Workplace-based clinical leadership training increases willingness to lead

2015 ◽  
Vol 28 (2) ◽  
pp. 100-118 ◽  
Author(s):  
Aleece MacPhail ◽  
Carmel Young ◽  
Joseph Elias Ibrahim
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Leadership Training ◽  
Low Cost ◽  
Leadership Role ◽  
Leadership Roles ◽  
Senior Executive ◽  
Clinical Leadership ◽  
Content Type

Purpose – The purpose of this paper is to reflect upon a workplace-based, interdisciplinary clinical leadership training programme (CLP) to increase willingness to take on leadership roles in a large regional health-care centre in Victoria, Australia. Strengthening the leadership capacity of clinical staff is an advocated strategy for improving patient safety and quality of care. An interdisciplinary approach to leadership is increasingly emphasised in the literature; however, externally sourced training programmes are expensive and tend to target a single discipline. Design/methodology/approach – Appraisal of the first two years of CLP using multiple sourced feedback. A structured survey questionnaire with closed-ended questions graded using a five-point Likert scale was completed by participants of the 2012 programme. Participants from the 2011 programme were followed up for 18 months after completion of the programme to identify the uptake of new leadership roles. A reflective session was also completed by a senior executive staff that supported the implementation of the programme. Findings – Workplace-based CLP is a low-cost and multidisciplinary alternative to externally sourced leadership courses. The CLP significantly increased willingness to take on leadership roles. Most participants (93 per cent) reported that they were more willing to take on a leadership role within their team. Fewer were willing to lead at the level of department (79 per cent) or organisation (64 per cent). Five of the 11 participants from the 2011 programme had taken on a new leadership role 18 months later. Senior executive feedback was positive especially around the engagement and building of staff confidence. They considered that the CLP had sufficient merit to support continuation for at least another two years. Originality/value – Integrating health-care professionals into formal and informal leadership roles is essential to implement organisational change as part of the drive to improve the safety and quality of care for patients and service users. This is the first interdisciplinary, workplace-based leadership programme to be described in the literature, and demonstrates that it is possible to deliver low-cost, sustainable and productive training that increases the willingness to take on leadership roles.

Patient satisfaction with the quality of care in Ghana’s health-care institutions

2019 ◽  
Vol 13 (2) ◽  
pp. 160-170 ◽  
Author(s):  
Aaron Asibi Abuosi ◽  
Mahama Braimah
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Service Delivery ◽  
National Survey ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Content Type ◽  
Care Facilities

Purpose The purpose of this study was to examine patient satisfaction with the quality of care in Ghana’s health-care facilities using a disaggregated approach. Design/methodology/approach The study was a cross-sectional national survey. A sample of 4,079 males and females in the age group of 15-49 years were interviewed. Descriptive statistics, principal component analysis and t-tests were used in statistical analysis. Findings About 70 per cent of patients were satisfied with the quality of care provided in health-care facilities in Ghana, whereas about 30 per cent of patients were fairly satisfied. Females and insured patients were more likely to be satisfied with the quality of care, compared with males and uninsured patients. Research limitations/implications Because data were obtained from a national survey, the questionnaire did not include the type of facility patients attended to find out whether satisfaction with the quality of care varied by the type of health facility. Future studies may, therefore, include this. Practical implications The study contributes to the literature on patient satisfaction with the quality of care. It highlights that long waiting time remains an intractable problem at various service delivery units of health facilities and constitutes a major source of patient dissatisfaction with the quality of care. Innovative measures must, therefore, be adopted to address the problem. Originality/value There is a paucity of research that uses a disaggregated approach to examine patient satisfaction with the quality of care at various service delivery units of health facilities. This study is a modest contribution to this research gap.

Factors influencing the quality of care learning disabled patients receive in hospital

2020 ◽  
Vol 25 (2) ◽  
pp. 83-92
Author(s):  
Alice Durrant
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Quality Of Care ◽  
General Hospital ◽  
Learning Disabled ◽  
Care Staff ◽  
Content Type ◽  
Increased Risk ◽  
Disabled Patients

Purpose In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This paper aims to look at the current experiences and treatment of people with learning disabilities within a general hospital setting to examine factors that affect their care. Design/methodology/approach A comprehensive literature search was conducted of primary research between 2013 and 2019 to evaluate what is known about the quality of care and treatment that learning disabled patients experience within a general hospital. Findings The research suggests that people with learning disabilities receive haphazard care in hospital settings, with inconsistent implementation of reasonable adjustments, insufficient arrangements to support family and other carer input, and poor knowledge of learning disability amongst hospital staff. Originality/value Previously, reviews focussing on hospital care have mainly focussed on access to health care rather than its delivery. This review has found evidence of significant failings in delivering care to this patient group, identifying a gap of knowledge in this field regardless of policies and laws already in place. There should be stricter monitoring of the Equality Act’s enforcement, along with improved and mandatory training for all general health-care staff. It is crucial that health-care professionals learn from mistakes to improve the care and experiences of learning disabled inpatients.

