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Robertson, Mary Eileen. "Virtual learning for health care managers." Curtin University of Technology, Department of Media and Information, 2006. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=17001.
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The health industry in Canada, as well as in other industrial countries, has been in the process of reform for many years. While such reform has been attributed to fiscal necessity due to increased health costs, the underlying causes are far more complex. Demographic changes, new technologies, expanded health care procedures and medications, increased demand and the globalization of health services have all contributed to the change and complexity of the industry. Health reform varies from country to country. In Canada, with a publicly funded health industry, the main reform method has been regionalization. This decentralized reform method arranges health services under a regional corporate management structure. The primary objective of this study was to assess the effects of health reform on the educational development of health-care managers in British Columbia, a western province of Canada. The study had a two-fold approach; to ascertain how health reform had changed the skill needs of health-care managers, and whether e-learning could benefit health management education. The key research questions that guided the study were: How might recent changes in the health industry have affected the learning needs and priorities of health-care managers? What factors might hinder attempts to meet any learning needs and priorities of health-care managers? and What benefits might e-learning provide in overcoming hindrances to effective health management education?A combination of quantitative (survey closed questions) and qualitative (survey open-ended questions, interviews and stakeholder feedback) methods was employed in this study. Overall, this study is described as productive social theory research, in that it addressed a recognized change in learning needs for health-care managers following a period of health reform, a socially significant phenomenon in the health industry. Relying on such tools as a survey, interviews, and stakeholder discussions, data was collected from over five hundred health-care managers. The data collected in this study provided valuable insight into the paradigm shift occurring in the educational needs of these managers. The study found that health reform had expanded the management responsibilities of healthcare managers and increased the complexity of service delivery. Restructuring of the health industry decreased the number of managers, support systems, and career opportunities for managers and increased the manager’s workload, communication problems and the need for new knowledge and skills. In addressing the learning needs of health-care managers, the study found there were limitations in health management educational opportunities available to health-care managers. The findings also show that current health management education was focused on senior managers leaving the majority of industry leaders with limited learning opportunities to upgrade their knowledge and skills at a time of great organizational change.
In addition, a classroom format dominated the learning delivery options for many managers. A list of fourteen management skills was used in the survey instrument to ascertain what new skills were needed by health-care managers following thirteen years of health reform. The findings show that of the fourteen skills, twenty-nine percent of health-care managers had no training and fifty-seven percent received their training through in-service, workshops and seminars. Irrespective of gender, age, working location and education the data showed that healthcare managers were mainly receiving training in change and complexity and people skills with less training occurring in planning and finances. Using the same fourteen skills, health-care managers priorized their immediate learning needs, listing the top three, as: evidence-based management, change and complexity and financial analysis. While evidence-based management and financial analysis could be attributed to the introduction of a corporate management structure in the health industry, change and complexity was an anomaly as managers were already receiving training in this skill. Health industry stakeholders believed this anomaly was due to continued uncertainties with ongoing health reform and/or a need for increased social interaction during a time of organizational change. In addressing the many learning needs of health-care managers a new health management education strategy was proposed for the province which included the need for an e-learning strategy.
The e-learning approach being proposed in this study is an integration of skill training and knowledge sharing directly blended into the workflow of the managers, using a variety of learning technologies. To support this idea, the study found that the majority of health-care managers were not only familiar with e-learning, they also felt they had the computer and Internet skills for more learning delivered in this manner. While a strong need for face-to-face learning still remained, a blended e-learning strategy was proposed for skill training, one that would accommodate the learning needs of managers in rural and remote areas of the province. Knowledge sharing technologies were also proposed to improve the flow of information and learning in small units to both newcomers and experts in the industry. Since this would be a new strategy for the province, attention to quality and costs were identified as essential in the planning. The study found that after years of health reform a new health management educational strategy was needed for the health industry of British Columbia, one that would incorporate a number of learning technologies. Such a change in educational direction is needed if the health industry wishes to provide their leaders with a responsive learning environment to adapt to ongoing organizational change.
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Ford, Lawrence Randolph. "Exploration of Practice Managers' Decision-Making Strategies in a Managed-Care Paradigm." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3094.
