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1780 results in Nursing

Page 65 of 89

  • Preface

  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp xix-xxii

  • Summary

    This book is a culmination of over 30 years of studying, practising, researching and observing leadership and management within the Australasian healthcare industry. Over this period, a range of industry and system factors has made working, managing and leading in health services more challenging and complex. These factors include greater scrutiny of the spending on health and the resulting outcomes, which has led to substantial reform initiatives; recognition of the importance of good governance and individual, organisational and system accountability; reliance on technology to support clinical and non-clinical healthcare decision-making; workforce shortages and role substitution; and better understanding of the ways to improve clinical safety and quality, and overall health outcomes. These factors have been driven by greater public interest and political scrutiny of the healthcare system, focused on quality and safety, access and equity, and the roles of the various levels of government and private operators. We have seen funders, regulators and other agencies requiring increasing levels of effectiveness, efficiency and better health outcomes.

    To navigate the complexity of the industry and national and international factors, it is not enough to just be a good manager or a good leader. Being successful as a manager or a health professional requires a combination of both management and leadership skills and aptitudes. Leading and managing health services: An Australasian perspective provides a critical and concise overview of the important skills, aptitudes and content areas required to successfully lead and manage in a wide range of healthcare settings, no matter where you sit in the organisational structure. It provides insights into aspects of healthcare leadership and management applicable to Australasian health systems from highly experienced healthcare managers, leaders and academics.

  • 14 - Influencing strategically

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 162-170

  • Summary

    Learning objectives

    How do I:

  • develop my skills in respect to influencing tactics and strategies?

  • choose key influencing tactics and strategies that might be used in engaging internally in my organisation, as well as outside the organisation?

  • understand the importance of influencing strategically as a leader?

  • help my department and organisation achieve strategic goals through the use of influencing tactics and strategies?

    • Introduction

    Everyone creates influence during their lives. This may be consciously or unconsciously, through communication, actions or behaviours. A person can be influential through who they are or what they do, such as through their creativity, dependency, vulnerability, position and example.

    A critically important element of creating change, growth and renewal in health service organisations is the need for strong and effective leadership, of which influencing skills are an integral part. Healthcare organisations are complex entities with large numbers of internal and external stakeholders. Strategic influence is an important aspect of the leadership and management of these organisations, as leaders and managers rely on the ability to enhance the effectiveness of those working in all parts and levels of the organisations as well as those outside the organisations in the broader system. Healthcare managers can increase their impact and achievements through understanding and applying infl uence, and key aspects of healthcare leadership relate to the processes of influence.

  • 8 - Leadership and critical reflective practice

  • from Part 2 - Leads Self
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 90-102

  • Summary

    Learning objectives

    How do I:

  • improve my ability to reflect on my own practice?

  • use a critical reflection approach?

  • reflect for action, reflect in action and reflect on action?

  • enhance my leadership abilities through reflective practice?

  • choose a reflective technique that works for me?

    • Introduction

    Humberto Maturana (1998) claims that ‘to know with full confidence is the enemy of reflection. Reflection is when what we claim to know has the ability to step back and take another look’. Reflection is not a new concept in the health sciences. Contemporary conceptions of reflective practice are underpinned by the works of John Dewey (1910, 1916, 1933, 1938), Carl Rogers (1951, 1969), Paulo Freire (1995) and Donald Schön (1983, 1987). Today, reflection is a core component of healthcare education and is evident in the governing codes and guidelines that underpin professional practice in many health disciplines in Australasia. References to reflection appear in each health discipline’s code of professional practice or code of conduct, and effective and purposeful reflection is seen to be a core component of proficiency and ongoing professional development. Despite this, students, practitioners and healthcare leaders often struggle with reflection and critical reflective practice.

    This chapter explores what is meant by reflection and critical practice, how to adopt a critically reflective attitude and foster skills in leadership, and how leaders can use critical reflection to support growth and change at personal, team and organisational levels.

  • 13 - Power and political astuteness

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 150-161

  • Summary

    Learning objectives

    How do I:

  • understand the use of power in organisations?

