Journal of Healthcare Leadership最新文献

Objective: To conduct a literature review to determine where and how variable control charts have contributed to quality improvement in healthcare.

Methods: A targeted literature search of the ABI/INFORM Global, Science Direct, Medline and Google Scholar databases was conducted, which yielded 6875 papers. Screening articles on the basis of title and abstract resulted in references to 163 articles, leading to the identification of 29 articles published between 1992 and 2019 that met the inclusion criteria. Common themes, variables and units of analysis were then analyzed.

Results: Variable control charts have been applied in 11 different healthcare contexts, using 17 different variables, at various levels within healthcare organizations. The main reason for applying variable control charts is to demonstrate a process change, usually following a specific change or quality intervention. The study identified various limitations and benefits of applying variable control charts. The charts are visually easy to understand for both management and employees, but they are limited by their requirement for potentially complex and resource-intensive data collection.

Conclusion: Variable control charts contribute to quality improvement in healthcare by enabling visualization and monitoring of variations and changes in healthcare processes. The methodology has been most frequently used to demonstrate process shifts after quality interventions. There still is a great potential for more studies applying variable control charts.

Purpose: In pandemics, centralized healthcare leadership is a critical requirement. The objective of this study was to analyze the early development, operation, and effectiveness of a COVID-19 organizational leadership team and transformation of healthcare services at West Virginia University Hospitals and Health System (WVUHS). The analysis focused on how Kotter's Leading Change eight-stage paradigm could contribute to an understanding of the determinants of successful organizational change in response to the COVID-19 pandemic.

Methods: The fifteen core leaders of WVUHS COVID-19 strategic system were interviewed. A qualitative thematic analysis of the interviews was used to evaluate key aspects of leadership dynamics and system-wide changes in healthcare policies and protocols to contain the pandemic. Outcome measures included the degree to which WVUHS could handle and contain COVID-19 cases as well as COVID-19 death and vaccination rates in West Virginia compared with other states.

Results: The leadership team radically and rapidly revamped nearly all healthcare policies, procedures, and protocols for WVUHS hospitals and clinics, and launched a Hospital Incident Command System. As a result of this effective leadership team and strategic plan, WVUHS surge capacity was adequate for COVID-19 cases. In addition, West Virginia was an early frontrunner in COVID-19 vaccination rates as well as lower death rates.

Conclusion: WVUHS's leadership response to the COVID-19 pandemic followed Kotter's eight-stage paradigm for Leading Change in organizations, including the establishment of a sense of urgency, formation of a powerful guiding coalition, creation of a vision, communication of the vision, empowerment of others to act on the vision, plan for and creation of short-term wins, consolidation of improvements and production of more changes, and institutionalization of new approaches. This approach was effective in limiting the spread and impact of COVID-19 within the hospital network and across the state, with many lessons learned along the way.

Dementia friendly (DF) is a term that has been increasingly used in the international literature to describe approaches that include and involve people living with dementia within their communities and wider society. How to support the involvement of people living with dementia to achieve dementia friendly care or support outcomes is an area that has begun to receive attention. We begin by introducing the concept of dementia friendly, the policy context and what has already been evidenced via prior reviews and conceptual discussions. We conducted a systematic review following PRISMA guidelines, resulting in the inclusion of nineteen papers that reported on the methods and approaches used to involve people living with dementia in achieving dementia friendly or supportive care outcomes. Five primary themes were identified: the potential of group-based activities to facilitate inclusion and engagement; achieving engagement in decision making; the value of developing tools to help service providers to engage those living with dementia in care decisions; the role of awareness raising and education to support the inclusion of a range of stakeholders in achieving DF support and care outcomes; the need for cultural and contextual sensitivity when seeking to engage stakeholders to achieve positive care outcomes. We conclude by considering how both the underpinning ethos of social citizenship and social inclusion need to be in place alongside a range of approaches that are adapted to fit local contexts and needs to enable the involvement of people living with dementia in achieving dementia friendly care outcomes.

