Pub Date : 2001-10-01DOI: 10.1108/EUM0000000006182
Gerald Wistow
This paper reviews the NHS Plan from the perspective of the Government's wider programme of "modernising" public services. Although broadly focussed, particularly highlights older people. Two dimensions of modernisation are identified. The NHS Plan is seen to be patient-cited--rather than citizen-centred. Argues further, that, if the economic, social and environmental causes of ill health are to be addressed more generally and if citizens are to be enabled to live in healthy, sustainable communities, planning for health services should logically be subordinate to planning for health. Health improvement plans should, therefore, be integrated within the wider community strategies for which local authorities are to have lead responsibility. Similarly, as ill health is recognised to be an important aspect of poverty, inequality and social exclusion, there is a strong case for the integration of the regional offices of the NHSE within the wider structure of regional governance. Finally, the personal social services should ensure that the values of social work and social care are not displaced by medical and nursing models which, historically, have shown little understanding of community development processes.
{"title":"Modernisation, the NHS Plan and healthy communities.","authors":"Gerald Wistow","doi":"10.1108/EUM0000000006182","DOIUrl":"https://doi.org/10.1108/EUM0000000006182","url":null,"abstract":"This paper reviews the NHS Plan from the perspective of the Government's wider programme of \"modernising\" public services. Although broadly focussed, particularly highlights older people. Two dimensions of modernisation are identified. The NHS Plan is seen to be patient-cited--rather than citizen-centred. Argues further, that, if the economic, social and environmental causes of ill health are to be addressed more generally and if citizens are to be enabled to live in healthy, sustainable communities, planning for health services should logically be subordinate to planning for health. Health improvement plans should, therefore, be integrated within the wider community strategies for which local authorities are to have lead responsibility. Similarly, as ill health is recognised to be an important aspect of poverty, inequality and social exclusion, there is a strong case for the integration of the regional offices of the NHSE within the wider structure of regional governance. Finally, the personal social services should ensure that the values of social work and social care are not displaced by medical and nursing models which, historically, have shown little understanding of community development processes.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 4-5 1","pages":"334-51"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/EUM0000000006182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62394531","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 : 2001-10-01DOI: 10.1108/EUM0000000006184
Stefanie E. Naumann, J. Miles
In a study of 195 patients visiting the urgent care department of a hospital in the UK, we examined the effects of three elements of process control on patients' fairness and satisfaction perceptions. Patients who believed they had a voice in the triage process had higher fairness perceptions and waited a shorter period of time than those who believed they did not have a voice in the triage process. In addition, patients who were told the expected waiting time and were kept busy while waiting had higher satisfaction perceptions. We identify implications for hospital employees in managing the patient waiting process.
{"title":"Managing waiting patients' perceptions: the role of process control.","authors":"Stefanie E. Naumann, J. Miles","doi":"10.1108/EUM0000000006184","DOIUrl":"https://doi.org/10.1108/EUM0000000006184","url":null,"abstract":"In a study of 195 patients visiting the urgent care department of a hospital in the UK, we examined the effects of three elements of process control on patients' fairness and satisfaction perceptions. Patients who believed they had a voice in the triage process had higher fairness perceptions and waited a shorter period of time than those who believed they did not have a voice in the triage process. In addition, patients who were told the expected waiting time and were kept busy while waiting had higher satisfaction perceptions. We identify implications for hospital employees in managing the patient waiting process.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"56 1","pages":"376-86"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/EUM0000000006184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62394808","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 : 2001-10-01DOI: 10.1108/EUM0000000006185
B. Alimo‐Metcalfe, J. Lawler
States that the development of leadership in the NHS is currently high on the agenda of the Department of Health, the government and local health sector organisations. Reports the findings of a study of public and private sector organisations, exploring the development of their in-house leadership skills. Outlines the findings in depth and discusses the implications for health organisations.
{"title":"Leadership development in UK companies at the beginning of the twenty-first century: lessons for the NHS?","authors":"B. Alimo‐Metcalfe, J. Lawler","doi":"10.1108/EUM0000000006185","DOIUrl":"https://doi.org/10.1108/EUM0000000006185","url":null,"abstract":"States that the development of leadership in the NHS is currently high on the agenda of the Department of Health, the government and local health sector organisations. Reports the findings of a study of public and private sector organisations, exploring the development of their in-house leadership skills. Outlines the findings in depth and discusses the implications for health organisations.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 4-5 1","pages":"387-404"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/EUM0000000006185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62394880","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 : 2001-08-01DOI: 10.1108/JMM.2001.15.4.323.1
N. Harding
{"title":"The Aesthetics of Organization","authors":"N. Harding","doi":"10.1108/JMM.2001.15.4.323.1","DOIUrl":"https://doi.org/10.1108/JMM.2001.15.4.323.1","url":null,"abstract":"","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 1","pages":"323-329"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62119722","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 : 2001-08-01DOI: 10.1108/02689230110403777
J. Farmer, R. Chesson
Presents models suggesting how research evidence can best be operationalised within health care commissioning. Models were derived from data gathered from surveys of Scottish health board managers and GP fundholders regarding the use of information in commissioning from 1995 to 1997. Feedback on the models was obtained subsequently from practitioners in 1998. Two models, one for health board managers and the other for GPs, are presented. These include critical success factors in achieving evidence-based commissioning and factors that are likely to predispose and precipitate evidence-based practice. Given a culture demanding transparency, accountability and continuing improvement, the models provide tools for reflection, evaluation and planning. In addition, they identify a pragmatic role for managers in evidence-based commissioning and provide a framework for audit.