  • identify the main sources of power in organisations?

  • critically analyse the positive and negative aspects of power and influence?

  • understand how political processes operate in organisations?

  • understand the consequences of political activities in organisations?

  • enhance my skills in the various tactics that can be used to shape political outcomes in organisations?

    • Introduction

    Politics is an inevitable feature of organisation life, particularly in large bureaucratic organisations such as hospitals. Political activities arise when there is a lack of consensus about how an organisation should be managed. They are typically employed in an attempt to reconcile these divergent interests, which may be the result of competition for resources within the organisation, the pursuit of personal goals by individuals or a high level of uncertainty within the organisation.

    Traditionally, political activities have been concerned with obtaining, developing and exploiting power to infl uence others in order to achieve desired outcomes (Pfeffer, 1981 ). Consequently, decisions shaped by political activities are not always rational - they do not always produce optimum outcomes, as individuals seek to satisfy their own wants and needs, often at the expense of others (Kumar & Ghadially, 1989). However, more recently, organisational behaviourists have conceptualised organisational politics as the perception that an individual or group is using infl uence and tactics to serve their own personal agenda (Ferris & Kacmar, 1992 ). One person may consider a co-worker’s behaviour to be a typical rational response, whereas another colleague may view the same behaviour as self-serving and highly political. Therefore, what is deemed to be political or normal behaviour ultimately depends on the opinion of the observer.

  • 15 - Networking

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 171-182

  • Summary

    Learning objectives

    How do I:

  • understand the purpose of networking and where it sits on the partnership continuum?

  • use the three levels of networking?

  • learn to appreciate the personal and organisational benefits of networking for leadership development?

  • enhance my skills in networking?

  • overcome the challenges to achieve the potential of intraorganisational and interorganisational networking?

    • Introduction

    Networks, which are defined as groups or systems of interconnected people or things, can be formal and informal in nature and can be applied for different purposes. The capability to network can build influence in groups and organisations to support change or generate new ideas. The process of networking can be seen as a supportive system of sharing information and services among individuals, groups and organisations with a common interest. Networking can be applied at a personal level for career and leadership development, at an intraorganisational level for organisational development, and at an interorganisational level for research, knowledge management, process improvement and relationship development.

    Definitions

    Networking is a key leadership capability. Besides being a supportive system of sharing information, it can develop trust or sharing of turf between partners and is a useful strategy for individuals and organisations in the initial stages of working relationships. It is a useful skill in environmental scanning and managing change.

  • 21 - Negotiating

  • from Part 4 - Achieves Outcomes
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 245-252

  • Summary

    Learning objectives

    How do I:

  • identify a negotiating opportunity?

  • improve my skills in negotiating?

  • plan a negotiation?

  • decide whether I should accept the proposed solution?

    • Introduction

    Negotiation is an important skill for a healthcare manager. According to Mealiea and Latham (1996), many managerial activities, such as budget development, performance appraisal and review, planned change, team-building, complaint-handling and resource allocation require negotiating skills. Other authors have suggested that great leaders need to be great negotiators (Nanus & Dobbs, 1999). This chapter introduces negotiating theory and tactics that can assist readers to develop their skills for use in personal and professional negotiations.

    Concepts

    Once two or more parties agree to enter into a negotiation, they may use either an integrative approach (win–win) or a distributive approach (win–lose). An example of an integrative approach might be the creation of a preferred health service provider relationship, in which the provider wins because they have negotiated a steady cashflow, while the organisation also wins because it has the guarantee of health services of a certain quality at an agreed price. In integrative approaches, the negotiation involves more than one factor. In the example used here, while price would be an important factor, other factors such as volume, availability, quality and mode of delivery would also be included in the negotiation.

  • 28 - Workforce-planning

  • from Part 6 - Shapes Systems
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 320-333

  • Summary

    Learning objectives

    How do I:

  • improve my skills in workforce-planning?

  • understand the principles of workforce-planning?

  • consider the Australian health workforce in relation to the structures, processes and trends in global health workforce-planning?

