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Article
Publication date: 14 December 2020

Ann-Charlotte Bivall, Maria Gustavsson and Annika Lindh Falk

Clinical placement is an important formalised student activity for linking healthcare education and healthcare practices. The purpose of this study is to investigate the…

Abstract

Purpose

Clinical placement is an important formalised student activity for linking healthcare education and healthcare practices. The purpose of this study is to investigate the organising of clinical placements by examining conditions for collaboration between higher education and healthcare organisations.

Design/methodology/approach

The study is based on interviews with central actors at a university and two healthcare organisations with official duties of organising clinical placements.

Findings

The findings indicate that collaboration in the organising of clinical placements is a complex matter of interconnected actors in different organisational positions, at both strategic and operative levels. The university and the healthcare organisations approached the clinical placement with a shared commitment.

Practical implications

The findings provide important guidance for improving collaboration in the organising of clinical placements. This may have an impact on how contextual conditions of the educational framing and daily healthcare practices are viewed and how the interdependency between the long-term strategic issues and the short-term needs of healthcare organisations is approached.

Originality/value

This research emphasises the need for careful consideration of the collaborative practices on an organisational level between higher education and healthcare organisations as different needs, motives and logics have to be considered.

Details

Higher Education, Skills and Work-Based Learning, vol. 11 no. 4
Type: Research Article
ISSN: 2042-3896

Keywords

Article
Publication date: 1 June 1997

Dave Buchanan, Simone Jordan, Diane Preston and Alison Smith

Aims to examine medical involvement in hospital management processes, and to consider the implications of current experience for the next generation of clinical directors. Doctors…

1785

Abstract

Aims to examine medical involvement in hospital management processes, and to consider the implications of current experience for the next generation of clinical directors. Doctors who move into a formal management role often find themselves unprepared for their new responsibilities. Research has thus concentrated on identifying the management competences which doctors lack, and with designing ways to remedy the deficit. Seeks to move beyond this deficit model by adopting a perspective which focuses on the engagement of doctors in the management process. Draws data from in‐depth interviews with six clinical directors and 19 other members of the hospital management team at Leicester General Hospital NHS Trust (LGH). Content analysis of interviews suggests that the engagement of clinical directors in the hospital management process at this site can be described as reluctant, transient, service‐driven, power‐pulled and pressured. This negative portrayal of the role, however, must be set in the context of the “management expectation” held of clinical directors by other hospital managers and staff ‐ an expectation that is not currently fulfilled.

Details

Journal of Management in Medicine, vol. 11 no. 3
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 1 July 2003

Keith Hurst

This article explores professional self‐regulation in the context of clinical governance. It begins by explaining clinical governance’s origins before setting out a framework in…

1791

Abstract

This article explores professional self‐regulation in the context of clinical governance. It begins by explaining clinical governance’s origins before setting out a framework in which the Department of Health expects managers and practitioners to work. Description, analysis and synthesis of professional self‐regulation issues, operating within a clinical governance framework, are greatly enhanced by comment drawn from the theoretical and empirical literature.

Details

International Journal of Health Care Quality Assurance, vol. 16 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 June 1995

Joanne Lord and Peter Littlejohns

In 1989, a programme of clinical audit was introduced throughoutthe UK National Health Service (NHS), in an attempt to improve carethrough the application of quality methodology…

361

Abstract

In 1989, a programme of clinical audit was introduced throughout the UK National Health Service (NHS), in an attempt to improve care through the application of quality methodology to clinical issues. However, the role of clinical audit in the new NHS “internal market” is unclear. Reviews evidence on the development of audit and concludes that it has operated largely in isolation, under professional control. Central policy is now advocating greater purchaser and provider management involvement in audit, enabling feedback from and to service provision and management decisions. Where there are constructive local relationships the opening up of audit should be beneficial, but these do not always exist. Discusses a range of models for the interaction of clinical audit with wider NHS management systems. Recommends a split system of professionally controlled background audit and collaborative shared audits to balance conflicting goals.

