Journal of Management & Marketing in Healthcare最新文献

{"title":"A qualitative and quantitative study of medical leadership and management: experiences, competencies, and development needs of doctor managers in the United Kingdom","authors":"S. Ireri, K. Walshe, L. Benson, M. Mwanthi","doi":"10.1179/175330304X10Y.0000000004","DOIUrl":"https://doi.org/10.1179/175330304X10Y.0000000004","url":null,"abstract":"Abstract Health-care systems need strong leadership if they are to be sustainable and responsive to the health needs of the future. There is little empirical and theoretical literature about how medical managers conceptualize management or undertake management roles. There is widespread support in the literature for the establishment of clinician management structures. In the UK, there is considerable interest in doctors becoming more involved in management of the National Health Service (NHS). The aim of the study was to explore the experiences, competencies, and development needs of doctor managers in the UK. Data were collected using a multi-method approach: qualitative interviews and a survey with doctor managers in the NHS. The template method was used for qualitative data analysis while appropriate statistical tests in SPSS were used for quantitative data analysis. The findings of the study add to the knowledge on experiences of doctor managers: motivations for a management role and difficulties encountered. Ways of addressing some of the difficulties are proposed. In addition, the study provides data on doctors' leadership and managerial competencies, training, and development needs as well as their preferred learning styles.","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124298817","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}

{"title":"The EHMA Agora for seeking new paradigms","authors":"A. de Roo","doi":"10.1179/175330310X12883550540259","DOIUrl":"https://doi.org/10.1179/175330310X12883550540259","url":null,"abstract":"At the opening session of the EHMA Annual Conference in Lahti, Finland, participants engaged in The Largo Simulation that instantly demonstrated the actuality of the conference theme: ‘Managing Radical Change in Health’. The simulation moderator, Laurie McMahon, confronted his audience with two major policy issues that will dominate health sector change in EU member states during the next decade. First, he raised the question about how to protect and improve health status in the face of the current recession. Public health research on previous economic crises has uncovered a broad range of negative effects on health and well-being, especially for lower socio-economic status groups. Second, he clarified the far-reaching consequences of the economic crisis on public funding of health services. EU governments are facing an unprecedented need to cut back budget deficits and national debts. As a consequence, they are looking for savings on health services expenditure on a scale not seen before. For example, the Dutch government is exploring opportunities to cut parts of its health sector budget by 20%. Other EU governments are looking for interventions of the same kind of magnitude. The health sector is used to financial pressure. Cost containment policies emerged in all Western countries during the 1980s, in reaction to a heavy economic recession and the extraordinary growth of health services expenditure in preceding years. Governments and health authorities filled a policy toolkit with instruments for restricting health service entitlements, refining need assessment procedures, slowing down capital investment, extending the range of co-payments, intervening in drugs price setting, tightening up macro budget control, and so on. During the last two decades the use of this toolkit intensified, as the growth rate of the publicly funded health sector tended to exceed domestic economic growth rate over and again. Under this pressure provider organizations have developed a broad repertoire of cost-saving routines to deal with recurrent budget cuts. These range from simply stopping waste, standardizing working procedures, and tightening financial control to measures to reduce labour costs and smarter procurement and utilization of buildings and equipment. Horizontal and vertical integration became a popular managerial option to pursue economies of scale and scope, as did substitution of cost-intensive clinical services for cheaper day treatment and ambulatory care. Efficiency became the buzz word that guided strategic actions on both the national and organizational levels. However, the present combination of growing health-care needs and macro-economic pressure on the sector requires strategic responses that go far beyond the conventional political and managerial routines of dealing with tight financial resources. This rapidly became visible for the participants participating in The Largo Simulation. First, everybody started to tackle the health and financ","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123218609","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}

{"title":"Editor's three day travelogue through the EHMA Agora","authors":"M. Nenonen","doi":"10.1179/175330310X12928426376142","DOIUrl":"https://doi.org/10.1179/175330310X12928426376142","url":null,"abstract":"We open this issue with an opinion paper of Aad de Roo, the new president of EHMA who takes you into the middle of our opening session. We did not want to have an ordinary and safe opening procedure but moved directly into the real world of uncertainty, confrontations, mixed interest and lack of evidence. The risk of this approach is to be left in this state of confusion for the following days of conference. This is where we need an experienced moderator and also positive experiences and case studies. This is also why we wanted to give this paper a positive and optimistic title. But do we actually have good examples of economic constraints promoting innovation and creating reforms? If we had at least few such cases, we would have published them in this issue. Too often researchers and policy makers adopt the classic formula of a sermon: start with describing the horrors of present, giving apocalyptic visions and end with a hope for a better world. I would like to challenge our readers to write positive papers and to present their success stories! This paper describes the journey we took with the Largo experiment. We managed to enter the area of unsafe debate, where the new paradigms do hide. Perhaps we need an economic crisis to enter this zone in real life. As long as we have all the money, we do not need to think. When we ran out of money we start to cut expenses. When this does not work, not earlier, we have to rethink our systems. Could we do it earlier, even before we start to cut and impoverish? On the other hand, if we find the new paradigm too early, are we able to “sell” it? Is it actually possible for a mainstream researcher to find a new paradigm? A new paradigm is not usually the way to proceed in your academic career, so why take all the pain. We also need a channel to publish the results in “a new way”. The classical scientific paradigm may find the results of new debate as “unscientific opinions needing heavy rewriting...” like editors use to say. The young and coming managers are also often stuck deep in the old paradigms, because this is the safe way to success and good position. We need an AGORA for seeking and testing new paradigms. This might also create a new research “school”? It might be more subjective, experimental, discussing and observational than what we have been used to. Aad gives a promise to expose us to paradigmatic innovation and unsafe debate. This is a good “mission” for EHMA.","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116367754","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}

