Search results

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care.

We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit.

We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level.

This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

This study investigates service excellence and hospitality perceptions in a hospital setting for an exploratory study of the familiarity of hospital administration with the topic of hospitality and service excellence. It is unique from other hospitality and service research in that it considers hospitality and service excellence as separate concepts, and specifically considers hospitality, such as service excellence, as a philosophy that may be transcend its traditional industries of origin. Part of the premise of this study explores how hospitality in a healthcare setting extends past service excellence in offering a service to a patient to create a comfortable and welcoming environment to combat patient anxiety and stress. This exploratory research provides a necessary foundation for more extensive empirical testing of the premise.

Using a qualitative case study, this research measured top management's perceptions of service excellence and hospitality within one community-based hospital located in Orlando, Florida. Three conclusions were revealed: (1) a mixed commitment by top management to concepts of service excellence and hospitality, (2) the terms “service excellence” and “hospitality” were generally discussed as though they were equivalent, and (3) significant external and internal barriers to the delivery of service excellence and hospitality in the hospital setting were identified.

The study has implications for healthcare organizations seeking to implement practices of hospitality and service management to improve overall healthcare service delivery. Additionally, the study of hospitality outside of its traditional industry boundaries may result in the generation of new improvement options/opportunities for traditional managers of hospitality businesses and organizational researchers. The study can be used as a foundation for the formulation of additional studies in the area of service excellence and hospitality applied to other layers in an organization irrespective of industry setting.

The voluntary hospital trustee has traditionally seen issues of medical care, including those of patient safety, as falling within the delegated sphere of the medical staff. This customary distancing of the trustee from direct involvement in patient safety issues is now challenged by unprecedented scrutiny of hospital safety results through voluntary disclosure or mandatory public reporting. This new climate, fostered by the Institute of Medicine's To Err is Human and the Institute for Healthcare Improvement's 100,000 Lives campaign, has complicated the role of the trustee in satisfying the traditional “prudent person” test for meeting fiduciary obligation as the trustee's breadth of involvement expands. Viewed theoretically, Mintzberg models the hospital as a case of a professional bureaucracy, in which the professional staff is responsible for standard setting and regulation. This traditional role of the professional staff is potentially assumed by others lacking technical background. Trustees are now asked to examine reports identifying physician compliance in attaining safety standards without education in the practice supporting those standards. Physician board members, whose numbers have increased in the past decade, are often sought to take the lead on interpretation of patient safety standards and results. The very public nature of patient safety reporting and its reflection on the reputation of the organization for which the trustee is ultimately accountable create a new level of tension and workload that challenges the dominant voluntary model of trusteeship in the United States health system.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

This chapter seeks to investigate the journey of breast and bowel cancer patients at the HMC Antoniushove. It zooms in on specific touch points and the possibilities for improvements. Furthermore, it elucidates the learning process and more particular the dissemination between the hospital (staff and medical students) and hospitality students and professionals and emphasizes that looking from different perspectives and various disciplines is beneficial for all the stakeholders involved in hospitals.

Diseases are increasingly chronic; patients are more demanding and competition between different hospitals is increasing. That is why, in addition to excellent medical treatment, excellent service (referred to here as hospitality) is becoming increasingly important in the healthcare sector, including in hospitals. What does it have to meet? What do patients appreciate, what needs to be improved and how can these improvements be designed and implemented with the involvement of both patients and hospital staff?

Medical and hospitality students collaborated in this project analysing and describing the journey of patients with breast and bowel cancer. They examined the patient journey and elucidated the touch points, which patients indicated as critical during their ‘journey’.

Most important finding resulted from the learning process of this collaboration and the insight gained, a greater awareness and understanding of the non-medical needs and wishes, i.e. hospitality, of patients. Furthermore, the mutual understanding between the evidence-based stance of thinking of medical students and hospital staff at the one side and the more on soft skills–focused attitude of hospitality students on the other hand increased.

Purpose: As specific emotional arenas, hospitals are characterized by the interweaving of various emotional requirements, arising from different sources of norms, rules, or guidelines. This study aims to highlight an often-overlooked dimension of emotional labor in healthcare by describing the coexistence of emotional rules (i.e. feeling and/or display rules) through a multilevel perspective (institutional level, cluster/department level, service level, ward level, professional level). Study Design/Methodology/Approach: These emotional requirements for nurses and nursing assistants are investigated through three sets of data (observation, interviews, and internal documents) in a French public hospital, focusing on two hospital services: three long-term care units (primary field of investigation), and five adult medical emergency wards (secondary field of investigation). Findings: The results of the analysis show the pervasive nature of emotional requirements which are intertwined and more or less implicit/explicit according to the level analyzed. In addition to organizational rules, professional and social emotional rules contribute to shaping emotional requirements, particularly through rules of “empathetic expression” and those of retenue bienveillante. Research Limitations/Implications: This research has contributed to showing the dynamic nature of emotional requirements and their appropriation and modulation by healthcare professionals. The qualitative methodology used allows for unique insights but limits the generalization of results. Originality/Value: This research has addressed various gaps in the existing literature by describing emotional requirements through a multilevel analysis, by outlining a set of rules that had not been previously described (retenue bienveillante) and by including the population of nursing assistants as well as nurses in a study on hospital emotional labor. Future research could envisage spatial analysis of emotional labor to help better understand emotional requirements' variability according to emotionalized zones.

One of the most challenging aspects in the health care industry is to understand the nuances and strategies of those companies that provide both B2B and B2C services, apart from being supported by their management team, quality officers, the HR Manager, the clinicians, the doctors, and the holistic support of all staff. This case study focusses on analyzing the various indicators of success of The Health Medical Services (THMS), a major service provider in the health care sector, serving both B2B and B2C markets in the UAE and the organizational factors that drove the service provider to success, creating an exceptional experience for both their internal and external customers. The unique success drivers of THMS, as brought out by the current study include Customer Relationship Management, unique leadership style, employee engagement, market orientation, Quality Circles, patient-centric care, and service innovation in health care that supports their sustainability and scalability. Moreover, a literature review on the success drivers brings out the academic implications of the study.

Resource constraints in the Canadian publicly funded healthcare system have created a need for more volunteer leaders to effectively manage other volunteers. Self-concept theory has been conceptualized and applied within a volunteer context, and the views of healthcare stakeholders, such as volunteers, volunteer leaders, and supervisors, triangulated to form an understanding of the attitudes and behaviors of volunteer leaders. We propose that leaders are differentiated from others by how they view their roles in the organization and their ability to make a difference in these roles. This interpretation can be informed by self-concept theory because each individual's notion of self-concept influences how employees see themselves, how they react to experiences, and how they allow these experiences to shape their motivation. A small case study profiles a volunteer leader self-concept that includes a proactive, learning-oriented attitude, capitalizing on significant prior work experience to fulfill a sense of obligation to the institution and its patients, and demands a high level of respect from paid employees.