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1.
AORN J ; 115(2): P7-P9, 2022 02.
Article in English | MEDLINE | ID: covidwho-2157689
2.
Healthc Q ; 25(3): 1-3, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2145329

ABSTRACT

It would be a vast understatement to say that our healthcare systems are facing extraordinary pressure. The COVID-19 pandemic has pushed our people and our systems to their limits. We observe with trepidation that the current state of healthcare has not looked more precarious at any time in recent memory. Patients and families are feeling it. Providers, clinicians and leaders in the system are feeling it. And all of us recognize that it will take incredible political will and system-wide commitment to make the changes that are needed to renew and strengthen our front-line teams, structures and capacity. As editors for Healthcare Quarterly (HQ), we see the opportunity to contribute to the daunting task ahead by shining a light on leading practices and lessons learned from implementing change across Canada and beyond. Our commitment is to continue to showcase healthcare leadership in all forms and share opportunities for post-pandemic recovery and the future of healthcare.


Subject(s)
COVID-19 , Population Health , Humans , Pandemics , COVID-19/epidemiology , Leadership , Delivery of Health Care
3.
BMC Public Health ; 22(1): 2154, 2022 Nov 23.
Article in English | MEDLINE | ID: covidwho-2139235

ABSTRACT

BACKGROUND: The Covid-19 pandemic has brought significant changes to the way people work and there are several reasons to believe that working from home will become more common in the future. Yet more knowledge is needed on whether the effectiveness of leadership differs if the work is performed remotely compared to on-site work. PURPOSE: The aim of this study is to examine the place of work as a moderator for the effectiveness of leadership on employee well-being. METHOD: A survey was answered by 364 white-collar workers, employed by a larger Swedish municipality, who because of the covid-19-pandemic were offered to work from home. RESULTS: The employees working in their regular office perceived having more sufficient work equipment. No other differences were found in the investigated variables. Supportive leadership was associated with all investigated well-being variables in the hypothesised directions. Place of work did not moderate the relationship between Support leadership and the investigated well-being outcomes (Job satisfaction, Stress, General well-being). CONCLUSION: This study shows that there are few differences between employees working from home or working on-site during the Covid-19 pandemic. The supportive leadership of the closest manager seem to be important for well-being regardless of the worksite.


Subject(s)
COVID-19 , Leadership , Humans , COVID-19/epidemiology , Pandemics , Job Satisfaction , Workplace
5.
J Nurs Adm ; 52(12): 653-658, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2135769

ABSTRACT

OBJECTIVE: The aim of this study was to describe leaders' experiences of remote leadership during the 1st year of the COVID-19 pandemic. BACKGROUND: The COVID-19 pandemic accelerated remote work. However, there is little research on the experience of remote leadership in the healthcare setting. METHODS: Data were collected using focus group interviews and analyzed by thematic analysis. RESULTS: A total of 8 leaders from a psychiatric care setting participated. The following themes were identified: increased work efficiency, work well-being, lack of organizational support, the need to be present, and the desire for a hybrid leadership model for the future. CONCLUSIONS: Remote leadership includes both benefits and challenges for healthcare leaders and organizations. Leaders in this study emphasized the need to be present for the clinical personnel and proposed a hybrid leadership model. To succeed in combining remote and face-to-face work and leadership in a new model, organizations need to provide clear guidelines and training for remote work and leadership.


