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Medical Leadership

Medical Leadership

Peter | Bob


Additional Information

Book Details


In this new edition Peter Spurgeon and Robert Klaber take you through the latest leadership and management thinking, in particular the medical leadership competency framework as endorsed by the GMC for undergraduate and postgraduate education.

Table of Contents

Section Title Page Action Price
Book Cover C
Title i
Copyright ii
About the publisher iii
Contents iv
Free Companion Material xii
About the authors xiii
Peter Spurgeon xiii
Bob Klaber xiii
Contributors xiv
Acknowledgements xv
Foreword to 1st Edition (Nov 2011) by Professor Parveen Kumar CBE xvii
Foreword to 1st Edition (Nov 2011) by Junior Doctors xix
Chapter 1 Introduction 2
Background to the emergence and value of medical leadership 2
Medical leadership: history and context 3
Clinical leadership vs medical leadership 4
Why medical leadership is important 5
A contextual framework to this book 7
The growth of managerialism 7
The development of medical leadership 9
References 9
Chapter 2 The Medical Leadership Competency Framework 12
Introduction 12
Competency frameworks 13
International competency frameworks 14
The Medical Leadership Competency Framework (MLCF) 15
The development of the MLCF 17
Where are we now? 19
Leadership training at undergraduate level 19
Leadership training at postgraduate level 20
Further developments 21
References 22
Chapter 3 Management and leadership 26
Introduction 26
Management or leadership 27
The interrelations of leadership and management 28
Approaches to leadership 29
Leadership models 30
Trait theory 31
Leadership style and context 32
From individual to collective models 33
Shared or distributed leadership 34
References 35
Chapter 4 Creating a comprehensive, integrated and centralised leadership development programme: A case study of the School of Psychiatry (West Midlands) 38
Introduction 38
Why is leadership not given the importance it needs? 39
Opportunity 41
Scoping 41
Leadership curricular 42
A model for adapting MLC to the specialty 42
Programme design 44
Faculty development 47
Assessment and progression of trainees 48
Workplace based assessment tools 48
Implementation issues 50
Summary 51
Chapter 5 Leadership learning on the wards 54
Introduction 54
Demonstrating personal qualities on the wards 55
Summary of issues 56
Improving continuity 57
Opening up communication 57
Teaching and learning where time is limited 58
Working with others on the wards 59
Summary of issues 60
Developing decision-making skills 61
Flattening hierarchies 62
The nursing perspective 63
Managing services on the wards 63
After Action Reviews (AARs) 64
Improving services on the wards 65
Summary of issues 66
Checklists 66
Setting direction on the wards 69
Integrated care pathways 69
Summary 71
References 72
Chapter 6 Leadership learning in clinic 76
Introduction 76
Demonstrating personal qualities in clinic 77
Multi-source feedback (MSF) 78
Feedback from patients 79
Developing a feedback culture 79
Working with others in clinic 80
Summary of issues 80
Administrative and managerial roles in outpatients 81
Clinical roles in outpatients 81
Shadowing the patient journey 81
Managing services in clinic 82
Improving DNA rates 82
Activity capture 83
Working alongside managers 83
Improving services in clinic 84
Patient and carer feedback 84
Summary of issues 85
Qualitative feedback from patients 86
Disseminating the learning from patient feedback 86
Setting direction in clinic 87
Summary of issues 88
Summary 89
References 90
Chapter 7 Leadership learning in handover 92
Introduction 92
Demonstrating personal qualities in handover 93
Learning and developing handover skills 94
Working with others in handover 95
Summary of issues 97
Leading handover 97
The 'dollar clock' 97
Managing services in handover 98
Objectives and standards for handover 99
Handover sheets 99
Structuring handover 100
Improving services in handover 101
Junior doctors improving handover 102
Summary of issues 103
Setting direction in handover 104
Evaluating the impact of improvement projects 105
Summary 106
References 107
Chapter 8 Leadership learning in the emergency department 110
Introduction 110
Demonstrating personal qualities in the emergency department 111
Stress in doctors: the wider impact 112
Developing strategies to manage stress 112
Support from colleagues 113
Working with others in the emergency department 114
Teamworking in a resuscitation 114
Debrief 115
Managing services in the emergency department 116
Learning through shadowing 117
Managing the workload: board rounds 118