  • take into account workforce issues in the Australian healthcare sector in workforce-planning?

    • Introduction

    Workforce-planning in the healthcare system is becoming a politically charged issue in many countries due to a looming shortage of various health professional groups and the subsequent costs and liabilities to governments hoping to generate improvements and efficiencies. In 2010 the World Health Organization (2010) released Models and tools for health workforce planning and projections in an attempt to optimise the sharing of countries’ experiences and best practices worldwide. Subsequently, both developing and developed nations are attempting to establish more sophisticated approaches to workforce-planning at national and regional levels (DalPoz, Gupta, Quain & Soucat, 2009; Dussault, Buchan, Sermeus & Padaiga, 2010; Lacerda, Caul Liraux, Spiegel & Neto, 2013).

    The policy direction on health workforce sustainability set out in the World Health Organization’s (2008) code on international recruitment of health workers recommends countries aim for workforce self-suffi ciency with regard to workforceplanning. This requires a defi ned population base, such as a region or country, to facilitate the ongoing production of health workers at a volume sufficient to meet its own healthcare needs.

  • 5 - Emotional intelligence and self-awareness

  • from Part 2 - Leads Self
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 55-66

  • Summary

    Learning objectives

    How do I:

  • understand the meaning behind the models of emotional intelligence?

  • enhance my emotional intelligence?

  • improve my skills in self-awareness as a major component of emotional intelligence?

  • compare intelligence quotient and emotional intelligence?

  • use the concepts of emotional intelligence in the workplace to improve my own performance and that of staff working with me?

    • Introduction

    Emotional intelligence (sometimes called EI or EQ) is a psychological construct that has attracted a lot of attention in the past 20 years. There have been many astonishing claims regarding emotional intelligence, many without scientific support. One popular claim is the notion that emotional intelligence is the most important factor for achieving success in life: in the workplace, at home or at school (Schulze & Roberts, 2005). Emotional intelligence – the ability to manage, understand, express and appraise emotions – is the theme of scientific controversy and investigation in spite of its huge appeal in business, education and popular literature.

    Definitions

    Intelligence has been defi ned in many different ways; however, most people associate it with the concept of testing for intelligence quotient (or IQ) and cognitive function. Throughout history, there have been attempts to recognise the importance of other forms of intelligence beyond the traditional intelligence quotient. In the 1920s, psychologist E. L. Thorndike (1920) coined the term social intelligence, referring to the skills of understanding and managing other people as well as engaging in adaptive social interactions and negotiating complex social relationships and environments. Sixty years later, developmental psychologist Howard Gardner (1983) described the idea of multiple intelligences, suggesting that all people have the capacity to possess different kinds of intelligences and that intelligence testing may be biased to certain types of individuals. He identified eight different types of intelligences, which may allow educators to identify differing strengths and weaknesses in students and provide suitable teaching and learning methods for them. Many experts believe that social intelligence, rather than quantitative intelligence, is important for quality of life and makes us what we are. It also appears that emotional intelligence can be developed rather than being biologically based (Goleman, 2000).

  • 17 - Critical thinking and decision-making

  • from Part 4 - Achieves Outcomes
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 195-203

  • Summary

    Learning objectives

    How do I:

  • increase my understanding of the elements of critical thinking?

  • counteract the barriers that might limit my critical thinking?

  • improve my skills in decision-making?

  • identify common decision-making errors?

  • make better use of evidence in healthcare decision-making?

    • Introduction

    It is important for managers and leaders to be able to critically analyse their own thinking and decision-making processes. Aspects of thinking and acting that managers and leaders should understand include their personal preferences, prejudices and cultural beliefs, and their personal motivations and desires. It is also important for them to understand the way these shape the biases they take to decision-making. To achieve success, leaders and managers require the ability to analyse, synthesise and establish their thoughts in a logical argument to reach a convincing conclusion.

    Critical thinking

    When faced with challenging management situations, the capacity to ask the right questions in order to clarify the situation helps managers to formulate appropriate responses. Critical thinking is a rational, systematic process that involves the assessment of statements and arguments, and the formulation of questions.

