ICU Management & Practice, ICU Volume 7 - Issue 4 - Winter 2007/2008

Applied Leadership Skills for Intensive Care Professionals

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Sylvia Schwarz, MD

Professor of

Anaesthesiology Department of Anaesthesia & Intensive Care

Hospital Hietzing, Vienna, Austria


Robert D. Fitzgerald, MD, PhD (Hon)

Associate Professor

Karl Landsteiner Institute for Anaesthesiology and Intensive Care

Vienna, Austria

[email protected]


Michaela Suske, MSc

Research Assistant

Karl Landsteiner Institute for Anaesthesiology and Intensive Care Medicine

Vienna, Austria

Physicians complete years of medical training to learn how to care for patients. However, especially in intensive care medicine, medical knowledge provides only limited help when these physicians enter their first management position. Suddenly they find themselves faced with the difficulties of leading an interdisciplinary team, coping with highly emotional situations with patients and relatives and challenged by sometimes stressful collaborations with other specialties. While an increasing number of physicians attend management courses, the emphasis of these is usually more on business theories and the presentation of management tools, than on the training of practical skills.


What are Practical Leadership Skills?

The basis of practical leadership skills is a combination of personal resources, social competencies and management tools. Main issues connected to personal resources are awareness of one’s role as a leader and self-management aptitude. Social competencies include communication skills, ability to solve problems in interpersonal contacts and the capability to manage conflict. Management tools important for daily work are human resource development, organisational development, time management, process skills and results-oriented work structuring.



To meet this need, the Karl Landsteiner Institute for Anaesthesiology and Intensive Care developed an applied course, focussing on practical leadership skills and management tools relevant for intensive care unit (ICU) professionals. The main goal of the course was to make top executives´ factors of success accessible to ICU professionals. To accomplish this goal, training focused on defining personal strengths and potential for development as a leader, acquiring tools for effective and efficient structuring of daily leadership work (process competence) and increasing competence to intervene in case of tension or conflicts, in addition to learning how to develop guidelines for successful teamwork.


Focus was set on the importance of self-development, interpersonal skills and the ability to get along with others. To supply a spectrum of solutions to problems that are beyond the range of the intensivist, top economic and healthcare executives were invited to informal evening discussions called fire-side rounds. These meetings provided an insight into the daily work of other managers and supplied incentives for enhancing one’s own work. A variety of teaching methods provided an interactive learning environment and dispensed suitable teamwork tools.



The course was structured in five parts—with two-day training sessions held over a period of six months. Between sessions, peer group meet ings and individual coaching sessions were organised to guarantee long term results. In each course, emphasis was placed on a differing approach to leadership: personality, active creation of leadership, teambuilding, staff support and communication. The layout of the course was designed to allow for a small group of participants to concentrate on personal development and training issues.



The Society of Medical Doctors of Lower Austria supports this course, accrediting it with the highest possible number of points achievable in the educational program. 88% of the participants filled out the standardised evaluation questionnaire from the Section of Continuous Education of the Society of Medical Doctors of Lower Austria. The evaluation showed that training not only met expectations of participants, but a high percentage (96%) commented on its high practical relevance for their daily work. All participants attested that the main goals of the course were reached. Participants also valued the level of the courses’ trainers – awarding them high marks in terms of didactics, rhetoric and medical knowledge.



With increasing management responsibilities, intensivists have a deficit of practical management skills, often neglected in management training. A specialised management training course for ICU professionals was well accepted and highly evaluated as helpful for fulfilling the tasks required from intensivists in management positions. Development of such management-centred courses, specifically designed to meet the needs of ICU professionals, may be an important step for other medical institutions to begin to overcome this deficiency in leadership and interpersonal skills and key to the successful management of ICUs in the coming decades.

Authors<br> Sylvia Schwarz, MD Professor of Anaesthesiology Department of Anaesthesia &amp; Intensive Care Hospital Hietzing, Vienna, Austria &nb

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