A perceção de líderes formais de enfermagem sobre a prática baseada na evidência / Formal nurse leaders' perception of evidence-based practice / La percepción de los líderes formales de enfermería sobre la práctica basada en la evidencia

Resumo Enquadramento: A implementação da Prática Baseada na Evidência (PBE) é crucial para a qualidade dos cuidados de enfermagem. As ações desenvolvidas pelos líderes formais são essenciais para implementar a PBE, tornando-se determinante conhecer as suas perceções. Objetivo: Conhecer as perceções de líderes formais de enfermagem sobre a PBE. Metodologia: Estudo descritivo exploratório com abordagem qualitativa. Foram realizadas entrevistas semiestruturadas a 17 líderes de três hospitais portugueses. Os dados foram analisados através de análise de conteúdo e do software MAXQDA Analytics Pro 2022. Salvaguardados os pressupostos éticos. Resultados: Emergiram dois temas com respetivas categorias − Conhecimento sobre PBE (Conceito de PBE, Impacto da PBE nos resultados em saúde e Autoperceção do conhecimento sobre PBE); Papel na implementação da PBE (comportamentos e caraterísticas). Conclusão: Os líderes descreveram a sua perceção sobre o Conceito de PBE e a relação do Impacto da PBE com resultados em saúde, a necessidade de conhecimento e o seu investimento formativo, bem como o seu papel neste processo. Futuros programas formativos deverão ser implementados nesta área.

Abstract Background: The implementation of Evidence-Based Practice (EBP) is critical to the quality of nursing care. Formal leaders play a crucial role in developing interventions to implement EBP, so it is important to understand their perceptions. Objective: To examine formal nurse leaders' perceptions of EBP. Methodology: Descriptive exploratory study with a qualitative approach. Semi-structured interviews were conducted with 17 leaders from three Portuguese hospitals. Data were analyzed using content analysis and MAXQDA Analytics Pro 2022 software. All ethical principles were observed. Results: Two themes and their categories emerged − Knowledge of EBP (Concept of EBP, Impact of EBP on health outcomes, and Self-perception of the knowledge about EBP) and Role in EBP implementation (behaviors and characteristics). Conclusion: The leaders described their perception of the concept of EBP and the association between the impact of EBP and health outcomes, the need for knowledge, and the investment in training, as well as their role in this process. Future training programs should be implemented in this area.

Resumen Marco contextual: La implantación de la Práctica Basada en la Evidencia (PBE) es esencial para la calidad de los cuidados de enfermería. Las acciones emprendidas por los líderes formales son esenciales para implantar la PBE, y es fundamental conocer sus percepciones. Objetivo: Conocer las percepciones de los líderes formales de enfermería sobre la PBE. Metodología: Estudio exploratorio descriptivo con enfoque cualitativo. Se realizaron entrevistas semiestructuradas a 17 líderes de tres hospitales portugueses. Los datos se analizaron mediante análisis de contenido y el programa MAXQDA Analytic Pro 2022. Se garantizaron los presupuestos éticos. Resultados: Surgieron dos temas con sus respectivas categorías − Conocimiento sobre la PBE (Concepto de la PBE, Impacto de la PBE en los resultados sanitarios y Autopercepción del conocimiento sobre la PBE); Papel en la aplicación de la PBE (comportamientos y características). Conclusión: Los líderes describieron su percepción del concepto de PBE y la relación del Impacto de la PBE con los resultados sanitarios, la necesidad de conocimientos y su inversión formativa, así como su papel en este proceso. Los futuros programas de formación deberían aplicarse en este ámbito.

Demographics and Characteristics of Vice Chairs in Academic Orthopaedic Surgery Programs: A Descriptive Study.