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Practice managers are facing challenging expectations when deploying a managed-care paradigm. The problem addressed in this study was a gap in knowledge regarding practice managers' decision-making strategies that affect, or could be perceived to affect, a climate of excellence with business and client relationships, primary health care, physicians, and patients in a managed-care paradigm. The purpose of the qualitative exploratory study was to explore practice managers' decision-making strategies affecting primary health care, physicians, and patients. Guided by Simon's ideology of decision-making strategies in a management environment, the overarching research question and 3 subquestions centered on how practice managers delineate their decision-making strategies and how those strategies affect primary health care, physicians, and patients. To close the gap in knowledge, the study included (a) a homogeneous purposive sampling of 14 practice managers (n = 2, pilot study; n = 12, main study) as research participants; (b) face-to-face interviews with semistructured, open-ended questions to collect data; and (c) in vivo and pattern coding during data analysis. The study results indicated a need for change agents, interactions, partnerships, and accountability in a managed-care paradigm. Managing health care is complex and practice managers will continue to be challenged. Alliances between practice managers and stakeholders are recommended to meet those challenging expectations. As a result, positive social changes may be observed in improved access to primary health care, better health care treatments, and collaborative interactions in a managed-care paradigm.
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DeMain, Karen A. "Healthcare Managers' Perspectives of their Management Education." The Ohio State University, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=osu1418909720.
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Parand, Anam. "The role of acute care managers in quality of care and patient safety." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/11677.
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Healthcare managers have a responsibility for the standard of their services and patient care delivered. Their work is thought to be essential in achieving and improving high quality care and patient safety. However, little is empirically known about their role in this. This thesis investigates acute care managerial work and impact in the context of quality of care and patient safety. It draws upon power and work-activity group theories and literature from other industries to guide investigation and elucidate findings. The introductory Chapters (Chapters 1-3) provide the background context of quality of care and patient safety, relevant management theory, and literature on the role of acute care managers in quality and safety. A systematic literature review in Chapter 4 illustrates a case for empirical research on this topic and suggests areas for further investigation. Chapters 5 and 6 report a case study investigation of the senior manager’s dimensions of involvement in a quality and safety improvement collaborative. These Chapters present self-reports of 17 Chief Executive Officers and 18 Medical Directors across 20 NHS hospitals on their actions and contributions to the UK Safer Patients Initiative (SPI). From this, a model of five principle dimensions of involvement emerged. Corroborating this model, Chapter 7 reports the staff perspective of their senior managements’ role in SPI, comprising interviews with 36 staff also involved in the SPI programme across the 20 hospitals. To explore the work of the acute care middle manager in quality and patient safety, 36 interviews with general managers, service and divisional managers across two NHS Trusts and two specialities reveal their relevant training/learning, demands, choices and constraints (Chapter 8). This informed two follow up surveys that further quantified the interview findings and explored theoretical power and role constructs. The first survey presents the views of 100 middle managers from 10 NHS Trusts on their quality and safety-related time, learning, activities, power and impact (Chapter 9). The second survey reports 60 clinical staff views on the same items, illustrating some divergence on critical constructs (Chapter 10). The thesis closes with a final Chapter (Chapter 11) comprising a summary of the key findings per Chapter and the overarching themes from the thesis. Methodological limitations/strengths, wider implications for managers and policy makers, and future research are considered. The Chapter ends with concluding remarks on the critical work performed by acute care managers across organisational levels for the daily preservation of quality and patient safety and its improvement.
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Matosevic, Tihana. "Profit or care : the motivations of care home owners and managers in England." Thesis, London School of Economics and Political Science (University of London), 2009. http://etheses.lse.ac.uk/2334/.
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Social care actors' motivations and attitudes play a central role in the delivery of services. This thesis examines the underlying motivations for providing care home services for older people, drawing data from private, voluntary and local authority homes in eight areas of England. The study explores care home owners'/managers' motivations. The majority of respondents were found to be primarily motivated by meeting the needs of older people and professional achievements. With regards to professional motivations, interviewees reported high levels of job satisfaction. Care home owners/managers were satisfied with their career choice and felt that, through their work, they were contributing to society as a whole. The study identified a range of personal and external factors that could influence owners'/managers' intrinsic motivations and professional aspirations. Local authority commissioners' perceptions of care-home owners'/managers' motivations are also identified as playing an important role. Commissioners' views of care home owners'/managers' motivations, their perceived strengths and weaknesses, and their motivations will have a bearing on commissioning decisions. The results indicate that owners/managers are generally perceived by commissioners as highly altruistic, but also relatively financially motivated individuals. Further analysis revealed significantly different views towards profit maximising, which commissioners perceive as very important, while providers consider it to be of little motivational value. Private sector care home owners/managers are described by commissioners as significantly more motivated by personal income. Associations are found between commissioners' perceptions of motivations and the nature of their relationships with providers. The study also examined changes in owners'/managers' motivations between 1994 and 2003. The findings indicated that, overall, care home owners'/managers' main motivations remained unchanged over time. The policy implications of the main findings are discussed with a specific focus on care home owners'/managers' intrinsic motivations, commissioner- provider relationships, and the role of motivations in social care markets.