Subject(s)
COVID-19 , Leadership , Humans , Pandemics , Delivery of Health Care , Focus Groups
6.
J Healthc Manag ; 67(6): 446-457, 2022.
Article in English | MEDLINE | ID: covidwho-2135683

ABSTRACT

GOAL: This study explored the use of a Lean daily management system (DMS) for COVID-19 response and recovery in U.S. hospitals and health systems. Originally developed in manufacturing, Lean is an evidence-based approach to quality and process improvement in healthcare. Although Lean has been studied in individual hospital units and outpatient practices, it has not been examined as a whole system response to crisis events. METHODS: We conducted qualitative interviews with 46 executive leaders, clinical leaders, and frontline staff in four hospitals and health systems across the United States. We developed a semistructured interview guide to understand DMS implementation in these care delivery organizations. As interviews took place 6-8 months following the onset of the pandemic, a subset of our interview questions centered on DMS use to meet the demands of COVID-19. Based on a deductive approach to qualitative analysis, we identified clusters of themes that described how DMS facilitated rapid system response to the public health emergency. PRINCIPAL FINDINGS: There were many important ways in which U.S. hospitals and health systems leveraged their DMS to address COVID-19 challenges. These included the use of tiered huddles to facilitate rapid communication, the creation of standard work for redeployed staff, and structured problem-solving to prioritize new areas for improvement. We also discovered ways that the pandemic itself affected DMS implementation in all organizations. COVID-19 universally created greater DMS visibility by opening lines of communication among leadership, strengthening measurement and accountability, and empowering staff to develop solutions at the front lines. Many lessons learned using DMS for crisis management will carry forward into COVID-19 recovery efforts. Lessons include expanding telehealth, reactivating incident command systems as needed, and efficiently coordinating resources amid potential future shortages. PRACTICAL APPLICATIONS: Overall, the Lean DMS functioned as a robust property that enabled quick organizational response to unpredictable events. Our findings on the use of DMS are consistent with organizational resilience that emphasizes collective sense-making and awareness of incident status, team decision-making, and frequent interaction and coordination. These features of resilience are supported by DMS practices such as tiered huddles for rapid information dissemination and alignment across organizational hierarchies. When used in conjunction with plan-do-study-act methodology, huddles provide teams with enhanced feedback that strengthens their ability to make changes as needed. Moreover, gaps between work-as-imagined (how work should be done) and work-as-done (how work is actually done) may be exacerbated in the initial chaos of emergency events but can be minimized through the development of standard work protocols. As a facilitator of resilience, the Lean DMS may be used in a variety of challenging situations to ensure high standards of care.


Subject(s)
COVID-19 , Pandemics , United States , Humans , Leadership , Delivery of Health Care , Hospitals
7.
Am J Health Syst Pharm ; 79(23): 2174-2178, 2022 Nov 22.
Article in English | MEDLINE | ID: covidwho-2134834
8.
J Med Imaging Radiat Sci ; 53(4S): S116-S125, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2131608

ABSTRACT

INTRODUCTION: In England, the NHS National Breast Screening Programme (NHSBSP) offers routine breast screening to all women, some trans men and non-bionary people, between the ages of 50 years and up to their 71 st birthday, every 3 years. The unfolding Covid-19 pandemic in early 2020 was understandably a time of great anxiety and concern. Culturally we were seeing strong behavioural shifts such as social distancing and a general change in all our daily life patterns. Conceptually, and as leaders, we understood the vulnerability we observed, but felt that we did not have the 'right language' and in fact lacked the relevant experience of how to address and communicate with staff and clients during this crisis. METHODS: A semiotic, observational research project was utilised that aimed at providing insight how cultural behaviour was being shaped and expressed during the early onset of the Covid-19 pandemic in England. The recommendations of the project were then integrated and implemented into an action plan and subsequent practice. RESULTS: Semiotic analysis revealed that several factors (positive and negative) impacted on peoples' confidence and had practical and emotional implications. Eleven main codes which are belief systems about oneself and others were identified and expressed in a multitude of different ways revealing three main themes or needs i.e. Reassurance, Trust and Clarity. An action plan was developed in response to the project findings and recommendation were implemented. CONCLUSIONS: Effective leadership relies on situational awareness. Our semiotic project enabled us to find the 'right' language and communication style so that we could connect with staff at the time of crisis. Using our own expert staff, we empowered them by providing the correct, easily digestible resources to facilitate confidence across the service teams which in turn supported the delivery of high-quality breast screening at a time of great uncertainty. IMPLICATION FOR PRACTICE: We must learn to be agile and adaptive, both in our operational delivery and our communication styles.


