Physician parents experience challenges during their transition to parenthood and their return to work. We expanded a Parental Wellness Programme (PWP) to Department of Medicine faculty physicians and evaluated its impact on physician well-being. The programme supported new physician parents through peer mentorship and financial resources. Through internal marketing, expectant and new parent faculty were encouraged to self-enrol and were supported until 12 months following the child's birth (up to an 18-month period). Participants enrolled between October 2021 and September 2022. The programme included a US$500 feeding/lactation reimbursement and pairing with a parental wellness advocate (PWA), a physician with parenting experience. Anonymised participant surveys were voluntary and conducted at programme entry, and at 6 months and 12 months following the child's birth to assess return-to-work experience, lactation, burnout and programme impact. A final feedback survey was sent after all participants completed the programme. The programme supported 67 participants (82% women). 53 participants responded to the baseline survey, of whom 85% were junior faculty/early career. At baseline, 85% of respondents planned to breastfeed; 88% at 12 months (n=25) reported breastfeeding. Participants indicated a desire for connection, support and resources at baseline; follow-up surveys confirmed that the programme provided these supports. By 12 months, 76% received individualised PWA support, 88% used the feeding/lactation reimbursement and 92% self-reported improved well-being on return to work. All respondents indicated they would recommend the programme to colleagues. Participant comments highlighted challenges with parental leave coverage, and time and space for lactation. We demonstrated the scalability of a novel PWP that successfully supported early career and junior faculty during a difficult transition period. Feedback indicated ongoing system-based challenges and a need for institutional culture change.

The health sector contributes 8.5% of US greenhouse gas (GHG) emissions and 4.4% of global GHG emissions. Health professionals are in a powerful position to advance mitigation and adaptation climate solutions, yet there is weak consensus about allaying concern and encouraging optimism and motivation in the research. In reviewing Climate and Health Tool (CHANT) data (2020-2024), authors explored these questions: (1) How are concern, optimism and motivation to act on climate change related? (2) What do respondents report motivates and demotivates action on climate and health? (3) How does concern and optimism relate to motivating and demotivating climate action? 6823 health professionals responded to the tool. Females (84%), non-US respondents (8%) and late-career nurses were most concerned about climate change. Nurses and females were most motivated to act. Optimism about prevention and preparation was higher among nurses-particularly late-career nurses. Most frequently identified motivators were 'clean air and water' (78%), 'the future' (75%) and 'health impacts' (73%). Most frequent demotivators included 'I don't know what to do' (37%), 'I am overwhelmed' (37%) and 'It is too complex' (34%). Results of the CHANT indicate health professionals are concerned and motivated-yet not optimistic. Amplifying motivating messaging, educating and simplifying climate mitigation or adaptation activities may encourage action among health professionals regardless of optimism.Leaders have opportunities to harness health professionals' motivation to act on climate change in the interest of health. By leveraging motivators and decreasing barriers, health leaders might inspire further climate action across health professions.

The relationship between the natural environment and health outcomes has garnered significant attention in recent years. However, few studies have explored whether the benefit of nature visibility can be translated into measurable clinical outcomes in inpatient settings, such as length of stay. This retrospective observational study investigated the impact of nature visibility from the patient's window on length of stay. Patients were sampled from two intermediate care units in Sussex, and the nature visibility from their window was classified into three predefined categories. A generalised linear model was used to analyse length of stay, while controlling for potential confounding factors. The final analysis included 459 patients. Nature visibility was a significant predictor (p=0.016) of an inpatient length of stay. However, seasonality (p=0.438) did not impact the effect of nature visibility on length of stay. Hospital location (p=0.020) and discharge age (p<0.001) had a significant impact, but sex (p=0.940), room type (p=0.619) and window view restrictions (p=0.756) did not have a significant impact on length of stay. The results demonstrated an ~8.7% decrease in length of stay for every increase in nature visibility category, regardless of the season. The study findings emphasise the value of non-pharmaceutical interventions in patient recovery and contribute to the idea of patient-centred care.

