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Leadership in Healthcare

Mary Lavelle, Jennifer Abthorpe, Thomas Simpson, Gabriel Reedy, Fiona Little, Anita Banerjee
The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as 'indirect deaths'. The MBRRACE report identified serious gaps in clinicians' human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49)...
March 21, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Roberta L Woodgate, Melanie Zurba, Pauline Tennent
Plain English summary: The involvement of patients in health research has resulted in the development of more effective interventions and policies in healthcare that respond to the needs of healthcare users. This article examines how working with youth and their families as co-researchers in health research communities of practice (CoPs), rather than just as participants, can benefit all involved. Health research (CoPs) promote an environment in which co-researchers have the opportunity to do more than just participate in the data collection phase of the research process...
2018: Research Involvement and Engagement
Luciano Rossetti
Luciano Rossetti, MD, Executive Vice President, Global Head of R&D at Merck KGaA, Darmstadt, Germany speaks to Laura Dormer, Commissioning Editor Luciano Rossetti, MD, is Executive Vice President, Global Head of R&D at Merck KGaA, Darmstadt, Germany, and a member of the Healthcare Executive Committee. As Global Head of R&D, Rossetti leads the strategy for Merck KGaA, Darmstadt, Germany's discovery and development efforts in healthcare. He joined Merck KGaA in July 2014, and has since led the acceleration of several key programs through the pipeline and advanced the innovation of Merck KGaA's discovery teams into development...
March 20, 2018: Neurodegenerative Disease Management
Stefanie Bachnick, Dietmar Ausserhofer, Marianne Baernholdt, Michael Simon
BACKGROUND: Patient-centered care is a key element of high-quality healthcare and determined by individual, structural and process factors. Patient-centered care is associated with improved patient-reported, clinical and economic outcomes. However, while hospital-level characteristics influence patient-centered care, little evidence is available on the association of patient-centered care with characteristic such as the nurse work environment or implicit rationing of nursing care. OBJECTIVE: The aim of this study was to describe patient-centered care in Swiss acute care hospitals and to explore the associations with nurse work environment factors and implicit rationing of nursing care...
November 24, 2017: International Journal of Nursing Studies
Sherine Ismail, Mohamed Osman, Rayf Abulezz, Hani Alhamdan, K H Mujtaba Quadri
Pharmacists possess pivotal competencies and expertise in developing clinical pathways (CPs). We present a tertiary care facility experience of pharmacists vis-a-vis interprofessional collaboration for designing and implementing CPs. We participated in the development of CPs as leading members of a collaborative team of healthcare professionals. We reviewed literature, aligning it with hospital formulary and institutional standards, and participated in weekly team meetings for six months. Several tools and services were adapted to guide prescribing and standardization of care through time-bound order sets...
March 16, 2018: Pharmacy (Basel, Switzerland)
Sagaren Govender, Cecile N Gerwel Proches, Abdulla Kader
Background: Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose: This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province...
2018: Journal of Multidisciplinary Healthcare
Isabelle Scholl, Allison LaRussa, Pola Hahlweg, Sarah Kobrin, Glyn Elwyn
BACKGROUND: Shared decision-making (SDM) is poorly implemented in routine care, despite being promoted by health policies. No reviews have solely focused on an in-depth synthesis of the literature around organizational- and system-level characteristics (i.e., characteristics of healthcare organizations and of healthcare systems) that may affect SDM implementation. A synthesis would allow exploration of interventions to address these characteristics. The study aim was to compile a comprehensive overview of organizational- and system-level characteristics that are likely to influence the implementation of SDM, and to describe strategies to address those characteristics described in the literature...
March 9, 2018: Implementation Science: IS
Eva M Luo, Henry S Opare-Ado, Joseph Adomako, Kwabena A Danso, Talya Peltzman, Frank W J Anderson
Introduction To provide a qualitative perspective on the changes that occurred after newly placed OB/GYNs began working at district hospitals in Ashanti, Ghana. Methods Structured interviews of healthcare professionals were conducted at eight district hospitals located throughout the Ashanti district of Ghana, four with and four without a full-time OB/GYN on staff. Individuals interviewed include: medical superintendents, medical officers, district hospital administrators, OB/GYNs (where applicable), and nurse-midwives...