Subject(s)
COVID-19 , Leadership , Male , Female , Humans , Middle Aged , COVID-19/epidemiology , Pandemics , Communication , Research
10.
Diabetes ; 70(8): 1623-1633, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-2114268

ABSTRACT

Women are broadly underrepresented in scientific leadership positions and their accomplishments are not provided equal recognition compared with those of men, but the imbalance in the field of diabetes is unknown. Hence, we analyzed multiple aspects of historical and present-day female representation in the diabetes field.We quantified gender representation at annual American Diabetes Association (ADA) meetings; editorial board service positions for ADA and the European Association for the Study of Diabetes (EASD) journals; principal investigators for ADA, JDRF, and National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases P30 grant funding; and ADA, JDRF, and EASD award recipients. There are many women in the field of diabetes: registration for the ADA Scientific Sessions has been 43% female since 2016, and for over five decades, women comprised 83% of ADA Presidents of Health Care and Education. Yet, only 9% of ADA Presidents of Medicine and Science have been women. Women were well represented on editorial boards for journals focused on diabetes education (Diabetes Spectrum, 89% female) and primary care (Clinical Diabetes, 49% female) but not for the more academically targeted Diabetes Care (34% female), Diabetes (21% female), and Diabetologia (30% female). Only one-third of ADA Pathway to Stop Diabetes and JDRF grants have been awarded to women, and females only lead 2 of 18 (11%) of the P30-supported Diabetes Research Centers. Finally, only 2-12% of major ADA, JDRF, and EASD awards were given to women, without significant change over time. Despite increasing recognition of gender imbalance in research and medicine, many disparities in the field of diabetes persist. We call for decreasing barriers for advancement of female investigators and creating environments that promote their retention and equitable recognition for their contributions to the field.


Subject(s)
Awards and Prizes , Diabetes Mellitus , Diabetes Mellitus/therapy , Female , Humans , Leadership , Male , National Institutes of Health (U.S.) , Societies, Medical , United States
11.
BMC Public Health ; 22(1): 765, 2022 04 15.
Article in English | MEDLINE | ID: covidwho-2113026

ABSTRACT

BACKGROUND: Co-creation approaches are increasingly used in physical activity promotion to develop interventions tailored to the target group and setting. The resulting complexity of such interventions raises challenges in evaluation. Accordingly, little is known about the effectiveness of co-created interventions and the underlying processes that impact their sustainable implementation. In this study, we attempt to fill this gap by evaluating co-created multi-component physical activity interventions in vocational education and training in nursing care and automotive mechatronics regarding (1) their sustainable implementation at the institutional level and (2) the effectiveness of single intervention components at the individual level. METHODS: Following a multimethod design, we conducted a questionnaire survey (n = 7) and semi-structured interviews (n = 4) to evaluate the sustainability of the interventions. Quantitative data were analyzed descriptively, and qualitative data were analyzed using qualitative content analysis. To examine the interventions' effectiveness, we conducted two non-randomized controlled trials (n = 111). Analysis of variance was used to examine differences between groups. RESULTS: At the institutional level, long-term implementation of single intervention components in nursing care was observed; in contrast, long-term implementation in automotive mechatronics was not observed. In this context, various factors at the outer contextual (e.g., COVID-19 pandemic), inner contextual (e.g., health-promoting leadership), intervention (e.g., acceptance), and personal levels (e.g., champion) influenced sustainability. At the individual level, no significant intervention effects were found for changes in physical activity behavior and physical activity-related health competence. CONCLUSION: The role of co-creation on the effectiveness and sustainability of physical activity promotion in vocational education and training cannot be answered conclusively. Only in the nursing care sector, a co-creation approach appeared promising for long-term intervention implementation. Sustainable implementation depends on various influencing factors that should be considered from the outset. Demonstrating effectiveness at the individual level was challenging. To conclusively clarify both the role and impact of co-creation, methodologically complex and elaborate evaluation designs will be required in future research projects. TRIAL REGISTRATION: This study was retrospectively registered at clinicaltrials.gov on 24/08/2021 ( NCT05018559 ).