INTRODUCTION: The Vice-chair (VC) position is gaining popularity in academic orthopaedic surgery departments; however, there is a paucity of information regarding qualifications and career advancements associated with this role. The purpose of this study was to define the characteristics of current orthopaedic surgery department VCs. DESIGN: Descriptive study following a retrospective web-based search utilizing the Fellowship and Residency Electronic Interactive Database (FREIDA) database and orthopaedic surgery residency program websites. SETTING: 200 ACGME-accredited orthopaedic surgery residency programs across the United States. PARTICIPANTS: Program name and hospital affiliations were collected from the FREIDA database to account for all ACGME-accredited programs. The following information was derived from publicly available program websites: title, role description, previously trained institutions, academic rank, and concurrent roles of VCs. Research productivity was measured using the H-index. The previous roles of current Department Chairs (DC) were also evaluated. RESULTS: Of the 178 VCs identified, VC of Research (n = 36; 20%), Education (n = 25; 14%), and Clinical Operations/Affairs (n = 21; 12%) were the most common titles. Women made up 17% (n = 30) of the VCs. Trauma (n = 36; 20%) was the most common fellowship subspecialty among VCs. The average H-index for VCs was 25. Among VCs, 94 (53%) were professors, 78 were also Chiefs/Heads/Directors (44%), 7 (4%) were Fellowship Directors, and 18 (10%) were Residency Directors. Twenty-six of 95 (27%) current DC had VC experience. CONCLUSION: The findings can facilitate effective leadership development, promotion of diversity and inclusion in these roles, and guidance for those who seek such leadership positions.

Surgical patients' assessment of healthcare encounters after elective surgery: A descriptive study.

INTRODUCTION: A Norwegian-Danish research team identified a gap in research regarding how surgical patients felt about their post-operative care needs being met in hospitals. A study was subsequently developed to understand their subjective assessments of how they value the perceived fulfilment of their actual care needs. The study was further informed by international calls to focus on the fundamentals of care practice. Our aim was to determine the extent to which surgical patients receiving elective treatment experience the physical environment, atmosphere and collaboration with staff as supportive of their care and treatment, and what this means for them after treatment. In addition, we aimed to document the extent to which patients experienced being understood and having influence in their care. METHODS: A descriptive observation study using a cross-sectional design. The validated Perioperative User Participation Perspectives (POUP) questionnaire was completed on the day of discharge by 194 adult (male and female) patients (mean age: 56 years) who had undergone elective surgery on gynaecological, internal medicine or orthopaedic wards. Agreement between the subjective importance of nursing care for patients and the perceived reality was determined. RESULTS: Agreement regarding the physical environment, a clean bed and clean surroundings was between 91.7 and 96.2%, and agreement with regard to a good relational atmosphere with staff it was 94.2 to 96.7%. In terms of the relational aspects of care, being understood and having influence the agreement was calculated to be 89.4 to 94.4%. However, 42.6% of the patients reported they were involved in drawing up a care plan. For those patients who valued collaborating in their care planning the congruency was 80%. CONCLUSION: A conducive atmosphere and a keen eye for the patients' wishes and needs is of particular importance at the time of discharge after elective surgery.

The Impact of PhD Degrees in Academic Plastic Surgery: An In-depth Analysis of Faculty and Residents.

BACKGROUND: Doctor of Philosophy (PhD) is the highest academic degree awarded by universities in most fields of study. In surgery, it is thought to provide surgeons with skills to conduct high-quality research and advance academically. However, this presumed effect has not been assessed among academic plastic surgeons (APSs) and plastic surgery residents (PSRs). The purpose of this study is to determine the differences in multiple strata of career progression and success between PhD and non-PhD graduates in academic plastic surgery. METHODS: We conducted a nationwide cross-sectional study of APSs and PSRs. Departmental websites of integrated plastic surgery residency programs were used to identify our study population and their demographics, degrees, and tenure status. Data on research productivity were collected using Scopus. Information on research funding was gathered through the National Institutes of Health and Plastic Surgery Foundation. To assess the plastic surgery programs' reputations, we divided residency programs into four quartiles (Q1, 1-20; Q2, 21-40; Q3, 41-60; Q4, 61+) according to their Doximity ranking. RESULTS: We identified 841 APSs (78.5% men) and 948 PSRs (58.1% men), of whom 5.1% and 2.7% had a PhD degree, respectively. PhD graduates had significantly more advanced research portfolios. PhD APSs were more likely to secure research funding, and PhD PSRs were more likely to train at highly reputed programs. However, academic rank and leadership appointments were not significantly influenced by PhDs. CONCLUSION: Holding a PhD can strongly advance a plastic surgeon's research portfolio, but it does not guarantee a better position or tenure status. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Empowering youth as agents of change: Gaps and opportunities for meaningful youth engagement (MAYE) for sustainable nutrition, climate and public health programmes.

