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1453 results in Nursing

Page 50 of 73

  • 17 - Critical thinking and decision-making

  • from Part 4 - Achieves Outcomes
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 195-203

  • Summary

    Learning objectives

    How do I:

  • increase my understanding of the elements of critical thinking?

  • counteract the barriers that might limit my critical thinking?

  • improve my skills in decision-making?

  • identify common decision-making errors?

  • make better use of evidence in healthcare decision-making?

    • Introduction

    It is important for managers and leaders to be able to critically analyse their own thinking and decision-making processes. Aspects of thinking and acting that managers and leaders should understand include their personal preferences, prejudices and cultural beliefs, and their personal motivations and desires. It is also important for them to understand the way these shape the biases they take to decision-making. To achieve success, leaders and managers require the ability to analyse, synthesise and establish their thoughts in a logical argument to reach a convincing conclusion.

    Critical thinking

    When faced with challenging management situations, the capacity to ask the right questions in order to clarify the situation helps managers to formulate appropriate responses. Critical thinking is a rational, systematic process that involves the assessment of statements and arguments, and the formulation of questions.

    A statement claims that something is, or is not, the case and is not necessarily an argument. For example, three different statements that by themselves do not form an argument are: ‘Smoking tobacco is bad for your health’, ‘Clinicians without management education make poor managers’ and ‘Healthcare is too expensive’. Critical thinking helps us decide if there is suffi cient information to accept these statements.

  • 29 - Strategic planning

  • from Part 6 - Shapes Systems
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 334-345

  • Summary

    Learning objectives

    How do I:

  • complete a strategic plan?

  • synthesise strategic planning and management concepts to adopt strategic management in my position?

  • improve the strategic planning and management processes within my organisation?

  • plan the implementation of my organisation’s strategic plan for my area?

  • set and evaluate my achievement of meaningful goals?

    • Introduction

    Effective strategic planning, implementation and management drive organisational performance (Rudd, Greenley, Beatson & Lings, 2008). Healthcare managers have recognised the increasing importance of strategic planning and management as the healthcare industry has become more dynamic and complex (Subramanian, Kumar & Yauger, 2011). However, development of feasible strategy can be difficult, and implementation of even well-developed strategy is often challenging. This chapter provides advice on leading and improving strategic planning and management in health service organisations.

    Use of strategic planning

    Strategic planning is a specific type of planning. Strategic planning was identified decades ago as essential for organisations competing in a variety of industries, with most of the seminal literature arising in the 1980s. More recently, strategic planning has been linked to successful operations in public sector healthcare organisations (Zuckerman, 2006 ) when applying previously developed concepts.

    The Australian Commission on Safety and Quality in Healthcare ( 2011 ) defines 10 safety and quality standards for health services.

  • 18 - Managing and leading staff

  • from Part 4 - Achieves Outcomes
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 204-215

  • Summary

    Learning objectives

    How do I:

  • develop my skills in leadership of human resources as a critical component of health policy and organisational activity?

  • understand the challenging role of the management of human resources in a complex, professionally dominated industry that is affected by constant change?

  • determine effective strategies for retention policies and practices that are required to respond to the global maldistributions and shortages within the health profession?

  • consider the requirements that human resources has for the management of four distinct generations in the substantially feminine and ageing health workforce?

    • Introduction

    In a text on leadership and management the perspective on human resource management requires a strategic approach. Health is dominated by a large, diverse, highly professionalised workforce. Human resource management is complex and needs to properly consider three aspects of workforce development – namely, supply, demand and mobility (Narasimhan et al., 2004).

    Definitions

    The health workforce is globalised, with maldistributions and existing and projected shortages (Health Workforce Australia, 2012 ). The mobilisation and strengthening of human resources are seen as critical in sustainable health systems (Chen et al. 2004, Kabene, Orchard, Howard, Soriano & Leduc, 2006; Karimi, Cheng, Bartram, Leggat & Sarkeshik, 2014). The health (75 per cent) and health management (61 per cent) workforce in Australia is predominantly female as compared with all industries (at 47 per cent and 36 per cent respectively) (Martins & Isouard, 2014). The health workforce is multigenerational, multicultural and substantially female. It requires collaboration across sectors on an interprofessional basis and across organisational boundaries within multidisciplinary teams and networks of service provision (Duckett, 2005).