    A statement claims that something is, or is not, the case and is not necessarily an argument. For example, three different statements that by themselves do not form an argument are: ‘Smoking tobacco is bad for your health’, ‘Clinicians without management education make poor managers’ and ‘Healthcare is too expensive’. Critical thinking helps us decide if there is suffi cient information to accept these statements.

  • 29 - Strategic planning

  • from Part 6 - Shapes Systems
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 334-345

  • Summary

    Learning objectives

    How do I:

  • complete a strategic plan?

  • synthesise strategic planning and management concepts to adopt strategic management in my position?

  • improve the strategic planning and management processes within my organisation?

  • plan the implementation of my organisation’s strategic plan for my area?

  • set and evaluate my achievement of meaningful goals?

    • Introduction

    Effective strategic planning, implementation and management drive organisational performance (Rudd, Greenley, Beatson & Lings, 2008). Healthcare managers have recognised the increasing importance of strategic planning and management as the healthcare industry has become more dynamic and complex (Subramanian, Kumar & Yauger, 2011). However, development of feasible strategy can be difficult, and implementation of even well-developed strategy is often challenging. This chapter provides advice on leading and improving strategic planning and management in health service organisations.

    Use of strategic planning

    Strategic planning is a specific type of planning. Strategic planning was identified decades ago as essential for organisations competing in a variety of industries, with most of the seminal literature arising in the 1980s. More recently, strategic planning has been linked to successful operations in public sector healthcare organisations (Zuckerman, 2006 ) when applying previously developed concepts.

    The Australian Commission on Safety and Quality in Healthcare ( 2011 ) defines 10 safety and quality standards for health services.

  • 18 - Managing and leading staff

  • from Part 4 - Achieves Outcomes
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 204-215

  • Summary

    Learning objectives

    How do I:

  • develop my skills in leadership of human resources as a critical component of health policy and organisational activity?

  • understand the challenging role of the management of human resources in a complex, professionally dominated industry that is affected by constant change?

  • determine effective strategies for retention policies and practices that are required to respond to the global maldistributions and shortages within the health profession?

  • consider the requirements that human resources has for the management of four distinct generations in the substantially feminine and ageing health workforce?

    • Introduction

    In a text on leadership and management the perspective on human resource management requires a strategic approach. Health is dominated by a large, diverse, highly professionalised workforce. Human resource management is complex and needs to properly consider three aspects of workforce development – namely, supply, demand and mobility (Narasimhan et al., 2004).

    Definitions

    The health workforce is globalised, with maldistributions and existing and projected shortages (Health Workforce Australia, 2012 ). The mobilisation and strengthening of human resources are seen as critical in sustainable health systems (Chen et al. 2004, Kabene, Orchard, Howard, Soriano & Leduc, 2006; Karimi, Cheng, Bartram, Leggat & Sarkeshik, 2014). The health (75 per cent) and health management (61 per cent) workforce in Australia is predominantly female as compared with all industries (at 47 per cent and 36 per cent respectively) (Martins & Isouard, 2014). The health workforce is multigenerational, multicultural and substantially female. It requires collaboration across sectors on an interprofessional basis and across organisational boundaries within multidisciplinary teams and networks of service provision (Duckett, 2005).

  • 7 - Ambiguity and leadership

  • from Part 2 - Leads Self
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 79-89

  • Summary

    Learning objectives

    How do I:

  • develop a clear understanding of how ambiguity in organisational settings impacts management and leadership?

  • reduce ambiguity?

  • develop confidence in the identification and articulation of ambiguity in healthcare organisations?

  • acquire skills and knowledge in useful approaches to managing positions, directions and outcomes related to ambiguous circumstances and problems?

    • Introduction

    Complexity is a feature of healthcare organisations. Irrespective of the role, size, processes and governance of these organisations, the internal and external environments in which they operate and the number of associated stakeholders represent significant challenges in managing clinical and social processes and outcomes, resources, workforces, decision-making and ethics. Within this complex framework, healthcare leaders need not only skills and strategies to manage their organisation, but also resources and personal competencies to lead individuals, groups and workforces.