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Postle, Karen Margaret. "Care managers' responses to working under conditions of postmodernity." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310558.
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Craig, Susan Yvonne. "Social care managers as staff developers : help or hindrance?" Thesis, University of Southampton, 2008. https://eprints.soton.ac.uk/66058/.
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There are many challenges facing the social care sector. These include how to ensure a qualified workforce exists that meets registration requirements as well as supporting the ongoing development of that workforce. At a time when social care services are under pressure to continuously improve and change, there is an increased pressure on care staff to meet greater demands from service users. Given the labour-intensive nature of social care provision, the training of staff is a significant factor in the provision of a high-quality service. The spectrum of learning and development for care staff is considerable and this presents challenges for managers and organisations. This thesis considers modern day social care provision with its diversity and challenges for those managing the delivery of a constantly changing care service where regulation is paramount and inspection regimes can significantly dictate the business need. Social care managers appear to deal with the demands of providing a service whilst meeting the development needs of staff. Balancing service needs with the need for staff to gain qualifications is an issue. Managers endeavour to overcome the challenges of releasing staff for training and development by considering diverse ways of delivering and accessing learning. The aim of this thesis therefore, is to assess whether social care managers could reasonably adopt a staff development role in addition to their care and other managerial responsibilities. The thesis also examines the perception of the managers and staff concerning the implementation of Government policies and aims to discover what impact this may have on the workplace. In seeking to understand what care staff and managers think about the expectations placed upon them what they say is clearly an important source of data. The use of interviews to gather primary data from a sample of care staff from the independent sector together with a review of secondary data in respect of learning and development research undertaken contributes to a clearer understanding of learning and development strategies adopted by managers. What emerges is that managers do require additional support to implement the learning and development spectrum required by the national minimum care standards and shifting trends in social care responsibilities, however, there is no single solution to the form of assistance required. As a result of this, a number of avenues for future action and recommendations for additional social care research are proposed.
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Cary, Barbara Lorraine. "Case managers and ethical decision making." Thesis, The University of Arizona, 1997. http://hdl.handle.net/10150/291522.
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In a descriptive study, Lutzen's Moral Sensitivity Questionnaire (MSQ) was used to describe nurse case managers' perception of ethical decision making. Both community-based and hospital-based case managers responded. Research questions addressed (a) relationship between respondent's age and patient autonomy and between length of experience as case manager and benevolence; and (b) difference in conflict in ethical decision-making by level of education and difference in rules in ethical decision-making by type of setting. No significant correlations were found between the respondent age and patient autonomy nor between the respondents' length of experience as case manager and benevolence. There was a statistically significant difference in perception of conflict by educational level. Difference in rules in ethical decision making by type of setting approached statistical significance.
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Jacobs-Kenner, Jerrie. "Analysis of alternative care placement changes as provided by case managers." Diss., Columbia, Mo. : University of Missouri-Columbia, 2008. http://hdl.handle.net/10355/5509.
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Thesis (Ph. D.)--University of Missouri-Columbia, 2008.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on July 27, 2009) Includes bibliographical references.
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Van, der Heever Mariana. "An ideal leadership style for unit managers in intensive care units of private health care institutions." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/4058.
