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Article

Louise Kippist and Anneke Fitzgerald

This article aims to examine tensions between hybrid clinician managers' professional values and health care organisations' management objectives.

Abstract

Purpose

This article aims to examine tensions between hybrid clinician managers' professional values and health care organisations' management objectives.

Design/methodology/approach

Data are from interviews conducted with, and observation of, 14 managerial participants in a Cancer Therapy Unit set in a large teaching hospital in New South Wales, Australia, who participated in a Clinical Leadership Development Program.

Findings

The data indicate that there are tensions experienced by members of the health care organisation when a hybrid clinician manager appears to abandon the managerial role for the clinical role. The data also indicate that when a hybrid clinician manager takes on a managerial role other members of the health care organisation are required concomitantly to increase their clinical roles.

Research limitations/implications

Although the research was represented by a small sample and was limited to one department of a health care organisation, it is possible that other members of health care organisations experience similar situations when they work with hybrid clinician managers. Other research supports the findings. Also, this paper reports on data that emerged from a research project that was evaluating a Clinical Leadership Development Program. The research was not specifically focused on organisational professional conflict in health care organisations.

Practical implications

This paper shows that the role of the hybrid clinician manager may not bring with it the organisational effectiveness that the role was perceived to have. Hybrid clinician managers abandoning their managerial role for their clinical role may mean that some managerial work is not done. Increasing the workload of other clinical members of the health care organisation may not be optimal for the health care organisation.

Originality/value

Organisational professional conflict, as a result of hybridity and divergent managerial and clinical objectives, can cause conflict which affects other organisational members and this conflict may have implications for the efficiency of the health care organisation. The extension or duality of organisational professional conflict that causes interpersonal or group conflict in other members of the organisation, to the authors' knowledge, has not yet been researched.

Details

Journal of Health Organization and Management, vol. 23 no. 6
Type: Research Article
ISSN: 1477-7266

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Article

Susanna Hihnala, Lilja Kettunen, Marjo Suhonen and Hanna Tiirinki

The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of…

Abstract

Purpose

The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers’ work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments.

Design/methodology/approach

These data were collected through a number of thematic interviews. The participants were nurse managers (n = 7) and medical managers (n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis.

Findings

A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills.

Practical implications

Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care.

Originality/value

The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers’ experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.

Details

Leadership in Health Services, vol. 31 no. 1
Type: Research Article
ISSN: 1751-1879

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Article

Parvaneh Esfahani, Ali Mohammad Mosadeghrad and Ali Akbarisari

Although strategic planning promised to boost organizational performance, many health care managers found it difficult to implement it successfully. The purpose of this…

Abstract

Purpose

Although strategic planning promised to boost organizational performance, many health care managers found it difficult to implement it successfully. The purpose of this paper is to investigate the success of strategic planning in health care organizations of Iran.

Design/methodology/approach

This descriptive and cross-sectional study was conducted in 2016 using a valid and reliable questionnaire completed by 99 health care managers in Tehran province, Iran.

Findings

Strategic planning was positively related to organizational performance including employees’ and patients’ satisfaction and organizational productivity. However, strategic planning was moderately successful in enhancing organizational performance of Iranian health care organizations (score of 2.84 out of 5). The most and least success was observed in the planning and employee management constructs of organizational performance. Process management, organizational culture and customer management constructs had the most effect on the success of strategic plans in health care organizations.

Practical implications

Strategic planning is effective and provides a clear focused direction for health care organizations. Understanding the success factors of strategic planning would enable managers to develop more effective methods for developing, implementing and evaluating strategic plans in health care organizations.

Originality/value

This paper highlights the relationship between strategic planning and organizational performance and offers suggestions on how to develop and implement strategic plans to achieve higher organizational performance.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 6
Type: Research Article
ISSN: 0952-6862

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Article

Outi Simonen, Elina Viitanen, Juhani Lehto and Anna‐Maija Koivisto

The purpose of this paper is to investigate how managers in social and health care evaluate the knowledge sources affecting their decision‐making, and how the evaluations…

Abstract

Purpose

The purpose of this paper is to investigate how managers in social and health care evaluate the knowledge sources affecting their decision‐making, and how the evaluations were associated with the managers' professional background, activity sector, gender, age and management experience.

Design/methodology/approach

The study data are gathered from a questionnaire survey to the middle‐line doctor, nurse and social managers (n=404) within the responsibility area of a Finnish university hospital. Assessed the proportions of individual knowledge sources in the complete data set and their associations with the subjects' background data. In addition, grouping of individual knowledge sources variables are made using factor analysis.