  • 7 - Ambiguity and leadership

  • from Part 2 - Leads Self
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 79-89

  • Summary

    Learning objectives

    How do I:

  • develop a clear understanding of how ambiguity in organisational settings impacts management and leadership?

  • reduce ambiguity?

  • develop confidence in the identification and articulation of ambiguity in healthcare organisations?

  • acquire skills and knowledge in useful approaches to managing positions, directions and outcomes related to ambiguous circumstances and problems?

    • Introduction

    Complexity is a feature of healthcare organisations. Irrespective of the role, size, processes and governance of these organisations, the internal and external environments in which they operate and the number of associated stakeholders represent significant challenges in managing clinical and social processes and outcomes, resources, workforces, decision-making and ethics. Within this complex framework, healthcare leaders need not only skills and strategies to manage their organisation, but also resources and personal competencies to lead individuals, groups and workforces.

    Definitions

    Ambiguity is defined as lack of certainty or dependability of meaning of communication, action or knowledge. It describes a situation in which information could be interpreted, construed or understood in more than one way. It is a natural aspect of the operations of healthcare facilities and the environments in which they engage with many stakeholders. Leading and managing health organisations requires awareness, understanding and focused action to ensure that ambiguous situations are managed for impact and usefulness to the health facility.

  • 10 - Leading interprofessional teams

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 116-125

  • Summary

    Learning objectives

    How do I:

  • understand the place that interprofessional teams have in healthcare organisations?

  • analyse the enablers and barriers to leading interprofessional teams?

  • apply principles of successful leadership of interprofessional teams to enhance my teamwork skills?

  • work with the benefits and challenges associated with hybrid roles in leading interprofessional teams?

    • Introduction

    Leadership is an elusive concept. Key authors cannot agree on the characteristics of leaders, but all agree that leadership is about relationships and evolves over time. For example, Rost and Barker (2000, p. 3) state that ‘leadership is an influence relationship among leaders and followers who intend real changes and outcomes that reflect a shared purpose’. Meanwhile, Landsdale (2002, p. 56) suggests that ‘effective leaders enable people to move in the same direction, toward the same destinations, at the same speed, but not because they have been forced to, but because they want to’. This raises the question of how we get people to want to go in the same direction and at the same pace. In the health services this is particularly challenging because of the multidisciplinary nature of the key stakeholders. It requires appropriate leadership of interprofessional teams.

    The increased complexity of patient needs has driven the necessity of interprofessional teamwork in health services (Bridges, Davidson, Odegard, Maki & Tomkowiak, 2011 ). Consequently, the importance of such teams within a health context is increasingly being accepted (Bajnok, Puddester, MacDonald, Archibald & Kuhl, 2012). While working in interprofessional teams is challenging, it also has benefits. Healthcare professionals working in interprofessional teams have reported that the system produces greater patient satisfaction and outcomes, reduced healthcare costs and improved job satisfaction (Baggs & Schmitt, 1997 ; Clarke & Hassmiller, 2013 ; Hendel, Fish & Berger, 2007 ; Zwarenstein, Reeves & Perrier, 2005).

  • 23 - Evidence-based practice

  • from Part 5 - Drives Innovation
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 265-272

  • Summary

    Learning objectives

    How do I:

  • determine when to look for evidence to assist in decision-making?

  • source relevant evidence for my management practice and decision-making?

  • critically appraise evidence for its strengths, weaknesses and relevance to a particular health services management question?

  • apply relevant evidence to my management practice and decision-making?

  • find out more about evidence-based management?

    • Introduction

    Building on the concepts of evidence-based medicine and evidence-based policy, the concept of evidence-based leadership and management suggests that leaders and managers find, evaluate and use the best available scientific evidence to inform their practice. An early definition of evidence-based management was ‘translating principles based on best evidence into organisational practices’ (Rousseau, 2006, p. 256). This chapter discusses when and how to look for evidence and outlines how to apply it to the leadership or management decision or situation at hand.

