Pub Date : 2000-01-01DOI: 10.1108/02689230010340354
Gerald Wistow
A changing boundary between hospital and home-care services over two decades has taken place enabling people to live in their own homes wherever possible, enabling "choice of independence". Against this background, five principal issues are raised regarding how hospital services have been reshaped over that time and how the pattern of service developments outside the hospital has altered over the same period.
{"title":"Home care and the reshaping of acute hospitals in England. An overview of problems and possibilities.","authors":"Gerald Wistow","doi":"10.1108/02689230010340354","DOIUrl":"https://doi.org/10.1108/02689230010340354","url":null,"abstract":"A changing boundary between hospital and home-care services over two decades has taken place enabling people to live in their own homes wherever possible, enabling \"choice of independence\". Against this background, five principal issues are raised regarding how hospital services have been reshaped over that time and how the pattern of service developments outside the hospital has altered over the same period.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"42 1","pages":"7-24"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010340354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62514942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-01-01DOI: 10.1108/02689230010359192
K Hurst, S Harrison, T Ride
This paper reports the experience of a single pilot in total primary care purchasing (TPP) between 1995 and 1997. The article's structure is based on a framework created from the seven original objectives of the pilot and 12 themes emerging from qualitative data analysis. Data are mainly drawn from interviews with participants. Interesting and useful findings emerge. For example, the TPP was able to build positive relationships with other local actors and amongst its GPs, though these did not necessarily lead to agreement or compliance. The TPP undertook conventional health needs assessment, but experienced difficulty reviewing referral practice and controlling the volume of secondary care services, contributing to problems of financial control. Though TPP has been abolished, the findings have implications for successors.
{"title":"Primary care organisation and management. Evidence from a total purchasing pilot.","authors":"K Hurst, S Harrison, T Ride","doi":"10.1108/02689230010359192","DOIUrl":"https://doi.org/10.1108/02689230010359192","url":null,"abstract":"This paper reports the experience of a single pilot in total primary care purchasing (TPP) between 1995 and 1997. The article's structure is based on a framework created from the seven original objectives of the pilot and 12 themes emerging from qualitative data analysis. Data are mainly drawn from interviews with participants. Interesting and useful findings emerge. For example, the TPP was able to build positive relationships with other local actors and amongst its GPs, though these did not necessarily lead to agreement or compliance. The TPP undertook conventional health needs assessment, but experienced difficulty reviewing referral practice and controlling the volume of secondary care services, contributing to problems of financial control. Though TPP has been abolished, the findings have implications for successors.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 3-4","pages":"199-209"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010359192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21963504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-01-01DOI: 10.1108/02689230010340363
B. Ferguson, P. Kelly, A. Georgiou, G. Barnes, B. Sutherland, B. Woodbridge
Aims to assess retrospectively the payback from NHS reactive research programmes in the Northern and Yorkshire region. A questionnaire was sent to all recipients of regional reactive research programme funding (biomedical, health services research (HSR), and primary and community care programmes) between 1 April 1991 and 31 March 1996. The sample available for analysis involved 174 respondents covering 119 projects, with a total financial value of 2.2 million Pounds. The main outcome measures used were peer-reviewed publications, changes in individual practice, changes in NHS service delivery and organisation, and impact on the careers of researchers. Overall, 119 projects produced 230 peer-reviewed publications: this was achieved at an average cost of 10,673 Pounds, 6,386 Pounds and 22,310 Pounds per publication for the biomedical, HSR, and primary and community care programmes respectively. From the qualitative data analysis, important changes in individual practice and NHS service delivery were identified by respondents. The researchers in our sample appeared to have attracted over 6 million Pounds in R&D funding related to the initial regional grant. Although based on self-report, there is evidence to suggest that the return on investment from NHS R&D can be substantial, taking a broad view of benefits to the NHS and to researchers. The findings also confirm the need for more effective dissemination and implementation of research findings.