Managing the workload: flexible staffing levels 118
Handover 118
Process targets 119
Gaming to meet targets 120
Local improvement initiatives 120
Improving services in the emergency department 121
Innovation 121
Lean thinking and experience-based design 122
Setting direction in the emergency department 124
Applying evidence to improve care 124
BestBETs 125
Embedding evidence-based medicine into clinical work 126
Summary 127
References 128
Chapter 9 Leadership learning in theatre 134
Introduction 134
Developing leadership skills in the operating theatre 135
The operating theatre as a learning environment 137
Leadership measurement tools 138
The 'micro-environment' of theatre 140
Demonstrating personal qualities in the operating theatre 146
Summary of issues 147
The importance of values 147
Working with others in the operating theatre 148
Summary of issues 149
World Health Organization (WHO) safety checklist 149
Using audit to stimulate change 149
Managing services in the operating theatre 150
Summary of issues 151
Getting involved with service management 152
Improving services in the operating theatre 152
Summary of issues 153
Improving care through simple low-cost initiatives 153
Setting direction in the operating theatre 154
Summary of issues 155
Summary 156
References and further reading 157
Chapter 10 Leadership learning in primary care 162
Introduction 162
General practice now and in the future 163
Demonstrating personal qualities in primary care 164
Managing stress 164
Neighbour's checkpoints: safety-netting 165
Neighbour's checkpoints: housekeeping 165
Summary of issues 167
Managing yourself 168
Working with others in primary care 169
Developing networks 169
Networking 171
Summary of issues 172
Stakeholder mapping 172
Building and managing relationships 173
Managing services in primary care 174
Developing planning skills 175
Summary of issues 175
Improvement methodologies 176
Process mapping 177
Value stream mapping 177
Improving services in primary care 181
Involving colleagues to accomplish change 181
Clinical engagement 182
The clinical engagement ladder 182
The danger of disengagement 183
Core messages 184
Summary of issues 184
Setting direction in primary care 186
Evidence-based service improvement 186
Summary of issues 187
Summary of issues 188
Summary 189
References 190
Chapter 11 Leadership learning as an undergraduate 194
Introduction 194
Demonstrating personal qualities as an undergraduate 196
Role-modelling 196
Working with others as an undergraduate 199
Understanding teamworking 199
Summary of issues 200
Groupthink 200
Teamworking in theatres: the WHO surgical checklist 201
Managing services as an undergraduate 202
Learning about financial flows in primary care 202
Shadowing as an undergraduate 203
Improving services as an undergraduate 204
Moving beyond audit 204
Improving patient experience 206
Summary of issues 207
Setting direction as an undergraduate 208
Learning about the wider context 209
Sustainable healthcare 209
Summary of issues 210
Summary 211
References 213
Chapter 12 Leadership learning in integrated care settings 216
Introduction 216
What is integrated care? 216
Healthcare policy 220
Integrated care opportunities 220
Demonstrating personal qualities in integrated care settings 221
Learning in community integrated MDT meetings 221
Summary of issues 224
Working with others in integrated care settings 225
Email advice lines develop networks 225
Telemedicine builds relationships 226
Collaboration through community MDTs 226
Summary of issues 227
Managing services in integrated care settings 228
Strategy for the wider healthcare system 228
A whole systems integrated care approach 228
Co-production for integrated care 229
Improving services in integrated care settings 230
Question the status quo 231
Summary of issues 232
Data influencing change 233
Public Health England Profiles 233
Hospital Episode Statistics (HES) 234
The NHS Atlas of Variation 235
Public Health Observatories 235
Setting direction in integrated care settings 236
Summary 239
References 240
Chapter 13 Supporting leadership learning: tutor notes 244
Introduction 244
Work-based leadership learning 244
Using feedback to support learning: providing insight 246
Using feedback to support learning: Pendleton's 'rules' 246
Using feedback to support learning: other approaches 247
'What can we learn from you?' 249
Moving beyond poor quality audit 250
Putting trainees at the heart of improving care 252
Working with, and learning from, managers 254
Paired learning 255
Summary 258
References and further reading 259
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