Preparing anesthesiology residents to lead: a leadership seminar

2019 ◽  
Vol 33 (1) ◽  
pp. 101-111
Author(s):  
Danielle Cobb ◽  
Timothy W. Martin ◽  
Terrie Vasilopoulos ◽  
Erik W. Black ◽  
Chris R. Giordano
Keyword(s):  
Health Care ◽  
Leadership Development ◽  
Leadership Training ◽  
Health Care Professionals ◽  
Leadership Skills ◽  
Development Program ◽  
Control Group ◽  
Clinical Leadership ◽  
Content Type ◽  
Leadership Development Program

Purpose The purpose of this paper is to discuss a unique leadership curriculum developed at the University of Florida and its impact on the leadership skills and values of the anesthesiology residents since its conception. The authors instituted a voluntary anesthesiology residency leadership development program at their institution to fill a perceived gap in leadership training. Mounting evidence reveals that strong clinical leadership skills improve outcomes for patients and health-care institutions. Additionally, this growing body of literature indicates that optimal outcomes result from effective team behaviors and skills, which are directed through the requisite clinical leadership. Unfortunately, adding leadership training into the existing medical education curriculum is a formidable challenge regardless of the level of learner. Design/methodology/approach To evaluate learners, the authors used the Aspiring leaders in Healthcare-Empowering individuals, Achieving excellence, Developing talents instrument, which is a validated and reliable assessment of leadership competency in health-care professionals. In 2017, the authors surveyed the past five graduating classes from the department (classes of 2012-2016), using the two graduating classes before the program’s implementation as a historical control group. Findings The survey was sent to 96 people, of whom 70 responded (73 per cent). Those participants who usually or always participated in the program responded with higher leadership-readiness skills scores than those who occasionally, rarely or never participated in the program. Notably, those who had participated in another leadership development course at any time had higher skills scores than those who had never participated. Originality/value The study’s data provide evidence that residents who either, often or always participated in the leadership development program perceived themselves to be better equipped to become effective health-care leaders as opposed to residents who never, rarely or occasionally participated.

Determinants of good and poor quality as perceived by US health care managers

2018 ◽  
Vol 32 (5) ◽  
pp. 708-725 ◽  
Author(s):  
Rebecca Amati ◽  
Amer A. Kaissi ◽  
Annegret F. Hannawa
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Quality Care ◽  
Poor Quality ◽  
Health Care Managers ◽  
Content Type ◽  
Written Narratives ◽  
Care Managers ◽  
Care Assessment

Purpose The scientific literature evidences that the quality of care must be improved. However, little research has focused on investigating how health care managers – who are responsible for the implementation of quality interventions – define good and poor quality. The purpose of this paper is to develop an empirically informed taxonomy of quality care as perceived by US managers – named the Integrative Quality Care Assessment Tool (INQUAT) – that is grounded in Donabedian’s structure, process and outcome model. Design/methodology/approach A revised version of the critical incident technique was used to collect 135 written narratives of good and poor quality care from 74 health care managers in the USA. The episodes were thematically analyzed. Findings In total, 804 units were coded under the 135 written narratives of care. They were grouped under structure (9 percent, n=69), including organizational, staff and facility resources; process (52 percent, n=419), entailing communication, professional diligence, timeliness, errors, and continuity of care; outcomes (32 percent, n=257), embedding process- and short-term outcomes; and context (7 percent, n=59), involving clinical and patient factors. Process-related categories tended to be described in relation to good quality (65 percent), while structure-related categories tended to be associated with poor quality (67 percent). Furthermore, the data suggested that managers did not consider their actions as important factors influencing quality, but rather tended to attribute the responsibility for quality care to front-line practitioners. Originality/value The INQUAT provides a theoretically grounded, evidence-based framework to guide health care managers in the assessment of all the components involved with the quality of care within their institutions.

