Showing papers by "Rod Sheaff published in 2016"
01 Jan 2016
TL;DR: This book discusses Management Innovations in Healthcare Organizations and Managerial innovations in an International Perspective from the perspective of Anders Ortenblad, Carina Abrahamson Lofstrom and Rod Sheaff, as well as future research into this topic.
Abstract: Part 1: Background and Introduction 1. The Relevance of Management Innovations for Healthcare Organizations Anders Ortenblad, Carina Abrahamson Lofstrom and Rod Sheaff 2. Healthcare Organizations and Managerial Innovations in an International Perspective Rod Sheaff, Carina Abrahamson Lofstrom and Anders Ortenblad Part 2: Examining Management Innovations 3. 360-Degree Feedback in Healthcare Organizations Joan F. Miller 4. Accreditation and Other External Evaluations of Quality and Safety of Care and Services: Innovations for Improvement? Marie-Pascale Pomey 5. The Balanced Scorecard in Healthcare Organizations Elin Funck 6. Business Process Reengineering (BPR) in Healthcare Organizations Anjali Patwardhan, Dhruv Patwardhan and Prakash Patwardhan 7. Consensus as a Management Strategy for Healthcare Organizations: Culture, Involvement and Commitment Marie Carney 8. Corporate Social Responsibility (CSR) for Healthcare Organizations Sherif Tehemar 9. Decentralizing Healthcare Mark Exworthy and Martin Powell 10. Empowerment in Healthcare Organizations Nelson Ositadimma Oranye and Nora Ahmad 11. Kaizen in Healthcare Organizations Mark Graban 12. Knowledge Management in Healthcare Organizations Nilmini Wickramasinghe and Raj Gururajan 13. Lean Healthcare - What is the Contribution to Quality of Care? Bozena Poksinska 14. Learning Organizations: Panacea or Irrelevance? Rod Sheaff 15. Management by Objectives (MBO) in Healthcare Organizations Then and Now: A Literature Overview of MBO Limitations and Perspectives in the Healthcare Sector Grigorios L. Kyriakopoulos 16. New Public Management in Healthcare Organizations Dawid Szescilo 17. Servant Leadership in Healthcare Organizations Jack McCann 18. Shared Leadership in Healthcare Organizations D. David Persaud 19. Six Sigma Applicability and Implementation in Healthcare Jacob Krive 20. Sustainability in Healthcare Organizations Tony Huzzard, Andreas Hellstrom and Svante Lifvergren 21. Teamwork in Healthcare Organizations Jan Schmutz, Annalena Welp and Michaela Kolbe 22. Total Quality Management in Healthcare Ali Mohammad Mosadeghrad and Ewan Ferlie 23. Transformational Leadership in Healthcare Organizations Bettina Fiery 24. Value-based Healthcare: Utopian Vision or Fit for Purpose Thomas Garavan and Gerri Matthews-Smith Part 3: Conclusions and Future Research 25. Should Healthcare Organizations Adopt, Abandon, or Adapt Management Innovations? Carina Abrahamson Lofstrom, Anders Ortenblad and Rod Sheaff
14 citations
TL;DR: This research shows how hospitals under pressure manage complexity, safety and risk in emergency care by developing ‘ground-up’ initiatives that facilitate timely, appropriate and safe decision-making, and alternative care pathways for lower-risk, ambulatory patients.
