Medical Leadership: A Toolkit for Service Development and System Transformation PDF
Preview Medical Leadership: A Toolkit for Service Development and System Transformation
MEDICAL LEADERSHIP Today’s healthcare systems need doctors and consultants to act as leaders, within the multi-disciplinary team, in addition to carrying out their clinical role. This book identifies the key elements of successful leadership through ‘medically led’ service development and system transformation and shows how this can benefit patient care, particularly when patients become partners in the process. The authors provide a conceptual framework of medical leadership and a set of scientific methods and tools that make a significant contribution to advancing quality and transforming services in healthcare. On top of this, they present analytical tools which medical professionals can use to support their own improvement or system transformation strategy, including ways of measuring improvement and the returns on investment of medical leadership. Weaved throughout the book are real-life case studies from medical leaders across the world, providing students with valuable practical insights. Chapter summaries and reflections are provided to support learning. Medical Leadership will be essential reading for students on medical and clinical leadership courses internationally as well as for all practising doctors, consultants and General Practitioners. Jill Aylott is Consultant in Autism and CEO at the International Academy of Medical Leadership (IAML) and Head of Programmes for Medical Leadership, Social Care and Quality Improvement. Jeff Perring is Consultant Intensivist and Medical Director, Sheffield Children’s NHS Foundation Trust. Ann LN Chapman is Consultant in Infectious Diseases and General Medicine, and Clinical Director for Medicine, NHS Lanarkshire; Honorary Clinical Associate Professor, University of Glasgow. Ahmed Nassef is Consultant Vascular Surgeon at Sheffield Teaching Hospitals Foundation NHS Trust, Council member & Deputy Convener of Exams for the Royal College of Surgeons Edinburgh, Lead of Communication Skills for the Intercollegiate Board of Surgical Exams, UK, and Medical Director, International Academy of Medical Leadership. MEDICAL LEADERSHIP A Toolkit for Service Development and System Transformation Edited by Jill Aylott, Jeff Perring, Ann LN Chapman and Ahmed Nassef First published 2019 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2019 selection and editorial matter, Jill Aylott, Jeff Perring, Ann LN Chapman and Ahmed Nassef; individual chapters, the contributors The right of Jill Aylott, Jeff Perring, Ann LN Chapman and Ahmed Nassef to be identified as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Aylott, Jill, editor. | Perring, Jeff, editor. | Chapman, Ann, Dr., editor. | Nassef, Ahmed, editor. Title: Medical leadership : a toolkit for service development and system transformation / edited by Jill Aylott, Jeff Perring, Ann Chapman and Ahmed Nassef. Description: Abingdon, Oxon ; New York, NY : Routledge, 2019. | Includes bibliographical references and index. Identifiers: LCCN 2018020299 | ISBN 9781138217348 (hbk.) | ISBN 9781138217355 (pbk.) | ISBN 9781315440880 (ebk.) Subjects: MESH: Leadership | Health Services Administration | Delivery of Health Care | Physician’s Role | Organizational Case Studies Classification: LCC RA971 | NLM W 84.1 | DDC 362.1068—dc23 LC record available at https://lccn.loc.gov/2018020299 ISBN: 978-1-138-21734-8 (hbk) ISBN: 978-1-138-21735-5 (pbk) ISBN: 978-1-315-44088-0 (ebk) Typeset in Bembo by Apex CoVantage, LLC CONTENTS Foreword ix Contributor bios xi PART 1 A global emergent context for medical leadership 1 1 An introduction 3 Ahmed Nassef, Mathew Fortnam and Jill Aylott 2 ‘Leadership’ and ‘medical leadership’ 8 Bolarinde Ola and Aishin Lok 3 Quality improvement as the goal of medical leadership 16 Rachael Baines 4 Understanding patient experience as a clinical leader 22 Suvira Madan 5 Primary care and general practice: medical leadership for all 33 Mathew Fortnam 6 A theoretical model to engage doctors in medical leadership 38 Ahmed Nassef vi Contents PART 2 Medical leadership 57 7 An introduction 59 Ann LN Chapman 8 Medical leadership and reducing health inequalities 61 Gilly Ennals 9 Medical leadership and reducing variation in healthcare 65 Ravishanka Sargur 10 Developing and analysing effective teams 79 Walaa Al-Safi 11 A strategy for engaging primary and secondary care doctors in medical leadership 86 Simon Boyes 12 Medical engagement – strategies for engagement from the ‘grass roots’ 95 