Addressing the intersection of food insecurity, malnutrition and climate change in Sub-Saharan Africa requires meaningful adolescent and youth engagement to drive sustainable change. Drawing on empirical evidence and collective experiences from youth-led initiatives and coalitions, four gaps and opportunities to better involve youth in programmes are discussed, including, the need to: (1) standardise the definition of youth to improve programme design and data harmonisation, (2) provide capacity building and mentorship for youth leadership in health service delivery, (3) foster youth leadership and multisectoral collaboration in food and health systems and (4) enhance capacity development for non-youth actors to support genuine youth participation. This viewpoint underscores the importance of involving African youth in public health nutrition, climate change and food security programmes design and implementation-as drivers of change to addressing hunger and climate crises. By centering youth voices and experiences, programmes and policies can better address African communities' complex challenges, fostering inclusivity, sustainability and resilience in achieving better nutrition and public health programmes and outcomes.

Gender representation in obstetrics and gynaecology leadership.

BACKGROUND: Women in leadership in obstetrics and gynaecology in Australia and Aotearoa New Zealand have historically been underrepresented, despite forming a significant portion of the workforce. This study extends prior research from 2017, examining shifts in gender representation, attitudes, and perceived leadership barriers within the specialty. AIMS: The study aims to evaluate changes in gender diversity among leadership positions in the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and accredited training hospitals since 2017. Additionally, it seeks to understand current attitudes toward leadership and identify perceived barriers among RANZCOG consultants and trainees. MATERIALS AND METHODS: A cross-sectional approach was employed, utilising publicly available information, a survey distributed to RANZCOG members, and data from accredited training hospitals. Gender representation in leadership positions was analysed, and survey responses were collected from consultants and trainees to evaluate attitudes and perceived barriers. RESULTS: The study reveals an increase in women's representation in RANZCOG leadership, particularly on the council and in clinical leadership positions. While the proportion of women trainees remained stable, there was a noteworthy increase in women specialists. Survey responses revealed shared perceptions on leadership qualities but diverged on barriers, with more women expressing concerns about skillsets, caring responsibilities, and mentorship support. CONCLUSIONS: The findings underscore substantial progress in achieving gender equity in obstetrics and gynaecology leadership roles, attributed to RANZCOG initiatives, societal changes, and improved policies. Ongoing efforts, including structured mentorship and flexible arrangements, are recommended to sustain and further enhance gender representation and address specific barriers identified by women in the specialty.

Mapping the landscape of pediatric neurosurgery: geography, gender, and trends over time.