{"title":"Assessing payback from NHS reactive research programmes.","authors":"B. Ferguson, P. Kelly, A. Georgiou, G. Barnes, B. Sutherland, B. Woodbridge","doi":"10.1108/02689230010340363","DOIUrl":"https://doi.org/10.1108/02689230010340363","url":null,"abstract":"Aims to assess retrospectively the payback from NHS reactive research programmes in the Northern and Yorkshire region. A questionnaire was sent to all recipients of regional reactive research programme funding (biomedical, health services research (HSR), and primary and community care programmes) between 1 April 1991 and 31 March 1996. The sample available for analysis involved 174 respondents covering 119 projects, with a total financial value of 2.2 million Pounds. The main outcome measures used were peer-reviewed publications, changes in individual practice, changes in NHS service delivery and organisation, and impact on the careers of researchers. Overall, 119 projects produced 230 peer-reviewed publications: this was achieved at an average cost of 10,673 Pounds, 6,386 Pounds and 22,310 Pounds per publication for the biomedical, HSR, and primary and community care programmes respectively. From the qualitative data analysis, important changes in individual practice and NHS service delivery were identified by respondents. The researchers in our sample appeared to have attracted over 6 million Pounds in R&D funding related to the initial regional grant. Although based on self-report, there is evidence to suggest that the return on investment from NHS R&D can be substantial, taking a broad view of benefits to the NHS and to researchers. The findings also confirm the need for more effective dissemination and implementation of research findings.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 1 1","pages":"25-36"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010340363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-01-01DOI: 10.1108/02689230010346556
J. Owen, K. Phillips
Current government policy places great emphasis on increased collaboration between disciplines and professions within health care, as in public services across the board. To date, analyses of doctor‐manager relations have tended to focus on equipping doctors with management skills, once they have reached consultant level. In contrast, this paper evaluates a new management development initiative, designed to involve doctors and managers at an earlier career stage, and on an inter‐disciplinary basis. Interview and questionnaire responses indicate that specialist registrars and young managers share common values; however, they also acknowledge a high degree of mutual ignorance. Evaluation suggests that inter‐disciplinary programmes can provide a starting‐point for closer collaboration in practice; in conclusion, some options for sustaining this in the long term are identified.
{"title":"Ignorance is not bliss","authors":"J. Owen, K. Phillips","doi":"10.1108/02689230010346556","DOIUrl":"https://doi.org/10.1108/02689230010346556","url":null,"abstract":"Current government policy places great emphasis on increased collaboration between disciplines and professions within health care, as in public services across the board. To date, analyses of doctor‐manager relations have tended to focus on equipping doctors with management skills, once they have reached consultant level. In contrast, this paper evaluates a new management development initiative, designed to involve doctors and managers at an earlier career stage, and on an inter‐disciplinary basis. Interview and questionnaire responses indicate that specialist registrars and young managers share common values; however, they also acknowledge a high degree of mutual ignorance. Evaluation suggests that inter‐disciplinary programmes can provide a starting‐point for closer collaboration in practice; in conclusion, some options for sustaining this in the long term are identified.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"22 1","pages":"119-129"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010346556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-01-01DOI: 10.1108/02689230010362954
L. Bacharova, S. Hlavacka, V. Rusňáková
This study reports the findings of the first survey of the knowledge and needs for training in evidence based medicine (EBM) of health-care workers in Slovakia. This study was primarily qualitative and based on a triangular approach, which included: analysis of the situation in pre- and postgraduate education in Slovakia aimed at estimating needs in EBM and critical appraisal skills (CAS) training; analysis of questionnaires distributed in a sample of medical doctors and university educated public health workers undergoing postgraduate training; and focus group discussions. The findings revealed a real gap in knowledge in EBM and CAS in Slovakia and identified several areas as the focus for intervention. The results showed also some important behavioural and cultural aspects, including low individual responsibility for education; tendency to delegate responsibility to authorities (experts, top management, Ministry of Health); and persistence of the state paternalistic type of education. Concludes that managers planning to implement EBM in Slovakia should therefore consider a broader behavioural and cultural context for change, not just introduction of a training EBM module.
