Journal of Healthcare Leadership最新文献

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.

Telehealth services have potential to enhance access to quality healthcare, reduce costs, and increase satisfaction for both patients and providers. As a disruptive healthcare innovation, telehealth disorders old systems and creates a new hybrid model of care that delivers significant value to stakeholders. However, the failure rate of innovation implementation in healthcare ranges from 30% to 90%, depending on the complexity involved. While researchers have conducted extensive studies on the barriers and facilitators to widespread innovation implementation, the root causes of innovation implementation failure in health services (eg, telehealth implementation failure) are not fully understood. The Consolidated Framework for Implementation Research (CFIR) introduced in 2009 has become increasingly popular as a framework for informing successful innovation implementation in health services. The CFIR identifies barriers and facilitators to innovation implementation across five domains of implementation-the innovation, individual, inner, outer, and process domains. However, it lacks a mechanism to capture the complex social challenges (tensions) underlying the barriers and facilitators that affect implementation success or failure. The Tensions framework supplies a foundation beyond barriers and facilitators to provide a dynamic understanding of the role of social conflicts impacting the implementation process. This paper presents a novel conceptual model, Tensions in Innovation Implementation Processes (TIIPs), which integrates tensions and management strategies within the CFIR framework. A key contribution of TIIPS is its ability to visualize the social conflicts within and across implementation domains, offering a clearer understanding of the challenges and opportunities involved in innovation implementation. We apply TIIPs to telehealth implementation, drawing implications for practice, policy, and research to enable successful telehealth implementation in healthcare organizations. This approach advances existing frameworks, aligning with the systems thinking essential for today's healthcare leadership.

Purpose: The widespread adoption of telemedicine tools poses new and little-known challenges for healthcare professionals, who are required to adapt their knowledge, skills, and work practices to this innovative scenario. Understanding healthcare professionals' expectations and concerns about adopting telemedicine can facilitate its effective integration. Therefore, drawing upon the Value Co-Creation in Healthcare model, the current study aims to investigate pediatricians' expectations regarding antecedents, outcomes, and management activities relevant to the implementation of a telehomecare service.

Methods: Interviews invitations were sent to all pediatricians (n=13) involved in a pilot study using the TytoCare device, a telehomecare tool that enables remote medical examinations, at an Italian pediatric hospital. All invited pediatricians agreed to participate. The semi-structured interviews, each lasting approximately 30 to 45 minutes, were conducted remotely via Microsoft Teams prior to the use of the TytoCare device. All interviews were recorded and transcribed verbatim. The content was subsequently analyzed through thematic analysis using MAXQDA software.

Results: Five overarching thematic areas emerged from the interviews: factors influencing the adoption of the telehomecare device, advantages of its use, impacts on work practices, changes in the patient-professional relationship, and management activities. While concerns exist about the adequacy of telehomecare compared to in-person visits, the device offers potential benefits, such as improving the hospital experience for children by shortening hospital stays. However, it may lead to an increased workload and necessitate stronger trust and communication in remote care. Successful integration requires dedicated support staff, regulatory adjustments, and effective leadership, with active involvement of healthcare professionals in decision-making.

Conclusion: By shedding light on healthcare professionals' expectations about telehomecare device, this study provides useful insights to healthcare leaders to tailor interventions to accompany technology within care practices to valorize its benefits and promote value co-creation processes.

Introduction: Professionalism among healthcare professionals is often defined in terms such as altruism, humanism, and excellence. The integration of such professionalism ideals to healthcare professionals' practice poses a challenge to medical tutors. We examined the assessment of professionalism among physicians and nurses by their peers and evaluated the significance of each professional role component within each sector. We also performed a cross-sector assessment whereby physicians assessed nurses' professionalism and vice versa.

Methods: A survey among physicians, interns, and nurses. The participants were asked to rate the extent that each of the 12 characteristics contributes to physicians' and nurses' professionalism of on a scale of 1 (does not contribute at all) to 10 (highly contributes). Each participant rated the contribution of each component to the professionalism of their own occupation (direct scoring) and to the professionalism of the other occupation (cross scoring).

Results: In total, 300 healthcare professionals (mean age 36.6, 46% males) responded to the survey. The most highly contributing characteristics to physicians' professionalism were knowledge, responsibility, decision-making and leadership, clustered as "strategic judgment". The most highly contributing characteristics to nurses' professionalism were responsibility, personal attention, empathy, and skills, clustered as "bedside approach" and "performance abilities". Cross-assessment among professionals was different: Nurses assigned higher ratings in general, interns assigned higher ratings to physicians' characteristics, whereas physicians assigned lower ratings to professionalism characteristics, and especially to those of nurses. Nurses emphasized patient centeredness and communication skills more than physicians. Nurses and interns appreciated teamwork compared to physicians. Major differences in how physicians and nurses perceive professionalism revealed physicians' emphasis on "strategic judgment" while nurses emphasis on "bedside approach".

Conclusion: Physicians and nurses hold differing viewpoints on many topics, including the objectives of their mission, expected performance, and activity types. Medical professionals can assess their colleagues and partners, recognizing both strengths and weaknesses in themselves and others.

Introduction: Healthcare is experiencing a global period of profound transformation, and digital health shows the promise of dispensing innovative and contemporary service models. However, changes are required to improve the capabilities of health managers in driving successful digital transformation.

