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Book part
Publication date: 12 August 2014

Bill Doolin and Andrew W. Hamer

This chapter examines why managed clinical networks are an appropriate approach to sustainable healthcare, and discusses the conditions for the effectiveness of these…

Abstract

Purpose

This chapter examines why managed clinical networks are an appropriate approach to sustainable healthcare, and discusses the conditions for the effectiveness of these multi-stakeholder, clinician-led modes of organizing. It describes the development of a national clinical network to achieve system-wide improvement in the provision of publicly funded cardiac surgery services in New Zealand, and the subsequent evolution of a broader network encompassing the whole cardiac care patient pathway.

Design

The case study of the two cardiac clinical networks focuses on the emergence and evolution of the networks over a four-year period from 2009. Data were collected from interviews with key stakeholders of both networks and from internal and published documentary evidence. Analysis of the case study is informed by network theory and prior studies of managed clinical networks.

Findings

Progress made towards the achievement of the goals of the initial cardiac surgery network encouraged a broadening of focus to the entire cardiac care pathway and the establishment of the national cardiac network. An important benefit has been the learning and increase in understanding among the different stakeholders involved. Both clinical networks have demonstrated the value of clinician engagement and leadership in improving the delivery of health services, and serve as a best practice model for the development of further clinical networks for health services that require a national population base.

Originality and value

The case study analysis of the two cardiac clinical networks identifies five mutually reinforcing themes that underpin network effectiveness: network structure, management and governance, and internal and external legitimation. These themes encompass a number of factors suggestive of successful managed clinical networks, and offer insights into the use of such networks in organizing for sustainable healthcare.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
ISBN: 978-1-78441-035-3

Keywords

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Article
Publication date: 27 January 2012

Stephen George Willcocks

The purpose of this paper is to explore leadership effectiveness, with reference to nurses in the UK National Health Service (NHS).

Abstract

Purpose

The purpose of this paper is to explore leadership effectiveness, with reference to nurses in the UK National Health Service (NHS).

Design/methodology/approach

The paper is literature based. It explores the history and policy background to nurse leadership. It reviews a range of approaches to leadership and applies the theoretical findings to the case study of nurse leaders

Findings

The paper suggests there are several inter‐related aspects to consider in relation to developing the effectiveness of nurse leaders – these may be grouped around: developing core competencies; developing emotional intelligence; developing readiness and motivation; developing contextual sensitivity; and developing clinical innovation and change.

Practical implications

The paper discusses the implications of the findings for the leadership development of nurses and makes recommendations.

Originality/value

The paper attempts to incorporate the insights from a variety of different approaches to leadership and apply them to nurse leaders in the UK NHS.

Details

Leadership in Health Services, vol. 25 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

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Article
Publication date: 14 November 2016

Rory Conn, Amit Bali and Elizabeth Akers

The purpose of this paper is to examine the impact of a structured clinical leadership programme on healthcare professionals working within the British National Health…

Abstract

Purpose

The purpose of this paper is to examine the impact of a structured clinical leadership programme on healthcare professionals working within the British National Health Service (NHS). Clinical leadership is now regarded as essential in addressing the complex challenges in the NHS, yet few trainees of any healthcare discipline receive formal training. The study describes a peer-led evaluation of a year-long, multidisciplinary, experiential programme, the “Darzi Fellowship”, based in London.

Design/methodology/approach

An anonymous survey was analysed using a mixed-methods approach. Individual and collective experiences of fellows were evaluated, in particular the perceived impact the fellowship had on: the fellows themselves, their “host” organisation and the NHS as a whole.

Findings

A 90 per cent return rate was achieved. In all, 94 per cent reported that the experience had been valuable to them, 85 per cent feeling more empowered to effect change in healthcare systems. Crucial mechanisms to achieve this included increased self-awareness, personal reflection and the freedom to gain a greater understanding of organisations. Particular emphasis was placed on the value of developing clinical networks which promote collaboration across boundaries. Fellows emerged as more reflexive, critical and strategic thinkers.

Practical implications

This paper demonstrates the positive impact that clinical leadership training can have on participants, and the mechanisms by which future leaders can be created.

Originality/value

The novel, non-commissioned, peer-initiated and peer-led evaluation describes the personal experiences of fellows in a unique, multidisciplinary clinical leadership programme. The authors hope this will inform the development of future schemes in the NHS and provide learning for an international healthcare audience.

Details

International Journal of Public Leadership, vol. 12 no. 4
Type: Research Article
ISSN: 2056-4929

Keywords

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Article
Publication date: 18 May 2018

Anne Koskiniemi, Hanna Vakkala and Ville Pietiläinen

The purpose of this study is to take an existential-phenomenological perspective to understand and describe the experienced leader identity development of healthcare…

Abstract

Purpose

The purpose of this study is to take an existential-phenomenological perspective to understand and describe the experienced leader identity development of healthcare leaders working in dual roles. Leader identity development under the influence of strong professional identities of nurses and doctors has remained an under-researched phenomenon to which the study contributes.

Design/methodology/approach

Existential-phenomenology serves as a perspective underpinning the whole research, and an existential-phenomenological method is applied in the interview data analysis.

Findings

The study showed leader identity development in healthcare to be most strongly influenced and affected by clinical work and its meanings and followers’ needs and leader–follower relationships. In addition, four other key categories were presented as meaningful in leader identity development; leader identity development is an ongoing process occurring in relations of the key categories.

Originality/value

The existential-phenomenological approach and analysis method offer a novel way to understand leader identity development and work identities as experienced.