Details

International Journal of Health Care Quality Assurance, vol. 8 no. 3
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 February 1997

Marion Judd

The quality of clinical care is a fundamental issue for both providers and recipients. It seems logical for the parties to collaborate. Increasing understanding of each other's…

Abstract

The quality of clinical care is a fundamental issue for both providers and recipients. It seems logical for the parties to collaborate. Increasing understanding of each other's values and perceived needs with commitment to incorporating both users' and clinicians' unique perspectives on clinical quality and effectiveness is a new venture which will further contribute to improving the quality of health care in the NHS.

Details

Journal of Clinical Effectiveness, vol. 2 no. 2
Type: Research Article
ISSN: 1361-5874

Article
Publication date: 1 December 2004

Pieter Degeling and Adrian Carr

The case literature strongly suggests that both in England and in Australia health care reforms have had very little impact in terms of “improved performance”. It is in the…

3046

Abstract

The case literature strongly suggests that both in England and in Australia health care reforms have had very little impact in terms of “improved performance”. It is in the context of a perceived failure in the implementation of the reforms that an interest has arisen in leadership at the level of individual clinical units (e.g. an orthopaedics unit or birth unit), as the possible “fix” for bridging the promise‐performance gap. Drawing upon extensive case studies that highlight the problem and context for appropriate forms of leadership, this paper argues that the appropriate discourse, in terms of leadership in health reform, needs to focus upon the issue of authorization. In making this argument, addresses the current conceptions of leadership that have been advanced in the discourse before offering some case study material that is suggestive of why attention should be focused on the issue of authorization. Illustrates how and why the processes of leading, central to implementing reform, cannot be construed as socially disembodied processes. Rather, leading and following are partial and partisan processes whose potential is circumscribed by participants' position‐takings and what is authorized in the institutional settings in which they are located. Argues that the “following” that clinical unit managers could command was shaped by the sub‐cultures and “regulatory ideals” with which staff of each profession are involved. In the interests of reform, policy players in health should not be focusing attention solely upon the performative qualities and potential leadership abilities of middle level management, but also on their own performance. They should consider how their actions affect what is authorized institutionally and which sets the scope and limits of the leadership‐followership dialectic in clinical settings.

Details

Journal of Health Organization and Management, vol. 18 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 February 1997

Hannah‐Rose Douglas, Charlotte Humphrey, Margaret Lloyd, Keith Prescott, Andy Haines, Joe Rosenthal and Ian Watt

Aims to evaluate the acceptability of commissioning to improve clinical effectiveness in secondary care and explore the conditions under which fundholders would be willing to use…

362

Abstract

Aims to evaluate the acceptability of commissioning to improve clinical effectiveness in secondary care and explore the conditions under which fundholders would be willing to use commissioning in this way. Describes how fundholders in two contrasting districts in North Thames Region were interviewed in 1995‐1996. Respondents were selected from a list of all fundholders in the district with few fundholding practices and from lists of fundholders holding contracts with specified hospitals in the district with many fundholders. Interviews were analysed using the constant comparison method of content analysis. All fundholders in the districts were eligible. The sample represented a broad range of fundholders, containing all fundholding waves and large and small practices. Managers and general practitioners from multifunds outside the districts were also interviewed to assess whether they faced different issues from single practice fundholders. Many respondents felt unable to use commissioning to improve clinically effectiveness despite their awareness of the policy. Reasons identified included the problem of agreeing complex commissioning arrangements to reflect clinical issues, and an unwillingness to use fundholding to challenge hospital practice. Respondents from early wave fundholding practices and those with training in critically appraising research literature expressed more readiness to review research evidence, but only a few early wave fundholders said they would consider evidence‐based commissioning. Concludes that steps should be taken to educate fundholders in clinical effectiveness and provide appropriate information to them. Also, they must be persuaded that clinical effectiveness is not a politically‐driven policy or they will resist it.