    Use of evidence

    While there are studies linking doctors who practise evidence-based medicine with better clinical outcomes (Pfeffer & Sutton, 2006), and despite the inherent logic of basing decisions on evidence, we could fi nd no studies linking evidence-based management with better organisational outcomes. In fact, there is a large body of research that suggests that managers have difficulty finding and applying evidence to their management practice generally (Hemsley-Brown & Sharp, 2003 ), and to healthcare leadership and management specifi cally (Finkler & Ward, 2003).

  • 26 - Leading and managing change

  • from Part 5 - Drives Innovation
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 295-304

  • Summary

    Learning objectives

    How do I:

  • plan and lead change within a workplace?

  • choose a relevant change management framework?

  • plan the change process and the human management component of the change?

  • develop my skills in leading organisational change?

    • Introduction

    This chapter provides an introduction to the world of change management. Firstly, it sets out the case for change – why change management matters – then looks at the theories concerning individual and organisational change. Finally, the role of the professional change manager is discussed.

    Definitions

    For the purposes of this chapter, change is viewed from an organisational perspective. Organisational change is a systematic approach to reshaping organisations in line with their future goals, aims, vision and philosophy. By its very nature, organisational change needs to be actively managed to ensure the desired outcomes. Organisational change management requires the manager to take account of the range of internal and external forces that can augment, shape, hinder or derail organisational change. The internal forces can include organisational objectives, work standards, personnel, staff expertise and profit, while the external forces can include economic, technical, political, governmental and sociocultural factors, as well as the operating environment (Pathak, 2010). The manager should realise that any number of these internal and external forces may need to be actively managed simultaneously to ensure a successful outcome.

  • 2 - Leadership and management frameworks and theories

  • from Part 1 - Introduction
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 16-28

  • Summary

    Learning objectives

    How do I:

  • determine the leadership approach I might take in my organisation?

  • decide when I might need to change my leadership approach to a different style?

  • learn about how management theory has changed over time?

  • consider how best to develop my own leadership and management skills?

  • integrate knowledge of leadership and management theory to inform future practice?

    • Introduction

    Effective leadership and management are crucial for healthcare services to meet the expectation to provide high-quality, accessible, affordable care that will result in improved health outcomes (Fehr, 2011) in the context of health reform. Healthcare professionals must understand the main theories of leadership and management and how these approaches translate into improving work practices in order to develop their own work capacity. This chapter presents leadership and management theories that healthcare professionals currently use to inform their practice.

    Definitions

    Definitions that locate the concepts of leadership and management in a healthcare context are important. The concept of leadership in healthcare receives attention from government, policy-makers, organisational managers, clinicians and researchers (Kean & Haycock-Stuart, 2011 ). To be effective, leadership must be appropriate for healthcare in its broadest sense and see issues addressed in a political, social, policy and economic context (Swearingen, 2009).

  • 12 - Partnering with stakeholders

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 138-149

  • Summary

    Learning objectives

    How do I:

  • understand definitions, rationale, key concepts and public policy associated with stakeholder partnerships in healthcare settings?

  • identify stakeholder groups essential to quality health service delivery?

  • use the success factors associated with effective partnerships?

  • evaluate real-world situations, undertake a stakeholder analysis and recommend key points for stakeholder engagement?

  • reflect on the skills associated with developing, formalising and maintaining effective stakeholder partnerships?

    • Introduction

    This chapter outlines how partnering with stakeholders is important for quality health service management and healthcare delivery, and highlights common patterns that drive partnership-based public policy. It also provides an introduction to concepts associated with partnering in health services, defining key terms and discussing the managerial skills or competencies required to engage with stakeholders and implement partnership-based policy. The interests of key stakeholders within the health sector are identified and discussed, and important steps are outlined for a manager undertaking a stakeholder analysis. Finally, the chapter explores the factors essential to successful partnerships and the competencies managers need to successfully develop and maintain stakeholder partnerships.

