"A different sense of what we do here, who we are and what we deliver": Provider perspectives on the effects of a change in governance of healthcare services in correctional facilities in British Columbia.

IF 1.6 Q3 HEALTH POLICY & SERVICES Health Services Management Research Pub Date : 2023-11-29 DOI:10.1177/09514848231218626
Katherine E McLeod, Jane A Buxton, Ruth Elwood Martin
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Abstract

In 2017, British Columbia (BC) transferred responsibility for healthcare services in provincial correctional facilities from the Ministry of Public Safety and Solicitor General to the Ministry of Health. This study explored how healthcare leadership perceived the impact of the transfer on services, work-life, and job satisfaction. We conducted one-on-one interviews (n = 8) with healthcare managers and medical and administrative leadership within Correctional Health Services. Using the Two-Factor theory of job satisfaction as a framework, we applied Interpretive Description methodology to analyse interview data. Participants identified changes to four areas of the working environment: (1) staffing, equipment, and resources (2) systems of supervision and support (3) standards, policies, and quality improvement and (4) culture and orientation. These changes predominantly affected motivational factors of job satisfaction and were described as enriching the roles of managers and staff. Participants described improved autonomy and recognition of providers, increased quality of services delivered, and a shift toward patient-centred care. The perspectives of healthcare leaders provide new insight into the potential impact of transferring healthcare services in custody to a public healthcare system. Discussion of changes and their affects also provide practical learning for jurisdictions seeking to improve healthcare under a variety of governance and service-delivery models.

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"对我们在这里做什么、我们是谁以及我们提供什么有不同的认识":提供者对不列颠哥伦比亚省惩教设施保健服务治理变化的影响的看法。
2017年,不列颠哥伦比亚省将省级惩教设施的医疗保健服务责任从公共安全部和副检察长移交给卫生部。本研究探讨医疗保健领导如何感知转移对服务、工作生活和工作满意度的影响。我们进行了一对一的访谈(n = 8),访谈对象是惩教卫生服务部门的医疗保健经理以及医疗和行政领导。以工作满意度的双因素理论为框架,运用解释性描述方法对访谈数据进行分析。与会者确定了工作环境的四个方面的变化:(1)人员配置、设备和资源;(2)监督和支持系统;(3)标准、政策和质量改进;(4)文化和方向。这些变化主要影响工作满意度的激励因素,并被描述为丰富了管理者和员工的角色。与会者描述了对提供者的自主性和认可度的提高,所提供服务的质量的提高,以及向以患者为中心的护理的转变。医疗保健领导者的观点为将医疗保健服务转移到公共医疗保健系统的潜在影响提供了新的见解。对变化及其影响的讨论也为寻求在各种治理和服务提供模式下改善医疗保健的司法管辖区提供了实用的学习。
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来源期刊
Health Services Management Research
Health Services Management Research HEALTH POLICY & SERVICES-
CiteScore
4.00
自引率
4.80%
发文量
33
期刊介绍: Health Services Management Research (HSMR) is an authoritative international peer-reviewed journal which publishes theoretically and empirically rigorous research on questions of enduring interest to health-care organizations and systems throughout the world. Examining the real issues confronting health services management, it provides an independent view and cutting edge evidence-based research to guide policy-making and management decision-making. HSMR aims to be a forum serving an international community of academics and researchers on the one hand and healthcare managers, executives, policymakers and clinicians and all health professionals on the other. HSMR wants to make a substantial contribution to both research and managerial practice, with particular emphasis placed on publishing studies which offer actionable findings and on promoting knowledge mobilisation toward theoretical advances.
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