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International Palliative Care Leadership Development Initiative

Purpose

The International Palliative Care Leadership Development Initiative (LDI) was developed to advance the understanding and practice of palliative care around the world. Palliative Care has been proven to be the best way to care for patients and their families when faced with any diagnosis of serious, advancing illness. This approach to care has been shown to relieve distressing symptoms such as pain, severe nausea, delirium, etc., and may actually prolong life. In low and moderate-resource countries around the world, where patients frequently present late to their healthcare systems with advanced diseases, palliative care is frequently the most appropriate therapeutic approach. Typically, the available palliative medicine consultants lack the leadership skills to advocate effectively for local, national and international changes in policy, opioid availability, education, the availability of palliative care services, and to ensure funding and sustainability.

LDI identified emerging palliative care leaders in low and moderate resource countries who were well positioned to apply leadership skills and advance palliative care in their organizations, communities, regions, and globally. Through this structured multidimensional educational initiative, physicians who participated in LDI learned to lead, teach, and model leadership skills to colleagues in their communities and regions. Significant personal and professional leadership growth of each leader resulted in advancements and expansion of palliative care delivery.

Numerous organizations, including the Open Society Foundations, World Health Organization, Center for Global Health at the U.S. National Cancer Institute, The Diana, Princess of Wales Foundation, the International Association for Hospice and Palliative Care, the National Hospice and Palliative Care Organization, the Atlantic Philanthropies, and many others continue to work around the world to ensure that the benefits of palliative care are available to those who need them.

Your Leadership Development Initiative

In the pages that follow, we will describe a comprehensive multi-modal leadership development curriculum that was delivered to two cohorts of international physician leaders from 2010 – 2014. Many of the rich resources available to the LDI participants may not be available in your context, however, the on-line curriculum including the Overview, Objectives, Important Teaching Points and References are available for each session. In addition, the PowerPoint presentations (with embedded audio when available) for all 3 Residential Courses are readily accessible. We will tell you how this Initiative unfolded for us, and offer a recommended curriculum with annotated resources. You are encouraged to adapt the curriculum and delivery techniques as you see fit, so you can also:

  1. Increase leadership capacity in a variety of settings (organization, region, country, etc.)
  2. Support any person who is positioned to become a leader, or advance leadership skills already present
  3. Create a network of skilled palliative care leaders
  4. Link leaders to existing international resource centers and programs
  5. Establish a sustainable approach to palliative care leadership development that can be catalytic, transferable and replicated across disciplines

Leadership Development Initiative Overview 2010 - 2014

LDI Curriculum

For each Cohort, the 2-year LDI Curriculum includes:

  • Advance preparation prior to the each Residential Course
  • 3 week-long Residential Courses (RC)
  • A foundational Individual Development Plan (IDP) developed by each participant
  • Mentorship and coaching by senior global palliative care leaders and the LDI Team
  • Ongoing reading and reflection exercises
  • Consultative site visits by mentors or coaches
  • Development of personal webpages that highlight each participant’s accomplishments
  • Publication of personal stories

Advance Preparation

As leadership development is very personal, prior to the first Residential Course each Leader completes a number of assessments to set the stage for understanding her/his personal, organizational and national situation.

The advance preparation for the first Residential Course (RC1) includes completion of:

  • Myers-Briggs Type Inventory
  • Leadership Practices Inventory (The Leadership Challenge®) www.lpionline.com
  • Leadership Skills Inventory
  • Leadership Attitudes Inventory
  • Situation Analysis (country and organization)
  • IDP (first draft)

In advance of the second Residential Course (RC2), leaders complete:

  • Kraybill Conflict Style Inventory®
  • Learning Styles Inventory (Kolb)

In advance of the third Residential Course (RC3), leaders complete:

  • Personal Leadership Story (draft)

Residential Courses

Over the 2 years of the LDI Curriculum, Leaders, Mentors, Coaches and the LDI team come together for 3 weeklong Residential Courses (RC). Faculty was most often drawn from the LDI Team, Coaches and Mentors. Expert guest faculty was included in each RC to present specific enriching content.
The Residential Courses are intense and highly interactive experiences. Planned emphasis and repetition of key leadership content and skills practice was included in every RC. Additionally, specific ‘through-themes’ in each Residential Course provided structure and guidance to build complex leadership concepts and outputs.

The RCs were spaced over the 2 years; RC1 at the beginning, RC3 near the end, and RC2 in the middle.

ThemeStructured Skill-Building Exercise
RC1 Developing self as a Leader Finalize Individual Development Plan
RC2 Developing your team, activities and organization Strategic and business planning
RC3 Leading beyond your organization Strategic message planning

Core Skills

  • Leadership Frameworks
  • Self-Awareness / Role Awareness
  • Presentation and Feedback Skills
  • Team Development
  • Situation Analysis / Needs Assessment
  • Advocacy and Social Change
  • Developing an Individual Development Plan
  • Personal Impact (Circle of Influence and Concern)
  • Facilitation Skills
  • Organizational Development
  • Implementation Planning
  • Change Management
  • Conflict Resolution
  • Leader as Educator
  • Media Relations
  • Developing Others (mentee and mentor skills)
  • Strategic and Business Planning
  • Fundraising
  • Outcome Measurement
  • Data collection
  • Capacity building
  • Influencing / Persuasion / Strategic Messaging

Individual Development Plan

Fundamental to LDI is the opportunity for Leaders to practice and further develop their newly acquired personal and leadership skills in one or more practical projects to build palliative care capacity in their home settings. Within their Individual Development Plans, each Leader articulates a 2-year plan that uniquely captures the leadership challenges and opportunities in her/his home setting. Each Individual Development Plan includes: personal leadership skills development, one or more palliative care activities, and the management of the resources needed to implement their activities (including budget and expense reporting). During the first Residential Course, each Leader finalizes her/his Individual Development Plan in collaboration with an assigned Mentor and Coach. During subsequent Residential Courses, Individual Development Plans are reviewed and revised as appropriate for the changing environment in which the Leader is working.