Subject(s)
COVID-19 , Vocational Education , Exercise , Humans , Leadership , Pandemics
12.
Hawaii J Health Soc Welf ; 81(11): 295-301, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2112009

ABSTRACT

The COVID-19 pandemic increased stress and worry among faculty and staff members at universities across the US. To assess the well-being of university faculty and staff, a survey was administered at a medical school in the state of Hawai'i during early fall 2020. The purpose of the exploratory study was to assess and gauge faculty and staff members' well-being regarding the school's response to COVID-19. Participants in this study represented a convenience sample of compensated teaching, research, and administrative faculty and staff members. A total of 80 faculty and 73 staff members participated. Overall, faculty and staff reported relatively low levels of worries and stress. Staff members reported greater levels of worry and stress than faculty members in 8 of the 11 questions. Statistical differences were detected in 3 questions, with staff reporting higher levels of worry and stress in their health and well-being of themselves (P < .001), paying bills (P < .001), and losing their jobs (P < .001). Both faculty and staff reported good overall satisfaction on the timeliness and clarity of messages that they received, support from leadership and the school, and support to adjust to changes in response to COVID-19. For both faculty and staff, the greatest worry or concern for the open-ended question on worry and stress was related to financial and economic issues. Data from this survey and can contribute to an understanding of medical school employee well-being during a major operational disruption and may help develop policies and programs to assist employees in different employment categories during future disruptions.


Subject(s)
COVID-19 , Schools, Medical , Humans , Pandemics , Faculty, Medical , Leadership
13.
Int J Environ Res Public Health ; 19(22)2022 Nov 19.
Article in English | MEDLINE | ID: covidwho-2116274

ABSTRACT

The COVID-19 pandemic has severely accelerated the transformation and rapid organisational change in the workplace. The impact of the COVID-19 pandemic on the hotel industry will not fade in a short time, and the long-term coexistence with the COVID-19 pandemic pressure is a real dilemma for the hotel industry. The topic of How to create employee positive workplace outcomes (task performance and innovative work behaviour) during the COVID-19 pandemic has garnered increasing interest in both practical and academic fields. Leaders play a critical role in influencing employee workplace outcomes, yet few studies have explored the predicting role of health-promoting leadership. Drawing upon the conservation of resources (COR) theory, this study aims to examine the employability mediator effect and workplace civility as the moderator effect in the relationship between health-promoting leadership and employee-positive workplace outcomes (task performance and innovative work behaviour). We conducted a two-wave survey of 421 participants from the hotel industry in China and formulated a series of hypotheses that were tested with structural equation modelling. The results showed that health-promoting leadership has a significant positive effect on employees' employability (ß = 0.479, p < 0.001), task performance (ß = 0.250, p < 0.001), and innovative work behaviour (ß = 0.446, p < 0.001). Employability has a significant positive effect on task performance (ß = 0.438, p < 0.001) and innovative work behaviour (ß = 0.296, p < 0.001). This study makes certain contributions to the extant hotel industry employees' positive workplace outcomes literature by attending to the healthy leadership styles that promote employability during the COVID-19 pandemic, and its novel point is to evaluate the workplace civility moderating effect between the above model. It also provides practical insight that mutual transformation in workplace relationships inspire those positive outcomes.