Do performance measurement models have any impact on primary health care? A systematic review

2020 ◽  
Vol 25 (4) ◽  
pp. 319-334
Author(s):  
Brahim Zaadoud ◽  
Youness Chbab ◽  
Aziz Chaouch
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Performance Measurement ◽  
Conceptual Framework ◽  
Conceptual Frameworks ◽  
Content Type ◽  
Primary Health

PurposeThe purpose of this article is to analyze and compare between the frameworks of performance measurement in primary health care in the world. The subject of search is to compare if the frameworks of performance measurement in primary health care have an influence on performances of health centers.Design/methodology/approachWe conducted a systematic review of the literature to (1) identify the conceptual framework for measuring quality management systems, (2) assess the effects of conceptual framework on quality improvement and quality of care outcomes. We opted for the frameworks that are more cited in the literature and we analyzed and compared between these frameworks.FindingsEight dimensions were identified for assessing performance in Primary Health Care Facilities “PHCF” in more than 50% frameworks: Effectiveness, Safety, Accessibility, Equity, Efficiency, Acceptability, Patient Centeredness and Timeliness.Research limitations/implicationsThe limits of this study can be represented by the following elements: (1) lack of exhaustiveness with regard to the current Frameworks. (2) The evaluation of reliability and validity of the qualitative studies remains difficult to appreciate. (3) Most of the evaluation tools of the primary health care are not validated yet. (4) The difference in performance levels between countries, especially for the developed countries and the multitude of the frames of measure of performance, limits the comparability of the results.Practical implicationsThis study provides a conceptual and descriptive literature on the different conceptual frameworks for performance measurement in primary health care, and a practical and useful tool for comparison between the different conceptual frameworks. Several organisations of accreditation or certification introduced, developed, incorporated and checked the indicators of clinical quality in the organizations of health care. Some studies revealed links with the governance, the access, the continuity, the coordination, the efficiency and the strength primary care (Dionne Kringos, 2018). Improvements in the quality of care have been observed in the results of accreditation and certification bodies regarding hospital infection control infrastructure, organization and performance.Originality/valueEven if the links are not established within the framework of a scientific research, quality approaches are generally recognized as an essential tool to help establishments to improve the quality and the safety of the patients. Until now, it is not still common to make evaluation of the quality of care in the “PHCF” to obtain the relevant information. The necessity of having performance measurement tools, which puts in coherence the piloting of the operational level with the strategy, to integrate the organizational objectives into the measures of operational performances and make estimate its structures towards a real management by the quality.

Value-based health-care principles in health-care organizations

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Fiorella Pia Salvatore ◽  
Simone Fanelli ◽  
Chiara Carolina Donelli ◽  
Michele Milone
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Organizations ◽  
Organizational Changes ◽  
Content Type ◽  
Health Care Outcomes ◽  
Analytical Technique ◽  
A Value ◽  
Care Outcomes

Purpose This study aims to analyze the value-based health-care model in defining a strategy to guide the evolution of health-care organizations toward a value-oriented model. To improve the quality of care by ensuring economic sustainability, it is necessary to redefine the concept of competition in healthcare and align it with the concept of maximizing value for patients. Design/methodology/approach Performance measurement is a crucial aspect of the analysis of health-care organizations. Porter developed an effective analytical technique and presented the measurement of health-care outcomes based on health conditions, the efficiency of health-care organizations and the type of service provided. Findings Clinical outcomes and data on the costs of care of each patient are essential to evaluate improvement in treatment value over time. Engaging in the evaluation of what happens to patients in their course of care enables the expansion of the measurement of outcomes because it measures all the health services related to it. Originality/value Building a health-care system based on the value and continuous improvement of care and services provided is a goal shared by many countries and international organizations. Today, the analysis of outcomes is important for making informed decisions, directing and planning clinical and organizational changes by improving the quality of care and services.