{"title":"Health care management: models for evidence-based practice.","authors":"J. Farmer, R. Chesson","doi":"10.1108/02689230110403777","DOIUrl":"https://doi.org/10.1108/02689230110403777","url":null,"abstract":"Presents models suggesting how research evidence can best be operationalised within health care commissioning. Models were derived from data gathered from surveys of Scottish health board managers and GP fundholders regarding the use of information in commissioning from 1995 to 1997. Feedback on the models was obtained subsequently from practitioners in 1998. Two models, one for health board managers and the other for GPs, are presented. These include critical success factors in achieving evidence-based commissioning and factors that are likely to predispose and precipitate evidence-based practice. Given a culture demanding transparency, accountability and continuing improvement, the models provide tools for reflection, evaluation and planning. In addition, they identify a pragmatic role for managers in evidence-based commissioning and provide a framework for audit.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"11 1","pages":"266-82"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110403777","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516372","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 : 2001-06-01DOI: 10.1108/EUM0000000005510
A. Franks
A review of 21 annual clinical governance reports for the period up to April 2000 reveals significant variation in presentation and content. There are certain common themes discernible, particularly concerns about audit and clinical incident reporting by doctors, and the frequent organisational separation of risk from other elements of clinical governance. Patient involvement and reference to a specific model for quality attainment were infrequent. It is concluded that while these reports can give insights into the perceived priorities of organisations and thus could stimulate others to consider their own approach, the value of these reports as a means of performance management or as a vehicle for informing users is uncertain.
{"title":"How goes the night, watchman? An overview of the first annual clinical governance reports (1999/2000) from acute trusts in an English NHS region.","authors":"A. Franks","doi":"10.1108/EUM0000000005510","DOIUrl":"https://doi.org/10.1108/EUM0000000005510","url":null,"abstract":"A review of 21 annual clinical governance reports for the period up to April 2000 reveals significant variation in presentation and content. There are certain common themes discernible, particularly concerns about audit and clinical incident reporting by doctors, and the frequent organisational separation of risk from other elements of clinical governance. Patient involvement and reference to a specific model for quality attainment were infrequent. It is concluded that while these reports can give insights into the perceived priorities of organisations and thus could stimulate others to consider their own approach, the value of these reports as a means of performance management or as a vehicle for informing users is uncertain.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 3 1","pages":"220-6"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/EUM0000000005510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62370768","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 : 2001-06-01DOI: 10.1108/EUM0000000005511
V. Harpwood
Explores the relationship between doctors, lawyers and the government in the context of the explosion in clinical negligence litigation, clinical governance and the introduction of the Human Rights Act 1998. Examines these issues from a legal perspective. Concludes that successful risk management, careful monitoring and the implementation of authoritative guidelines hold the key to legal change.
{"title":"Clinical governance, litigation and human rights.","authors":"V. Harpwood","doi":"10.1108/EUM0000000005511","DOIUrl":"https://doi.org/10.1108/EUM0000000005511","url":null,"abstract":"Explores the relationship between doctors, lawyers and the government in the context of the explosion in clinical negligence litigation, clinical governance and the introduction of the Human Rights Act 1998. Examines these issues from a legal perspective. Concludes that successful risk management, careful monitoring and the implementation of authoritative guidelines hold the key to legal change.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"36 1","pages":"227-41"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/EUM0000000005511","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62370933","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 : 2001-06-01DOI: 10.1108/02689230110403678
M. Roland, S. Campbell, D. Wilkin
Clinical governance is a new policy introduced by the UK government to improve quality of care in the National Health Service; it imposes a "duty of quality" on all NHS organisations, and aims to bring together managerial, organisational and clinical approaches to improving quality of care. Infrastructures have been established to support quality improvement in NHS organisations and priorities for quality improvement have been established. Initial approaches are largely educational. However, information on quality of care is starting to be shared, and experiments are being conducted with a range of financial and contractual incentives for quality improvement. For widespread cultural change to occur, a "no blame" approach to quality improvement will be necessary; this may be incompatible with the need to identify and eliminate bad practice. Other tensions include the rapid pace of change being centrally driven and uneven development of the infrastructure to support clinical governance. What has not yet been shown is that quality of care has improved. It is too early to say this yet. Given the magnitude both of the vision and the work required, it is unlikely that change will be rapid, or seen on a widespread scale.
