Leadership, team ethos and board supportGood emergency departments are run by teams that function well and are managed by leaders who understand how to get the most from their staff. These leaders know that if they want change to happen in a high-pressure environment, they need to take their teams with them. This leadership must go all the way up to board level.

Top emergency departments are generally found in NHS trusts where boards listen to staff and understand the problems they are facing. They also know what is required of the leadership team. Rather than leaving the department to run itself and deal with its own challenges, the leadership team will offer support from the top to encourage collaborative working and ensure that all staff in the hospital are contributing to smooth patient flow.

High-performing trusts know not to view an emergency department in isolation but will be able to commission services from the rest of the hospital. This ensures that specialty medicine is on hand, which improves the patient experience.

A good leader builds a strong team and puts an emphasis on teamwork. If staff start working on their own in silos, the system starts to break down. Dr Ros Tolcher believes her management team in Harrogate is very supportive. She says: “There has been a big culture change, with a focus on working collaboratively and meeting the four-hour target as an organisation. There is a much wider focus on the issue of crowding.”

Having leaders with experience in an emergency department is also an advantage. They will be able to see the whole picture and have a clearer knowledge of the requirements. College of Emergency Medicine president Clifford Mann refers to the example of the national accelerated leadership programme, which has several emergency department consultants participating. He says some of those with an appetite for good leadership have stepped up; one has been asked to be medical director and sent by the trust to Harvard Business School. This was a significant investment but the trust will reap rewards by having a senior leader with an emergency-department background.

Dr Ruth Brown, vice-president of the College of Emergency Medicine and also emergency medicine consultant at Imperial College Healthcare NHS Trust, says leadership skills are crucial in this high-pressure, high-risk environment. With the NHS’s current emphasis on outcomes and efficiency, she counts leadership as an increasingly important part of the emergency clinician’s skillset.

She says: “Our clinical leaders must be able to respond to the variation in demand and capacity, support and comply with performance standards, both clinical and operational, and importantly work with the team to maximise the efficient delivery of safe care.

“Developing leadership skills in our trainees is an important part of the curriculum delivery in emergency medicine and relies on consultant presence, supervision and role modelling. Trainees must be able to hone their leadership skills in supervised shifts but also have the chance to reflect on their performance with their consultant supervisors.”

This is just one of the sections from our forthcoming ‘What makes a top hospital?’ report on accident and emergency care which will be published on 9th September. This will be available at http://www.chks.co.uk.Good emergency departments are run by teams that function well and are managed by leaders who understand how to get the most from their staff. These leaders know that if they want change to happen in a high-pressure environment, they need to take their teams with them. This leadership must go all the way up to board level.

Top emergency departments are generally found in NHS trusts where boards listen to staff and understand the problems they are facing. They also know what is required of the leadership team. Rather than leaving the department to run itself and deal with its own challenges, the leadership team will offer support from the top to encourage collaborative working and ensure that all staff in the hospital are contributing to smooth patient flow.

High-performing trusts know not to view an emergency department in isolation but will be able to commission services from the rest of the hospital. This ensures that specialty medicine is on hand, which improves the patient experience.

A good leader builds a strong team and puts an emphasis on teamwork. If staff start working on their own in silos, the system starts to break down. Dr Ros Tolcher believes her management team in Harrogate is very supportive. She says: “There has been a big culture change, with a focus on working collaboratively and meeting the four-hour target as an organisation. There is a much wider focus on the issue of crowding.”

Having leaders with experience in an emergency department is also an advantage. They will be able to see the whole picture and have a clearer knowledge of the requirements. College of Emergency Medicine president Clifford Mann refers to the example of the national accelerated leadership programme, which has several emergency department consultants participating. He says some of those with an appetite for good leadership have stepped up; one has been asked to be medical director and sent by the trust to Harvard Business School. This was a significant investment but the trust will reap rewards by having a senior leader with an emergency-department background.

Dr Ruth Brown, vice-president of the College of Emergency Medicine and also emergency medicine consultant at Imperial College Healthcare NHS Trust, says leadership skills are crucial in this high-pressure, high-risk environment. With the NHS’s current emphasis on outcomes and efficiency, she counts leadership as an increasingly important part of the emergency clinician’s skillset.

She says: “Our clinical leaders must be able to respond to the variation in demand and capacity, support and comply with performance standards, both clinical and operational, and importantly work with the team to maximise the efficient delivery of safe care.

“Developing leadership skills in our trainees is an important part of the curriculum delivery in emergency medicine and relies on consultant presence, supervision and role modelling. Trainees must be able to hone their leadership skills in supervised shifts but also have the chance to reflect on their performance with their consultant supervisors.”

This is just one of the sections from our forthcoming ‘What makes a top hospital?’ report on accident and emergency care which will be published on 9th September. This will be available at http://www.chks.co.uk.Good emergency departments are run by teams that function well and are managed by leaders who understand how to get the most from their staff. 
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