Journal Cover
BMJ Leader
Number of Followers: 0  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Online) 2398-631X
Published by BMJ Publishing Group Homepage  [68 journals]
  • Leadership in the spotlight
    • Authors: Blanshard; C.
      Pages: 65 - 66
      PubDate: 2019-09-27T01:00:23-07:00
      DOI: 10.1136/leader-2019-000155
      Issue No: Vol. 3, No. 3 (2019)
  • Professionalism and leadership in medical education: how do they differ
           and how are they related'
    • Authors: Hardy, L. J; Neve, H.
      Pages: 67 - 68
      PubDate: 2019-09-27T01:00:23-07:00
      DOI: 10.1136/leader-2019-000184
      Issue No: Vol. 3, No. 3 (2019)
  • Do surgeon non-technical skills correlate with teamwork-related outcomes
           during robot-assisted surgery'
    • Authors: Ahmed, Y; Lone, Z, Hussein, A. A, Feng, Y, Khan, H, Broad, S, Kannappan, R, Skowronski, A, Cole, A, Wang, D, Stone, K, Hasasneh, A, Sexton, K, Gotsch, A, Ali, T, Braun, J, Khan, S, Durrani, A, Durrani, M, Guru, K. A.
      Pages: 69 - 74
      Abstract: IntroductionTo evaluate the impact of non-technical skills (NTS) on team performance, workload and clinical outcomes.MethodsThe operating room (OR) environment of 20 robot-assisted radical prostatectomies performed by three different surgeons was recorded. Trained observers assessed NTS utilising the Non-Technical Skills for Surgeons (NOTSS) questionnaire. Associations between NOTSS scores, teamwork attributes (anticipation and inconveniences), workload (measured by National Aeronautics and Space Administration-Task Load Index (NASA-TLX)) and clinical outcomes (operative time, blood loss and surgical complexity) were determined using logistic regression and Pearson correlation.Results1780 requests were observed, 703 (39%) were non-verbal. Utilisation of non-verbal requests differed significantly among surgeons (26%, 36% and 44%, p
      PubDate: 2019-09-27T01:00:23-07:00
      DOI: 10.1136/leader-2018-000128
      Issue No: Vol. 3, No. 3 (2019)
  • Enablers and barriers to clinical leadership in the labour ward of
           district hospitals in KwaZulu-Natal, South Africa
    • Authors: Mianda, S; Voce, A. S.
      Pages: 75 - 80
      Abstract: Introduction and backgroundLike many health systems in low-income and middle-income countries, the South African health system has failed to decrease both maternal and perinatal mortality significantly, especially in district hospitals. Inappropriately trained healthcare providers and poor clinical leadership are repeatedly linked to healthcare providers’ preventable factors contributing to most maternal and perinatal deaths. Clinical skills of healthcare providers have been largely addressed, while clinical leadership remained neglected. One strategy implemented recently to support clinical leadership is the introduction of District Clinical Specialist Teams (DCSTs). Clinical leadership in the labour ward of district hospitals in KwaZulu-Natal (KZN) is conceptualised as an emergent phenomenon arising from dynamic interactions in the labour ward and the broader health system, converging to attain optimal patient care.AimTo evaluate the enablers and barriers to clinical leadership in the labour ward of district hospitals.MethodIterative data collection and analysis, following the Corbin and Strauss grounded theory approach, was applied. In-depth interviews were carried out with the midwifery members of the DCSTs in KZN. The emergent enablers and barriers to clinical leadership were presented and discussed at a workshop with broader midwifery representation, leading to a final classification of enablers and barriers to clinical leadership.Results and conclusionEnablers and barriers to clinical leadership arise as a result of emergent dynamic interactions within the labour ward and the broader health system, located at policy, organisational, team and individual healthcare provider levels, with the policy context as the overriding factor framing the implementation of clinical leadership.
      Keywords: Open access
      PubDate: 2019-09-27T01:00:23-07:00
      DOI: 10.1136/leader-2018-000130
      Issue No: Vol. 3, No. 3 (2019)
  • Lessons for leadership and culture when doctors become second victims: a
           systematic literature review
    • Authors: Willis, D; Yarker, J, Lewis, R.
      Pages: 81 - 91
      Abstract: This review set out to understand what leaders and organisational cultures can learn about supporting doctors who experience second victim phenomenon; the types, levels and availability of support offered; and the psychological symptoms experienced. A systematic review of keywords ‘Medical Error’ [MeSH], ‘Near Miss’, ‘Adverse Event’, ‘Second Victim’ and ‘Support’ was carried out using CINAHL Plus, Medline and Embase Classic and Embase 1947-2017 databases. Results show that poor organisational culture and leadership negatively influences and hinders doctors who make mistakes. Leaders who promote and create environments for open and constructive dialogue following adverse events enable the concept of fallibility and imperfection to be assimilated into new ways of learning. Guilt and fear are the most consistently reported psychological symptoms along with a perception of loss of professional respect and standing. Doctors often carry unresolved trauma for several years causing them to constantly relive an event. Unchecked, this can lead to poor relationships with colleagues and impact greatly on their ability to sleep and performance at work. The review concludes that a prevailing silence, exacerbated by poor organisational culture, inhibits proper disclosure to the first victim, the patient and family. It also impedes a healthy recovery trajectory for the doctor, the second victim. Leaders of organisations have a vital strategic and operational role in creating open, transparent and compassionate cultures where dialogue and understanding takes place for those affected by second victim phenomenon.
      Keywords: Editor''s choice
      PubDate: 2019-09-27T01:00:23-07:00
      DOI: 10.1136/leader-2018-000117
      Issue No: Vol. 3, No. 3 (2019)
  • Power and physician leadership
    • Authors: Saxena, A; Meschino, D, Hazelton, L, Chan, M.-K, Benrimoh, D. A, Matlow, A, Dath, D, Busari, J.
      Pages: 92 - 98
      Abstract: Power and leadership are intimately related. While physician leadership is widely discussed in healthcare, power has received less attention. Formal organisational leadership by physicians is increasingly common even though the evidence for the effectiveness of physician leadership is still evolving. There is an expectation of leadership by all physicians for resource stewardship. The impact of power on interprofessional education and practice needs further study. Power also shapes the profession’s attempts to address physician and learner well-being with its implications for patient care. Unfortunately, the profession is not exempt from inappropriate use of power. These observations led the authors to explore the concept and impact of power in physician leadership. Drawing from a range of conceptualisations including structuralist (French and Raven), feminist (Allen) and poststructuralist (Foucault) conceptualisations of power, we explore how power is acquired and exercised in healthcare systems and enacted in leadership praxis by individual physician leaders (PL). Judicious use of power will benefit from consideration and application of a range of concepts including liminality, power mediation, power distance, inter-related use of power bases, intergroup and shared leadership, inclusive leadership, empowerment, transformational leadership and discourse for meaning-making. Avoiding abuse of power requires moral courage, and those who seek to become accountable leaders may benefit from adaptive reflection. Reframing ‘followers’ as ‘constituents or citizens’ is one way to interrupt discourses and narratives that reinforce traditional power imbalances. Applying these concepts can enhance creativity, cocreation and citizenship-strengthening commitment to improved healthcare. PLs can contribute greatly in this regard to further transform healthcare.
      Keywords: Open access
      PubDate: 2019-09-27T01:00:23-07:00
      DOI: 10.1136/leader-2019-000139
      Issue No: Vol. 3, No. 3 (2019)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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