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Developing collective leadership for health care

Our paper argues that collective leadership – as opposed to command-and-control structures – provides the optimum basis for caring cultures. With the NHS facing bigger challenges than ever before, leaders must ensure that cultures within health care organisations sustain high-quality, compassionate and ever-improving care. Key to shaping these cultures is leadership.  
kingsfund.org.uk
over 7 years ago
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20

Culture and leadership in the NHS

The King's Fund's second leadership survey revealed a mixed picture of leadership, culture and the working environment across the NHS. In February and March 2014 The King’s Fund conducted a survey of NHS managers and clinicians about leadership, culture and compassionate care in the NHS. We received more than 2,000 responses. This is the second leadership survey of NHS staff we have undertaken and it revealed a mixed picture of leadership, culture and the working environment across the NHS.  
kingsfund.org.uk
over 7 years ago
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27

Medical engagement

Our report is based on case studies of four NHS trusts with acknowledged high levels of medical engagement. It aims to help other organisations that are seeking to create cultures in which doctors want to engage more in the management, leadership and improvement of services. What is good medical engagement? In those organisations where it exists, how has good medical engagement been created and sustained? These questions are at the heart of this report, which builds on earlier work from The King’s Fund on medical leadership.  
The King's Fund
over 7 years ago
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929

Blaufuss Multimedia - Heart Sounds and Cardiac Arrhythmias

Interactive multimedia tutorials and tests are available for aortic and mitral valve disease, and for supraventricular tachycardias (SVTs), using actual patient sounds, video, and custom animations.  
blaufuss.org
over 7 years ago
Www.bmj
1
18

Intolerance of error and culture of blame drive medical excess

Jerome R Hoffman and Hemal K Kanzaria argue that efforts to reduce overdiagnosis and overtreatment should focus on changing professional and public attitudes towards medical error and uncertainty  
bmj.com
over 7 years ago
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9

Medical Student Podcast Special Edition - Ben Goldacre

Ben Goldacre answers your questions. 00:12 Affect of big data on medicine. 2:18 How med students can change pharma industry. 3:25 What culture change is needed to change bad medicine?  
audioBoom
over 7 years ago
Www.bmj
1
26

NHS is not (yet) in crisis, but what about school rugby?

If a crisis is the point of judgment, the nadir, the turning point, the NHS in England can’t yet be judged to be in crisis, said John Appleby of the health think tank the King’s Fund in a BBC interview this week, because things may well get worse (doi:10.1136/bmj.h50). This is hardly reassuring but probably realistic. Hospitals around the country are declaring “major incidents” because of a lack of beds or staff or both, emergency departments report that they are at breaking point, and general practice is under unprecedented pressure (doi:10.1136/bmj.h66, doi:10.1136/bmj.g7266, doi:10.1136/bmj.g6069, doi:10.1136/bmj.g6040). And there is little sign yet of things improving. Less realistic but more palatable is the belief of NHS England’s chief executive, Simon Stevens, that the £30bn (funding gap expected for 2020-21 can be narrowed to £8bn. This is magical thinking, says Nigel Hawkes (doi:10.1136/bmj.g7842).  
bmj.com
almost 7 years ago
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24

Exploring CQC’s well-led domain

The CQC’s inspections focus on five key lines of enquiry as part of its ‘well-led’ domain. This paper sets out what boards can do in these five areas and draws on examples of good practice in leadership and culture in health care. Following the Francis Report into the failures of care at Mid Staffordshire NHS Foundation Trust, and the government’s response to the report, the Care Quality Commission (CQC) has introduced a more rigorous and wide-ranging approach to inspecting health care providers. The main purpose of inspections is to assess the quality of care delivered to patients. In making this assessment, CQC now also analyses the leadership and organisational culture of providers.  
The King's Fund
almost 7 years ago
Www.bmj
1
24

Clinical applications of preimplantation genetic testing

Genetic diagnostic technologies are rapidly changing the way medicine is practiced. Preimplantation genetic testing is a well established application of genetic testing within the context of in vitro fertilization cycles. It involves obtaining a cell(s) from a developing embryo in culture, which is then subjected to genetic diagnostic analysis; the resulting information is used to guide which embryos are transferred into the uterus. The potential applications and use of this technology have increased in recent years. Experts agree that preimplantation genetic diagnosis is clinically appropriate for many known genetic disorders. However, some applications of such testing, such as preimplantation genetic screening for aneuploidy, remain controversial. Clinical data suggest that preimplantation genetic screening may be useful, but further studies are needed to quantify the size of the effect and who would benefit most.  
bmj.com
almost 7 years ago
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Leadership and leadership development in health care

A summary of the evidence about leadership in health care services, published in collaboration with the Faculty of Medical Leadership and Management and the Center for Creative Leadership. A key challenge facing all NHS organisations is to nurture cultures that ensure the delivery of continuously improving high-quality, safe and compassionate health care. Leadership is the most influential factor in shaping organisational culture and ensuring the necessary leadership behaviours, strategies and qualities are developed is fundamental. But what do we really know about leadership in health care services?  
The King's Fund
almost 7 years ago
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Me, my brain and hypochondria: is fear of illness a problem or a curious blessing?