Paddy Dobbs and Alix Fonfe 13 Leadership diagnostics and reflections on personal leadership development 106 Michael Robinson and Eleni Lekoudis PART 3 Improvement science, medical leadership and measurement for improvement 127 14 An introduction 129 Jill Aylott 15 Data analysts building capability in partnership with medical leaders 132 Lisa Fox 16 Root cause analysis and simulation to improve quality 137 Adam Burns Contents vii 17 Leadership diagnostics for self-awareness and bespoke course design 141 Prosenjit Giri 18 Medical leadership and the use of data for a continuous quality improvement collaborative (CQIC) in an accident and emergency department 153 Prakash Subedi, Jill Aylott, Prosenjit Giri, Martha Zaluaga Quintero, Sanjay Sinha, Sanjai Subramanian and Sathi Permaul 19 Developing a human transplantation health service in Nepal with ethical and moral medical leadership 163 Pukar C. Shrestha PART 4 Service development 173 20 An introduction 175 Jeff Perring 21 ‘Patient reported outcome measures’: we have barely started to walk let alone run 176 Fiona Kew 22 Service improvement to reduce early deaths of children in hospital: the design of an electronic observation system 189 Victoria Hemming 23 Innovations in person-centred service redesign for young carers 197 Samantha Wong 24 Service improvement in paediatric dentistry 203 Halla Zaitoun 25 Reflections on service improvement by medical leaders 210 Jeff Perring, Fiona Kew, Victoria Hemming, Samantha Wong and Halla Zaitoun viii Contents PART 5 System transformation 223 26 Introduction to critical issues in health system transformation 225 Jill Aylott and Ahmed Nassef 27 System transformation for health and social care 229 Branko Perunovic 28 A strategy for engaging teams and motivating staff through system transformation 232 Rachael Baines and Prasad Godbole 29 Transforming operating theatre services with medical leadership 238 Ahmed Othman, Jayarama Mohan, Prabhakar Motkur, Salma Noor, Milind Rao, Adam Wolverson, Amit Shukla, Gurdip Singh Samra, Mohit Gupta, Chloe Scruton, Jill Aylott, Karen Kilner and Prasad Godbole 30 Transforming the emergency medicine medical workforce: a new ‘hybrid’ doctor with integrated speciality training and a competency-based Fellowship in Quality Improvement (FQim) 244 Prakash Subedi, Jill Aylott, Naushad Khan, Prosenjit Giri and Lesley Hammond 31 Quality improvement and system transformation in emergency medicine 251 Elizabeth Hutchinson 32 Transforming the quality of hospital care through advocacy for people with a learning disability and/or autism 257 Jonathan Sahu 33 Transforming services for patients with spinal cord injury – a national review of standards and practice 263 Pradeep Thumbikat Index 279 FOREWORD Medical leadership: a toolkit for service development and system transformation In 2008, during my time as health minister, I produced the report High Quality Care for All, in which I addressed leadership as a fundamental component of the NHS. The report focused on the importance of encouraging clinicians to not only be practitioners but also to be partners and leaders with patients within the NHS. With empowered leaders comes a motivated workforce who will drive forward the quality and safety agenda. I previously highlighted the need for a stronger role for clinical leadership and management throughout the healthcare system. Since 2008, we have seen some drive towards this with national leadership schemes, courses and frameworks. However, leadership is not just about individuals, but also about teams, and there is still a long way to go to empowering staff to fully take on these roles. We need to encourage staff to step up and make a case for change. As I once said – “It is relatively easy to set out a vision, much harder to make it a reality”. This insightful book offers a toolkit that can be applied for those wanting to develop their medical leadership skills in order to see service development and system transformation. The book covers the key principles of leadership, developing a strong foundation of the role of medical leadership in various settings, and the fundamental principle of ensuring that care remains patient-centric. The second part of the book builds on the foundations laid out by the first part, discussing more specific aspects of leader- ship such as how it can reduce variation in quality of healthcare and help to reduce health inequalities. The latter parts of the book delve deeper into how we measure improvement to ensure we see service transformation and system development.
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