Mentorship / Coaching

To foster personal and leadership skill development and assist Leaders to develop their palliative care projects, senior palliative care leaders from around the globe with demonstrated leadership skills were selected to be Mentors and/or Coaches for the Leaders in collaboration with the LDI Team. Additional coaches were selected for their specialized skills, e.g., presentation, mentorship and editing skills. All of the Leaders, Mentors, Coaches and the LDI Team met at all 3 Residential Courses. In between Residential Courses, there are frequent email, phone and Skype interactions, to share ideas, discuss new concepts and skills, foster relationships, build community and help the Leaders be more effective in their current and future leadership activities. Individual Development Plan goals and milestones are reviewed regularly and progress documented. We have observed that ongoing communication between the Leaders, Mentors and Coaches is a high value in the LDI community.

Reading / Reflecting Exercises, Resources

In between Residential Courses, Leaders are provided with ongoing readings, webinars and reflective exercises. These reflective exercises challenge the Leaders in a personal way to further develop their personal and leadership skills, reinforce concepts covered during the Residential Courses, stimulate discussion and reflection, and foster networking and relationship development within the LDI Community. They are drawn from a number of key leadership resources that have been assimilated by the LDI Team and participants, and are posted at http://www.ipcrc.net/who-program-leadership.php.

Consultative Site Visits

Within the first 6-18 months of the program, Leaders organize a site visit so their Mentor will meet the Leader’s colleagues and supervisors, and better understand the Leader’s working situation. These site visits also provide more time for mentorship/coaching, opportunities for education of colleagues in partnership with the Leader, and stimulate and enhance the Leader’s projects. The Leaders and Mentors all report that these site visits have had a high impact for everyone involved.

Web Presence / Press Releases / Personal Stories

At the outset of the program, to give them a web presence, the Leaders and Mentors create personal webpages that they are encouraged to update regularly. At each Residential Course they are provided with press releases they can customize and disseminate to local media. Throughout the program, Leaders write a private journal about their discoveries and personal developments. As a final project, each Leader writes her/his personal ‘leadership story’ for publication online. The LDI Team anticipates that these stories will serve as models for many others who aspire to be leaders in palliative care, or other healthcare disciplines.

Other Activities

Throughout the 2-year program, Leaders are encouraged to share their newly acquired leadership exercises and skills with colleagues and participate in local, national and international palliative care associations and activities to broaden their networks of relationships and influence, and practice their presentation and leadership skills. The LDI Leaders and Mentors use this sustainable leadership development curriculum, choosing the components that best fit the educational needs in their environment. All participants were provided with the entire curriculum, worksheets, guidelines, exercises, small group activities and interactive outlines on USB sticks.

Evaluation

In addition to self-assessments, the Leaders, Mentors, and the LDI Team have evaluated all aspects of LDI at baseline, prior and during Residential Courses, and at the completion of each Cohort. Leaders have committed to complete annual evaluations for at least three years after their graduation. This data is being used to capture experiences and accomplishments, rate effectiveness and provide feedback to strengthen all aspects of the Initiative.

Achievements

Already the graduates from Cohorts 1 and 2 are demonstrating that they are the next generation of local, national, and global palliative care leaders through:

  • Significant increases in the numbers of patients and families receiving palliative care
  • Changes in national cancer and palliative care policy
  • Increases in opioid availability
  • New undergraduate and postgraduate medical and other curricula
  • New palliative medicine university departments and research initiatives

In June 2013, about one-half of the Leaders presented their accomplishments at the European Association for Palliative Care Congress in Prague, Czech Republic; three were on the organizing committee; one co-chaired the Congress.

Read the Leaders and Mentors biosketches and personal stories, including their evolving accomplishments, at http://www.ipcrc.net/news/category/international-leaders/

In Conclusion . . .

The hope of the funders and of the LDI Team is to advance palliative care globally; in low, moderate, and well-resourced countries. Critical skills are needed to lead, educate, model, envision, communicate, strategically plan and deliver a more holistic patient-centered model of health care than currently exists for the majority of the world. We offer this model curriculum in the hopes that you will choose aspects that fit your needs, which will be adapted for your context and challenges.

For any questions, or if we may ever be of help, please contact:

Frank D. Ferris, MD, FAAHPM, FAACE
Executive Director, Palliative Medicine, Research & Education
OhioHealth, Columbus, Ohio
Frank.Ferris@OhioHealth.com
1-888-389-6231 or +1-614-533-6299

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Page Last Modified: Fri Apr 24 2015