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How to manage the implementation of shared care: a discussion of the role of power, culture and structure in the development of shared care arrangements. 如何管理共享护理的实施:权力、文化和结构在共享护理安排发展中的作用的讨论。
Journal of management in medicine Pub Date : 2001-04-01 DOI: 10.1108/02689230110394552
I. Mur-Veeman, I. Eijkelberg, C. Spreeuwenberg
{"title":"How to manage the implementation of shared care: a discussion of the role of power, culture and structure in the development of shared care arrangements.","authors":"I. Mur-Veeman, I. Eijkelberg, C. Spreeuwenberg","doi":"10.1108/02689230110394552","DOIUrl":"https://doi.org/10.1108/02689230110394552","url":null,"abstract":"The Dutch health care sector has become familiar with innovation of care delivery in order to meet the changing demand of the steadily ageing population, in need of complex care. Innovations often concern the implementation of shared care models, implying collaboration and substitution of care. Whereas ageing is a European-wide phenomenon, the development of such new care arrangements can be observed not only in The Netherlands, but also in the UK, Scandinavia, Italy and other countries. In this article we discuss the implementation of shared care, with the help of three concepts: power, culture and structure. We discuss the role of these factors from the view that shared care can be considered as inter-professional working within a network context. The central question is how structure, culture and power can offer change managers a starting-point for improving their innovative capacity. To illuminate our discussion we make use of a number of event-descriptions from five Dutch shared care projects. Also, we give some practical recommendations for change managers.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 2 1","pages":"142-55"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110394552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516349","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}
引用次数: 56
Conflict management in a hospital: designing processing structures and intervention methods. 医院冲突管理:处理结构与干预方法的设计。
Journal of management in medicine Pub Date : 2001-04-01 DOI: 10.1108/02689230110394660
M. Skjørshammer
{"title":"Conflict management in a hospital: designing processing structures and intervention methods.","authors":"M. Skjørshammer","doi":"10.1108/02689230110394660","DOIUrl":"https://doi.org/10.1108/02689230110394660","url":null,"abstract":"This article presents a case study describing the development, structure and operation of a comprehensive system for managing conflicts in a Norwegian city hospital. This was done in an effort to further develop the dispute mechanisms available in the hospital and to strengthen the management skills of clinical leaders and managers in general. By changing the ways managers and professionals handle their disputes, the hospital hopes to reduce the cost of conflicts and realize its benefits. The new conflict management system includes new procedures for managers and professionals to process disputes. The design process of the new system was framed according to an action research approach characterized by creating change through dialogue and the use of local expertise.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 2 1","pages":"156-66"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110394660","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516438","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}
引用次数: 28
Rationality and Power: Democracy in Practice 理性与权力:实践中的民主
Journal of management in medicine Pub Date : 2001-02-01 DOI: 10.1108/JMM.2001.15.1.95.2
S. Harrison
{"title":"Rationality and Power: Democracy in Practice","authors":"S. Harrison","doi":"10.1108/JMM.2001.15.1.95.2","DOIUrl":"https://doi.org/10.1108/JMM.2001.15.1.95.2","url":null,"abstract":"","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 1","pages":"95-97"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62119710","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}
引用次数: 906
New roles and relationships in the NHS--barriers to change. NHS中的新角色和新关系——变革的障碍。
Journal of management in medicine Pub Date : 2001-02-01 DOI: 10.1108/02689230110386353
D. Goldie, J. Sheffield
{"title":"New roles and relationships in the NHS--barriers to change.","authors":"D. Goldie, J. Sheffield","doi":"10.1108/02689230110386353","DOIUrl":"https://doi.org/10.1108/02689230110386353","url":null,"abstract":"The incoming Labour Government's vision for reforming the NHS in Scotland was outlined in the White Paper Designed to Care. While bearing similarities to the proposals outlined for the rest of the UK, it also had distinctive differences. Organisational structures, roles, and relationships between the different parts of the NHS were to be fundamentally altered, particularly in primary and community care. This paper reports upon a series of interviews undertaken across several Health Board areas, with key stakeholders involved in the primary and community sectors. These interviews were intended to examine the development and evolution of the new organisational arrangements, and to identify potential barriers to the successful implementation of Designed to Care. Several barriers and sources of institutional resistance to the new roles and relationships were found during this study, and are discussed. Suggestions upon how these may be overcome and implementation improved are then made.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 1 1","pages":"6-27"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110386353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515941","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}
引用次数: 8
Performance implications of Porter's generic strategies in Slovak hospitals. 波特的通用策略在斯洛伐克医院的绩效影响。
Journal of management in medicine Pub Date : 2001-02-01 DOI: 10.1108/02689230110386489
S. Hlavacka, Ljuba Bacharova, Viera Rusnakova, Robert Wagner
{"title":"Performance implications of Porter's generic strategies in Slovak hospitals.","authors":"S. Hlavacka, Ljuba Bacharova, Viera Rusnakova, Robert Wagner","doi":"10.1108/02689230110386489","DOIUrl":"https://doi.org/10.1108/02689230110386489","url":null,"abstract":"The aim of the study was to examine the use of Porter's generic strategies and their effect on performance in the context of the Slovak hospital industry. Using mail survey the study first identified the natural taxonomy of four strategic types of Slovak hospitals, based on their use of Porter's generic strategies in pure form and in combination. Next the study examined whether different strategic types were associated with different levels of organisational performance, while controlling for such variables as size and location, which have been argued to influence the hospital performance. The findings indicate that hospitals which follow a \"stuck-in-the-middle\" strategy, in general, have superior performance on all used performance measures, while hospitals that place only low emphasis on cost leadership, differentiation and focus, labelled \"wait and see\" in this study, perform the poorest. The study concludes that the research provided body of knowledge relevant for the Slovak hospital industry, that may be used by hospital managers in the strategy formulation process as well as by the researches in exploring the influence of different contingencies on hospitals' strategic orientation.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 1 1","pages":"44-66"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110386489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516099","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}
引用次数: 92
Health, Medicine and Society: Key Theories, Future Agendas 健康，医学和社会:关键理论，未来议程
Journal of management in medicine Pub Date : 2001-02-01 DOI: 10.1108/jmm.2001.15.1.95.1
C. Bern
{"title":"Health, Medicine and Society: Key Theories, Future Agendas","authors":"C. Bern","doi":"10.1108/jmm.2001.15.1.95.1","DOIUrl":"https://doi.org/10.1108/jmm.2001.15.1.95.1","url":null,"abstract":"","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 1","pages":"95-97"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62119666","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}
引用次数: 23
How do directors of public health perceive leadership? 公共卫生主管如何看待领导力?