{"title":"Basic estimate of needs for training in evidence-based medicine in Slovakia.","authors":"L. Bacharova, S. Hlavacka, V. Rusňáková","doi":"10.1108/02689230010362954","DOIUrl":"https://doi.org/10.1108/02689230010362954","url":null,"abstract":"This study reports the findings of the first survey of the knowledge and needs for training in evidence based medicine (EBM) of health-care workers in Slovakia. This study was primarily qualitative and based on a triangular approach, which included: analysis of the situation in pre- and postgraduate education in Slovakia aimed at estimating needs in EBM and critical appraisal skills (CAS) training; analysis of questionnaires distributed in a sample of medical doctors and university educated public health workers undergoing postgraduate training; and focus group discussions. The findings revealed a real gap in knowledge in EBM and CAS in Slovakia and identified several areas as the focus for intervention. The results showed also some important behavioural and cultural aspects, including low individual responsibility for education; tendency to delegate responsibility to authorities (experts, top management, Ministry of Health); and persistence of the state paternalistic type of education. Concludes that managers planning to implement EBM in Slovakia should therefore consider a broader behavioural and cultural context for change, not just introduction of a training EBM module.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 5-6 1","pages":"362-82"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010362954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-01-01DOI: 10.1108/02689230010359165
P Reedy, M Learmonth
Examines the ideological nature of competence-based approaches to the management training of nurse managers. Explores the transition required from a "clinical" identity to a managerial one. Employs Habermas' theory of communicative action to analyse the ideological features and to provide a way of reflecting on the nature of the professional identity they are being encouraged to accept. Indicates some further avenues for research.
{"title":"Nursing managers, transformed or deformed? A case study in the ideology of competency.","authors":"P Reedy, M Learmonth","doi":"10.1108/02689230010359165","DOIUrl":"https://doi.org/10.1108/02689230010359165","url":null,"abstract":"<p><p>Examines the ideological nature of competence-based approaches to the management training of nurse managers. Explores the transition required from a \"clinical\" identity to a managerial one. Employs Habermas' theory of communicative action to analyse the ideological features and to provide a way of reflecting on the nature of the professional identity they are being encouraged to accept. Indicates some further avenues for research.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 3-4","pages":"153-65"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010359165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21963501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-06-01DOI: 10.1108/jmm.1999.13.3.3.2
Hugh Lee
{"title":"Moral Problems in Medicine","authors":"Hugh Lee","doi":"10.1108/jmm.1999.13.3.3.2","DOIUrl":"https://doi.org/10.1108/jmm.1999.13.3.3.2","url":null,"abstract":"","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62118939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1108/jmm.1999.13.2.219.1
N. Goodwin
{"title":"Who Cares? The Great British Health Debate","authors":"N. Goodwin","doi":"10.1108/jmm.1999.13.2.219.1","DOIUrl":"https://doi.org/10.1108/jmm.1999.13.2.219.1","url":null,"abstract":"","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"13 1","pages":"219-220"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62118876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-02-01DOI: 10.1108/jmm.1999.13.1.219.1
K. Hurst
{"title":"Managing High Security Psychiatric Care","authors":"K. Hurst","doi":"10.1108/jmm.1999.13.1.219.1","DOIUrl":"https://doi.org/10.1108/jmm.1999.13.1.219.1","url":null,"abstract":"","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"13 1","pages":"219-220"},"PeriodicalIF":0.0,"publicationDate":"1999-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62118866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-01-01DOI: 10.1108/02689239910269653
T Forbes, N Prime
Examines a group of radiographers developing management roles within the backdrop of a changing NHS. A comparative study of 25 Scottish and English radiographer managers were interviewed using semi-structured interviews. Interviews were based on a number of issues associated with moving from a clinical professional to a clinical manager and were analysed using domain theory. The interviews formed a number of emerging themes, which included management, professionalism, management style, conflicts between the role of both manager and professional, and role change. Radiographer managers are forming new "hybrid" manager roles, which have been developing within a changing NHS. A definite tension was seen in this role change. This transition was not easy for this group of radiographer managers. However, they have shown resilience in undertaking both operational and strategic management decisions, while using their clinical background to inform their decision making.
{"title":"Changing domains in the management process. Radiographers as managers in the NHS.","authors":"T Forbes, N Prime","doi":"10.1108/02689239910269653","DOIUrl":"https://doi.org/10.1108/02689239910269653","url":null,"abstract":"<p><p>Examines a group of radiographers developing management roles within the backdrop of a changing NHS. A comparative study of 25 Scottish and English radiographer managers were interviewed using semi-structured interviews. Interviews were based on a number of issues associated with moving from a clinical professional to a clinical manager and were analysed using domain theory. The interviews formed a number of emerging themes, which included management, professionalism, management style, conflicts between the role of both manager and professional, and role change. Radiographer managers are forming new \"hybrid\" manager roles, which have been developing within a changing NHS. A definite tension was seen in this role change. This transition was not easy for this group of radiographer managers. However, they have shown resilience in undertaking both operational and strategic management decisions, while using their clinical background to inform their decision making.</p>","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"13 2-3","pages":"105-13"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689239910269653","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21597894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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