Objective: This paper aims to explore the organizational barriers that health service managers have encountered when realizing the benefits of a digitally transforming environment. This is part of a larger research study exploring digital competencies for health service managers, with the findings from focus group discussions providing a baseline from which to address the organizational improvements and changes in system capabilities required to assist in realizing the benefits of digital health transformation.

Methods: The study is qualitative in nature. It employs focus group discussions to gain an in-depth understanding of the experiences and views of health service managers and identify the benefits and barriers that managers have experienced in introducing digital health in their workplace.

Results: Barriers encountered in realizing digital health benefits in the workplace were evidenced across five major themes: (1) change resistance and usage, (2) trust and uniformity, (3) resourcing and procurement, (4) digital literacy, and (5) siloed systems.

Discussion: Findings from this study demonstrate that in driving the realization of digital health transformation benefits, health service managers need organizational and system-wide efforts to support managing in the digital health context. The key identified barriers experienced by health service managers include facing human and technical challenges with system adoption and the governance of data-driven decision-making in the digital context.

Conclusion: The importance of digital transformation in healthcare is evident and will increasingly become a necessity for organizational survival and success. This study adds important insights into the organizational barriers that health service managers have encountered when realizing the benefits resulting from digital transformation. Addressing these barriers requires macro-, meso- and micro-level system investments. These benefits are enhanced by enabling factors critical for digital health adoption that have been described in key categories involving health system related: (1) policy and system, (2) organizational structure and processes, and human resource management, and (3) people factors. The importance of ensuring the organizational factors driving the realization of benefits in a digitally transforming environment is also addressed and capitalized upon for health service managers.

Aim: This study explores the experiences of mentors and mentees participating in a mentor program for nurses in leadership positions, aiming to identify areas for program improvement.

Design and methods: A qualitative approach was used, with semi-structured interviews conducted with 20 nurses in leadership roles. The participants, 10 mentees and 10 mentors, were involved in the Norwegian Nurses Organization's "Mentor Program for Nurses as Leaders". Thematic analysis was applied to the data.

Results: Participants in the mentorship program reported increased leadership awareness, stronger motivation, better stress-coping mechanisms, and greater confidence as leaders. They received valuable feedback and support from their mentors, boosting their motivation to pursue leadership roles. Both mentees and mentors expressed a desire for a longer program and emphasized the importance of networking opportunities, along with the need for predictability and long-term planning to improve program effectiveness.

Conclusion: Participants reported that the mentorship program increased their awareness, motivation, coping skills, and confidence as leaders, encouraging them to pursue leadership roles. The results show that the NNO's mentor program positively influences leadership aspirations of new nurse leaders, with potential for further development in networking and program duration.

Background: Although US research agencies have instituted peer review processes to require participant diversity in clinical trials before funding decisions are made, the underrepresentation of certain populations (eg, racial and ethnic minorities) in clinical trials remains a persistent challenge in biomedical research. This issue has the potential to affect the generalizability of findings and impede efforts to ensure the provision of high-quality healthcare across all populations. In this study, we examined barriers to the recruitment and retention of underrepresented populations in cancer clinical trials from the perspective of research coordinating staff.

Methods: Semi-structured interviews were conducted at a US-based academic cancer center and included 6 patient-facing staff (clinical research coordinators) and 6 non-patient-facing staff (regulatory and financial specialists). Interview data were subjected to thematic analysis. To provide additional organizational context, descriptive data were obtained on the characteristics of clinical trials undertaken at the cancer center.

Results: The following themes emerged from the staff interviews: 1) absence of a consistent structure for decision-making and problem-solving related to recruitment and retention, 2) staff shortages, 3) administrative burden, and 4) lack of resources. In addition, descriptive data revealed that nearly half the trials, 64/134 (48%), offered informed consent only in English, and only 3/134 (2%) offered participant incentives or reimbursement (eg, for transportation). These interrelated organizational issues were indicative of inadequate systems for ensuring diverse and equitable representation in cancer clinical trials.

Conclusion: Results indicate that overcoming barriers to underrepresentation may require dedicated support from sponsoring agencies in the form of evidence-based guidelines, learning collaboratives to facilitate implementation, technical support, resources, and oversight. For progress to be made therefore, both sponsors and cancer centers may need to assume joint responsibility for the implementation of effective systems for ensuring diverse and equitable representation in cancer clinical trials.

Purpose: The digitalization of healthcare is developing quickly. Every care provider needs to be up-to-date on this technology. The purpose of this research was to identify the digital literacy of nursing staff and nurse managers.

Methods: A cross-sectional study assessed nurses' digital literacy, specifically with regard to nursing informatics competencies in hospitals, primary healthcare, and clinics. The study sample included 100 nurses and 83 nurse managers. Researchers applied a modified questionnaire on nurses' informatics competencies from TIGER Nursing Informatics, with a validity range of 0.497-0.897 and a reliability value of 0.975.

Results: Participants showed an acceptable level of computer literacy, although their scores were below 80%. Their scores were unrelated to workplace, duration and type of technology used, or gender. Nursing informatics competencies correlated significantly with age and work experience (p = 0.001). Age correlated negatively with technical computer skills but positively with competence in the implementation of healthcare. There was a positive link with a nurse's position and education level, indicating that nurses with more education acquire higher levels of informatics competencies than those with less education. Additionally, those in higher positions tended to possess more advanced digital competence.

Conclusion: Nurse managers play a significant role in training nursing staff members to enhance their informatics competencies. This study's findings underscore the need to raise staff members' informatics competencies by providing additional training.