Findings

The findings indicate that social and health care managers attempt to utilize diverse knowledge sources. Overall, professional experience and education, organization budget, and action plans of one's own unit are estimated as knowledge sources with the greatest impact. Manager's professional background and activity sector are associated with the kind of knowledge affecting their decision‐making. Some differences are noted between genders, but differences with respect to age or management experience are non‐significant.

Research limitations/implications

Social and health care organizations represent expert organizations where decision‐making is steered by professions and management tasks.

Originality/value

This paper suggests that the future decision‐makers will be required to identify versatile knowledge areas across cultural barriers, and to be capable of making comprehensive decisions affecting the entire organization.

Details

Journal of Health Organization and Management, vol. 23 no. 2
Type: Research Article
ISSN: 1477-7266

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Article

Kristina L. Guo

This paper describes managed care, competition and high health care costs and reductions in funding as the major market forces that affect US academic health centers. As…

Abstract

This paper describes managed care, competition and high health care costs and reductions in funding as the major market forces that affect US academic health centers. As academic health centers continue to preserve their missions of providing patient care, educating and training health professionals and conducting research, they are negatively impacted by these market changes, thus, resulting in increased expenses and lowered revenue. A key component to surviving in difficult times is market‐focused management. This paper develops a model to show the path of senior level management teams in their decision making. Through the performance of essential managerial roles, senior level managers are responsible for strategies that result in the long‐term viability and growth of academic health centers.

Details

Journal of Health Organization and Management, vol. 17 no. 2
Type: Research Article
ISSN: 1477-7266

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Article

Faridahwati Mohd‐Shamsudin and Nirachon Chuttipattana

The purpose of this paper is first, to identify the critical managerial competencies of primary care managers; and second, to determine the relationship between…

Abstract

Purpose

The purpose of this paper is first, to identify the critical managerial competencies of primary care managers; and second, to determine the relationship between personality and motivation, and managerial competency.

Design/methodology/approach

A survey was conducted involving distribution of questionnaires to 358 rural primary care managers in Southern Thailand.

Findings

The survey found six critical managerial competencies: visionary leadership; assessment, planning, and evaluation; promotion of health and prevention of disease; information management; partnership and collaboration; and communication. Both personality and motivation are found to significantly influence primary care managers' managerial competency. In particular, conscientiousness (i.e. perseveres until the task is finished, does a thorough job, full of energy, does things efficiently, and a lot of enthusiasm) is related to all managerial competencies. It is clear that extrinsic and intrinsic factors (i.e. quality of supervision and leadership, organizational policy and administration, interpersonal relationship, working conditions, work itself, amount of responsibility, and job recognition) are influential in primary care manager motivation that can significantly improve morale.

Research limitations/implications

The short version of the personality instrument may limit the generalization of some of the findings. Future research is needed to assess the relationship between managerial competency and performance. Further research could be done in other countries to see if this conclusion is in fact correct. It would also be useful to research if the findings apply to other health and social areas.

Practical implications

Personality and motivation are able to co‐predict managerial competency whereby motivation tends to have a stronger influence than personality. These findings will be useful to policy makers and to those responsible for the human development in the preparation of management training and development programs. Moreover, top management should not overlook the motivational system as a way to encourage managers to be competent in their job.

Originality/value

The paper contributes to our understanding of managerial competency within the context of rural primary care sectors. The success of any organized health program depends upon effective management, but health systems worldwide face a lack of competent management at all levels. Management development for health systems, particularly at the first line of supervision, must be given much higher priority for investment.

Details

Journal of Health Organization and Management, vol. 26 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

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Book part

Thomas T. H. Wan, Maysoun Dimachkie Masri and Judith Ortiz

The implementation of the Patient Protection and Affordable Care Act has facilitated the development of an innovative and integrated delivery care system, Accountable Care

Abstract

Purpose

The implementation of the Patient Protection and Affordable Care Act has facilitated the development of an innovative and integrated delivery care system, Accountable Care Organizations (ACOs). It is timely, to identify how health care managers in rural health clinics (RHCs) are responding to the ACO model. This research examines RHC managers’ perceived benefits and barriers for implementing ACOs from an organizational ecology perspective.

Methodology/approach

A survey was conducted in spring of 2012 covering the present RHC network working infrastructures – (1) Organizational social network; (2) organizational care delivery structure; (3) ACO knowledge, perceived benefits, and perceived barriers; (4) quality and disease management programs; and (5) health information technology (HIT) infrastructure. One thousand one hundred sixty clinics were surveyed in the United States. They cover eight southeastern states (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) and California. A total of 91 responses were received.