{"title":"Ensuring equity in healthcare delivery","authors":"I. Durand-zaleski","doi":"10.1179/175330310X12883550540132","DOIUrl":"https://doi.org/10.1179/175330310X12883550540132","url":null,"abstract":"Abstract Over the past 20 years, the development of health care services and the availability of health care coverage to the population have been accompanied by major gains in life expectancy. There remains, however, an issue in equity of access to health care services which may increase with the economic downturn. Evidence of health inequities can be found in health statistics all around Europe, where low income groups are less healthy and report more limitation to use of healthcare services than higher income groups. There is a strong commitment among researchers in health services to put health inequities on the political and research agendas. This is done by providing tools that assess the effect of new technologies on equity and by ensuring that dashboard indicators include measures of equity.","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131080657","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}

{"title":"Serving primary health care: a national action programme for primary care in Finland","authors":"T. Mäntyranta, M. Kaila, J. Mattila, Paula Risikko","doi":"10.1179/1753304X10Y.0000000002","DOIUrl":"https://doi.org/10.1179/1753304X10Y.0000000002","url":null,"abstract":"Abstract In Finland, municipalities are responsible for organizing primary health care (PHC). Current challenges include recruitment problems, especially concerning physicians and dentists; system-centred planning; and overall focus in specialized care and problems in access to care. A national action programme for primary care was launched in 2008 to respond to the challenges. Legislative amendments were carried out. Local and regional development projects were endorsed with financial support from a national development programme for social and health care. The action programme consists of 24 actions, focusing on three domains: Mission clarification: The value of PHC is in the health gain it produces. The main action is the national implementation of the chronic care model. Patient to the centre: A new legislation increasing patient choice was approved by Parliament. Support for better self-management and empowerment is implemented. Personnel: Changes in education and division of responsibilities between physicians, nurses, and allied health professionals are implemented. Evaluation of the programme will take place in 2011. Professional societies were involved in the PHC programme from the beginning as partners. This has created a strong commitment to the programme among professionals. The current economic depression is a challenge, but also an opportunity for the programme.","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131208992","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}

{"title":"Empowering local communities to commission for health and wellbeing: the connected care initiative in England","authors":"G. Wistow, Gillian Callaghan","doi":"10.1179/1753304X10Y.0000000007","DOIUrl":"https://doi.org/10.1179/1753304X10Y.0000000007","url":null,"abstract":"Abstract The connected care pilot in Hartlepool has been commended in government documents for its potential to 'put people in control' and, thereby, enable them 'to shape improvements in provision and contribute to greater fairness in service use'. This article focuses on the development by that pilot of a 'model' for community commissioning which residents were centrally involved in designing and operationalizing. It aims to describe how far and in what ways community members helped to shape those processes so that the pilot 's implications for promoting community commissioning can be identified and consolidated.","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127478652","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}

{"title":"EHMA Editorial","authors":"Jeni Bremner","doi":"10.1179/175330310x12883551518334","DOIUrl":"https://doi.org/10.1179/175330310x12883551518334","url":null,"abstract":"","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127343413","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}

{"title":"Developing an innovation ecosystem: A framework for accelerating knowledge transfer","authors":"S. Hamer","doi":"10.1179/175330310X12736578177607","DOIUrl":"https://doi.org/10.1179/175330310X12736578177607","url":null,"abstract":"Abstract Health organisations are being challenged to change rapidly in response to a variety of competing demands. There is a temptation to look for externally promoted solutions rather than making better use of existing organisational talent. Evidence from the fields of knowledge transfer and diffusion of innovation suggest that it takes a range of purposeful actions to successfully innovate, including supportive management. This paper describes the development and subsequent use of a knowledge transfer framework which can help in a sense-making process to enable decision makers take a systems approach to innovation development and adoption.","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"58 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127578419","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}

{"title":"Health literacy: A new dimension for healthcare development?","authors":"J. P. Moreira","doi":"10.1179/175330310X12918040319775","DOIUrl":"https://doi.org/10.1179/175330310X12918040319775","url":null,"abstract":"","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129601926","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}

{"title":"Managing the paradox between equality and diversity in healthcare: Unwarranted vs warranted variations","authors":"S. Bojakowski","doi":"10.1179/175330310X12736578177562","DOIUrl":"https://doi.org/10.1179/175330310X12736578177562","url":null,"abstract":"Abstract Unwarranted variations in healthcare services are variations that cannot be explained by public health needs or medical needs. The NHS has introduced several policy initiatives aimed at reducing unwarranted variations, but there are barriers to their effectiveness. In recent years, efforts to address unwarranted variations in England and Wales have led to the Department of Health setting standards via agencies such as the National Institute for Health and Clinical Excellence, with implementation and service development left to local health services. The implementation of centrally set standards has brought about greater transparency in the variations in healthcare provision across the UK. The key task for policymakers, managers and clinicians is to determine which of these variations are justifiable — or warranted — and which are unwarranted. This paper examines the extent of unwarranted variations as well as their implications for patient care and public confidence in the UK health system. It suggests that some local variation is warranted, provided minimum care standards are maintained.","PeriodicalId":354315,"journal":{"name":"Journal of Management & Marketing in Healthcare","volume":"225 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126895407","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}