OBJECTIVE: Recently there has been an increase in pediatric neurosurgical fellowship graduates. It is important to understand the current pediatric neurosurgical workforce to help with prospective strategic workforce planning. The authors sought to determine 1) the geographic distribution and regional retention after training and 2) academic and leadership metrics by geographic location, era of training, and gender for practicing pediatric neurosurgeons in the United States. METHODS: Current practicing pediatric neurosurgeons were identified through American Board of Pediatric Neurological Surgery (ABPNS) certification status and the American Association of Neurological Surgeons directory. NIH RePORTER, Web of Science, and departmental and hospital networking websites were used to collect data on demographics, training, leadership, NIH involvement, and academic metrics. RESULTS: A total of 298 ABPNS-certified pediatric neurosurgeons were identified as currently practicing in the United States. Of these pediatric neurosurgeons, 26.2% were women, 74.5% were academic, and 11.7% have received current or past NIH funding. There were significant differences in the concentration of pediatric neurosurgeons per general population based on region. A total of 117 (39.3%) pediatric neurosurgeons held leadership positions; 4 (1.3%) served as neurosurgery department chairs, 67 (22.5%) served as chief of pediatric neurosurgery (9 of whom were women), 12 (4.0%) served as residency program directors, and 32 (10.7%) served as pediatric fellowship directors. Women were more likely to currently practice in the same region in which they trained for medical school (p = 0.050), have a lower academic rank (p = 0.004), and have a lower h-index (p < 0.001). Pediatric neurosurgeons practicing in the Northeast were more likely to have completed residency (p = 0.022) and medical school (p = 0.002) in the same region as their current practice. CONCLUSIONS: There are differences in the concentration of pediatric neurosurgeons based on region. In pediatric neurosurgery, women hold fewer leadership positions, have lower academic ranks, and are less academically impactful as measured by the h-index. As the demand for pediatric neurosurgeons evolves, thoughtful monitoring of the distribution and composition of the neurosurgical workforce can help ensure equitable access to care across the country.

[The care team, from roots to new challenges]. / L'équipe soignante, des racines aux nouveaux défis.

The team is a fundamental and structuring dimension of care, founded on the principles of complementarity, interdependence, and shared objectives and responsibilities towards the patient. As a result of the pandemic and the rationalization of public hospitals, teams are faced with changes in the role of supervisors and the arrival of new figures such as advanced practice nurses. While these changes can bring new dynamism and questioning of practices, they can also be destabilizing. The institution must preserve the role of the team and its members.

[The world is changing, and so is the world of care]. / Le monde change, l'univers du soin aussi.

In the post-Covid context, which is unstable and changing, what is the role of the team when it is reduced to operating with a growing number of temporary staff? The medical desertification that is gradually taking hold in certain regions is a cause for concern, as is the growing disaffection of nurses throughout France. It is essential to draw up a map that incorporates survival oases, in order to meet the essential need to provide care anyway, while at the same time perpetuating the process of improving care. Advanced practice nursing faces many challenges.

Dr. Manuel Martinez-Maldonado: A Pioneer in Renal Therapeutics and Mentor to a Generation of Minority Physician-Scientists.

Dr. Manuel Martinez-Maldonado is a distinguished Puerto Rican internist, nephrologist, physician-scientist, mentor, and prolific writer whose leadership in academic and clinical settings has significantly advanced the fields of nephrology, renal physiology and pharmacology, fluids and electrolyte metabolism, calcium metabolism, hypertension research, and medical education. His research on electrolyte imbalances has led to innovative hypercalcemia treatments, notably furosemide with IV fluid therapy. This is an approach that, combined with pharmacotherapy using calcitonin and bisphosphonates, became the standard practice for managing hypercalcemia until specific therapies became available. His nephrology research team and laboratory in the San Juan VA (Veterans Affairs) Medical Center and the Medical School of the University of Puerto Rico were internationally renowned. Throughout his career, he fostered a culture of mentorship while spearheading superb clinical teaching and research initiatives. His transformative tenures at several institutions, including Baylor College of Medicine; the University of Puerto Rico-Medical Sciences Campus; the VA medical centers in Atlanta, Houston, and San Juan; Emory University; Oregon Health Sciences University; Ponce School of Medicine; and the University of Louisville School of Medicine demonstrate his lasting contributions to medical science and education. His interdisciplinary approach, advocacy for kidney and clinical research, and contributions to understanding the renin-angiotensin system and the role of sodium-potassium-activated adenosine triphosphatase in renal concentration mechanisms illustrate his enduring impact on renal physiology and human health.

Needs Assessment for a Leadership Course in Saudi Medical Schools: The Student Perspective.

