Pub Date : 2001-01-01DOI: 10.1108/02689230110386515
Anna Gaughan
The UK National Health Service (NHS) is undergoing cataclysmic change following the election of the first Labour Government in 18 years. This is primarily embodied in the implementation of the White Paper The New NHS Modern-Dependable, which has resulted in the creation of primary care groups (PCGs) and primary care trusts (PCTs). The task facing both PCGs and PCTs is a radically new and complex one, requiring a new set of leadership skills to the traditional command and control style management. Leadership theories have evolved over the past 70 years. However, it was not until the 1980s that a major change in the paradigm of thinking around what is the nature of leadership occurred. The interaction between the leader and his/her followers is explored in what has become known as transformational leadership theories, developed by Bass and Avolio. Recent studies have, however, questioned the applicability of leadership models derived in the USA, to other cultures. This paper explores the leadership behaviours required for the management boards of PCGs and PCTs. A qualitative research method "Grounded Theory" approach was chosen for this study of leadership. The Repertory Grid technique was used to collect data. There are a number of implications arising from the findings of this study for both leadership models in general, and more specifically, for the development of leadership skills in both PCGs and PCTs.
{"title":"Effective leadership behaviour: leading \"the third way\" from a primary care group perspective. A study of leadership constructs elicited from members of primary care group management boards.","authors":"Anna Gaughan","doi":"10.1108/02689230110386515","DOIUrl":"https://doi.org/10.1108/02689230110386515","url":null,"abstract":"The UK National Health Service (NHS) is undergoing cataclysmic change following the election of the first Labour Government in 18 years. This is primarily embodied in the implementation of the White Paper The New NHS Modern-Dependable, which has resulted in the creation of primary care groups (PCGs) and primary care trusts (PCTs). The task facing both PCGs and PCTs is a radically new and complex one, requiring a new set of leadership skills to the traditional command and control style management. Leadership theories have evolved over the past 70 years. However, it was not until the 1980s that a major change in the paradigm of thinking around what is the nature of leadership occurred. The interaction between the leader and his/her followers is explored in what has become known as transformational leadership theories, developed by Bass and Avolio. Recent studies have, however, questioned the applicability of leadership models derived in the USA, to other cultures. This paper explores the leadership behaviours required for the management boards of PCGs and PCTs. A qualitative research method \"Grounded Theory\" approach was chosen for this study of leadership. The Repertory Grid technique was used to collect data. There are a number of implications arising from the findings of this study for both leadership models in general, and more specifically, for the development of leadership skills in both PCGs and PCTs.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"66 1","pages":"67-94"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110386515","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516153","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 : 2001-01-01DOI: 10.1108/02689230110403812
V. Allgar, B. Leese, P. Heywood, R. Walker
Contracts and interim local evaluation reports for the 14 first wave PMS pilots in Northern and Yorkshire region were analysed by documentary analysis. Both contracts and reports were found to vary considerably in size and scope. Most contracts contained aims and objectives that were too broad or vague to guide project management and they lacked useful milestones. This made it difficult to identify criteria for measuring success. The local evaluation reports were also of variable quality. It is recommended that contracts should be accompanied by a development plan containing specific objectives, timescale and process for implementation as well as an evaluation strategy. The relative importance of different targets should be agreed and specified at the outset, to allow weighting of partial success, where some objectives, but not others, are achieved. Project milestones would be made explicit and measurable in the development plan. More clarity in contracts and evaluation for future pilots is essential.
{"title":"First wave PMS pilots: a critical analysis of documentation.","authors":"V. Allgar, B. Leese, P. Heywood, R. Walker","doi":"10.1108/02689230110403812","DOIUrl":"https://doi.org/10.1108/02689230110403812","url":null,"abstract":"Contracts and interim local evaluation reports for the 14 first wave PMS pilots in Northern and Yorkshire region were analysed by documentary analysis. Both contracts and reports were found to vary considerably in size and scope. Most contracts contained aims and objectives that were too broad or vague to guide project management and they lacked useful milestones. This made it difficult to identify criteria for measuring success. The local evaluation reports were also of variable quality. It is recommended that contracts should be accompanied by a development plan containing specific objectives, timescale and process for implementation as well as an evaluation strategy. The relative importance of different targets should be agreed and specified at the outset, to allow weighting of partial success, where some objectives, but not others, are achieved. Project milestones would be made explicit and measurable in the development plan. More clarity in contracts and evaluation for future pilots is essential.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 4-5 1","pages":"299-311"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110403812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516808","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 : 2001-01-01DOI: 10.1108/02689230110394543
J. Øvretveit
The UK NHS quality proposals require all NHS organisations to develop an “integrated approach” to quality. In other countries, health care organisations are also working to ensure that the many different quality methods and systems used in health organisations do not duplicate or conflict with each other. The question this paper addresses is “what would an integrated approach to quality look like and how might managers and clinicians develop such an approach in their organisation?“ The findings from the Norwegian total quality management experiment in six hospitals were that TQM could not be applied in its pure form in public health care services to ensure integration. The paper draws on this research to describe these hospitals’ approach to integrate the different projects and systems which were stimulated by their initial quality programmes. The paper describes the ”integrated quality development" approach which characterised these programmes.