Journal of management in medicine Pub Date : 2001-01-01 DOI: 10.1108/jmm.2001.15.6.446
M. J. McAreav, B. Alimo‐Metcalfe, J. Connelly
{"title":"How do directors of public health perceive leadership?","authors":"M. J. McAreav, B. Alimo‐Metcalfe, J. Connelly","doi":"10.1108/jmm.2001.15.6.446","DOIUrl":"https://doi.org/10.1108/jmm.2001.15.6.446","url":null,"abstract":"This study examines how directors of public health (DsPH) perceive effective leadership. Kelly's repertory grid technique is used. A total of 13 out of a possible 14 DsPH in one NHS region of England were interviewed. Qualitative and quantitative analysis were carried out. The findings show that male DsPH (n = 8) rate their leadership ability more highly than do female DsPH (n = 5). Qualitative analysis produced a number of categories of constructs, some of which are perceived to be indicative of effective leadership, these being \"working for others\", \"personal attributes\", \"vision and innovation\" and \"courage and integrity\" Some categories appear to be applicable only to the UK (or to public health) and not to the existing dominant US models of leadership. In general, DsPH perceptions of effective leadership converge with current theories; most specifically the UK-based theories. This study therefore refutes any simple extrapolation of US theories of leadership to UK health organisations.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 6 1","pages":"446-62"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/jmm.2001.15.6.446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62119769","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}
引用次数: 13
New Zealand pathologists: a case study in occupational control. 新西兰病理学家:职业控制的个案研究。
Journal of management in medicine Pub Date : 2001-01-01 DOI: 10.1108/02689230110386416
N. France, Stewart Lawrence, John F. Smith
{"title":"New Zealand pathologists: a case study in occupational control.","authors":"N. France, Stewart Lawrence, John F. Smith","doi":"10.1108/02689230110386416","DOIUrl":"https://doi.org/10.1108/02689230110386416","url":null,"abstract":"This paper examines the progressive exertion of external managerial control over New Zealand pathologists as the country's New Public Management health reforms were implemented during the 1990s. Perspectives on professionalism, and its role in the effective use of resources, are discussed as part of the examination of this shift in decision-making power from pathologists to external management. Our analysis, based on a range of archived and interview data collected over the period 1997-2000, suggests that publicly unacceptable compromises in pathology service quality were risked by the pursuit of tight bureaucratic and free market controls over pathology practice. The paper concludes with suggestions for a health professional control model facilitative of maximal health gain.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 1 1","pages":"28-43"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110386416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62515959","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}
引用次数: 3
Theorising the social within physician decision making. 理论化医生决策中的社会因素。
Journal of management in medicine Pub Date : 2001-01-01 DOI: 10.1108/02689230110403704
R. Mano‐Negrin, B. Mittman
{"title":"Theorising the social within physician decision making.","authors":"R. Mano‐Negrin, B. Mittman","doi":"10.1108/02689230110403704","DOIUrl":"https://doi.org/10.1108/02689230110403704","url":null,"abstract":"Explores the underlying behavioral processes influencing the clinical behavior of physicians toward their patients. Utilizing educational and social influence explanatory models as a baseline, we sought how each, through peer group settings, would affect clinical specific practice decisions. Focusing on family physicians in Israel who were engaged in ongoing professional peer group meetings, it is suggested that health decisions affecting clinical practice are not universal but particularistic and depend a great deal on the transfer of clinical knowledge through selective social networks. Health managers, utilizing these findings, can therefore intervene in the formation of clinical practice decisions. This can be done primarily through management policy to induce the formation of specific types of peer group social networks.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 4-5 1","pages":"259-65"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110403704","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516261","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}
引用次数: 26
Involving patients in research: setting up a service users' advisory group. 让病人参与研究:建立服务使用者咨询小组。
Journal of management in medicine Pub Date : 2001-01-01 DOI: 10.1108/02689230110394679
P. Rhodes, A. Nocon, John Wright, S. Harrison
{"title":"Involving patients in research: setting up a service users' advisory group.","authors":"P. Rhodes, A. Nocon, John Wright, S. Harrison","doi":"10.1108/02689230110394679","DOIUrl":"https://doi.org/10.1108/02689230110394679","url":null,"abstract":"Looks at some of the issues raised by patients' involvment in the research process. Uses the example of a service users' advisory group established as part of a diabetes service evaluation in the north of England. Key conclusions were: a precise role for the group should be specified at the outset; genuine user involvement is needed; wide and accurate representation of all relevant groups in society is essential; and, researchers must approach users with open minds with a view to shared decision making rather than control.","PeriodicalId":80033,"journal":{"name":"Journal of management in medicine","volume":"15 2 1","pages":"167-71"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/02689230110394679","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62516559","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}
引用次数: 21
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