scholarly journals Exploration of ‘perception of self’ as medical leader: does perception of self require a paradigm shift from clinician to clinical leader?

BMJ Leader ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 103-109
Author(s):  
Charlotte Moen ◽  
Jeremy Brown ◽  
Axel Kaehne
Keyword(s):  
Quality Improvement ◽  
Leadership Development ◽  
Paradigm Shift ◽  
Significant Shift ◽  
Clinical Leadership ◽  
Starting Point ◽  
Self Development ◽  
Before And After ◽  
Perception Of Self ◽  
Medical Leadership

BackgroundClinical leadership is key to quality improvement; however, there is limited research regarding doctors’ perceptions of clinical leadership.AimTo investigate senior trainees’ perception of self as medical leader and explore what influenced their perception.MethodsA questionnaire with open and closed questions was distributed before and after a medical leadership module. Twelve trainees were then interviewed.ResultsOne hundred and fifty-six questionnaires were completed (95.7 % response rate). A significant number of senior trainees did not consider themselves to be a leader; however, there was a statistically significant shift in their self-perception during the programme. Themes identified during the interviews included a lack of understanding of the leadership concept, a lack of clarity of the medical leader’s role and vehicles for perspective transformation.ConclusionsTo our knowledge, this is the first study to explore senior trainees’ perception of self as medical leader. Findings suggest, following a paradigm shift from clinician to clinical leader, senior trainees are a potential, valuable resource for quality improvement. To aid understanding of the leadership self-development process, a conceptual model is offered. The significance of the model is its focus on the individual’s leadership paradigm, as the starting point for self-exploration. This model could inform leadership development programmes.

A long and winding road: non-traditional routes into medical leadership

BMJ Leader ◽  
2021 ◽  
pp. leader-2021-000528
Author(s):  
Steve Gulati ◽  
Christiane Shrimpton
Keyword(s):  
Leadership Development ◽  
Medical Profession ◽  
Leadership Education ◽  
Doctor Who ◽  
Development Activity ◽  
Leadership Practice ◽  
Clinical Leadership ◽  
Self Image ◽  
Personal Reflections ◽  
Medical Leadership

IntroductionClinicians enter the medical profession through a variety of routes. This paper explores how non-traditional routes into the medical profession can follow through into subsequent medical leadership practice, influencing issues of confidence, self-image and assumptions about leadership as a concept.MethodThe first-person reflections of a doctor who entered the profession and the National Health Service from the German system and with a non-standard background are considered. We then discuss how those involved in leadership education can use diversity as a developmental tool. The article starts and ends with personal reflections and observations from a Consultant Opthalmologist, interposed with insights from the pedagogy of leadership development by a University academic.ConclusionsWe conclude that medical leadership development can be enriched through recognising the value that non-traditional routes in clinical leadership can bring, and that educators can use the leverage of difference and diversity to create positive loops of development activity.

scholarly journals The impact of preferences for clinical and managerial leadership roles on the willingness to apply for a medical leadership position: Analysis of gender differences among a sample of German senior physicians

2021 ◽  
pp. 095148482110102
Author(s):  
Florian Liberatore ◽  
Julia Schätzle ◽  
Henrik Räwer ◽  
Kia Homayounfar ◽  
Jörg Lindenmeier
Keyword(s):  
Structural Equation ◽  
Medical Profession ◽  
Equation Modeling ◽  
Mentoring Programs ◽  
Leadership Roles ◽  
University Hospitals ◽  
Managerial Leadership ◽  
Clinical Leadership ◽  
Medical Leadership ◽  
The Impact

Background The hybrid role (clinical and managerial leadership tasks) of physicians in medical leadership positions (MLPs) is a driver of the attractiveness of these positions. The increasing feminization of the medical profession makes gender-related preferences for hybrid roles relevant. Purpose The current study uses the (EPL) career aspirations framework to analyze the (gender-related) effects that efficacy beliefs, motivations, and preferences for clinical leadership and managerial leadership have on the willingness of chief physicians to apply for an MLP. Methodology: A survey of senior physicians in German university hospitals yielded a sample size of N = 496. The resulting data were analyzed using a structural equation modeling approach. Findings The results confirm the low preference for MLPs among senior physicians, which is mainly affected by preferences for managerial leadership tasks. Female senior physicians perceive the position of an MLP to be less attractive than their male counterparts do, and female physicians’ willingness to apply for an MLP is concurrently driven by their preferences for clinical leadership and managerial leadership tasks. Practical implications: Mentoring programs could boost female senior physicians’ preparedness for MLPs. Further, flexibility in fulfilling managerial leadership tasks could be promoted to make MLPs more attractive to women.

