspective article is written by authors who have served during or after the transition to the COVID-19 pandemic. We discuss our experiences as chief residents as well as evolving roles and wellness needs of chief residents in psychiatry. Based on the administrative, advocacy, academic and middle management roles of chief residents in psychiatry and their wellbeing, we also make recommendations for support and interventions needed for chief residents in the context of the COVID-19 pandemic and beyond.

Aim: The purpose of this study is to examine the relationship between leadership styles of nurse managers, nurses' motivation, and turnover intentions among Jordanian nurses.

Design: A descriptive correlational cross-sectional study using a self-administered questionnaire was conducted.

Methods: A convenience sampling technique was utilized to select the required .sample A sample of 170 registered nurses working at private hospitals in Jordan was surveyed. Moreover, a questionnaire of Path-Goal Leadership, Multidimensional Work Motivation Scale, and Turnover Intention Scale was used to assess leadership styles of nurse managers, nurses' motivation and turnover intention among the participants. Descriptive and inferential tests were used to ask the research questions.

Results: The participants perceived the supportive leadership style as the highest (M = 24.4, SD = 4.66). The mean work motivation among participants was 87.12, and the mean turnover intention was 22.01. Nurses' motivation has a positive correlation with all leadership styles. Years of experience predict the nurses' work motivation. Among the leadership styles; two of them significantly predict nurses' work motivation (supportive style) p < 0.001, and (achievement-oriented style) p < 0.001. Finally, the highest correlation coefficient was noticed between work motivation and achievement-oriented style (r = 0.46, p < 0.001) by moderate positive correlation, and the lowest correlation coefficient was between work motivation and directive style (r = 0.29, p < 0.001), whereas the results revealed that turnover intention was not significantly correlated with any of the leadership styles.

Conclusion: The results present a unique theoretical underpinning that highlights the factors that affect nurses' turnover intention. So, these findings could be used as guide for policy makers to establish organizational policies toward satisfying nurses' motivation and quality of life to enhance their retention. Besides, enriching the factors that may enhance nurses' motivation and reduce their turnover intention.

Introduction: Past studies have neglected the role of resources that enhance motivation, such as health-specific leadership (H-SL) and social support colleagues (SSC), in dealing with the prerequisites of psychological health of workers, especially the duo of stress and burnout.

Objective: This empirical study aimed to identify the impact of psychosocial job demands (emotional demands) and psychosocial job resources (health-specific leadership and social support of colleagues) on the psychological health (stress, burnout) of 284 Malaysian industrial workers (who participated both times).

Methods: The Hierarchical regression analysis was employed to examine all study hypotheses and a time lagged study design was used with a lag of three months between T1 and T2 for data collection.

Results: The survey data found a significant impact of emotional demands on stress and burnout, while we found insignificant findings of health-specific leadership and social support from colleagues on workers' psychological health.

Future directions: Future studies should consider the different formations of psychosocial job resources and higher dimensions of health promotion leadership.

Background: Midwife turnover is a major problem and challenge for health-care leaders in Ethiopia. However, to date, little has been documented on turnover intention and its associated factors among midwifery professionals in southwest Ethiopia. Therefore, this study was conducted to fill the information gap on turnover intention and the factors influencing turnover intention among midwives in southwest Ethiopia.

Objective: This study aimed to determine the turnover intention and associated factors among midwives, southwest Ethiopia/2022.

Methods and materials: An institutional-based cross-sectional study design was conducted among one hundred twenty one (121) midwives using structured self-administered and a pre-tested questionnaire from May 19/2022-June to 6/2022. Data were entered into Epi-data 4.4.2.1 edited, coded, categorized and entered into the data analysis. Data were analyzed using the statistical package for social science (SPSS) version 24, and the results are presented using figure, tables, and statements. Bivariate and multivariate logistic regression analyses were conducted to determine the factors associated with turnover intention at significance level of 0.25 and 0.05, respectively.

Results: In this study, from 121 midwives included in the analysis, approximately 48.76% (95% CI: 39.86-57.74) of midwives had a turnover intention from their current health-care institution, and 53.72% (95% CI: 44.68-62.52) of midwives did not have job satisfaction. Being male (AOR: 2.9 (95% CI: 1.14-7.39)), working in Health center (AOR: 0.20 (95% CI: 0.06-0.70)) and not having mutual support (AOR: 0.17 (95% CI: 0.07-0.44)) were associated factors of turnover intention among midwives.

Conclusion and recommendation: In this study, the turnover intention among midwives was higher than that among other local and national figures. Gender, mutual support and type of working institution were factors associated with turnover intention among midwives. Therefore, public health organizations should review their maternity staff to establish teamwork and mutual support.

Background: Physicians are essential in health-care delivery. Physician engagement, defined as active participation in administrative and leadership activities in their organization, is a useful metric for hospital leaders to evaluate as they develop and implement strategy. The purpose of this study was to gain insight into the perspectives of senior hospital physician leaders on factors impacting physician engagement.

Methods: Semi-structured interviews were conducted virtually. A purposive sample was used. Hospital physician senior leaders were recruited from Ontario public hospitals in Canada. The interviews were recorded, transcribed verbatim, and analyzed.

Results: Ten participants in senior hospital physician leadership positions were interviewed. Seven themes were identified as impacting physician engagement: being seen and being heard, accountability, trust, leadership engagement, intercommunication, organizational stability, and discord within the organization. Saturation of themes was achieved.

Conclusion: Two-way communication is essential to physician engagement. Physician input in decision-making processes is a vital way to improve engagement. For this to work, leadership must also be engaged. Trust and accountability are critical attributes for senior hospital physician leaders, especially during times of organizational instability. For physicians whose remuneration model is fee-for-service, new compensation models are required for them to actively participate in hospital decision-making.

According to the United Nations High-Level Meeting 2018, five non-communicable diseases (NCDs) including cardiovascular diseases, chronic respiratory diseases, diabetes mellitus, cancer, and mental health conditions accounted for two-thirds of global deaths. These five NCDs share five common risk factors including tobacco use, unhealthy diets, physical inactivity, alcohol use, and air pollution. Low- and middle-income countries (LMICs) face larger burden of NCDs than high-income countries (HICs), due to differences in ecological, technological, socioeconomic and health system development. Based on high-level evidence albeit mainly from HICs, the burden caused by NCDs can be reduced by affordable medicines and best practices. However, "know-do" gaps, ie, gaps between what we know in science and what we do in practice, has limited the impact of these strategies, especially in LMICs. Implementation science advocates the use of robust methodologies to evaluate sustainable solutions in health, education and social care aimed at informing practice and policies. In this article, physician researchers with expertise in NCDs reviewed the common challenges shared by these five NCDs with different clinical courses. They explained the principles of implementation science and advocated the use of an evidence-based framework to implement solutions focusing on early detection, prevention and empowerment, supplemented by best practices in HICs and LMICs. These successful stories can be used to motivate policymakers, payors, providers, patients and public to co-design frameworks and implement context-relevant, multi-component, evidence-based practices. In pursuit of this goal, we propose partnership, leadership, and access to continuing care as the three pillars in developing roadmaps for addressing the multiple needs during the journey of a person with or at risk of these five NCDs. By transforming the ecosystem, raising awareness and aligning context-relevant practices and policies with ongoing evaluation, it is possible to make healthcare accessible, affordable and sustainable to reduce the burden of these five NCDs.