    Definitions

    The roots of contemporary whole-of-government and partnership-based public policies are evident in economic development theory dating back 25 years or more (Brownie, 2007). During the 1990s, a number of leading economic development theorists wrote of networked and associational approaches as being essential for local development and economic success (Cooke & Morgan, 1998; Morgan, 1997; Morgan & Nauwelaers, 1999). In 2001, the Organisation for Economic Co-operation and Development (2001) noted that governments across most of its member countries worked in partnerships involving the public, provider and not-for-profit sectors, plus partners from the wider community.

  • 25 - Building positive workplace cultures

  • from Part 5 - Drives Innovation
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 283-294

  • Summary

    Learning objectives

    How do I:

  • understand the key concepts associated with workplace cultures?

  • identify the impacts of positive and negative workplace cultures on the functioning of an organisation, particularly in the area of patient safety and quality?

  • identify different types of workplace cultures?

  • understand the impact a health manager or leader can make on the culture of an organisation or department?

  • build positive workplace cultures?

    • Introduction

    Understanding, managing and building culture within a workplace are key responsibilities of leadership and management. This chapter outlines what workplace culture is, the impact of poor culture on an organisation and what managers can do to improve workplace culture.

    Peter Drucker (as cited in Fernández-Aráoz, 2014 , para. 2) once famously said, ‘Culture eats strategy over breakfast’. This might seem implausible, because there is an expectation on healthcare managers to plan, set out, implement and then evaluate strategy. Drucker’s point is that unless there is a positive culture in a workplace, seeing a strategy move to successful implementation and adoption is very difficult, sometimes impossible.

    Definitions

    Workplace culture (also called organisational or corporate culture) has been well defined in the literature. Culture has often been described as the particular beliefs or values of an organisation that distinguish it from other similar organisations.

  • 11 - Clinical governance

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 126-137

  • Summary

    Learning objectives

    How do I:

  • understand the origins of clinical governance?

  • ensure my organisation has the key components of clinical governance?

  • make the connection between corporate governance and clinical governance?

  • explain responsive regulation?

  • develop skills to lead clinical governance in my organisation?

    • Introduction

    The past two decades have seen the rise of clinical governance, firstly as a concept and ultimately as a system. Increased knowledge of the scope of iatrogenic harm to consumers coupled with public inquiries into poor care around the world has driven the development of governance of clinical care as a component of corporate governance. Despite this growing awareness and activity, various studies suggest we still do not have the processes in place for consistently safe, high-quality care for consumers. Compared with other high-risk industries, healthcare appears to have a high tolerance for ambiguity in processes, outcomes and roles (Spear & Schmidhofer, 2005). Accreditation, although now more focused on the quality of clinical care, is still seen as an administrative burden by many, with most health services subject to a rolling schedule of requirements and visits from a range of accreditation providers. It appears that the adverse event rate for overnight stay patients in public and private hospitals has plateaued at around 10 per cent (Australian Institute of Health and Welfare, 2013). These are not easy issues for governing bodies and executives to address within a funding environment focused more on efficiency than quality and safety (Balding, 2008).

  • 30 - Health service planning

  • from Part 6 - Shapes Systems
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 346-360

  • Summary

    Learning objectives

    How do I:

  • understand when and why health service planning is required and initiated?

  • identify important stakeholders and consider how they may be engaged in health service planning?

  • develop critical thinking regarding the implications of various approaches and instruments used in health service planning?

  • improve my skills in effective health service planning?

    • Introduction

    Matching available health resources to consumer needs is challenging. Governments and health bureaucracies with finite resources face increasing demands from their client populations, which often have complex health issues. No country has sufficient resources to meet every single health need of every citizen. Consequently, health service planning is important to maximise population health outcomes and ensure value for the available money.

    Due to the inherent contradictions existing between the high demand for and the limited responsive supply capacity by health services, health service planning is often characterised by negotiation, lobbying and compromise among various interest groups. A consensus can best be achieved if stakeholders agree upon a set of core values and all involved in the process endorse principles and the procedures of planning.