There is no simple answer as understanding mental health can be a complex process — but an exploration of culture, history and how the brain works is a start  
the Guardian
almost 7 years ago
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321

Why doesn’t the NHS make money?

The NHS provides care free at the point of us to British citizens and anyone who needs emergency care while in the UK. It tries to provide every kind of service and treatment that it can but obviously there are limits. The NHS gets its money mainly from governments taxes, charities, research grants, some payment for services and from renting out retail space etc. Healthcare is a financial blackhole, any money put in the budget will get spent, efficiently and effectively or not. The NHS is constantly being expected to provide a better, more efficient service and new treatments, without a comparable increase in government funding. So, why doesn’t the NHS set up services that could make it money? Some money making suggestions Gift shops and NHS clothing brand – The American hospital I went to for elective had quite a large shop near the entrance that sold hospital branded goods. People love the NHS and it could make itself a brand, “I love the NHS” t-shirts, “I was born here” ties, “I gave birth at Blah hospital” car stickers, hats, jackets, tracksuits, teddy bears in white coats and so many more things could be sold in this shops to raise money for the NHS. Patients in a hospital are a captive market and their visitors are semi-captive. The captives get very bored! Why not provide opportunities for these people to spend their money and relieve the boredom while they are in hospital with some retail therapy? For instance, new hospitals should be built with a shopping mall in them and a cinema. A couple of clothes shops would give people something to do and raise money from rent. While we are on the subject of new hospitals, they should be designed with the input of the clinical staff who know how to maximise the flow of patients through the "patient pathway". Hospitals should be built like industrial conveyor belts: patients enter through ED, get stabilised, get fixed in theatre, stabilised again in ITU, recover on the wards and out the exit to social services and the outpatient clinics. New hospitals should be designed to sit on top of HUGE underground multi-story car parks. If shopping centres can do this then so can hospitals. Almost all hospitals are short of parking spaces and most car parks are eye sores. So, try to plan from the beginning to get as many car parking spaces as possible. Estimate how many are needed for staff and visitors - then double it! Also, design a park and ride system so additional parking is available off site. If costa can make money from a coffee shop in an NHS hospital, why isn’t the NHS setting up its own brand of high quality coffee shops in the hospitals and cutting out Costa the middle man? “NHS healthy eating” – NHS branded diet plans or ready meals could be produced in partnership with a supermarket brand. Mixing public heath, profit and the NHS brand. “Good for you and good for the NHS” The NHS could set up hospitals abroad that are for profit institutions that use the NHS structures, or market our services to foreigners that they then pay for. Health tourism is a thing, why not make the most of it? “NHS plus” – the NHS should be a two tier system. Hours of 8am til 6pm should be for elective procedures free at the point of use and free emergency care. Between 6pm and 11pm the hospitals currently only do emergency care, so there is loads of rooms and kit lying about unused. Why not allow hospitals to set up systems where patients can pay for an evening slot in the MRI scanner and cut the queue? Allow surgeons to pay to use the facilities for private procedures in the evenings. Allow physicians to pay to use the outpatients clinics for private work after hours. An “NHS Journal” could publish research and audits conducted within and relevant to the NHS. “NHS pharma” – the NHS buys a huge amount of off patent drugs, why not produce them itself? Set up a drug company that produces off patent medication, these can be given to the NHS at cost price and sold to other healthcare providers for profit. NHS pharma could also work with British universities and researchers to produce new drugs for the British market that would be cheaper than new Drug company drugs because they wouldn’t need huge advertising budgets. There are so many ways the NHS could make more money for itself that could then be used to deliver newer and better treatments. Yes, it is a shift in ideology and culture, but I am sure it would have positive outcomes for the NHS and patients. If you have any ideas on how the NHS could produce more money then please do leave a comment.  
jacob matthews
over 7 years ago
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The Truth About Medical Education: Corrupted Seeds with Far-Reaching Roots – in-Training, the online magazine for medical students

The continuation and progress of the human condition has been founded on the inheritance of knowledge. With each generation, the lessons learnt are passed on as another valuable brick in the pyramid towards the pinnacle of human success. However, just as progress necessitates the study of the phenomenon in question, the educational system itself has become a topic of scrutiny. Having been a student for most of my life and a mentor intermittently (whether as the fearless older sister or a tutor for other students), the architecture of the educational system is something that I have often pondered over. My dual citizenship in two very different cultures has provided me with two strains of the education system — one of Taiwanese, the other American — to juxtapose. No educational system is perfect, and I don’t believe it is possible to create a curriculum that can be “one size fits all.” That being said, as a current medical student, I often talk to past, current, and future medical students and wonder why medical school is so difficult? While the analogy of “drinking from a fire hose” parallels the insane amount of knowledge we must absorb within the given timeline and contributes to the difficulty of medical education, I find it hard to believe that time-pressed content is the sole reason. I believe that the attitudes and expectations already planted in our minds, the curriculum design, and the methods of student evaluation are crucial factors — just to mention a few — that contribute to the hefty weight that we carry as medical students.  
in-training.org
almost 7 years ago