Grace under pressure: Leadership in emergency medicine

Abstract

Physicians in general, including emergency physicians (EPs), are trained in the diagnostic, therapeutic, and administrative aspects of patient care but not so much in the theoretical and practical aspects of assuming and delivery of leadership. EPs are always taught to focus on their performance, to excel and achieve, to be accountable for their own clinical decisions, and to appreciate feedback and peer-to-peer review. Currently, if there are some semblances of formal or semi-formal leadership instruction, the organized theoretical curriculum often does not formally include very structured and planned departmental leadership and management elements. Leadership is a process for a person (“the leader”) to lead, influence, and engage a group or organization to accomplish their objectives and mission. To do this, the leader must understand a variety of issues of working, interacting, and integrating with people, the environment and both, the intrinsic and extrinsic factors, and elements that have an impact on the industry or area he/she is leading in. Leadership in emergency medicine (EM) is even more challenging, with its unique focus, issues, and trajectory, moving into the new century, with new considerations. No single strategy is sufficient to ace EM leadership and no single specific leadership model is complete. This paper shares some current views on medical/EM leadership. The author shares her views and some suggested proposals for more formal and structured leadership, implementation, and succession to help nurture and groom Eps who will become leaders in EM in the near future.

The Need for Purposeful Teaching, Learning and Assessment of Crisis Resource Management Principles and Practices in the Undergraduate Pre-Hospital Emergency Care Curriculum: A Narrative Literature Review

“…The need for strong leadership has been identified, encouraged and codified across virtually all disciplines, including EMS (45).…”

Emergency department registrar transformation: It is not all about the medicine

“…Good medicine has no place for egos . Being able to recognise your own limitations and having avenues to call for help is essential no matter who you are.…”

“…Good medicine has no place for egos. 3 Being able to recognise your own limitations and having avenues to call for help is essential no matter who you are. This can be infinitely more difficult outside the comfort of a department that you are familiar with.…”

STOP5: a hot debrief model for resuscitation cases in the emergency department

“…5 Leading a safe and healthy ED team requires the delivery of timely and effective peer support after particularly difficult or distressing clinical cases. 6 The term 'moral injury' has been used to describe the resultant mental health difficulties of war veterans and is increasingly applied to psychological trauma presenting in frontline emergency and health services staff. 7 In preventing this, there is emphasis on fostering a safe clinical environment for all staff and patients whilst simultaneously supporting the development and specific needs of individual team members.…”

“…11,12 Team debriefing is a consistently positive theme that features highly in systems improvement, team interactions and patient safety literature. 5,6,8,9 The 2013 white paper "Safety II" recommends a change in emphasis, suggesting we should examine more closely the many cases where thing go right and try to truly understand why, rather than focussing on the few cases when things go wrong. 13 Accordingly, the greatest gains in ED systems improvement may be determined by examining the routine daily work of an ED team, rather than studying extreme or exceptional events.…”