Doing More With Less: Pragmatic Implementation of Vancomycin Area-Under-the-Curve (AUC) Monitoring

2021 ◽  
pp. 089719002110272
Author(s):  
Joanne Huang ◽  
Jeannie D. Chan ◽  
Thu Nguyen ◽  
Rupali Jain ◽  
Zahra Kassamali Escobar
Keyword(s):  
Quality Improvement ◽  
High Risk ◽  
Therapeutic Drug Monitoring ◽  
Paradigm Shift ◽  
Area Under The Curve ◽  
Cost Effective ◽  
Practical Method ◽  
Therapeutic Drug ◽  
Short Term ◽  
Quality Improvement Process

Universal area-under-the-curve (AUC) guided vancomycin therapeutic drug monitoring (TDM) is resource-intensive, cost-prohibitive, and presents a paradigm shift that leaves institutions with the quandary of defining the preferred and most practical method for TDM. We report a step-by-step quality improvement process using 4 plan-do-study-act (PDSA) cycles to provide a framework for development of a hybrid model of trough and AUC-based vancomycin monitoring. We found trough-based monitoring a pragmatic strategy as a first-tier approach when anticipated use is short-term. AUC-guided monitoring was most impactful and cost-effective when reserved for patients with high-risk for nephrotoxicity. We encourage others to consider quality improvement tools to locally adopt AUC-based monitoring.

Reducing Hospital-acquired Pressure Injuries Among Pediatric Patients Receiving ECMO: A Retrospective Study Examining Quality Improvement Outcomes

2021 ◽  
Vol 67 (9) ◽  
pp. 14-24
Author(s):  
Jordan Jackson ◽  
Holly Kirkland-Kyhn ◽  
Laura Kenny ◽  
Alana Beres ◽  
Stephanie Mateev
Keyword(s):  
Quality Improvement ◽  
Pediatric Patients ◽  
Wound Care ◽  
Occipital Region ◽  
Provider Education ◽  
Before And After ◽  
Prevention Interventions ◽  
Improvement Interventions ◽  
Quality Improvement Interventions ◽  
Hospital Acquired

BACKGROUND: Pediatric patients immobilized for certain procedures, such as extracorporeal membrane oxygenation (ECMO), are at high risk for developing hospital-acquired pressure injuries (HAPIs). PURPOSE: To evaluate the rate of HAPI occurrence in ECMO patients before and after implementation of prevention interventions. METHODS: Patients younger than 18 years of age who were placed on ECMO from January 2012 through March 2020 were identified, and patient data, including the development of a stage 3, 4, or unstageable pressure injuries, were abstracted. From August 2018 through December 2018, HAPI prevention interventions were implemented, which included targeted HAPI prevention and ECMO provider education, fluidized positioner provider education, and the addition of 2 wound care interventions for ECMO patients. RESULTS: Of the 120 ECMO patients identified, 5 (4.2%) developed a HAPI. All patients developed HAPI in the occipital region, and 1 patient developed an additional HAPI on their back. The median age of patients with HAPI was 1 month (interquartile range [IQR], 0.3–6.8 months). The median duration from ECMO cannulation to identification of HAPI was 9.5 days (IQR, 4.8–32.3 days). The median total run time was 4.9 days (IQR, 2.5-7.6 days): 8.5 days for patients who did develop a HAPI and 4.8 days for those who did not develop a HAPI (P = .02). The overall HAPI rate dropped from 4.8% of ECMO patients before quality improvement interventions to 0% of ECMO patients after quality improvement interventions. CONCLUSIONS: The development of stage 3, 4, or unstageable HAPIs in pediatric ECMO patients was low (4.2%) over the period studied (January 2012 through March 2020). As of the time of this writing, no HAPIs occurred after implementation of provider education in 2018.