Details

Leadership in Health Services, vol. 32 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

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Article
Publication date: 4 October 2011

John Edmonstone

The paper seeks to describe a national strategic and multi‐professional clinical leadership programme designed and developed for the National Health Service in Scotland…

Abstract

Purpose

The paper seeks to describe a national strategic and multi‐professional clinical leadership programme designed and developed for the National Health Service in Scotland. It addresses the policy imperatives behind the programme, the local and national processes for identifying future clinical leaders and their preparation through the programme.

Design/methodology/approach

The background context and case for the programme are considered against international and local contexts. The programme's roots are explored, drawing upon the extensive consultation process used. The programme design is explained and the evaluation methodology and results are described.

Findings

Key learning related to programme design and delivery issues is highlighted, as is that relating to leadership itself.

Research limitations/implications

This is a one‐country case study but draws upon recent international good practice.

Originality/value

The case study identifies how a small (five million population) country can devise a strategic clinical leadership programme which reflects the distinctive direction adopted at policy level of working closely with clinical leaders.

Details

Leadership in Health Services, vol. 24 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

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Article
Publication date: 4 October 2011

Anne Marinelli‐Poole, Allan McGilvray and Diane Lynes

This article aims to provide an overview of what is occurring within two large District Health Boards in New Zealand: Counties Manukau DHB, ranking number three in…

Abstract

Purpose

This article aims to provide an overview of what is occurring within two large District Health Boards in New Zealand: Counties Manukau DHB, ranking number three in relative population size, and Canterbury DHB, number two. The conclusions provide a comparison of these approaches and draw on some of the new developments which are being driven by and through these District Health Boards.

Design/methodology/approach

Canterbury DHB have embraced a capability/competency framework while Counties Manukau DHB have chosen an alternative approach, enacting “leadership as a practice approach”. CMDHB have developed a range of development intervention across management and leadership levels while CDHB have chosen a path of HR practices aligned to a capability framework.

Findings

The approaches taken by Counties Manukau DHB and Canterbury DHB, while different, are driven by many of the same elements both internally and externally, indeed they might even be considered complementary. A focus on quality and patient safety, the changing dynamics of clinicians and managers, the integration of primary and secondary care and the increasing move to multi‐disciplinary teams who focus on care systems in an environment of increased demand alongside proportionally decreasing resources feature in both and require an adaptation of leadership in a health context.

Originality/value

The approaches taken by the two DHBs are unique to their organisations and the sector, yet provide exemplars of practice for other large health providers. The outcomes will reflect their differences in approach and the specific workforce challenges each faces.

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Article
Publication date: 16 May 2016

Nicky Stanley-Clarke, Jackie Sanders and Robyn Munford

The purpose of this paper is to discuss the lessons learnt from the process of implementing a new model of governance within Living Well, a New Zealand statutory mental…

Abstract

Purpose

The purpose of this paper is to discuss the lessons learnt from the process of implementing a new model of governance within Living Well, a New Zealand statutory mental health agency.

Design/methodology/approach

It presents the findings from an organisational case study that involved qualitative interviews, meeting observations and document analysis. Archetype theory provided the analytical framework for the research enabling an analysis of both the formal structures and informal value systems that influenced the implementation of the governance model.

Findings

The research found that the move to a new governance model did not proceed as planned. It highlighted the importance of staff commitment, the complexity of adopting a new philosophical approach and the undue influence of key personalities as key determining factors in the implementation process. The findings suggest that planners and managers within statutory mental health agencies need to consider the implications of any proposed governance change on existing roles and relationships, thinking strategically about how to secure professional commitment to change.

Practical implications

There are ongoing pressures within statutory mental health agencies to improve the efficiency and effectiveness of organisational structures and systems. This paper has implications for how planners and managers think about the process of implementing new governance models within the statutory mental health environment in order to increase the likelihood of sustaining and embedding new approaches to service delivery.

Originality/value

The paper presents insights into the process of implementing new governance models within a statutory mental health agency in New Zealand that has relevance for other jurisdictions.

Details

Journal of Health Organization and Management, vol. 30 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Content available
Article
Publication date: 6 September 2011

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

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Article
Publication date: 29 November 2019

Hanif Abdul Rahman, Amin Abdul Aziz, Muhamad Adib Ibrahim, Noor-Arpah Suhaili, Ahmad Zahid Daud and Lin Naing

The purpose of this paper is to develop and validate the Islamic Governance Examination tool (IGET) in applicability to the healthcare setting.

Abstract

Purpose

The purpose of this paper is to develop and validate the Islamic Governance Examination tool (IGET) in applicability to the healthcare setting.

Design/methodology/approach

A cross-sectional study using IGET, developed by a panel of expert and extensive literature, which measures Islamic governance (IG) domains – Tauhid, Juristic, Values and Culture. Health and allied health professionals from the largest hospital in Brunei were recruited to establish validity and reliability of the instrument. Structural equation modelling (SEM) was applied to explore the relationship of the IG domains.

Findings

Content validity and construct validity were established with good internal consistency reliability (Cronbach’s α ranged 0.835–0.953). SEM supports the conceptual model and demonstrated potential to improve quality of health services. By articulating internal and organisational processes put in place for compatibility of Muslim patients and accommodating incumbent form of healthcare governance.

Originality/value

To the authors’ knowledge, this is the first study developing, validating and exploring IG components in healthcare setting. Usage of IGET should be cross-validated in different disciplines and settings before application. Nonetheless, IG as a whole need to be developed further to create healthcare environment compatible for Muslim patients and complement current health services to improve health service quality for everyone.

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Article
Publication date: 1 October 2001

Norman McClelland, Graham Towl and David Crighton

Abstract

Details

The British Journal of Forensic Practice, vol. 3 no. 3
Type: Research Article
ISSN: 1463-6646

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