Volume 5 Number 4 In This Issue
In this issue of CJPL, we celebrate the success of the 2019 Canadian Conference on Physician Leadership (see Pat Rich’s article1 and CCPE recipients2).
Health care and hospitals are among the most complicated industries to understand, manage, and govern. Canadian health care is governed by boards responsible for various geographic regions depending on the province or territory. The governors are mostly volunteers.
Health care systems in Canada and Sweden are facing increasing challenges to do with access and wait times for non-emergent issues. Both are seeing the erosion of single-payer health care systems as a consequence of these challenges, and both are emphasizing moving care out of hospitals into community and home care. Sweden has moved ahead in this area and Canadians can learn two key lessons from its experience. First, rather than thinking in terms of what’s best for the system or the provider, the Jönköping region in Sweden emphasizes the perspective of “Esther,” a hypothetical patient with a life beyond the walls of the institution. Second, viewing patients as copilots in their care has patients learning treatments, such as self-dialysis, with benefits to themselves and the system. read article
In a conference focused on the broad and challenging issue of showing leadership in bringing more diversity and equity to medicine, it was personal stories of discrimination and taking on leadership roles that seemed to move the 350 delegates most.
In response to an identified need for an advanced leadership course for experienced physician leaders, we sought to better understand the specific needs of such physicians in Nova Scotia. In 2017, 51 applications for Doctors Nova Scotia’s Physician Leadership Development Program (PLDP) were subjected to thematic content analysis to determine the top physician leadership skills that experienced physicians desired to develop or enhance. To complement this information, we consulted three content experts from PLDP partner organizations and carried out a systematic literature review of five academic databases. read article
Leadership is a critical factor for successful health care reform. Leadership development is, therefore, vital to ensure that future leaders have the right competencies to succeed. Building on the journey of two military health care leaders, this article argues that current leadership development frameworks and the sponsoring health care leadership organizations lack integration, considering that physicians and non-physicians are trained separately and belong to different networks. read article
The evolving nature of how health care is delivered in Canada requires effective complex adaptive systems, which depend on capable leaders, including physicians. Understanding the core concepts of “leadership,” “leaders,” and “team members” is the foundation for the “great task of our generation,” which is creating and leading the kinds of systems needed to meet the opportunities, challenges, and uncertain future of modern health care. Based on a literature review and consideration of theoretical and practical implications, three definitions are provided, along with discussion of their composite terms.
Peter Drucker famously said “Culture eats strategy for breakfast.” In health care, the way things are done, rather than what is done, can make the difference between an engaged workforce and an apathetic one. This case study looks at how the Kelowna General Hospital’s emergency department staff changed their way of doing their usual work and improved their engagement and, subsequently, their quality of care. The article highlights methods leaders can use to uncover previously underground barriers that are affecting engagement. We review the differences between technical problems and adaptive challenges and add to other research that suggests command-and-control leadership is rarely effective in complex systems such as health care.
Engaged health care teams are necessary for any improvement in quality or safety. But health care teams will not engage simply because we ask them to do so. Any improvements in health care will require leaders to understand the why of disengagement. In the first of this three-part series — Disengagement in health care: today’s new culture — we began to understand why only 57% of health care workers are engaged and why that number is decreasing annually. We now examine how health care’s approach to safety and quality has unwittingly been complicit in building this disengagement. read article
There is a need to professionalize leadership development in Canada; for physicians, that need has increased with the inclusion of the new role of Leader in CanMEDS 2015. For the health care system, LEADS provides a set of standards for guiding leadership development for each individual health care worker and for all organizations. This paper addresses how to engage physicians in leadership roles and explores what professionalized leadership might
look like. read article
Helen Riess, MD
Sounds True, Boulder, Colorado, 2018
Reviewed by Johny Van Aerde, MD
BOOK REVIEW: That’s What She Said What Men Need To Know (And Women Need To Tell Them) about Working Together
Harper Collins, New York, 2018
Reviewed by L. Calhoun, MD