The COVID-19 pandemic had the unintended consequence of placing nurses in the spotlight because their knowledge and skills were in desperate need. While it will be years until we fully understand the impact that this pandemic has exacted on the nursing workforce, early studies have found that nurses have been traumatized by this event and many intend to leave the profession This seismic event only further exacerbated an already vulnerable and strained nursing workforce that pre-existed worldwide prior to COVID-19. The pandemic also highlighted the many challenges facing nursing leadership, in particular, how to create conditions to maintain and sustain a healthy nursing workforce. Nurses' job satisfaction has emerged as an important predictor of whether nurses remain in an organization and stay in the profession. When examined more closely, job satisfaction has been related to nurses feeling empowered to exercise autonomy over their own practice and having agency. Autonomy and agency, in turn, are affected by their managers' leadership styles. Leaders are instrumental in setting the tone and creating the climate and culture that either values or devalues autonomy and agency. To help leaders create empowering conditions, we have developed a guide for leaders. This guide, based on the value-driven philosophy of leadership called Strengths-Based Nursing and Healthcare Leadership (SBNH-L), is founded on principles of person-centered, empowerment, relationship-focused, and innate capacities (ie, strengths) that are operationalized in eight core values. This guide can be used by leaders as their roadmap to create empowering workplace conditions that value and facilitate nurses' autonomy and agency.

Background: Routine health information (RHI) systems are vital for the acquisition of data for health sector planning, monitoring, and evaluation, patient management, health education, resource allocation, disease prioritization, and decision-making. Use RHI for decision-making is low in Ethiopia. Thus, the study aimed to assess barriers and associated factors to the use of RHI among managers working at public hospitals in North Shewa, Ethiopia.

Methods: A facility-based mixed-method study was conducted from May to June 2020. A total of 102 randomly selected managers were included in the survey and six key informant interviews were done. Data were collected using a structured self-administered questionnaire and interview guide by trained data collectors. Data were entered into Epi-info version 7.1 and transferred into SPSS version 23 for further statistical analysis. Both bivariate and multivariable logistic regression analyses were performed. In the multiple logistic regression analysis, a less than 0.05 P-value was considered statistically significant. The odds ratio along with a 95% confidence interval was estimated to measure the strength of the association. Thematic analysis was done for key informant interview data.

Results: In this study, the level of RHI use for decision-making was 71.6% (95% CI: 61.8%, 79.4%). According to the multivariable logistic regression analysis, training on health information system (AOR = 0.28, 95% CI: 0.08-0.98) and supportive supervision (AOR = 0.27, 95% CI: 0.09-0.78) were found significantly associated with the use of RHI for decision-making. Moreover, the lack of staff motivation and computer and data analysis skills were the major reasons for not using RHI.

Conclusion: Three-fourth of the managers working at public hospitals used RHI for decision-making. Training on health information systems and supportive supervision were factors associated with the use of RHI. Therefore, training of managers and the provision of supportive supervision were highly recommended.

Purpose: Drawing on the decade of experience of Boston University Medical Campus' Faculty Development Office, this paper reports strategies used to launch and continually improve faculty development programming within an academic health sciences campus.

Patients and methods: The authors explain the steps that Boston University Medical Campus took to institute their set of faculty development programs, including an overview of resources on how to periodically conduct needs assessments, engage key institutional stakeholders, design and evaluate an array of programming to meet the needs of a diverse faculty, and institute real-time program modifications.

Results: In a step-by-step guide, and by highlighting vital lessons learned, the authors describe a process by which biomedical educators can create and sustain a robust faculty development office within their own institutions.

Conclusion: This paper identifies steps to launch and improve faculty development program. Faculty development programs should be expanded to support faculty in academic medical centers.