    Definitions

    Health service planning may stem from the perspective of consumers (populationbased) or from the perspective of providers (institutional-based) (Eagar, Garrett & Lin, 2001). The ultimate choice between these two options often depends on who is responsible for performing the planning and the rationale.

  • 4 - Self-management

  • from Part 2 - Leads Self
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 41-54

  • Summary

    Learning objectives

    How do I:

  • ensure a plan for self-management that helps my integration into the workforce and facilitates lifelong learning?

  • motivate myself to strive for continual improvement through self-management?

  • set personal and professional goals for self-management?

  • plan to improve areas of intelligence that I have identified as not being as strong as needed?

  • find and work with a mentor?

    • Introduction

    Nurses and allied health personnel are held in high esteem by the general public, a fact confirmed consistently by rankings of trust and reliability in both the United States (Swift, 2013) and Australia (Roy Morgan Research, 2014). People may approach student health workers for advice because of this inherent trust and recognition of their status. Throughout their careers health professionals help people manage their own health, and they can be more effective if they understand how to manage themselves. People have varying abilities, talents, life experiences, upbringings and opportunities that shape their lives. While self-management is a foundational philosophy of lifelong learning, it comes more naturally to some than to others.

    Some of the literature discusses self-management from a management perspective (Markham & Markham, 1995 ); and theorists come from a variety of backgrounds, including organisational development, psychology and sociology. An added complexity is the interchangeability of some of the terms found in the literature (self-management, self-leadership, self-control, self-effi cacy, self-regulation and so on), so for the sake of clarity for this chapter, the terminology is restricted to facilitate understanding, acknowledging that others may have contradictory perspectives.

  • 22 - Creativity and visioning

  • from Part 5 - Drives Innovation
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 254-264

  • Summary

    Learning objectives

    How do I:

  • work with others in my organisation to develop an effective vision for the future?

  • increase my ability to identify and explore creative solutions to organisational issues?

  • foster creativity among the people I work with?

  • assist my organisation to become a learning organisation?

    • Introduction

    The healthcare sector is continually confronted with the issue of how to manage with less. In response, health leaders and managers must explore and use new ways to face such challenges. Such issues ultimately affect the quality and safety, and the productivity and efficiency of the health services delivered. Within each organisation, the effectiveness of the leadership and culture impact squarely on the quality of patient care delivered. In order to effectively address such challenges, leaders have started to adopt new strategies and roles focusing on visioning and creativity.

    Definitions

    Creativity, or creative capital, is by far an organisation’s most important asset. It results from an effectively led and managed unit of creative thinkers and planners whose ideas can be transformed into valuable services and products (Florida & Goodnight, 2005). It is important to identify those factors which influence creativity within the organisation; Andriopolous (2001) identifies these as: organisational climate; leadership style; organisational culture, resources and skills; organisational structure; and organisational systems.

  • 6 - Exploring values

  • from Part 2 - Leads Self
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 67-78

  • Summary

    Learning objectives

    How do I:

  • identify my personal values?

  • learn how my personal values developed over time?

  • consider the importance and role of values in healthcare leadership?

  • ensure an organisational culture that is based on appropriate values?

  • develop my skills in values-based leadership strategies in my organisation?

    • Introduction

    As Mahatma Gandhi once said, ‘Your beliefs become your thoughts, your thoughts become your words, your words become your actions, your actions become your habits, your habits become your values, your values become your destiny’. Values permeate every aspect of our lives, shaping individual actions and giving meaning, direction and scope to our work environments and organisational cultures. Defining positive behaviours and identifying unprofessional, disrespectful or negative behaviours, values permeate and define every aspect of our work and personal lives. Values also have an emotional component: when we act in accordance with our values, we experience positive emotions; conversely, when we act against our values or are placed in situations that compromise our values, we experience negative emotions. It is this emotional component that drives us to seek values alignment in our personal and professional lives.

    In healthcare, values-based leadership is particularly important. Patients seek our care often at the most vulnerable time in their lives. In their vulnerability, they must trust us to provide competent and compassionate care.

Page 50 of 73