March 8, 2018: Maternal and Child Health Journal
Neisha Sundaram, Kathryn Duckett, Chee Fu Yung, Koh Cheng Thoon, Sucitro Sidharta, Indumathi Venkatachalam, Angela Chow, Joanne Yoong
BACKGROUND: Influenza vaccine acceptance among healthcare workers (HCWs) is a worldwide problem, but relatively little research has focussed on Asia, including Singapore. Despite widespread access and recommendations from public health authorities, influenza vaccine uptake remains suboptimal among HCWs. METHODS: Our qualitative study used focus group discussions to identify and explain factors limiting influenza vaccine acceptance among HCWs in Singapore. A total of 73 doctors, nurses, allied health and ancillary staff across three public hospitals were included...
March 5, 2018: Vaccine
Jennifer W Goldsberry
Healthcare delivery has become increasingly complex and fragmented. Leading healthcare organizations, such as the Institute of Medicine and the World Health Organization, have recognized that interprofessional collaboration is essential to improve healthcare delivery. The process of integrating interprofessional collaboration is complex and involves overcoming historical hierarchical factors and professional boundaries. The integration of interprofessional education in healthcare professions can help to alleviate these barriers...
February 28, 2018: Nurse Education Today
Barbara G Bokhour, Gemmae M Fix, Nora M Mueller, Anna M Barker, Sherri L Lavela, Jennifer N Hill, Jeffrey L Solomon, Carol VanDeusen Lukas
BACKGROUND: Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little is known about how best to transform the culture of care in these organizations. We sought to understand key organizational factors for implementing patient-centered care cultural transformation through an examination of efforts in the US Department of Veterans Affairs. METHODS: We conducted multi-day site visits at four US Department of Veterans Affairs medical centers designated as leaders in providing patient-centered care...
March 7, 2018: BMC Health Services Research
Fathima Ahmed
The ever-evolving nature of nursing requires professionals to keep their knowledge up to date and uphold the Nursing and Midwifery Council (NMC) Code by engaging themselves in ongoing personal and professional development (PPD). This article aims to highlight the importance of good leadership and management in healthcare and to explore the literature surrounding leadership and management, such as the current NHS healthcare leadership model ( NHS Leadership Academy 2013 ), the Leading Change, Adding Value Framework underpinned by the 10 commitments and 6Cs ( NHS England 2016 ) and the NMC Code ( NMC 2015a ) in relation to PPD...
March 7, 2018: Nursing Children and Young People
Carien W Alingh, Mathilde M H Strating, Jeroen D H van Wijngaarden, Jaap Paauwe, Robbert Huijsman
BACKGROUND: Nursing management is considered important for patient safety. Prior research has predominantly focused on charismatic leadership styles, although it is questionable whether these best characterise the role of nurse managers. Managerial control is also relevant. Therefore, we aimed to develop and test a measurement instrument for control-based and commitment-based safety management of nurse managers in clinical hospital departments. METHODS: A cross-sectional survey design was used to test the newly developed questionnaire in a sample of 2378 nurses working in clinical departments...
March 6, 2018: BMJ Quality & Safety
Gudbjörg Erlingsdottir, Anders Ersson, Jonas Borell, Christofer Rydenfält
Purpose The purpose of this paper is to describe five salient factors that emerge in two successful change processes in healthcare. Organizational changes in healthcare are often characterized by problems and solutions that have been formulated by higher levels of management. This top-down management approach has not been well received by the professional community. As a result, improvement processes are frequently abandoned, resulting in disrupted and dysfunctional organizations. This paper presents two successful change processes where managerial leadership was used to coach the change processes by distributing mandates and resources...
