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Leadership and management

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Robert A Berenson
Vertical integration has been a central feature of health care delivery system change for more than two decades. Recent studies have demonstrated that vertically integrated health care systems raise prices and costs without observable improvements in quality, despite many theoretical reasons why cost control and improved quality might occur. Less well studied is how physicians view their newfound partnerships with hospitals. In this article I review literature findings and other observations on five aspects of vertical integration that affect physicians in their professional and personal lives: patients' access to physicians, physician compensation, autonomy versus system support, medical professionalism and culture, and lifestyle...
September 1, 2017: Health Affairs
Lola Butcher
How the world looks depends on your point of view. Medical directors, some with experience as payers and providers, share their thoughts on prior authorization, value-based care, and quality measurement. One opportunity: Payers should work with specialty organizations and physician advocates to develop metrics and processes that make sense from the physician perspective.
November 2017: Managed Care
Tait Shanafelt, Joel Goh, Christine Sinsky
Importance: Widespread burnout among physicians has been recognized for more than 2 decades. Extensive evidence indicates that physician burnout has important personal and professional consequences. Observations: A lack of awareness regarding the economic costs of physician burnout and uncertainty regarding what organizations can do to address the problem have been barriers to many organizations taking action. Although there is a strong moral and ethical case for organizations to address physician burnout, financial principles (eg, return on investment) can also be applied to determine the economic cost of burnout and guide appropriate investment to address the problem...
December 1, 2017: JAMA Internal Medicine
Patricia A McDaniel, Ruth E Malone
PURPOSE: To explore employers' decisions to base hiring policies on tobacco or nicotine use and community perspectives on such policies, and analyze the implications for organizational identity, community engagement, and health promotion. METHOD: From 2013 to 2016, 11 executives from six health care organizations and one non-health-care organization with nonsmoker-only hiring policies were interviewed about why and how their policies were created and implemented, concerns about the policies, and perceptions of employee and public reactions...
October 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Quentin Eichbaum
Whereas the business professions have long recognized that conflict can be a source of learning and innovation, the health professions still tend to view conflict negatively as being disruptive, inefficient, and unprofessional. As a consequence, the health professions tend to avoid conflict or resolve it quickly. This neglect to appreciate conflict's positive attributes appears to be driven in part by (1) individuals' fears about being negatively perceived and the potential negative consequences in an organization of being implicated in conflict, (2) constrained views and approaches to professionalism and to evaluation and assessment, and (3) lingering autocracies and hierarchies of power that view conflict as a disruptive threat...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Russell Mannion, Judith Smith
No abstract text is available yet for this article.
December 20, 2017: BMJ Quality & Safety
Roger A Edwards, Sandhya Venugopal, Deborah Navedo, Subha Ramani
Designing and evaluating health professions educational programs require a range of skills in a rapidly changing educational and healthcare environment. Not all program directors possess all the required leadership skills. In this twelve tips article, we describe a systematic approach to effectively address the complexity facing program leadership, implement robust programs and meaningfully evaluate their impact. They also offer a roadmap for managing diverse stakeholders with often competing demands. The tips are categorized under three domains: Planning, Initial Implementation, and Monitoring...
November 16, 2017: Medical Teacher
Janice L Dreachslin, Robert Weech-Maldonado, Judith Gail, Josué Patien Epané, Joyce Anne Wainio
How can healthcare leaders build a sustainable infrastructure to leverage workforce diversity and deliver culturally and linguistically appropriate care to patients? To answer that question, two health systems participated in the National Center for Healthcare Leadership's diversity leadership demonstration project, November 2008 to December 2013. Each system provided one intervention hospital and one control hospital.The control hospital in each system participated in pre- and postassessments but received no preassessment feedback and no intervention support...
May 2017: Journal of Healthcare Management / American College of Healthcare Executives
Susan J Lieff, Francis J Yammarino
Academic medicine is in an era of unprecedented and constant change due to fluctuating economies, globalization, emerging technologies, research, and professional and educational mandates. Consequently, academic health science centers (AHSCs) are facing new levels of complexity, constraint, and uncertainty. Currently, AHSC leaders work with competing academic and health service demands and are required to work with and are accountable to a diversity of stakeholders. Given the new challenges and emerging needs, the authors believe the leadership methods and approaches AHSCs have used in the past that led to successes will be insufficient...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Alicia A Bergman, Deborah M Delevan, Isomi M Miake-Lye, Lisa V Rubenstein, David A Ganz
Background Within many large health care organizations, researchers and operations partners (i.e., policymakers, managers, clinical leaders) join to conduct studies to improve the quality of patient care. Yet optimal approaches to conducting partnership research and evaluation are only beginning to be clearly defined. The Veterans' Health Administration (VA) Quality Enhancement Research Initiative (QUERI), funded by operations leaders and administered by the VA's research service, now has nearly two decades of experience in fostering research-operations partnerships for improving quality of VA care...