Subject(s)
COVID-19 , Workplace , Humans , Leadership , COVID-19/epidemiology , Pandemics , Creativity
14.
Int J Environ Res Public Health ; 19(22)2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2116262

ABSTRACT

After experiencing many public crisis events, such as SARS in 2003 and COVID-19 in 2020, the Chinese public crisis governance system has been improved from its initial state. The distribution structure and cooperation network among various government departments in China have become more complex. How to accurately clarify the relationship between the various departments in the existing governance system has become an important issue of the Chinese public crisis governance system. Based on the perspective of networked research, this article examines the network relationship between institutions in the Chinese public crisis governance system from the two dimensions of network centrality and network density. Using the bibliometric method to use public policies released in 2003 and 2020 as data samples and the two large-scale institutional reforms in 2003 and 2018 as the time nodes, this paper conducts a comparative analysis of the institutional network relationship of the Chinese public crisis governance system during different periods. The research shows that the network relationship among institutions in the Chinese public crisis governance system has changed from a centralized type to a diverse type; there is a trend of expansion in network relations; the legalization of governance networks is strengthened and the core of the network is transformed into the direct leadership of the Party Committee; and the overall network structure is experiencing a rational evolution.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Public Policy , China/epidemiology , Leadership
15.
Nurs Clin North Am ; 57(2): 245-258, 2022 06.
Article in English | MEDLINE | ID: covidwho-1819287

ABSTRACT

This article highlights the critical role of advanced practice registered nurses in the care of older adults living in nursing homes. This population is one of the frailest, marginalized, and often neglected in the United States. The COVID-19 pandemic impact on nursing homes resulted in a stunning number of infections and subsequent resident deaths. This is a shameful reminder of the many challenges and gaps in the nursing home industry including inadequate staffing, high staff turnover, improper isolation technique, and lack of fundamental knowledge of how to adequately implement infection prevention and control processes. Strong advanced practice registered nurse leadership may have mitigated some of these factors.


Subject(s)
COVID-19 , Nurses , Aged , Humans , Leadership , Nursing Homes , Pandemics , United States
16.
Int J Environ Res Public Health ; 19(21)2022 Nov 03.
Article in English | MEDLINE | ID: covidwho-2099524

ABSTRACT

The COVID-19 pandemic has brought new challenges to the medical industry, including hybrid work, in which specialists can perform some of their duties remotely, in addition to physical contact with patients and their teams. Hybrid work provides opportunities, but also generates difficulties (e.g., accurate long-distance diagnosis); therefore, there is a need to ensure the well-being of healthcare workers, especially in the context of leadership strategies. As there is little research on leadership practices in remote and hybrid medical worker management, this study analyses the relationship between certain behavioural strategies and competencies of leaders and the affective well-being of hybrid employees. The research was conducted among a group of employees (N = 135) from seven countries who provide healthcare in a hybrid model. The correlations between the variables showed the statistical significance of all leadership strategies introduced into the model and focused on building involvement (employee empowerment and team orientation), creating a shared vision, defining clear goals and strategies, promoting adaptability (change management, promotion of organisational learning and patient focus), managing consistency through shared values, agreement and effective coordination, as well as competencies such as communicativeness, credibility, self-development and digital readiness. Despite the significance of all the relationships, the linear regression showed that the variability of affective well-being was explained mainly by the adaptability leadership strategy. The results of the study expand the knowledge on the competencies of healthcare leaders, and shed new light on the management of medical employees performing remote and hybrid work. Because such research into well-being has not been published to date, the analysis begins an important discussion on redefining leadership in the healthcare sector, taking into account the digital transformation.


Subject(s)
COVID-19 , Leadership , Humans , Pandemics , COVID-19/epidemiology , Health Personnel , Communication
18.
Sci Rep ; 12(1): 17869, 2022 Oct 25.
Article in English | MEDLINE | ID: covidwho-2087293