{"title":"Clinical governance: a convincing strategy for quality improvement?","authors":"M. Roland, S. Campbell, D. Wilkin","doi":"10.1108/02689230110403678","DOIUrl":"https://doi.org/10.1108/02689230110403678","url":null,"abstract":"Clinical governance is a new policy introduced by the UK government to improve quality of care in the National Health Service; it imposes a \"duty of quality\" on all NHS organisations, and aims to bring together managerial, organisational and clinical approaches to improving quality of care. Infrastructures have been established to support quality improvement in NHS organisations and priorities for quality improvement have been established. Initial approaches are largely educational. However, information on quality of care is starting to be shared, and experiments are being conducted with a range of financial and contractual incentives for quality improvement. For widespread cultural change to occur, a \"no blame\" approach to quality improvement will be necessary; this may be incompatible with the need to identify and eliminate bad practice. Other tensions include the rapid pace of change being centrally driven and uneven development of the infrastructure to support clinical governance. What has not yet been shown is that quality of care has improved. It is too early to say this yet. Given the magnitude both of the vision and the work required, it is unlikely that change will be rapid, or seen on a widespread scale.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 3 1","pages":"188-201"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110403678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516703","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 : 2001-06-01DOI: 10.1108/EUM0000000005509
P. Quennell
Examines the interaction of patient organisations with the National Institute for Clinical Excellence (NICE) during the first two years of its existence. In particular, it considers the intersection of two policy areas prominent in the Labour Government's health reforms--patient participation and evidence-based medicine. Data has been obtained from unstructured interviews with patient/carer representatives from NICE's committees and patient/carer groups with an interest in NICE's technology appraisals, supplemented by observation of NICE's Board and Partners' Council meetings, and analysis of documentary evidence. The paper focuses on "formal" and "informal" involvement of patient groups in NICE's structures and appraisals process. Most interviewees felt that the patient voice had been strengthened in these areas, though there was concern about the relative weights of patient and scientific evidence. Thus NICE illustrates two paradoxes in Labour's policy objectives--centralisation/participation and evidence-based medicine/patient perspective--which may become problematic.
{"title":"Getting their say, or getting their way? Has participation strengthened the patient \"voice\" in the National Institute for Clinical Excellence?","authors":"P. Quennell","doi":"10.1108/EUM0000000005509","DOIUrl":"https://doi.org/10.1108/EUM0000000005509","url":null,"abstract":"Examines the interaction of patient organisations with the National Institute for Clinical Excellence (NICE) during the first two years of its existence. In particular, it considers the intersection of two policy areas prominent in the Labour Government's health reforms--patient participation and evidence-based medicine. Data has been obtained from unstructured interviews with patient/carer representatives from NICE's committees and patient/carer groups with an interest in NICE's technology appraisals, supplemented by observation of NICE's Board and Partners' Council meetings, and analysis of documentary evidence. The paper focuses on \"formal\" and \"informal\" involvement of patient groups in NICE's structures and appraisals process. Most interviewees felt that the patient voice had been strengthened in these areas, though there was concern about the relative weights of patient and scientific evidence. Thus NICE illustrates two paradoxes in Labour's policy objectives--centralisation/participation and evidence-based medicine/patient perspective--which may become problematic.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 3 1","pages":"202-19"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/EUM0000000005509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62370540","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 : 2001-04-01DOI: 10.1108/02689230110394534
R. Mano‐Negrin
Occupational preferences and subsequent turnover behaviour are part of a complex relationship between employees and their occupational and organizational labour markets. Both markets contribute to matching skills and jobs. Differences in individual and occupational attributes can predict the direction and intensity of preferences for alternative organizations, occupations and job locations. Occupational preferences, which reflect the attractiveness of alternative positions within and outside the employing organization, are examined as central antecedents of occupation-specific turnover behaviour. The results of a logistic regression analysis, based on a cross-sectional occupational representative data set of 700 medical sector employees and a follow-up sample of 81 "quitters" suggest that turnover behaviour is influenced by organizational and occupational employment opportunities and occupational preferences.
{"title":"An occupational preference model of turnover behaviour: the case of Israel's medical sector employees.","authors":"R. Mano‐Negrin","doi":"10.1108/02689230110394534","DOIUrl":"https://doi.org/10.1108/02689230110394534","url":null,"abstract":"Occupational preferences and subsequent turnover behaviour are part of a complex relationship between employees and their occupational and organizational labour markets. Both markets contribute to matching skills and jobs. Differences in individual and occupational attributes can predict the direction and intensity of preferences for alternative organizations, occupations and job locations. Occupational preferences, which reflect the attractiveness of alternative positions within and outside the employing organization, are examined as central antecedents of occupation-specific turnover behaviour. The results of a logistic regression analysis, based on a cross-sectional occupational representative data set of 700 medical sector employees and a follow-up sample of 81 \"quitters\" suggest that turnover behaviour is influenced by organizational and occupational employment opportunities and occupational preferences.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 2 1","pages":"106-24"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110394534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516216","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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