January 1, 2017: Journal of Health Services Research & Policy
Jenna M Evans, Agnes Grudniewicz, G Ross Baker, Walter P Wodchis
BACKGROUND: Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability. PURPOSE: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts...
August 31, 2016: International Journal of Integrated Care
Jason A Wolf
In a healthcare world in which consumerism is no longer a question and value has claimed its place at center stage, leaders are called to think differently about how they operate and manage their organizations. Priorities are curving in new directions with shifts in policy, direction of dollars, and evolution of practice. At the center of this transition is an opportunity for healthcare leaders to recognize that patient experience is the new heart of healthcare leadership.To address quality, safety, service, cost, and population health outcomes, leaders must rethink how they understand and engage in experience efforts overall...
April 2017: Frontiers of Health Services Management
J Matthew Austin, Renee Demski, Tiffany Callender, K H Ken Lee, Ann Hoffman, Lisa Allen, Deborah A Radke, Yungjin Kim, Ronald J Werthman, Ronald R Peterson, Peter J Pronovost
BACKGROUND: As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety...
April 2017: Joint Commission Journal on Quality and Patient Safety
Sara Kim, Naike Bochatay, Annemarie Relyea-Chew, Elizabeth Buttrick, Chris Amdahl, Laura Kim, Elise Frans, Matthew Mossanen, Azhar Khandekar, Ryan Fehr, Young-Mee Lee
Unresolved conflicts among healthcare professionals can lead to difficult patient care consequences. This scoping review examines the current healthcare literature that reported sources and consequences of conflict associated with individual, interpersonal, and organisational factors. We identified 99 articles published between 2001 and 2015 from PubMed, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medical Database. Most reviewed studies relied on healthcare professionals' perceptions and beliefs associated with conflict sources and consequences, with few studies reporting behavioural or organisational change outcomes...
May 2017: Journal of Interprofessional Care
Elizabeth W Patton, Kent A Griffith, Rochelle D Jones, Abigail Stewart, Peter A Ubel, Reshma Jagsi
No abstract text is available yet for this article.
April 1, 2017: JAMA Internal Medicine
Saate Shakil, Rita F Redberg
No abstract text is available yet for this article.
April 1, 2017: JAMA Internal Medicine
Joel Yager, Jeffrey W Katzman
OBJECTIVE: Although meetings are central to organizational work, considerable time devoted to meetings in Academic Health Centers appears to be unproductively spent. The primary purposes of this article are to delineate and describe Meeting Disorders, pathological processes resulting in these inefficient and ineffective scenarios, and Meeting Fatigue Disorder (MFD), a clinical syndrome. The paper also offers preliminary approaches to remedies. METHODS: The authors integrate observations made during tens of thousands of hours in administrative meetings in academic medical settings with information in the literature regarding the nature, causes and potential interventions for dysfunctional groups and meetings...
March 2, 2017: Academic Psychiatry
Graham T McMahon
Continuing medical education (CME) has the power and capacity to address many challenges in the health care environment, from clinician well-being to national imperatives for better health, better care, and lower cost. Health care leaders who recognize the strategic value of education and engage their people in education can expect a meaningful return on their investment-not only in terms of the quality and safety of their clinicians' work but also in the spirit and cohesiveness of the clinicians who work at their institution...
August 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Alexander Norbash
RATIONALE AND OBJECTIVES: To suggest a methodical approach for refining transitional management abilities, including empowerment of a growing leader, leading in an unfamiliar organization or leading in an organization that is changing. MATERIALS AND METHODS: Management approaches based on the body of work dealing with leadership studies and transitions and dealing with leadership during times of transition and change management were consolidated and categorized...
June 2017: Academic Radiology
John Duncan Edmonstone
Purpose This paper aims to propose that healthcare is dominated by a managerialist ideology, powerfully shaped by business schools and embodied in the Masters in Business Administration. It suggests that there may be unconscious collusion between universities, healthcare employers and student leaders and managers. Design/methodology/approach Based on a review of relevant literature, the paper examines critiques of managerialism generally and explores the assumptions behind leadership development. It draws upon work which suggests that leading in healthcare organisations is fundamentally different and proposes that leadership development should be more practice-based...
February 6, 2017: Leadership in Health Services
2017-02-25 22:07:12
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