ABSTRACT

Leadership has become an increasingly important issue in medicine as leadership skills, job satisfaction and patient outcomes correlate positively. Various leadership training and physician psychological well-being programmes have been developed internationally, yet no standard is established in primary care. The IMPROVEjob leadership program was developed to improve job satisfaction among German general practitioners and practice personnel. Its acceptance and effectiveness were evaluated. The IMPROVEjob intervention is a participatory, interdisciplinary and multimodal leadership intervention that targets leadership, workflows and communication in general practices using three elements: (1) two leadership workshops with skills training; (2) a toolbox with printed and online material, and (3) a 9-month implementation phase supported by facilitators. A cluster-randomised trial with a waiting-list control evaluated the effectiveness on the primary outcome job satisfaction assessed by the Copenhagen Psychosocial Questionnaire (range 0-100). A mixed-methods approach with questionnaires and participant interviews evaluated the acceptance of the intervention and factors influencing the implementation of intervention content. Statistical analyses respected the clustered data structure. The COVID-19 pandemic necessitated intervention adjustments: online instead of on-site workshops, online material instead of facilitator practice visits. Overall, 52 of 60 practices completed the study, with altogether 70 practice leaders, 16 employed physicians, and 182 practice assistants. According to an intention-to-treat analysis, job satisfaction decreased between baseline and follow-up (not significantly) in the total study population and in both study arms, while the subgroup of practice leaders showed a non-significant increase. A mixed multilevel regression model showed no effect of the intervention on job satisfaction (b = - 0.36, p > 0.86), which was influenced significantly by a greater sense of community (b = 0.14, p < 0.05). The acceptance of the IMPROVEjob workshops was high, especially among practice leaders compared to assistants (1 = best to 5 = worst): skills training 1.78 vs. 2.46, discussions within the practice team 1.87 vs. 2.28, group discussions 1.96 vs. 2.21. The process evaluation revealed that the COVID-19 pandemic complicated change processes and delayed the implementation of intervention content in practice routines. The workshops within the participatory IMPROVEjob intervention were rated very positively but the multimodal intervention did not improve job satisfaction 9 months into the pandemic. Qualitative data showed an impairment of implementation processes by the unforeseeable COVID pandemic.Trial registration Registration number: DRKS00012677 on 16/10/2019.


Subject(s)
COVID-19 , General Practitioners , Humans , Leadership , COVID-19/epidemiology , Pandemics , Job Satisfaction , Surveys and Questionnaires
19.
Mo Med ; 119(4): 337-338, 2022.
Article in English | MEDLINE | ID: covidwho-2083804

Subject(s)
COVID-19 , Leadership , Humans
20.
J Med Imaging Radiat Sci ; 53(4S): S107-S115, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2082619

ABSTRACT

INTRODUCTION: The COVID-19 pandemic had a profound impact on the provision of obstetric ultrasound services, leading to the publication of new guidance and requirement for individual departmental risk assessments in the UK. The impact of these changes on clinical practice for UK obstetric sonographers is not currently well reported in published literature. METHODS: Obstetric sonographers working in the UK (n = 138) used the Qualtrics XMTM platform to complete an anonymous, online questionnaire about their experiences during the pandemic. Participants responded to closed-type questions about national guidance, risk assessment and their perception of support, and provided additional detail about their experiences in these areas through free-text response options. RESULTS: Over 90% of respondents were aware of or had read guidance issued by professional organisations, although challenges for its implementation in departments were identified. These were commonly related to the clinical working environment and included limitations on physical space (76.3%), time constraints (67.5%) and ventilation (61.3%). Sonographers felt most supported by their ultrasound colleagues (83.5%) and line managers (41.2%). They felt least supported by senior management and leadership personnel (60.8%), other antenatal colleagues (51.5%) and professional organisations (41.2%). CONCLUSION: Obstetric sonographers will need support from the wider service team and professional organisations to facilitate post-pandemic recovery of the workforce. Formal clinical supervision programmes may be beneficial in facilitating a more holistic approach to peer-support, although there is currently limited evidence of their use in sonographic practice.


Subject(s)
COVID-19 , Female , Humans , Pregnancy , COVID-19/epidemiology , Pandemics , Leadership , Risk Assessment , United Kingdom
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