Findings

RHC managers’ personal perceptions on ACO’s benefits and knowledge level explained the most variance in their willingness to join ACOs. Individual perceptions appear to be more influential than organizational and context factors in the predictive analysis.

Research limitations/implications

The study is primarily focused in the Southeastern region of the United States. The generalizability is limited to this region. The predictors of RHCs’ participation in ACOs are germane to guide the development of organizational strategies for enhancing the general knowledge about the innovativeness of delivering coordinated care and containing health care costs inspired by the Affordable Care Act.

Originality/value of chapter

RHCs are lagged behind the growth curve of ACO adoption. The diffusion of new knowledge about pros and cons of ACO is essential to reinforce the health care reform in the United States.

Details

Technology, Communication, Disparities and Government Options in Health and Health Care Services
Type: Book
ISBN: 978-1-78350-645-3

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Article

Martin Fojt

This special “Anbar Abstracts” issue of the Journal of Management in Medicine is split into seven sections covering abstracts under the following headings: General…

Abstract

This special “Anbar Abstracts” issue of the Journal of Management in Medicine is split into seven sections covering abstracts under the following headings: General Management; Personnel and Training; Quality in Health Care; Health Care Marketing; Financial Management; Information Technology; Leadership, management styles and decision making.

Details

Journal of Management in Medicine, vol. 9 no. 3
Type: Research Article
ISSN: 0268-9235

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Article

Nirachon Chuttipattana and Faridahwati Mohd. Shamsudin

The purpose of this paper is to examine the moderating or contingent effect of organizational culture on the relationship between the personality and managerial…

Abstract

Purpose

The purpose of this paper is to examine the moderating or contingent effect of organizational culture on the relationship between the personality and managerial competencies of primary care managers in Thailand.

Design/methodology/approach

A survey involving distribution of questionnaires to 358 rural primary care managers in southern Thailand was conducted. Self‐reported measures on personality, managerial competency and organizational culture constructs, adopted from previous research, were employed. Exploratory factor analysis, confirmatory factor analysis, and hierarchical multiple regressions were used for data analysis.

Findings

Humanistic, prescriptive, and leadership culture moderated significantly the relationship between conscientiousness and specific dimensions of managerial competency, i.e. partnership, collaboration, and visionary leadership. In particular, the study found that managers seemed to be demonstrating the highest level of such competencies when they scored high on conscientiousness and worked in an environment that emphasizes a high humanistic culture, high leadership culture, and low prescriptive culture.

Research limitations/implications

The findings may be generalizable to any people working in primary care who have a responsibility to engage people in their own care. Further research could be done in other countries to see whether this conclusion is in fact correct. It would also be useful to research whether the findings apply to other health and social areas.

Practical implications

Specific personality traits have an influence on managerial competency within certain organizational cultures. A humanistic and leadership culture should be fostered in primary health care units. Focusing on developing conscientiousness in managers should not be overlooked. Relevant training development programs may be important.

Originality/value

This study argues that the effects of personality on managerial competency are moderated by organizational culture. The findings will be useful to policy makers and those responsible in human development, particularly, health care managers.

Details

Leadership in Health Services, vol. 24 no. 2
Type: Research Article
ISSN: 1751-1879

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Article

Henna Hasson, Staffan Blomberg, Anna Dunér and Anneli Sarvimäki

The purpose of this paper is to analyze how staff and managers in health and social care organizations use scientific evidence when making decisions about the organization…

Abstract

Purpose

The purpose of this paper is to analyze how staff and managers in health and social care organizations use scientific evidence when making decisions about the organization of care practices.

Design/methodology/approach

Document analysis and repeated interviews (2008-2010) with staff (n=39) and managers (n=26) in health and social care organizations. The respondents were involved in a randomized controlled study about testing a continuum of care model for older people.

Findings

Scientific evidence had no practical function in the social care organization, while it was a prioritized source of information in the health care organization. This meant that the decision making regarding care practices was different in these organizations. Social care tended to rely on ad hoc practice-based information and political decisions when organizing care, while health care to some extent also relied in an unreflected manner on the scientific knowledge.

Originality/value

The study illustrates several difficulties that might occur when managers and staff try to consider scientific evidence when making complicated decisions about care practices.

Details

Journal of Health Organization and Management, vol. 30 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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