March 19, 2018: Journal of Health Organization and Management
Allan Best, Alex Berland, Trisha Greenhalgh, Ivy L Bourgeault, Jessie E Saul, Brittany Barker
Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders...
March 19, 2018: Journal of Health Organization and Management
Chantal Backman, Paul C Hebert, Alison Jennings, David Neilipovitz, Omar Choudhri, Akshai Iyengar, Romain Rigal, Alan J Forster
Purpose Patient safety remains a top priority in healthcare. Many organizations have developed systems to monitor and prevent harm, and have invested in different approaches to quality improvement. Despite these organizational efforts to better detect adverse events, efficient resolution of safety problems remains a significant challenge. The authors developed and implemented a comprehensive multimodal patient safety improvement program called SafetyLEAP. The term "LEAP" is an acronym that highlights the three facets of the program including: a Leadership and Engagement approach; Audit and feedback; and a Planned improvement intervention...
March 12, 2018: International Journal of Health Care Quality Assurance
Felipe Maia de Toledo Piza, Leo Anthony Celi, Rodrigo Octavio Deliberato, Lucas Bulgarelli, Fabricio Rodrigues Torres de Carvalho, Roberto Rabello Filho, Miguel Angel Armengol de La Hoz, Jennifer Cohn Kesselheim
BACKGROUND: Datathons are increasingly organized in the healthcare field. The goal is to assemble people with different backgrounds to work together as a team and engage in clinically relevant research or develop algorithms using health-related datasets. Criteria to assess the return of investment on such events have traditionally included publications produced, patents for prediction, classification, image recognition and other types of software, and start-up companies around the application of machine learning in healthcare...
April 2018: International Journal of Medical Informatics
Richard J McManus, Jonathan Mant, Marloes Franssen, Alecia Nickless, Claire Schwartz, James Hodgkinson, Peter Bradburn, Andrew Farmer, Sabrina Grant, Sheila M Greenfield, Carl Heneghan, Susan Jowett, Una Martin, Siobhan Milner, Mark Monahan, Sam Mort, Emma Ogburn, Rafael Perera-Salazar, Syed Ahmar Shah, Ly-Mee Yu, Lionel Tarassenko, F D Richard Hobbs
BACKGROUND: Studies evaluating titration of antihypertensive medication using self-monitoring give contradictory findings and the precise place of telemonitoring over self-monitoring alone is unclear. The TASMINH4 trial aimed to assess the efficacy of self-monitored blood pressure, with or without telemonitoring, for antihypertensive titration in primary care, compared with usual care. METHODS: This study was a parallel randomised controlled trial done in 142 general practices in the UK, and included hypertensive patients older than 35 years, with blood pressure higher than 140/90 mm Hg, who were willing to self-monitor their blood pressure...
February 27, 2018: Lancet
Michelle Giles, Vicki Parker, Jane Conway, Rebecca Mitchell
BACKGROUND: Clinical Leaders drive healthcare performance in the provision of safe high quality patient care by influencing others and augmenting change. Clinical leadership features strongly in Nurse Consultant (NC) roles and holds potential to strengthen the NC's place in healthcare teams, making their contribution as clinical leaders more recognisable. This study explores how clinical leadership is enacted through the NC role, providing understanding of the elements that influence their effectiveness as clinical leaders...
March 1, 2018: Journal of Clinical Nursing
Amanda J Hays, Jennifer R Smith, Rebecca M Guth, Susan E Samet
Drug formularies are a necessary part of medication management in hospitals and health systems. The system-level P&T committee at BJC HealthCare, a multihospital health system in St. Louis, Missouri, developed an approach to standardization of a system-wide formulary using available layered learners to complete the work in an expedited manner before implementation of a system-wide electronic medical record. The formulary standardization work was allocated to reviewers-including pharmacy students, residents, clinical pharmacy specialists, and pharmacy leadership-according to the complexity of the drug class under review, and a pharmacist was assigned to oversee and support the learner (student or resident) as class reviews were performed...
March 2018: P & T: a Peer-reviewed Journal for Formulary Management
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