Creating a fractal-based quality management infrastructure

2014 ◽  
Vol 28 (4) ◽  
pp. 576-586 ◽  
Author(s):  
Peter J Pronovost ◽  
Jill A Marsteller
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Quality Of Care ◽  
Quality Management ◽  
Health System ◽  
Fractal Structure ◽  
Coordination Theory ◽  
Content Type ◽  
Fractal System

Purpose – The purpose of this paper is to describe how a fractal-based quality management infrastructure could benefit quality improvement (QI) and patient safety efforts in health care. Design/methodology/approach – The premise for this infrastructure comes from the QI work with health care professionals and organizations. The authors used the fractal structure system in a health system initiative, a statewide collaborative, and several countrywide efforts to improve quality of care. It is responsive to coordination theory and this infrastructure is responsive to coordination theory and repeats specific characteristics at every level of an organization, with vertical and horizontal connections among these levels to establish system-wide interdependence. Findings – The fractal system infrastructure helped a health system achieve 96 percent compliance on national core measures, and helped intensive care units across the USA, Spain, and England to reduce central line-associated bloodstream infections. Practical implications – The fractal system approach organizes workers around common goals, links all hospital levels and, supports peer learning and accountability, grounds solutions in local wisdom, and effectively uses available resources. Social implications – The fractal structure helps health care organizations meet their social and ethical obligations as learning organizations to provide the highest possible quality of care and safety for patients using their services. Originality/value – The concept of deliberately creating an infrastructure to manage QI and patient safety work and support organizational learning is new to health care. This paper clearly describes how to create a fractal infrastructure that can scale up or down to a department, hospital, health system, state, or country.

Assessing health care quality in adolescent clinics, implications for quality improvement

2018 ◽  
Vol 23 (4) ◽  
pp. 269-280 ◽  
Author(s):  
Emmanuel Anongeba Anaba ◽  
Aaron Asibi Abuosi
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Adolescent Health ◽  
Health Care Quality ◽  
Care Quality ◽  
Urban Setting ◽  
Content Type ◽  
Seek Health Care

Purpose Adolescents are more exposed to risky health behaviors. However, many adolescents do not seek health care due to the poor quality of care. The purpose of this paper is to assess health care quality in adolescent clinics in Tema, a suburb of Ghana. Design/methodology/approach Cross-sectional survey design was adopted to collect data from 365 adolescent respondents. Data were analyzed with the aid of Statistical Package for Social Science (version 20) using descriptive statistics and multiple linear regression. Findings The results demonstrate that adolescents perceived quality of care in adolescent clinics to be good. The significant predictors of adolescents’ overall perceptions of quality of care were provider competencies (β=0.311, p<0.01), adolescent’s health literacy (β=0.359, p<0.01), appropriate package of services (β=0.093, p<0.05), and equity and non-discrimination (β=0.162, p<0.01). Research limitations/implications The study was conducted in an urban setting. Therefore, the generalization of findings must be done with caution. Originality/value Adolescent health care quality in Ghana is below expectation. However, it has received little attention from researchers. This study provides empirical evidence for adolescent health care quality improvement in developing countries like Ghana.

Stakeholders’ roles and responsibilities regarding quality of care

2016 ◽  
Vol 29 (8) ◽  
pp. 864-876 ◽  
Author(s):  
Päivi Huotari ◽  
Zuzana Havrdová
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Care Management ◽  
Master's Degree ◽  
Health Care Management ◽  
Strategic Decision ◽  
Ageing Population ◽  
Content Type ◽  
Master’S Degree

Purpose The purpose of this paper is to describe how different stakeholders (society, managers, employees and clients) can together ensure the quality of care. Design/methodology/approach Qualitative data were collected from four focus group interviews conducted in three countries. All interviewees were pursuing a master’s degree in social and/or health care management and had begun working in their field after completing their bachelor’s degree. The data were analysed using inductive content analysis. Findings The society and managers are responsible for the care system as a whole and must apply system-oriented, rather than sector-oriented, thinking. Employees are responsible for ensuring the continuity of client services in their work, and managers and employees share the responsibility of achieving the organisational goals and quality standards. The clients are responsible for acting as responsible service users and providing the required information to obtain care. Communication was strongly emphasised in the data, and it necessitates cross-professional and organisational boundaries, professional and political boundaries, as well as boundaries between the professional and the client. Research limitations/implications Since the interviewees were all pursuing a master’s degree in social and/or health care management, when reflecting on their work experience, they may have also been reflecting what they had learned in university. Practical implications This study emphasises the importance of collaboration and communication between stakeholders in ensuring the quality of care. Unpredictable economies, the ageing population and the ongoing integration and reorganisation of health and social care services in Europe highlight systematic and strategic approach in quality of care. Originality/value This paper claims that communication between different care stakeholders gives a more systematic and coherent framework for the quality of care. Quality of care is a strategic choice and part of the strategic decision making at the societal, political, organisational and managerial levels.

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