This article challenges the dominance of multidisciplinary and often generic leadership development programmes in healthcare. Drawing on nearly a decade of experience with the Executive Masters in Medical Leadership (EMML) at Bayes Business School-a physician-only programme-we argue that profession-specific education is not just preferable but essential. This paper reflects on our experience designing and delivering the EMML, combined with a review of evidence on physician personality traits, professional responsibilities, and the historical development of generic management education. We examine the theoretical and practical case for tailored leadership development that recognises professional differences. Physicians possess distinct personality traits, undergo uniquely extensive training, carry exceptional legal and professional responsibilities, and operate within a fundamentally different professional culture than other healthcare workers or general managers. We do not believe that this is adequately recognised in the National Health Service. Our experience and EMML learning outcomes data demonstrate that physician-only programmes create psychological safety, build lasting professional networks, and deliver learning outcomes that generic, multidisciplinary courses are unlikely to replicate. Professional differences demand profession-specific education. The NHS champions diversity in race, gender and background. It is time to recognise cognitive, professional and situational diversity with equal vigour.

The researcher aims to analyse the concept of nursing followership to identify its defining attributes, antecedents and consequences, as well as to explore its relevance and impact on clinical settings. This concept analysis was conducted using Walker and Avant's (2005) analysis framework. PubMed, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsycINFO databases searches were carried out from 1980 to 2025. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines were used. Effective followership is defined as a role wherein nurses are actively engaged in care processes, capable of having advanced critical thinking and decision-making skills and proficiently communicative with their colleagues and team leaders alike for the purposes of eventually facilitating the achievement of the team goals and objectives. Nursing followership key attributes are active engagement, independent critical thinking, effective communication, adaptability and commitment to shared goals. The organisational culture, leadership styles, role clarity, recognition and reward systems, communication channels and training and development opportunities are the antecedents of nursing followership. The consequences of nursing followership include improved team dynamics, increased job satisfaction and enhanced patient care and professional development. These consequences also extend to strengthening organisational commitment and resilience in the nursing workforce. Nursing followership plays a crucial role in promoting teamwork, professional empowerment and achieving better patient care outcomes. It is therefore essential to incorporate followership into nursing education and practice, and to implement strategies that eventually support the development of effective followership competencies on behalf of nurses.

Climate change is an escalating public health emergency, yet within the National Health Service (NHS) it remains marginal to board-level leadership and governance. Despite its direct implications for population health, service resilience and health inequalities, responsibility for climate action is often delegated away from strategic decision-making forums. This article draws on the author's experience as the NeXt Director (Non-Executive Director in Training) with a remit for future generations, including climate change and sustainability, on a newly established Integrated Care Board in England. Using a reflective leadership lens, the article examines how climate change was reframed from a peripheral sustainability issue into a core governance and risk concern. Practical strategies included embedding climate-related threats into formal risk registers, aligning climate action with population health and inequality priorities and integrating climate considerations into existing strategic and operational levers. Positioning climate risk within established governance structures shifted board-level engagement, normalised climate-informed questioning in strategic discussions and enabled early integration of climate considerations into population health, commissioning and resilience planning. These changes established climate change as a shared leadership responsibility rather than a siloed agenda. The article argues that NHS leadership models must evolve to address long-term, systemic risks such as climate change. Boards should treat climate change as a determinant of quality, safety and equity, embedding it within risk management, strategy and accountability frameworks to ensure system preparedness in an increasingly unstable climate.

To identify contemporary leadership and governance approaches used to drive environmentally sustainable healthcare in high-income countries, such as Australia at the macro (governmental), meso (organisational) and micro (individual) levels. A rapid scoping review of peer-reviewed and grey literature published between 1 January 2018 and 26 July 2024 was conducted based on Population Concept Context methodology. Key themes were identified using qualitative content analysis and inductive thematic analysis, and findings were presented in a multi-level, systems thinking framework. 81 articles were included. Leadership and governance approaches found to be present across all levels were collaboration, education and advocacy. In addition, at the macro and meso levels, the need for financial investment, decarbonisation roadmaps, ambitious emissions reductions targets and delivery of sustainable models of care was evident. At the micro level, healthcare providers taking on the role of sustainability champions and communicating the health risks of climate change to increase receptiveness to climate messages was important. At the macro level, there was a greater focus on policies, while the meso level focused on organisational influence to drive decarbonisation. Australian and global healthcare systems alike require strong leadership and governance across multiple scales to rapidly transition to environmentally sustainable healthcare systems. To achieve this transition, key contemporary leadership and governance approaches crossing all levels from healthcare providers to healthcare organisations and governments were found to be (1) collaboration within the healthcare sector and externally, (2) education of the healthcare workforce and community about the health impacts of climate change, and (3) advocacy for transitioning to environmentally sustainable healthcare.