Abstract: Background: Hospital emergency admissions have risen annually, exacerbating pressures on emergency departments (EDs) and acute medical units. These pressures have an adverse impact on patient experience and potentially lead to suboptimal clinical decision-making. In response, a variety of innovations have been developed, but whether or not these reduce inappropriate admissions or improve patient and clinician experience is largely unknown. Aims: To investigate the interplay of service factors influencing decision-making about emergency admissions, and to understand how the medical assessment process is experienced by patients, carers and practitioners. Methods: The project used a multiple case study design for a mixed-methods analysis of decision-making about admissions in four acute hospitals. The primary research comprised two parts: value stream mapping to measure time spent by practitioners on key activities in 108 patient pathways, including an embedded study of cost; and an ethnographic study incorporating data from 65 patients, 30 carers and 282 practitioners of different specialties and levels. Additional data were collected through a clinical panel, learning sets, stakeholder workshops, reading groups and review of site data and documentation. We used a realist synthesis approach to integrate findings from all sources. Findings: Patients’ experiences of emergency care were positive and they often did not raise concerns, whereas carers were more vocal. Staff’s focus on patient flow sometimes limited time for basic care, optimal communication and shared decision-making. Practitioners admitted or discharged few patients during the first hour, but decision-making increased rapidly towards the 4-hour target. Overall, patients’ journey times were similar, although waiting before being seen, for tests or after admission decisions, varied considerably. The meaning of what constituted an ‘admission’ varied across sites and sometimes within a site. Medical and social complexity, targets and ‘bed pressure’, patient safety and risk, each influenced admission/discharge decision-making. Each site responded to these pressures with different initiatives designed to expedite appropriate decision-making. New ways of using hospital ‘space’ were identified. Clinical decision units and observation wards allow potentially dischargeable patients with medical and/or social complexity to be ‘off the clock’, allowing time for tests, observation or safe discharge. New teams supported admission avoidance: an acute general practitioner service filtered patients prior to arrival; discharge teams linked with community services; specialist teams for the elderly facilitated outpatient treatment. Senior doctors had a range of roles: evaluating complex patients, advising and training juniors, and overseeing ED activity. Conclusions: This research shows how hospitals under pressure manage complexity, safety and risk in emergency care by developing ‘ground-up’ initiatives that facilitate timely, appropriate and safe decision-making, and alternative care pathways for lower-risk, ambulatory patients. New teams and ‘off the clock’ spaces contribute to safely reducing avoidable admissions; frontline expertise brings value not only by placing senior experienced practitioners at the front door of EDs, but also by using seniors in advisory roles. Although the principal limitation of this research is its observational design, so that causation cannot be inferred, its strength is hypothesis generation. Further research should test whether or not the service and care innovations identified here can improve patient experience of acute care and safely reduce avoidable admissions. Funding: The National Institute for Health Research (NIHR) Health Services and Delivery Research programme (project number 10/1010/06). This research was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.
13 citations
01 Apr 2016
12 citations
TL;DR: This research focuses on NHS services heavily used by older people at high risk of hospital admission: community health services; out-of-hours primary care; and secondary care (planned orthopaedics or ophthalmology).
Abstract: Introduction The variety of organisations providing National Health Service (NHS)-funded services in England is growing Besides NHS hospitals and general practitioners (GPs), they include corporations, social enterprises, voluntary organisations and others The degree to which these organisational types vary, however, in the ways they manage and provide services and in the outcomes for service quality, patient experience and innovation, remains unclear This research will help those who commission NHS services select among the different types of organisation for different tasks
Research questions The main research questions are how organisationally diverse NHS-funded service providers vary in their responsiveness to patient choice, NHS commissioning and policy changes; and their patterns of innovation We aim to assess the implications for NHS commissioning and managerial practice which follow from these differences
Methods and analysis Systematic qualitative comparison across a purposive sample (c12) of providers selected for maximum variety of organisational type, with qualitative studies of patient experience and choice (in the same sites) We focus is on NHS services heavily used by older people at high risk of hospital admission: community health services; out-of-hours primary care; and secondary care (planned orthopaedics or ophthalmology) The expected outputs will be evidence-based schemas showing how patterns of service development and delivery typically vary between different organisational types of provider
Ethics, benefits and dissemination We will ensure informants' organisational and individual anonymity when dealing with high profile case studies and a competitive health economy The frail elderly is a key demographic sector with significant policy and financial implications For NHS commissioners, patients, doctors and other stakeholders, the main outcome will be better knowledge about the relative merits of different kinds of healthcare provider Dissemination will make use of strategies suggested by patient and public involvement, as well as DH and service-specific outlets
9 citations