Leadership And Evidence-Based Medicine

Successful organizations need leaders at every level, whether be CEO of a Fortune 500 company, coach of a NFL team, or manager of a local supermarket. Effective leadership builds confidence amongst the participants of an organization, in addition to acting as the catalyst for the aspects of the organization to work in tandem. Fortunately, being a leader does not require a certain title or degree. Leadership is an “attitude, not a position” (Grant et al. IHI, 2017). A leader is one who “creates conditions that enable and encourage others to achieve a shared goal through collective action” (Bohmer, 2013). Therefore, everyone can be a leader in a distinct way.
Often we become like those around us. The people we surround ourselves with either
Bohmer believes clinicians leading local systems have four key tasks, one of which is to improve performance. (Bohmer, 2013). Often time workers are content with how things are currently and do not consider the question “What can we do to get even better results?” This is especially true with physicians who are only involved in direct patient care and make most of their decisions off evidence-based medicine due to the fact that their decisions directly influence health outcomes. Engaging in medicine that does not have strong evidence backing it rather than evidence-based medicine may result in better outcomes but also risk the chance of failure and lawsuits. Therefore, this is a path most physicians are too risk averse to take. Clinical leaders must have the courage to explore beyond accepted boundaries “despite colleagues’ preferences for stability and familiarity.” An example of such a leader is found in Atul Gawande’s 2007 article from The New Yorker. Despite his colleagues’ insistence they knew how to prevent line infections, Dr. Pronovost made a checklist which he distributed to nurses (Gawande 2007). Nurses found physicians skipped at least one step more than a third of the time. This checklist was able to lower the line infection rate in the hospital from 11%, which physicians were content
Therefore, people in traditional leadership roles are not always the best since they are often disconnected from patients and patient interaction. Due to their long hours and the nature of their work, residents are often closest to the problems. Also because they seek to advance their career and changes to the future affect them the most, they are the most eager to “provide brilliant solutions if empowered.” Hence residents, despite their relative inexperience, can serve in leadership roles effectively. An example of this is Dr. Kamran Hamid, who while a resident was called into the office of the chair of orthopedic surgery to discuss long wait times in the ER (Hamid, 2013). When she presented solutions to the issues at hand, the Chair gave her control of the redesign project to fix the issues discussed. Dr. Hamid states that due to their dedication to the hospital, residents knew where the inefficiencies of the hospital lay, but because of their low position in the hospital chain of command, they need empowerment, like given to her by the Chair, to try to fix the