{"title":"The Norwegian approach to integrated quality development","authors":"J. Øvretveit","doi":"10.1108/02689230110394543","DOIUrl":"https://doi.org/10.1108/02689230110394543","url":null,"abstract":"The UK NHS quality proposals require all NHS organisations to develop an “integrated approach” to quality. In other countries, health care organisations are also working to ensure that the many different quality methods and systems used in health organisations do not duplicate or conflict with each other. The question this paper addresses is “what would an integrated approach to quality look like and how might managers and clinicians develop such an approach in their organisation?“ The findings from the Norwegian total quality management experiment in six hospitals were that TQM could not be applied in its pure form in public health care services to ensure integration. The paper draws on this research to describe these hospitals’ approach to integrate the different projects and systems which were stimulated by their initial quality programmes. The paper describes the ”integrated quality development\" approach which characterised these programmes.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"47 4 1","pages":"125-141"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110394543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516245","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 : 2001-01-01DOI: 10.1108/02689230110408060
K. Mahmood
Examines the professional stratification in general practice in the UK National Health Service. Looks in particular at the reforms implemented by New Labour--the introduction of primary care groups and their transition to primary care trusts. Concludes that the key to restratification lies in understanding the agenda being pursued.
{"title":"Clinical governance and professional restratification in general practice.","authors":"K. Mahmood","doi":"10.1108/02689230110408060","DOIUrl":"https://doi.org/10.1108/02689230110408060","url":null,"abstract":"Examines the professional stratification in general practice in the UK National Health Service. Looks in particular at the reforms implemented by New Labour--the introduction of primary care groups and their transition to primary care trusts. Concludes that the key to restratification lies in understanding the agenda being pursued.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 3 1","pages":"242-52"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110408060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516915","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 : 2001-01-01DOI: 10.1108/02689230110412326
James Alastair McLaughlin
Evidence-based medicine (EBM) has become a major theme within health care. This has fuelled a significant debate about its role in reducing risk and its possible impact on professional autonomy. Challenges arguments that propose that EBM is a threat to professional power and status by looking at how evidence, risk and professional knowledge come to have meaning. The objective is to deconstruct all three as discursive constructions whose meanings are malleable and embedded in social and power relations. By drawing on sociological debates about the social construction of evidence, risk and professional autonomy indicates the ways in which EBM is neither a rational alternative to the seemingly unending risks of contemporary medicine, nor in opposition to professional status. Instead it concludes by arguing that EBM and notions of risk are rhetorical resources in the articulation of professional autonomy and identity.
{"title":"EBM and risk: rhetorical resources in the articulation of professional identity.","authors":"James Alastair McLaughlin","doi":"10.1108/02689230110412326","DOIUrl":"https://doi.org/10.1108/02689230110412326","url":null,"abstract":"Evidence-based medicine (EBM) has become a major theme within health care. This has fuelled a significant debate about its role in reducing risk and its possible impact on professional autonomy. Challenges arguments that propose that EBM is a threat to professional power and status by looking at how evidence, risk and professional knowledge come to have meaning. The objective is to deconstruct all three as discursive constructions whose meanings are malleable and embedded in social and power relations. By drawing on sociological debates about the social construction of evidence, risk and professional autonomy indicates the ways in which EBM is neither a rational alternative to the seemingly unending risks of contemporary medicine, nor in opposition to professional status. Instead it concludes by arguing that EBM and notions of risk are rhetorical resources in the articulation of professional autonomy and identity.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 4-5 1","pages":"352-63"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110412326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516978","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 : 2001-01-01DOI: 10.1108/02689230110403795
R. Gross, H. Tabenkin, S. Brammli-Greenberg
Assesses the degree of self-reported implementation of gatekeeping in clinical practice, and gains insight into primary care physicians' attitudes toward gatekeeping and their perceptions of necessary conditions for implementation of gatekeeping in daily practice. A self-administered questionnaire was mailed to a national sample of 800 primary care physicians in Israel, with a response rate of 86 per cent. Multivariate analysis indicated that sick fund affiliation was the main predictor of self-reported implementation of gatekeeping, while specialty training predicted primary care physicians' attitude toward this role. Close communication with specialists, continuous medical education, and management support of physician decisions were identified by respondents as being important conditions for gatekeeping. Discusses strategies to gain the cooperation of primary care physicians, which is necessary for implementing an effective gatekeeping system.