The current healthcare systems across the world are well established with the use of information and communication technologies. However, the developments of healthcare systems during the early Islamic and medieval ages have contributed to the establishment of various procedures and practices which are still relevant today. In addition, the research related to the history of medicine in the Arab world mainly focused on the medical literature and very few practices; whereas the healthcare infrastructure and management were undermined. In order to address this gap, this study focuses on reviewing the healthcare systems and infrastructural developments through the history of Islamic civilization, which spread across the Middle East, Africa, Spain, and West Asia. The findings are presented systematically under the categories of types of care centers, management and human resources, medical education system, and medical ethics, and then discussed.

The healthcare system in the United States has been taxed in various ways throughout the COVID-19 pandemic, stressing healthcare facilities to their breaking point. This has forced decision-makers in healthcare to make difficult choices, highlighting the need for effective leadership. However, there are little intentional leadership development curricula in medical education. Leadership skills can be taught and acquired similar to other skills in medical school, and we believe medical education institutions should cultivate these skills in their trainees. We hope that this will help inspire change in medical education curricula to intentionally teach and develop leadership skills in their students.

Purpose: To analyze self and 360-evaluation scores of the professionalism intelligence model domains within an academic Otolaryngology-Head and Neck Surgery Department.

Methods: A leadership course was introduced within the Department of Head and Neck Surgery & Communication Sciences at Duke University Medical Center. A 360 evaluation assessing domains of the professional intelligence model was recorded for all participants. Participant demographics included gender (male vs female), generation group (generation Y vs older generations) and physician status of participants (physician vs non-physician). Differences in mean self-scores were modeled using linear regression. When analyzing the evaluator scores, gaps were defined as self-score minus evaluator-score for each member of a participant's evaluator groupings (supervisor, peer, and direct report). Two types of linear mixed models were fit with a random intercept to account for the correlated gaps in the same participant.

Results: Scores of 50 participants and 394 evaluators were analyzed. The average age was 40.6 (standard deviation 9.3) years, and 50% (N=25) of participants were females. Physicians accounted for 36% (N=18) of the cohort, and 61% (N=11) of physicians were residents. Physicians scored themselves lower than non-physicians when assessing leadership intelligence, interpersonal relations, empathy, and focused thinking. On average, participants under-rated themselves compared to their evaluators with direct reports giving higher scores than managers and peers. When compared with generation Y, older generations tended to rate themselves lower than their peers and managers in cognitive intelligence. No significant association was observed between gender and any scores.

Conclusion: Participants rate themselves lower on average than their evaluators. This work is important in understanding how perceived leadership qualities are assessed and developed within an academic surgical department. Finally, the results presented could serve as a model to address the gap between self- and other-perceptions of defined leadership virtues in future leadership development activities.

Introduction: Health-care waste is a great concern because, in addition to containing conventional toxic pollutants like mercury, chlorinated plastics, and solvents; it also includes a number of toxic materials not found in typical waste. There were no scientific data in Ethiopia that reveal practice toward management of health-care waste. Therefore, the aim of this study was to assess the management of health professionals toward health-care waste in South Omo zone public health facilities, South West Ethiopia, 2018.

Methods: A facility-based cross-sectional study was used with in the period of February 1-30, 2018. A total of 362 health-care workers were sampled using the lottery method. Coding and entry of data was done using Epi Info™ version: 7.2 and analyzed with SPSS version 20 computer software. Descriptive statistics were computed. Bivariate analyses and multivariable logistic regression were used to identify predictor variables for practice of health-care providers.

Results: The overall finding of safe practice on health-care waste management among health-care workers was only 29.3%. Receiving training regarding medical waste management, work hours per day among respondents, availability and usage of color coded containers and yellow plastic bags for infectious waste had significant association with safe practice on health-care waste management.

Conclusions and recommendation: The overall finding of safe practice on health-care waste management was only 29.3% among health-care workers. This study showed that most of health-care workers did not meet standard practice. Providing training on medical waste management is essential to encourage safe practices among health-care workers and more attention should be directed at the health-care attendants in order to close the yawning gap in their practice level of medical waste management.