Introduction: Leaders in healthcare no longer need to hold formal management positions; instead, leadership is perceived to be the responsibility of all healthcare professionals. Despite changes in curricula and teaching design, however, this review of the content taught in medical colleges in Saudi Arabia reveals a lack of leadership and a failure to equip young graduates to compete on the global stage. Medical students need leadership skills for patient care, cooperation, and navigating the complex healthcare system. Clinical management skills in hospitals require these talents also. The complexity of healthcare and the impact healthcare executives have on people's lives highlight the importance of these skills. Thus, healthcare practitioners must develop non-technical skills like proactivity, motivation, and change management to lead across professional boundaries and negotiate the increasingly complex healthcare landscape. Methods: This cross-sectional study combines a quantitative approach with a self-administered questionnaire-based survey. The sampling procedure is a non-probability convenience technique, adapted for 700 male and female undergraduate medical students from four medical colleges. Results: Of the students, 75.46% had minimal leadership experience and 22.69% had some leadership experience; 3.02% of 464 students considered themselves highly experienced in leadership. Conclusion: As the needs assessment and other relevant factors show, leadership should be introduced as a skilled subject. There will always be a growing demand for competent medical graduates, who are capable of becoming future leaders. Although elementary leadership concepts remain fundamentally the same, curricular development must focus on the needs of society and stakeholders.

Assessing emergency room leadership of ObGyn residents in a public university teaching hospital of Sindh, Pakistan: a cross-sectional survey.

BACKGROUND: Leadership is a critical competency for medical professionals, yet it is often neglected in medical training. For ObGyn residents, leadership training is particularly crucial as it significantly impacts both maternal and newborn outcomes, as well as the operational efficiency of healthcare teams. The main objective of this study was to assess the perceptions of obstetrics and gynecology residents who served as group leaders in the emergency team at the Department of Gynecology, Ward 3, Dr. Ruth K.M. Pfau Civil Hospital Karachi. METHODS: A Cross-sectional survey was conducted with purposively sampled 28 year-4 residents who worked as group leaders during last 3 years (from 2018 to 2020) of their residency program at the emergency team in the department of Gynecology Ward 3 Dr Ruth KM Pfau Civil Hospital Karachi. The perceptions on leadership were assessed on 25 items scale sent through a questionnaire on email. Grading of responses was done using a 4-point ordinal scale where 1 meant little importance and 4 was regarded as having great importance. Data was summarized with relevant descriptive statistics and was analyzed on SPSS version 22. RESULTS: The mean age of residents was 30.36. The mean leadership scores of the group of residents were calculated to be 77.50 (SD ± 9.57) while 14(50%) residents showed good and 14 (50%) showed excellent leadership skills based on cumulative scores. Of the 25 traits examined in this study, the highest reported trait was humility 3.82 (± 0.39) followed by empowerment 3.68 (± 0.77) and effective communication 3.68 (± 0.77). While responding about learning experiences, 89.3% of participants felt that the experience enhanced their decision-making skills and boosted their confidence in dealing with emergencies. CONCLUSION: Our study highlights the critical importance of leadership development in the training of ObGyn residents, particularly in high-pressure emergency settings. The findings reveal that residents value leadership traits such as humility, empowerment, and effective communication, which are essential for building teamwork and ensuring optimal patient outcomes and patient satisfaction.

Furthering the Field of Lifestyle Medicine Through the Donald A. Pegg Student Leadership Award.

Lifestyle medicine focuses on six pillars: a predominantly whole food, plant-based dietary pattern, physical activity, stress management, avoidance of risky substances, sleep, and positive social connection. Lifestyle medicine has been shown to be effective in treating heart disease, type 2 diabetes, and hypertension, among others. Despite these data, lifestyle medicine education amongst medical schools continues to be inadequate. Lifestyle Medicine Interest Groups (LMIGs) are student-led organizations which work to fill the gap in lifestyle medicine education by holding a variety of programming for their student bodies, while concurrently advocating for designated lifestyle medicine education within formal curricula. The Donald A. Pegg Student Leadership Award was created by Dr. Beth Frates, current President of the American College of Lifestyle Medicine, to recognize outstanding student leaders in the field of lifestyle medicine, and specifically for the work related to their LMIG. The Donald A. Pegg Award provides recipients with LMIG funding for their respective institutions, complementary registration for the American College of Lifestyle Medicine national conference, and a stipend for conference travel. The funding provided by the Donald A. Pegg Award allows LMIGs to expand their reach to their greater student bodies, helping to further the field of lifestyle medicine. The purpose of this article is to highlight the 2022 Donald A. Pegg award recipients and how they are using its merit to advance the field of lifestyle medicine.