Abstract 8: Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Sarah Song ◽  
Gregg Fonarow ◽  
Wenqin Pan ◽  
DaiWai Olson ◽  
Adrian F Hernandez ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Early Period ◽  
Quality Improvement Program ◽  
Administrative Claims ◽  
Improvement Program ◽  
All Cause Mortality ◽  
Before And After ◽  
Get With The Guidelines

Background: Get With The Guidelines (GWTG)-Stroke is a national, hospital-based quality improvement program developed by the American Heart Association. While studies have shown a beneficial effect of hospital participation in GWTG-Stroke upon processes of care, whether there are associated improvements in clinical outcomes has not been previously investigated. Methods: From among all acute care US hospitals, we matched 366 hospitals that joined the GWTG-Stroke program between April 2004 and December 2007, with 366 hospitals that did not. Matching was based on ischemic stroke case volume, calendar year, baseline hospital post-stroke 1-year all-cause mortality rates, teaching status, and geographic region. Outcomes of all acute ischemic stroke (AIS) patients admitted to the study hospitals were abstracted from the CMS administrative claims database (65 years and older). Outcomes at matched hospitals were compared in the PRE-GWTG-Stroke period (-540 to -181 days before program launch), RUN-UP period (-180- to -1 day), EARLY period (0 to 180 days) and SUSTAINED period (181 to 540 days). Additional analysis was performed of the entire BEFORE (-540 to -1 days) and AFTER periods (0 to 540 days). The main analytical approach was stratified Cox proportional hazard modeling, with matched site ID at stratum. We adjusted for patient characteristics (age, gender, race, medical history) and hospital characteristics (rural vs. urban, # beds, annual IS discharges.) Results: The study analyzed 88,584 AIS admissions at the 366 GWTG-Stroke hospitals and 85,401 admissions at the 366 matched non-GWTG-Stroke hospitals. In adjusted analysis comparing BEFORE and AFTER periods, GWTG-Stroke hospitals achieved reduced 30 day mortality (30M - HR 0.911, p<0.0001), reduced 1 year mortality (1YM - HR 0.902, p<0.0001), reduced 30 day all-cause rehospitalization (HR 0.956, p=0.013), reduced 30 day stroke rehospitalization (HR 0.927, p=0.038), and reduced 1 year all-cause rehospitalization (HR 0.972, p=0.007). Conversely, matched, non-GWTG-Stroke hospitals showed only reduced 30M (HR 0.954, p=0.010) between the BEFORE and AFTER periods. Comparing the degree of change at GWTG-Stroke with non-GWTG Stroke hospitals, there were greater improvements in discharge to home (DCH), 30M, and 1YM at GWTG-Stroke hospitals in each of the intervention periods: EARLY: DCH, HR 1.090, p<0.0001; 30M, HR 0.894, p=0.0006; 1YM, HR 0.889, p<0.0001; SUSTAINED: DCH, HR 1.097, p<0.0001; 30M, HR 0.934, p=0.004; 1YM, HR 0.918, p<0.0001. Conclusions: Hospitals joining the GWTG-Stroke quality improvement program between 2004-2008 achieved significantly greater improvement in stroke patient outcomes than matched hospitals not joining the program, with lower all-cause mortality at 30 days and 1 year and higher rates of discharge directly to home.

Quality improvement in melanoma care: Multidisciplinary quality program development and comparison of care before and after implementation

2019 ◽  
Vol 217 (3) ◽  
pp. 527-531
Author(s):  
Barrett A. Kielhorn ◽  
Jensen B. Jantz ◽  
Mark S. Kosten ◽  
Stephen S. Phillips ◽  
Sarat C. Khandavalli ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Program Development ◽  
Quality Program ◽  
Before And After

scholarly journals COALITION REGIME AND INDUSTRIAL POLICY IN JAMMU AND KASHMIR: AGRO-BASED INDUSTRY IN BARAMULLA DISTRICT OF J&K STATE

2017 ◽  
Vol 5 (6) ◽  
pp. 437-446
Author(s):  
GH MOHD SHEIKH
Keyword(s):  
Industrial Policy ◽  
Food Processing ◽  
Paradigm Shift ◽  
The State ◽  
Special Importance ◽  
Jammu And Kashmir ◽  
Main Thrust ◽  
Development Policies ◽  
Before And After ◽  
Industry Policy

Since 2002 political structure of the state of Jammu and Kashmir underwent a paradigm shift. A coalition era has deepened its roots in the state politics. PDP and Congress joined the governance of the state as a coalition regime in the year 2002. This coalition regime has brought up the various development policies; one among them was the industry policy which was formulated in the year 2004. Under the policy, food processing including agro-based industry was one among the main thrust areas. Similarly, in the paper an attempt has been made to analyze the factors which were responsible for the formulation of industry policy. In particular, the paper explores the agro-based industry of the Baramulla district in terms of removal of regional disparities/imbalances which exists between three regions of the State. The research paper argues that Kashmir region has widely neglected in terms of industry development while the Jammu region has been given special importance before and after the coalition regime of PDP-Congress (2002-2008).

Sign in / Sign up

Export Citation Format

Share Document