Leadership in intensive care: A review

Abstract

An integrative review of the literature specific to leadership within the intensive care unit was planned to guide future research. Four databases were searched. Study selection was based on predetermined inclusion and exclusion criteria and a quality check was done. Data extraction and synthesis involved developing a preliminary thematic coding framework based on a sample of papers. The coding framework and all selected papers were entered into NVivo software. All papers were then coded to the previously identified themes. Themes were summarised and presented with illustrative quotes highlighting key findings. In total, 1102 relevant quotations were coded across the 28 included papers. Four themes pertaining to leadership were described and analysed: (a) leadership dimensions and discourses; (b) leadership experiences; (c) facilitators and/or barriers to leadership; and (d) leadership outcomes. The literature was found to focus on leader behaviours, as well as the leader dimensions of role allocation, clinical and communication skills and traditional hierarchies. Positive behaviours mentioned included good decision-making, staying calm under pressure and being approachable. Leadership experiences (and outcomes) are typically reported to be positive. Personal individual factors seem the biggest enablers and barriers to leadership within the intensive care unit. Training is considered to be a facilitator of leadership within the intensive care unit. This study highlights the current literature on leadership in intensive care medicine and provides a basis for future research on interventions to improve leadership in the intensive care unit.

Establishing Competencies for Leadership Development for Postgraduate Internal Medicine Residents

“…More specifically, critical skills identified in this study, including collaboration, communication, and feedback, are identified as key competencies within surgical, emergency, and critical care settings. 35,39,40 Similarly, character, emotional, and relational domains of leadership are emphasized both in the aforementioned settings [39][40][41] and within pharmacy 32 and nursing 42 domains. Based on reviews of existing literature, 39,40,43 one area in which The resident demonstrates self-awareness (eg, can identify when leadership skills are not working) b…”

“…35,39,40 Similarly, character, emotional, and relational domains of leadership are emphasized both in the aforementioned settings [39][40][41] and within pharmacy 32 and nursing 42 domains. Based on reviews of existing literature, 39,40,43 one area in which The resident demonstrates self-awareness (eg, can identify when leadership skills are not working) b…”

Leadership during airway management in the intensive care unit: A video-reflexive ethnography study

“…Effective leadership in healthcare is important as it is known to optimize team performance ( 1 – 3 ). This is especially crucial in the complex environment of the intensive care unit (ICU) ( 3 , 4 ). Existing evidence that underpins our understanding of leadership in the ICU is commonly discussed in an individualist fashion, similar to how it is conceptualized in the broader healthcare literature ( 4 ).…”

Association Between Interdisciplinary Collaboration and Leadership Ability in Intensive Care Unit Nurses: A Cross-Sectional Study

“…Leadership is necessary to provide interdisciplinary collaboration and quality care, and good leadership has been shown to improve healthcare provider satisfaction (Kiwanuka et al, 2021). One of the effects of ICU leadership is improving the ability to make appropriate decisions (Brewster et al, 2020). This underscores the importance of leadership in bringing patients, families, and healthcare providers together to make decisions about patient care (Kiwanuka et al, 2021).…”