The Effectiveness of Leadership Interventions on Cardiologists' Performance Using Benchmarking as a Tool.

BACKGROUND: Aligned with the Health Sector Transformation Strategy of Saudi Vision 2030, the study analyzed the attitudes and behaviors of cardiologists toward change and identified factors that could either facilitate or hinder the success of leadership interventions. At our cardiac center, the cath lab department is at the forefront of operations, accounting for 80% of the procedures. Our team members may not be fully equipped with the necessary attitudes and behaviors to drive successful improvement projects. Therefore, our top priority is ensuring they remain productive and engaged throughout the process. This is especially crucial because 60% of our budget is allocated to the cath lab department. OBJECTIVES: The study aimed to assess the effectiveness of a leadership intervention on cardiologists' performance in terms of safety, speed, and cost. The research analyzed the behavior and attitude of cardiologists towards change and encouraged progress and collaborative learning between doctors, using benchmarking as a tool. Besides, the study sought to determine the contribution of the interventions used to overall efficiency in performing interventions. This case study focuses on four main aspects of the program. First, it aims to explore an innovative approach to improving the PSCCQ cath lab for patients. Second, it assesses the collective effort of all participants involved in the program. Third, it analyzes the program results and compares them with those of international experiences. And finally, it examines the program's potential benefits for our patients. METHODS: The study's objectives were evaluated through qualitative analysis of in-depth interviews and quantitative data analysis of three variables in the cath lab: radiation dose, time, and inventory. The reason for using mixed methods was to comprehensively understand the same concept from different angles. RESULTS: According to the study, participants improved the safety and effectiveness of our cath lab by reducing the radiation dose and its cost. The study revealed a 52% decrease in the radiation dose for diagnostic cases and an 11% decrease for interventional cases. Similarly, the cost of the radiation dose decreased by 28% for diagnostic cases and 11% for interventional cases. During the observation, it was noted that the participants were highly engaged and willing to adapt to the situation. Some even viewed it as an opportunity for personal growth and improvement in the cath lab. However, they stressed the significance of awareness as a crucial element in improving their behavior and reinforcing it as the foundation for maintaining progress. Furthermore, the study revealed that collaborative work among the participants could have been more optimal. CONCLUSION: The study concludes that implementing innovative improvements to the cath lab was a necessary yet complex undertaking. Participants were more inclined to embrace the changes when they were easily understandable and motivating. The study recommends the appointment of a change agent, the establishment of benchmarks, and the creation of a collaborative working environment between leaders and staff. Above all, the leader should support and sponsor the change to facilitate the transition at various levels.

A Qualitative Study on the Impact and Feasibility of a Simulation-Based Program for Shared Decision-Making in Non-Small Cell Lung Cancer Care.

