Health manpower management最新文献

Functions of primary care groups (PCG) should be considered ahead of structures and those forming PCGs need to see the links between the key health and social policy initiatives. Early influence by PCGs will shape the design and local implementation of health action zones, health improvement programmes and performance frameworks. The Green Paper "Our Healthier Nation" and its successor are central to the emerging role of PCGs. Partnership work between GPs, practice staff, trusts, local authorities and health authorities needs emphasis. Recognition of what people and existing organisations can contribute needs to be given. Leadership themes of good primary care operations, health development and clinical leadership or their equivalents need time and space to emerge.

There can be no doubt that literature regarding healthcare commissioning is on the increase. In particular, documentation is continuously emerging on the innovative models which have been designed and implemented to secure effective healthcare for the future. However, the literature tends to focus on the processes that have been designed rather than any required changes in human skills and outlook. While this article examines some of the organisational issues surrounding healthcare commissioning, it also covers the changes and demands required of the personnel practising within the purchasing arms of the National Health Service.

The delivery of effective postgraduate education for doctors in trusts is becoming vital to secure the individual services of trusts. Increasingly, training requirements are impacting on the location of clinical services that NHS trusts provide. Failure to understand the benefits and drawbacks of providing postgraduate education could affect the long-term strategic direction of trusts. The paper seeks to identify the case for investment, the need to address key deliverables to secure effective postgraduate education and the need for clinicians and managers to evaluate the effectiveness of such training for their organisations.

The EFQM model for organisational excellence is used in the health care sector as a tool to diagnose and assess the starting position for the effective QM programme. Feedback reports cover the fields of acute medical care, rehabilitation and ambulant care and contain strengths areas for improvement. Building on the EFQM feedback reports, the Modular Concept for Quality in Health Care ("Heidelberg Model") improves QM both holistically and specifically by implementing so-called "Modules for Excellence". The implementation process follows principles of project management covering medical, nursing and managing issues and the performance is periodically evaluated against targets. QM projects that are designed in the dichotomic way follow three goals. Organisational diagnosis and therapy lead to numerical health care improvements in "Prevention of nosocomial infections" and "Optimising out-patient treatment". Different assessment approaches lead to a diagnosing feedback report for QM in health care. The Modular Concept for Quality in Health Care ("Heidelberg Model") clusters, priorities, implements and evaluates the organisation's key areas for improvement.

The role of the chief executive in a transformed organisation is an extremely challenging one. The development of vision, building a commitment to it and communicating it constantly are key skills for a chief executive. However, the need to build and empower the stakeholders within and outside the organisation to support the changes required to deliver the vision requires leaders who can connect with a wide range of people and build alliances and partnerships to secure organisational success. A passion for understanding human intervention and behaviour is needed to encourage, cajole and drive teams and individuals to own and commit to change and a new direction. This requires leaders who have imagination and creativity--who seek connections and thread them together to create order out of incoherence. These skills are not taught in schools or textbooks, but are probably innate. They are what separate leaders from the rest. These skills need to be developed. A movement towards encouraging experimentation, career transfers and more individuality is needed if capable leaders of the future are to appear.

By definition the practice of job-sharing starts from the premiss that there is a full-time job to be shared by those who want to balance their work with other commitments. In a public sector institution, such as the National Health Service (NHS), where most employees are female, it seems logical to believe that a job-sharing policy would be able to promote equal opportunities, to increase employee job satisfaction and to reduce labour costs. Hence, this paper attempts to discuss the advantages and disadvantages of having a job-sharing policy, and to analyse the reasons for the limited number of job-sharers in the NHS despite the apparent benefits of job-sharing to both the employees and the employer. This study was carried out in 15 NHS Trusts in northern England and Scotland, by the use of questionnaires and interviews, and found that most NHS managers did not see the practice of job-sharing as a major cost-saving opportunity or as a working pattern that would enhance employee satisfaction and commitment. They saw job-sharing as just a routine equal opportunities request which did not deserve such managerial attention or long-term strategic thinking. It is argued in this paper that job-sharing is a potentially useful option against a background of demographic and other social and economic changes which require the development and use of long-term strategic policies. Therefore it is concluded that, in the NHS, there is a need for a more active and creative approach to job-sharing rather than the reactive and passive approach that has dominated the practice so far.

Health care providers offer an ideal setting to study the effectiveness of resilient behavior. The notion of a resilient organization is an emerging concept for understanding and coping with the modern-day pace of change and associated work stress. Resilience is the ability of an individual or organization to expeditiously design and implement positive adaptive behaviors matched to the immediate situation, while enduring minimal stress. This paper reports on the development and testing of several scales designed to measure aspects of resilience in the health care provider industry. Six factors explaining over half the instrument variance were found, including: goal-directed solution seeking; avoidance; critical understanding; role dependence; source reliance; and resource access. Results are discussed and future research is outlined.

The "work attitudes-turnover" linkage was compared among four medical-sector occupational groups. In a sample of 707 employees, drawn from eight variously-sized medical-sector sites, intended and actual turnover behavior is predicted. Combining a cross-sectional and longitudinal analysis, and using two logistic regression models, the direct effect of work attitudes on intended and actual turnover was assessed. The "work attitudes-turnover" was shown to be occupationally-dependent.

The BDC has implemented several team briefing schemes into various NHS organisations over the last seven years. Evaluation over the last three years has highlighted several problems with the team briefing system. The article explores these and suggests ways of overcoming the problems with clear, definable actions. It highlights that the basic team briefing model is sound but that organisations need to consider their commitment and whether the culture is compatible or not with some reinforcement of certain processes which includes training team briefers and having effective feedback as part of the process. The article concludes that team briefing is a useful tool, which can help organisations communicate effectively with their employees.