Details

Journal of Management in Medicine, vol. 11 no. 1
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 13 March 2017

Virginia Minogue and Rebecca McCaffry

The Department of Health and the National Health Service (NHS) Future Focused Finance (FFF) programme promotes effective engagement between clinical and finance staff. Surveys…

Abstract

Purpose

The Department of Health and the National Health Service (NHS) Future Focused Finance (FFF) programme promotes effective engagement between clinical and finance staff. Surveys undertaken by the Department of Health between 2013 and 2015 found few NHS Trusts reported high levels of engagement. The purpose of this paper is to gain a better understanding of current working relationships between NHS clinical and finance professionals and how they might be supported to become more effective.

Design/methodology/approach

Ipsos MORI were commissioned by the NHS FFF programme to undertake an online survey of NHS clinical and finance staff between June and August 2015.

Findings

The majority of clinicians had a member of a finance team linked to their speciality or directorate. Clinical and finance professionals have a positive view of joint working preferring face-to-face contact. Clinician’s confidence in their understanding of finance was generally good and finance staff felt they had a good understanding of clinical issues. Effective working relationships were facilitated by face-to-face contact, a professional relationship, and the availability of clear, well presented finance and activity data.

Research limitations/implications

Data protection issues limited the accessibility of the survey team to NHS staff resulting in a relatively low-response rate. Other forms of communication, including social media, were utilised to increase access to the survey.

Originality/value

The FFF programme is a unique programme aimed at making the NHS finance profession fit for the future. The close partnering work stream brings together the finance and clinical perspective to share knowledge, evidence, training, and to develop good practice and engagement.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 24 May 2011

Eleonora Karassavidou, Niki Glaveli and Kostas Zafiropoulos

The purpose of this paper is to consider organisational climate as the vehicle to get an understanding, map and enhance the appropriate organisational culture for good clinical

2152

Abstract

Purpose

The purpose of this paper is to consider organisational climate as the vehicle to get an understanding, map and enhance the appropriate organisational culture for good clinical governance (CG). Based on this assertion, the purpose of this research is fourfold: to investigate CG attributes embedded in Greek hospitals' climate; to test the validity and reliability of the Clinical Governance Climate Questionnaire (CGCQ) and highlight the dimensions of CG climate in the Greek context; to illuminate the “red flag” aspects of hospital's climate and areas shaping the perceptions of the quality of the provided services; and to explore the influence of hospital's legal status on CG climate and service quality.

Design/methodology/approach

Empirical research using the CGCQ was conducted in three Greek NHS hospitals. A total of 214 usable questionnaires completed by the hospitals' personnel were gathered.

Findings

The validity and reliability tests proved that the study's five‐dimension structure of CGCQ is capable of conceptualising the basic elements of CG climate in the Greek context. Hospital's climate was found to be not supportive to successful CG implementation, and areas that demand attention were illuminated. Hospital's legal status seems to mediate CG climate and service quality.

Practical implications

CGCQ proved to be a useful tool for managers and policymakers to trace “problematic” areas of hospital's climate and develop strategies for successful CG initiatives.

Originality/value

The paper contributes to the field of health care management, since it demonstrates that CG climate can be used as a “gauge” of the prevailing CG culture. CGCQ is revealed as a valid, reliable and flexible tool.

Details

Journal of Health Organization and Management, vol. 25 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 April 1999

Tom Forbes and Neil Prime

Examines a group of radiographers developing management roles within the backdrop of a changing NHS. A comparative study of 25 Scottish and English radiographer managers were…

661

Abstract

Examines a group of radiographers developing management roles within the backdrop of a changing NHS. A comparative study of 25 Scottish and English radiographer managers were interviewed using semi‐structured interviews. Interviews were based on a number of issues associated with moving from a clinical professional to a clinical manager and were analysed using domain theory. The interviews formed a number of emerging themes, which included management, professionalism, management style, conflicts between the role of both manager and professional, and role change. Radiographer managers are forming new “hybrid” manager roles, which have been developing within a changing NHS. A definite tension was seen in this role change. This transition was not easy for this group of radiographer managers. However, they have shown resilience in undertaking both operational and strategic management decisions, while using their clinical background to inform their decision making.

Details

Journal of Management in Medicine, vol. 13 no. 2
Type: Research Article
ISSN: 0268-9235

Keywords

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