BACKGROUND: In the pursuit of improved clinical outcomes and patient experience in health care, shared decision-making (SDM) stands as a pivotal concept garnering increasing attention, but SDM utilization varies widely, often leading to confusion regarding team members' roles. This study explores knowledge, skills, and attitudes of oncology clinicians engaged in a pioneering educational initiative at a comprehensive cancer care center, aimed at enhancing frontline SDM capabilities. METHODS: Utilizing a prospective cohort qualitative approach, the team conducted interviews with 6 clinicians in a multidisciplinary oncology program who were engaged in an SDM continuing education program. In the program, participants were immersed in experiential learning activities including standardized didactic sessions and simulation-based SDM case role-play activities. RESULTS: Thematic analysis of interview data revealed 5 major categories: 1) perceptions of SDM; 2) training; 3) patient-centered care; 4) challenges and constraints; and 5) leadership buy-in. Participants perceived benefits, including adopting a better approach to integrate SDM into their practice, heightened engagement, emphasizing team collaboration, and embracing a patient-centric care model. CONCLUSIONS: This study underscores the transformative impact of education and training on enhancing SDM capabilities among oncology clinicians and is not intended for generalizability. By promoting a basic understanding and application of SDM principles, practicing clinicians can be better empowered to improve health care outcomes and experience. Our findings contribute to the broader endeavor of embedding practical SDM principles within clinical practice, thereby fostering a more patient-centered and effective health care environment.

Participatory leadership and supportive organisational culture Panacea for job satisfaction regulatory role of work-life balance.

This study examines the direct influence of participatory leadership (PL) and supportive organisational culture (SOC) on employee job satisfaction (JC). Additionally, the research delves into the mediating role of work-life balance in the relationship between PL, SOC, and job satisfaction. Data was collected using 450 questionnaires through random sampling from hotels managing food security in Saudi Arabia. These findings indicate a direct correlation between participatory leadership, supportive organisational culture, and job satisfaction. Furthermore, work-life balance was found to mediate the relationship between PL, SOC, and job satisfaction. Given the importance of a supportive organisational culture for robustness, this study suggests that hotels, particularly those managing food security in Saudi Arabia, should prioritise fostering a supportive culture. They should also encourage democratic leadership and formulate strategies to help employees achieve work-life balance (WLB), leading to enhanced job satisfaction.

Responsible north-south research and innovation: A framework for transdisciplinary research leadership and management.

The number, scale and ambition of transdisciplinary research initiatives between the global north and the global south is increasing, yet there is very little theoretical or empirical scholarship on how to lead and manage implementation to promote responsible practice. Within science, technology and innovation (STI) studies and decolonising research frameworks, and utilising collaborative autoethnography, this study codifies experience with implementing the 'Revitalising Informal Settlements and their Environments' (RISE) program (2017-2020). Our specific aim is to explore the leadership and management tensions and challenges of implementing transboundary transdisciplinary research. The findings reaffirm the importance of research leaders and managers carefully operationalising north-south research by critically reflecting on power asymmetries between disciplines, partners and locations, leveraging the potential for transdisciplinary consortia to build research capabilities in the global south, and creating a culture of reflexivity on the historical and social positionality in which research is designed, funded, implemented and evaluated. The findings foreground the role of boundary-spanning 'integrators' and 'pracademics', roles that have received little attention to date but are essential for effective delivery and societal impact beyond scientific advances. A framework for implementing north-south transdisciplinary research is outlined with five domains: (1) collaborative leadership; (2) agile management; (3) flexible consortia; (4) researcher positionality; and (5) co-design and participation. The framework can support efforts for responsibly designing and implementing large, transdisciplinary, cross-country research programs in line with ambitions for decolonising north-south research.

ISCCM Position Statement for Improving Gender Balance in Critical Care Medicine.

Gender disparity in Critical Care Medicine (CCM) persists globally, with women being underrepresented. Female Intensivists remain a minority, facing challenges in academic and leadership positions at the workplace and within academic societies. The Indian Society of Critical Care Medicine (ISCCM) recognized the need for addressing issues related to gender parity and constituted its first Diversity Equity and Inclusion (DEI) Committee in 2023. Through a Delphi process involving 38 Panelists including 53% women, consensus and stability were achieved for 18 statements (95%). From these 18 consensus statements, 15 position statements were drafted to address gender balance issues in CCM. These statements advocate for equal opportunities in recruitment, workplace inclusivity, prevention of harassment, and improved female representation in leadership roles, nominated positions, and conferences. While the consensus reflects a significant step toward gender equity, further efforts are required to implement, advocate, and evaluate the impact of these measures. The ISCCM position statements offer valuable guidance for promoting gender balance within society and the CCM community. How to cite this article: Sathe P, Shukla U, Kapadia FN, Ray S, Chanchalani G, Nasa P, et al. ISCCM Position Statement for Improving Gender Balance in Critical Care Medicine. Indian J Crit Care Med 2024;28(S2):S288-S296.