    Definitions

    Ambiguity is defined as lack of certainty or dependability of meaning of communication, action or knowledge. It describes a situation in which information could be interpreted, construed or understood in more than one way. It is a natural aspect of the operations of healthcare facilities and the environments in which they engage with many stakeholders. Leading and managing health organisations requires awareness, understanding and focused action to ensure that ambiguous situations are managed for impact and usefulness to the health facility.

  • 10 - Leading interprofessional teams

  • from Part 3 - Engages Others
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 116-125

  • Summary

    Learning objectives

    How do I:

  • understand the place that interprofessional teams have in healthcare organisations?

  • analyse the enablers and barriers to leading interprofessional teams?

  • apply principles of successful leadership of interprofessional teams to enhance my teamwork skills?

  • work with the benefits and challenges associated with hybrid roles in leading interprofessional teams?

    • Introduction

    Leadership is an elusive concept. Key authors cannot agree on the characteristics of leaders, but all agree that leadership is about relationships and evolves over time. For example, Rost and Barker (2000, p. 3) state that ‘leadership is an influence relationship among leaders and followers who intend real changes and outcomes that reflect a shared purpose’. Meanwhile, Landsdale (2002, p. 56) suggests that ‘effective leaders enable people to move in the same direction, toward the same destinations, at the same speed, but not because they have been forced to, but because they want to’. This raises the question of how we get people to want to go in the same direction and at the same pace. In the health services this is particularly challenging because of the multidisciplinary nature of the key stakeholders. It requires appropriate leadership of interprofessional teams.

    The increased complexity of patient needs has driven the necessity of interprofessional teamwork in health services (Bridges, Davidson, Odegard, Maki & Tomkowiak, 2011 ). Consequently, the importance of such teams within a health context is increasingly being accepted (Bajnok, Puddester, MacDonald, Archibald & Kuhl, 2012). While working in interprofessional teams is challenging, it also has benefits. Healthcare professionals working in interprofessional teams have reported that the system produces greater patient satisfaction and outcomes, reduced healthcare costs and improved job satisfaction (Baggs & Schmitt, 1997 ; Clarke & Hassmiller, 2013 ; Hendel, Fish & Berger, 2007 ; Zwarenstein, Reeves & Perrier, 2005).

  • 23 - Evidence-based practice

  • from Part 5 - Drives Innovation
  • Gary E. Day, Griffith University, Queensland, Sandra G. Leggat, La Trobe University, Victoria
  • Book:
    Leading and Managing Health Services
    Published online:
    17 August 2019
    Print publication:
    19 June 2015, pp 265-272

  • Summary

    Learning objectives

    How do I:

  • determine when to look for evidence to assist in decision-making?

  • source relevant evidence for my management practice and decision-making?

  • critically appraise evidence for its strengths, weaknesses and relevance to a particular health services management question?

  • apply relevant evidence to my management practice and decision-making?

  • find out more about evidence-based management?

    • Introduction

    Building on the concepts of evidence-based medicine and evidence-based policy, the concept of evidence-based leadership and management suggests that leaders and managers find, evaluate and use the best available scientific evidence to inform their practice. An early definition of evidence-based management was ‘translating principles based on best evidence into organisational practices’ (Rousseau, 2006, p. 256). This chapter discusses when and how to look for evidence and outlines how to apply it to the leadership or management decision or situation at hand.

    Use of evidence

    While there are studies linking doctors who practise evidence-based medicine with better clinical outcomes (Pfeffer & Sutton, 2006), and despite the inherent logic of basing decisions on evidence, we could fi nd no studies linking evidence-based management with better organisational outcomes. In fact, there is a large body of research that suggests that managers have difficulty finding and applying evidence to their management practice generally (Hemsley-Brown & Sharp, 2003 ), and to healthcare leadership and management specifi cally (Finkler & Ward, 2003).

Page 65 of 89