1. Salcido, Richard MD

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My fundamental principles about leadership were forged by 2 major influences in my life-my father and the military-the former, paternalistic, and the latter, authoritarian, and/or a mixture of both. In retrospect, however, those leadership traits were balanced by other characteristics of leadership, such as charisma and leading by example and trust. When combined, these leadership attributes form the core competencies needed to make a leader.

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As I later entered into the world of academia, business, and the clinical arena of wound care, the lines of leadership structures became less rigid and more ambiguous at times. I could see that exceptional qualities, skill, and knowledge were necessary for an individual to succeed in a leadership role.


Through my institution, I recently had the opportunity to attend the Academic Medicine Leadership Program at the Wharton School, University of Pennsylvania, Philadelphia, PA. The enlightening experience expanded and further influenced my notion of leadership. Having said that, I surmise that leadership is one of the hottest topics in any business or health care arena, as well as the common subject of political campaigns and many a PowerPoint presentation.


Defining Leadership

Absent any novel ideas about leadership, I would like to quote a recent article in the Wall Street Journal titled "Putting Ideas to Work."1 This article was not necessarily about leadership but about concepts in which they allude to a management principle known as "knowledge management." My interpretation is that this piece was indeed about leadership-translating ideas into action-basically, organizations can become more competitive and productive by managing knowledge or the "ideas, insights, and expertise that originate in the human mind." The author defines knowledge management as a concerted effort to improve how knowledge is created, delivered, and used. In my view, this concept could also be described as a chain of leadership principles, a series of steps that, when linked together, "take the ideas created by the human hard drive (brain) to applications that work."


In clinical wound care, wound management, knowledge, and leadership in the field of wound care are paramount. The creation of knowledge in our field stems from 2 ends of the spectrum-on one end, there is the clinician at the bedside and on the other end is the research and development of the wound care products we use from the various manufacturers. The knowledge is delivered in a multitude of knowledge dissemination venues available to us through technology, the Internet, journals, and books, as well as through local, regional, national, and international forums. This colossal amount of information needs to be developed, packaged, and provided to the clinician at the bedside. To make that chain of linked events occur, a tremendous amount of effective leadership is required. Thus, the leadership process guides the creation of ideas that optimally helps patients. Leaders in wound care must possess any or all of the leadership traits mentioned, including tact and diplomacy.


Leading by Example

Two professionals who display exemplary leadership in our particular field are R. Gary Sibbald, BSc, MD, FRCPC, FAPWCA, MEd, and Elizabeth A. Ayello, RN, APRN,BC, PhD, FAAN, FAPWCA. They have been on an indefatigable quest for knowledge management in the global wound care knowledge-management arenas. They are essentially creating knowledge, delivering it, and facilitating the use of it for patient care throughout the world. They are doing this through their leadership of the Third Congress of the World Union of Wound Healing Societies (WUWHS) meeting, June 4-8, 2008, in Toronto, Ontario, Canada. Dr Sibbald serves as Congress chair and president-elect of the WUWHS, and Dr Ayello is co-chair of the Congress. Through their actions, they not only possess the attributes of leaders in our field, but also exemplify the meaning of the term leadership. The combined efforts of Drs Sibbald and Ayello have allowed them to lead, create, deliver, and provide information for wound care practitioners worldwide. I asked each of them what motivated their participation in the Congress.


Dr Ayello's comments: "Education changes lives. That is what my dad always said to me and it has been a guiding principle for me in my professional career. As a wound, ostomy, and continence nurse, educating patients, families, and colleagues was an important part of my daily practice. When Dr Sibbald called to ask me if I would be able to work with him as one of the co-chairs, along with Heather L. Orsted, RN, BN, ET, MSc, on the Third Congress of the WUWHS, it was a dream come true. Imagine the possibility of learning from others around the world, while sharing my own knowledge. The opportunity to be part of a global initiative where the wound care community could critique the evidence basis of our practice and speak in one voice about the common wound problems we all share was something special. Being part of the WUWHS collaborative team with Dr Sibbald as the leader has been an amazing journey. I have traveled to several continents to meet members of hosting and supporting societies, as well as visited wound care clinics and toured in patient hospital units. It is inspiring to see and learn from the knowledge, commitment, and dedication of all who are wound healers worldwide."


Dr Sibbald's comments: "Evidence-informed practice can change outcomes for wound patients globally. We have focused on providing succinct summaries of the evidence for the major conference streams that readily can be used by clinicians. Delegates will have the opportunity to benefit from the latest wound care evidence. From more than 1200 submitted abstracts, 800 will be posters, and about 150 will be oral presentations. On June 4, we will launch WoundPedia, a 'just-in-time' ongoing compilation of the latest wound care knowledge. Our commitment to making a difference for patients suffering the consequences of chronic wounds worldwide will extend well beyond the June meeting. We need to combine the best available scientific knowledge with expert knowledge and patient-centered care to improve the lives of people with chronic wounds worldwide ('One Problem-One Voice' is the theme for the WUWHS Congress). Each local wound care professional can use this just-in-time tool kit to translate current information for the best possible patient and health care system outcomes in his or her particular wound care setting."


The Future of Wound Care

The field of wound care needs leaders along the knowledge-management continuum. We need thinkers, creators of new knowledge, and thought and content leaders that disseminate the information for the acquisition of new knowledge benefiting clinicians. The leaders of today are out in front, utilizing all of the time-honored principles of leadership as they inspire the wound care leaders of tomorrow-all of you. You will lead by creating and delivering regional, national, and now global advances in the wound care field, both at the point of service and at the education and research levels. Thus, we are creating an environment of optimal outcomes for our patients.


Richard "Sal" Salcido, MD

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1. Davenport TH, Prusak L, Strong B. Putting ideas to work: knowledge management can make a difference-but it needs to be more pragmatic. Wall Street Journal, March 10, 2008:R11. [Context Link]