Leadership support and satisfaction of healthcare professionals in China's leading hospitals: a cross-sectional study.

BACKGROUND: Healthcare professionals' job satisfaction is a critical indicator of healthcare performance, pivotal in addressing challenges such as hospital quality outcomes, patient satisfaction, and staff retention rates. Existing evidence underscores the significant influence of healthcare leadership on job satisfaction. Our study aims to assess the impact of leadership support on the satisfaction of healthcare professionals, including physicians, nurses, and administrative staff, in China's leading hospitals. METHODS: A cross-sectional survey study was conducted on healthcare professionals in three leading hospitals in China from July to December 2021. These hospitals represent three regions in China with varying levels of social and economic development, one in the eastern region, one in the central region, and the third in the western region. Within each hospital, we employed a convenience sampling method to conduct a questionnaire survey involving 487 healthcare professionals. We assessed perceived leadership support across five dimensions: resource support, environmental support, decision support, research support, and innovation encouragement. Simultaneously, we measured satisfaction using the MSQ among healthcare professionals. RESULTS: The overall satisfaction rate among surveyed healthcare professionals was 74.33%. Our study revealed significant support from senior leadership in hospitals for encouraging research (96.92%), inspiring innovation (96.30%), and fostering a positive work environment (93.63%). However, lower levels of support were perceived in decision-making (81.72%) and resource allocation (80.08%). Using binary logistic regression with satisfaction as the dependent variable and healthcare professionals' perceived leadership support, hospital origin, job role, department, gender, age, education level, and professional designation as independent variables, the results indicated that support in resource provision (OR: 4.312, 95% CI: 2.412 ∼ 7.710) and environmental facilitation (OR: 4.052, 95% CI: 1.134 ∼ 14.471) significantly enhances healthcare personnel satisfaction. CONCLUSION: The findings underscore the critical role of leadership support in enhancing job satisfaction among healthcare professionals. For hospital administrators and policymakers, the study highlights the need to focus on three key dimensions: providing adequate resources, creating a supportive environment, and involving healthcare professionals in decision-making processes.

[Skill-grade mix and shared governance in the intensive care unit: development of a management triangle and the advancement of nursing roles]. / Skill-Grade-Mix und Shared Governance auf der Intensivstation: Entwicklung eines Leitungsdreiecks und weiterführender pflegerischer Rollen.

BACKGROUND: In the Federal Republic of Germany, it has been possible for some years to study (intensive) nursing care alongside further training in intensive care and anaesthesia. This results in a nursing skill-grade mix in the intensive care unit (ICU), which nursing management must consider. OBJECTIVES: The aim is to show the development and implementation of a new nursing management structure in the ICU and also provide an overview of the parallel role development with preliminary results at a university hospital. MATERIALS AND METHODS: Within a working group of nursing management, a narrative analysis of the current situation was carried out with close involvement of the ICU ward managers and the staff units for nursing development, further education and nursing education. The content was organized into subject areas and a new management model was subsequently developed. The evaluation took place narratively within the context of employee interviews. RESULTS: The management model in the ICU was divided into the areas of nursing management, nursing education, and nursing science as a management triangle. Nursing management is staffed by at least two people as ward managers and deputies, while the nursing education and science team leaders have equal decision-making powers in terms of shared governance. The respective specialist departments work together within the hospital in networks with other ICUs. Other specialist roles such as primary nurses, advanced practice nurses, heart failure nurses or practical instructors are given specific contact persons in the management team to match their tasks, which was viewed positively. CONCLUSIONS: The development of nursing practice can be promoted through close co-operation within the management team.