Frontiers of Health Services Management最新文献

Summary: Enterprise risk management (ERM) is a proactive strategy that, when effectively implemented, can support an organization in reducing risk, improving alignment, and building staff trust. An effective program includes leadership transparency and a range of initiatives focusing on regulatory and financial compliance, patient safety, overall risk reduction, information management, and the use of data in the decision-making process. An effective ERM program must include a highly functioning emergency preparedness program if it is to truly support risk reduction. Emergency preparedness is an integral component of ERM, and it is also a clear example of how proactive management within a high-reliability culture catalyzes an organization's pursuit of excellence. Today's healthcare challenges have shifted disaster planning from an operational requirement to a foundational imperative. Regardless of an organization's mission, structure, or size, operational continuity depends on a culture that supports sustained readiness. An organizational planning process that includes potential disruptions to daily activities is an important factor when preparing for and responding to the unexpected. Although operational leaders cannot predict every type of event, all efforts should be made to implement a fiscally sound readiness program that achieves the desired outcomes while minimizing workflow disruptions. Leaders need to ensure that their emergency preparedness program is adaptive enough to support mission-critical components of the organization when faced with unanticipated and potentially unfavorable events. In order for the program to be effective, it is important to holistically assess its necessary elements for excellence and determine how the program should be dynamically aligned with organizational culture.

Summary: Located in Los Angeles, a diverse and expensive city of 3.8 million residents, Cedars-Sinai Health System seeks to hire and retain a qualified workforce that reflects its patient population. Research shows that concordance of a person's ethnicity with their clinical care team improves outcomes and reduces health disparities. Across the nation and at Cedars-Sinai, the pandemic exacerbated already existing workforce shortages and challenges to hiring, training, and retaining allied health workers. In September 2021, leaders at Cedars-Sinai began exploring ways to address these potential workforce risks to its operations. Through interviews with stakeholders and thorough analysis of Cedars-Sinai and local workforce and educational data, the decision was made to launch an allied health school. The goal of the program is to help fill the pipeline to meet the highest areas of need and provide opportunities for community members and existing Cedars staff to upgrade their skills and earning power.

Summary: As healthcare faces mounting financial challenges and an uncertain flow of resources, proactive risk officers are working to implement effective operating policies to handle those challenges and uncertainties. Clear governance structures that are fully integrated into the organization's strategic planning process can provide the framework for effective risk management. At Providence, a large not-for-profit health system, enterprise risk management practices serve to identify, assess, and manage the risks that can affect the entire organization. Armed with a complete view of risks (both taken and those avoided), system executives, core leaders, and board members work together to protect value and advance the corporate mission.

Summary: Tiered accountability and the seven elements of an effective compliance program provide a scalable framework for enterprise risk management within high reliability healthcare organizations (HROs). However, these elements do not self-assemble into a mature system. They must be intentionally built into an effective compliance program that assesses, controls, and manages risks at an ongoing enterprise level. This starts with good governance from the governing body and passes through the organization's chief executive officer into a psychologically safe, fair, and just culture that embraces imperfections as teaching moments. In an HRO, detected deviances from desired practices are seen as opportunities to embark on short excursions of self-improvement on the longer journey toward zero events of preventable harm.The Centers for Medicare & Medicaid Services (CMS) and the US Department of Justice (DOJ) have published regulations and guidance that require and encourage organizations to proactively manage risk, with tiered accountability written into the CMS hospital conditions of participation (COP) and strongly encouraged in the DOJ newly revised Compliance Program Guidance containing its seven essential elements of an effective compliance program. Both CMS and the DOJ utilize a mixture of incentives and consequences to incentivize proactive risk management and compel reactive risk reduction. In these toolboxes of incentives and consequences, proactive healthcare executives can find the standards and rules to engineer and build highly reliable enterprise risk management systems with tiered accountability and risk-based talent management that focus available resources on high-risk, high-volume, and problem-prone areas.

Integrating neuroscience strategies in the creation of leadership development programs can significantly increase their effectiveness. Neuroscience offers insights into how the brain processes information, learns, and adapts, allowing program designers to tailor leadership training to specific individual needs and thereby generate optimal outcomes. Understanding brain functions related to leadership skills-such as decision-making, emotional regulation, and stress management-is crucial for effective leadership performance. Programs should leverage this knowledge by incorporating activities that stimulate the brain regions responsible for these skills. For instance, interactive and experiential learning can engage the brain's prefrontal cortex, which is essential for executive functions like problem-solving. Negative stress impacts brain performance in a variety of ways, disrupting leadership performance. Neuroscience confirms that managing stress improves cognitive flexibility and critical thinking abilities. Training that includes mindfulness practices and other stress management techniques can help leaders stay focused and manage their emotions more effectively. Finally, incorporating social and collaborative learning opportunities aligns with the brain's social networks, which are essential for leadership development. Peer interactions and mentorship can enhance learning through social feedback and shared experiences. By applying these neuroscience-based strategies, leadership development programs can more effectively foster the cognitive and emotional skills necessary for effective leadership.

Back-to-back black swan events during the COVID-19 pandemic and the ensuing economic downturn hastened the rate of change in healthcare. Hospitals and healthcare organizations of all sizes and configurations are facing difficult decisions with greater consequences than ever before-for patients, communities, employees, and the delivery of quality care. It can feel like a leap into the unknown. It takes a different kind of leader to navigate this exponentially changing healthcare environment-and a different kind of training to ensure that those leaders develop the skills and mental models to advance systemic organizational change. Healthcare needs transformational leaders who have skills that go beyond subject matter expertise and business sense. We need leaders who emphasize people and purpose and who are willing to take risks to improve sustainability, access to care, and health equity and to build organizations that prioritize mission to the community and support those who choose healthcare as their calling.

The healthcare landscape is undergoing rapid transformation, marked by technological advancements, shifting patient demographics, and the increasing complexity of care delivery. In this ever-changing environment, the role of nurse leaders is more critical than ever. As we navigate the challenges of the 21st century, the development of the next generation of nurse leaders must be a top priority. This article explores the most effective approaches to nurturing leadership competencies in emerging nurse leaders, drawing on contemporary research and frameworks to guide our efforts.

Physicians are increasingly stepping into leadership roles that extend beyond the bedside. Their clinical expertise enhances quality outcomes, drives organizational change, and improves strategic decision-making. Physician leadership is critical for balancing quality patient care with the financial pressures faced by healthcare organizations today. With unique clinical credibility, physicians are well-positioned to influence strategic decisions, culture, and outcomes within their institutions.