Healthcare professionals play a vital role in addressing planetary health; however, their proenvironmental behaviour (PEB) remains underexplored, particularly in Pakistan. The study aimed to assess healthcare professionals' knowledge and attitudes regarding planetary health and the new ecological paradigm (NEP) and to determine the PEB of healthcare professionals. The cross-sectional study was conducted in Rawalpindi and Islamabad, Pakistan, from July to November 2024. A total of 307 healthcare professionals filled out a structured questionnaire. Spearman's correlation was used to assess the relationship between knowledge of planetary health and the NEP, as well as PEB. The mean age of participants was 40±11.4 years. Regarding knowledge, 238 (77.5%) of participants agreed that environmental problems have a direct impact on human health. The majority, 283 (92.2%), expressed their concern about climate change. Most respondents recognised the limits to Earth's resources (268; 87.3%), agreed that humans are abusing the environment (260; 84.7%) and expressed concern about ecological crises (280; 91.3%). Almost 85% (261 respondents) thought that encouraging sustainable healthcare practices is necessary for both present and future generations. PEBs included frequent recycling, conserving water and educating others about environmental impacts, as mentioned by 249 (81.1%) respondents. A highly significant, positive correlation was observed between participants' endorsement of the NEP and their PEB, specifically in 'day-to-day activities' (correlation coefficient=0.47, p value<0.001), as well as between NEP and attitude (correlation coefficient=0.45, p value<0.001). Knowledge about planetary health and the NEP has a positive influence on environmental attitudes and PEBs. Similarly, environmental attitudes have a positive impact on PEBs.

This study quantified the energy consumption of radiology reporting stations, identified inefficiencies and explored power management strategies to reduce energy waste and negative environmental impact. The energy consumption of our reporting stations was monitored over 3 months in three operational states: active, standby and off modes. Three scenarios were analysed: (1) current conditions where workstations enter standby after 20 min and remain in standby overnight (baseline scenario), (2) reduced standby activation period of 5 min and (3) complete power-down of workstations overnight. The most environmentally friendly scenario was assessed both in terms of energy consumption and carbon footprint. The baseline scenario resulted in an annual energy consumption of 55 750 kWh and a carbon footprint of 75.6 tons of CO2. Reducing the standby activation period (scenario 2) led to a minor decrease in consumption (55 349 kWh) and emissions (75.1 tons of CO2). The most effective strategy (scenario 3) involving powering down workstations overnight reduced annual energy consumption to 37 602 kWh (by 32.5%) and lowered carbon emissions to 51.0 tons of CO2. Implementing automated power-down protocols during non-working hours can reduce the overall energy consumption and environmental impact of the department. These findings support integrating sustainable power management strategies across healthcare facilities.

Preventing patient harm is a core ethical responsibility in healthcare. While support for patients and families after adverse events has improved, formal support for clinicians involved in serious medical errors, referred to in the USA as 'caregivers' remains inconsistent. This study reports the qualitative findings from a mixed-methods US study exploring healthcare leaders' perspectives on medical errors and caregiver support. The quantitative phase (n=81) found that only 64% of organisations had a caregiver-support programme and over one-third of leaders could not confirm such support existed. These results informed 19 in-depth interviews analysed thematically to identify perceived barriers and enablers to support. Healthcare leaders who participated in the quantitative phase were recruited for semistructured interviews. Transcripts were coded independently by multiple researchers and synthesised through iterative consensus using thematic analysis. Five themes emerged: (1) impact of leadership, (2) embedded in the culture, (3) supportive response, (4) utilisation of existing infrastructure and (5) self-imposed barriers. Leadership engagement, organisational culture and stigma were central in shaping caregiver recovery after medical error. Findings highlight the need for a 'compassionate just culture', defined here as an organisational approach that integrates accountability, empathy and restorative practices to support all parties after harm events. Quantitative and qualitative insights underscore the urgent need for trauma-responsive, co-designed caregiver support systems that address both individual and structural contributors to distress. Healthcare leaders play a pivotal role in ensuring compassionate, non-punitive support following medical errors. Strengthening these systems can enhance workforce well-being, organisational trust and patient safety.