{"title":"Gatekeeping: a challenge in the management of primary care physicians.","authors":"R. Gross, H. Tabenkin, S. Brammli-Greenberg","doi":"10.1108/02689230110403795","DOIUrl":"https://doi.org/10.1108/02689230110403795","url":null,"abstract":"Assesses the degree of self-reported implementation of gatekeeping in clinical practice, and gains insight into primary care physicians' attitudes toward gatekeeping and their perceptions of necessary conditions for implementation of gatekeeping in daily practice. A self-administered questionnaire was mailed to a national sample of 800 primary care physicians in Israel, with a response rate of 86 per cent. Multivariate analysis indicated that sick fund affiliation was the main predictor of self-reported implementation of gatekeeping, while specialty training predicted primary care physicians' attitude toward this role. Close communication with specialists, continuous medical education, and management support of physician decisions were identified by respondents as being important conditions for gatekeeping. Discusses strategies to gain the cooperation of primary care physicians, which is necessary for implementing an effective gatekeeping system.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 4-5 1","pages":"283-98"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110403795","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516387","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 : 2001-01-01DOI: 10.1108/EUM0000000005921
J. Adams
There has been a movement towards integrating complementary and alternative medicine (CAM) into the NHS and a growing number of general practitioners (GPs) are personally practising CAM to treat their NHS patients (direct integrative practice). While research has begun to examine DIP, time constraints and related issues--of importance not only to practitioners but also to those purchasing and planning health care--have not yet received in depth attention. In response this paper examines GP therapists' experiences of the clinical reality of their DIP. The analysis reveals how a lack of time is perceived by GP therapists as a serious constraint upon their CAM practice and also how they employ a number of strategies in an attempt to overcome such difficulties.
{"title":"Direct integrative practice, time constraints and reactive strategy: an examination of GP therapists' perceptions of their complementary medicine.","authors":"J. Adams","doi":"10.1108/EUM0000000005921","DOIUrl":"https://doi.org/10.1108/EUM0000000005921","url":null,"abstract":"There has been a movement towards integrating complementary and alternative medicine (CAM) into the NHS and a growing number of general practitioners (GPs) are personally practising CAM to treat their NHS patients (direct integrative practice). While research has begun to examine DIP, time constraints and related issues--of importance not only to practitioners but also to those purchasing and planning health care--have not yet received in depth attention. In response this paper examines GP therapists' experiences of the clinical reality of their DIP. The analysis reveals how a lack of time is perceived by GP therapists as a serious constraint upon their CAM practice and also how they employ a number of strategies in an attempt to overcome such difficulties.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"43 1","pages":"312-22"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/EUM0000000005921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62386938","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 : 2001-01-01DOI: 10.1108/14777260110695518
B. Leese, K. Baxter, N. Goodwin, J. Scott, A. Mahon
Primary care in the UK has been the subject of numerous changes and reorganizations since 1990. Each innovation in organization, with the exception of fundholding, has been the subject of evaluation. However, the complexities of some innovations make the evaluation process problematic and this is further complicated by the trend towards central policy decision making being subject to local interpretation and implementation, by means of simultaneous devolution and centralization. This paper discusses the challenges and problems posed by attempting to evaluate these new organizations, particularly with regard to whether or not they can be considered to be "successful". It draws specifically on the national evaluation of the total purchasing pilots and indicates how the findings can be applied to primary care groups.
{"title":"Measuring the success of primary care organizations: is it possible?","authors":"B. Leese, K. Baxter, N. Goodwin, J. Scott, A. Mahon","doi":"10.1108/14777260110695518","DOIUrl":"https://doi.org/10.1108/14777260110695518","url":null,"abstract":"Primary care in the UK has been the subject of numerous changes and reorganizations since 1990. Each innovation in organization, with the exception of fundholding, has been the subject of evaluation. However, the complexities of some innovations make the evaluation process problematic and this is further complicated by the trend towards central policy decision making being subject to local interpretation and implementation, by means of simultaneous devolution and centralization. This paper discusses the challenges and problems posed by attempting to evaluate these new organizations, particularly with regard to whether or not they can be considered to be \"successful\". It draws specifically on the national evaluation of the total purchasing pilots and indicates how the findings can be applied to primary care groups.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 2 1","pages":"172-80"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/14777260110695518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62065251","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 : 2000-12-01DOI: 10.1108/02689230010362909
Liz Barker
UNLABELLED In this study the Repertory Grid interview technique was used to investigate constructs of leadership held by a group of male and female senior managers from within hospice and Specialist Palliative Care Units (SPCUs) in the UK. The themes that emerged were compared with those from existing research models of leadership. RESULTS Men and women in these roles describe different constructs of effective leadership. The women's constructs that emerged were predominantly transformational, whilst the men's were predominantly transactional. Themes were also identified in this study, which differed from previous studied, i.e. those of political and environment awareness and the valuing of others' views regardless of their status. These themes do not feature highly in other research, and may be in response to the environment within which hospice and specialist palliative care functions.
{"title":"Effective leadership within hospice and specialist palliative care units.","authors":"Liz Barker","doi":"10.1108/02689230010362909","DOIUrl":"https://doi.org/10.1108/02689230010362909","url":null,"abstract":"UNLABELLED\u0000In this study the Repertory Grid interview technique was used to investigate constructs of leadership held by a group of male and female senior managers from within hospice and Specialist Palliative Care Units (SPCUs) in the UK. The themes that emerged were compared with those from existing research models of leadership.\u0000\u0000\u0000RESULTS\u0000Men and women in these roles describe different constructs of effective leadership. The women's constructs that emerged were predominantly transformational, whilst the men's were predominantly transactional. Themes were also identified in this study, which differed from previous studied, i.e. those of political and environment awareness and the valuing of others' views regardless of their status. These themes do not feature highly in other research, and may be in response to the environment within which hospice and specialist palliative care functions.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 5-6 1","pages":"291-309"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010362909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515817","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 : 2000-12-01DOI: 10.1108/02689230010363007
Robert Wagner, S. Hlavacka, Ljuba Bacharova
The study is an attempt to provide empirical evidence, in the context of acute hospital care, of the current human resource practices in the health sector of the Slovak Republic. Using a sample of 72 acute care hospitals the research explored the perceived functions, typical customers and priorities of hospital human resource departments, ownership of a workforce plan, and the relationships between ownership of a workforce plan and type of hospital, as well as the degree to which different human resource activities are given priority. Cross-tabulation procedure revealed statistically significant relationships between ownership of a workforce plan and the degree of priority given to having a quick, efficient and cost-effective recruitment and selection system and, not surprisingly, the degree of priority given to ensuring that the human resource department has a workforce plan. The study evidence also indicates that, although the human resource staff in hospitals seem to be aware of their role in assisting hospital management in decision making, the human resource function in the Slovak hospitals still rather resembles that of a personnel administration than that of an important strategic human resource activity.
{"title":"Hospital human resource planning in Slovakia.","authors":"Robert Wagner, S. Hlavacka, Ljuba Bacharova","doi":"10.1108/02689230010363007","DOIUrl":"https://doi.org/10.1108/02689230010363007","url":null,"abstract":"The study is an attempt to provide empirical evidence, in the context of acute hospital care, of the current human resource practices in the health sector of the Slovak Republic. Using a sample of 72 acute care hospitals the research explored the perceived functions, typical customers and priorities of hospital human resource departments, ownership of a workforce plan, and the relationships between ownership of a workforce plan and type of hospital, as well as the degree to which different human resource activities are given priority. Cross-tabulation procedure revealed statistically significant relationships between ownership of a workforce plan and the degree of priority given to having a quick, efficient and cost-effective recruitment and selection system and, not surprisingly, the degree of priority given to ensuring that the human resource department has a workforce plan. The study evidence also indicates that, although the human resource staff in hospitals seem to be aware of their role in assisting hospital management in decision making, the human resource function in the Slovak hospitals still rather resembles that of a personnel administration than that of an important strategic human resource activity.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"14 5-6 1","pages":"383-405"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230010363007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515885","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：