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Thesis (MCur (Nursing Science))--University of Stellenbosch, 2009.ENGLISH ABSTRACT: The work environment in critical care units in South Africa is hampered by a profound shortage of nurses, heavy workloads, conflict, high levels of stress, lack of motivation and dissatisfaction among the staff. The task of managing a C.C.U. has therefore become a challenge. It is important that unit managers apply a leadership style that matches these challenges. The aim of this study was to investigate the ideal style of leadership. The objectives set for the study were to identify the ideal leadership style required in the following areas: administrative functions education functions patient care research An explorative, descriptive research design was applied, with a quantitative approach to determine the ideal leadership style for unit managers in critical care units of private health care institutions. The research sample consisted of all nurses working permanently in eleven private hospitals in the Cape Metropolitan area. A questionnaire consisting of predominantly closed questions was used for the collection of data, which was collected by the researcher in person. Ethical approval was obtained from the Committee of Human Science Research at Stellenbosch University. Permission to conduct the research was obtained from the institutions and informed consent from the participants. A pilot study was conducted to test the questionnaire at a private hospital which did not form part of the study. A 10% sample of the relevant staff, namely 27 participants were involved in this study. The validity and reliability was assured through the pilot study and the use of a statistician as well as experts in nursing and a research methodologist. Data was tabulated and presented in histograms and frequencies. Statistical significant associations were drawn between variables, using the Chi-square test. The Spearman rank (rho) order correlation was used to show the strength of the relationship between two continuous variables. Findings of the study show that participatory leadership style and transformational leadership approach were valued in all four (4) of the objectives. Emphasis was placed on consultation prior to any decisions. Nurses requested an opportunity to give feedback on a regular basis regarding the unit managers conduct (Chi-square test p = 0.025). They also agreed that unit managers should apply the necessary rules and procedures (Chi-square test p = 0.016). A huge request was made for integrity, trust, impartiality, openness, approachability and particularly honesty. The nurses also maintained that the nurse manager’s behaviour should be congruent. Furthermore, the results indicate that nurses would like to be empowered by: being involved in the scheduling of off-duties taking the lead in climate meetings being granted opportunities (to all categories of nurses) to attend managerial meetings. N = 41 (48.2%) of nurses admitted that unit managers would instruct them to cope with insufficient staffing pertaining to ventilated patients, putting them under severe strain and at risk legally. N = 39 (47%) of nurses admitted that unit managers only consider qualifications and experience in the delegation of tasks if the workload in the unit justifies it. Safe patient care is not always a priority. N = 99 (96%) of nurses agreed that autocratic behaviour relating to task delegation exists. Recommendations included the application of transformational leadership and participatory management. The aim to create a healthier, more favourable work environment for critical care nurses will hopefully be attained through applying the ideal leadership style and leadership approach.
AFRIKAANSE OPSOMMING: Die werksverrigtinge in kritieke sorgeenhede in Suid-Afrika word deur ‘n ernstige tekort aan verpleegsters, hoë werklading, konflik, spanning, min motivering en baie ontevredenheid onder verpleeglui gekortwiek. Die leiding en bestuur van ‘n kritieke sorgeenheid is dus nie ‘n maklike taak nie. Dit is dus belangrik dat eenheidsbestuurders ‘n leierskapstyl aan die dag lê wat dié uitdagings doeltreffend aanspreek. Die doel van die studie is dus om ondersoek in te stel na die wenslike leierskapstyl vir kritieke sorgeenhede. Die doelwitte daargestel is dus om die ideale leierskapstyl in elk van die volgende funksies te bepaal: administrasie opleiding pasiënte-sorg navorsing Die ideale leierskapstyl vir eenheidbestuurders in kritieke sorgeenhede in privaathospitale is bepaal deur ‘n kwantitatiewe benadering met ‘n beskrywende ontwerp toe te pas. Die populasie het alle kritieke sorg verpleeglui ( permanent werksaam by een van elf privaathospitale in die Kaapse Metropool) ingesluit. Instrumentasie het ‘n vraelys behels (met oorwegend geslote vrae) en data is persoonlik deur die navorser ingevorder. Etiese toestemming is vanaf die Etiese Komitee van die Mediese Fakulteit te Universiteit Stellenbosch verkry asook die hoofde van die verskillende privaathospitale waar navorsing plaasgevind het. Ingeligte toestemming is ook van elkeen van die deelnemers verkry. Ten einde die vraelys te toets, is ‘n loodstudie by ‘n privaathospitaal ( wat nie by die studie ingesluit was nie) gedoen. Die loodstudie het N = 27 (10%) van die totale populasie behels. Die betroubaarheid en geldigheid van die studie is deur die loodstudie, die gebruik van ‘n statistikus, verpleegdeskundiges en die navorser-metodoloog versterk. Data is getabuleer en in histogramme en frekwensies voorgestel. Deur die Chi-square- toets te gebruik, is statisties betekenisvolle assosiasies tussen veranderlikes bepaal. Ten einde sterkte van verhoudings tussen twee opeenvolgende veranderlikes te bepaal, is die Spearman rangordekorrelasie (rho) aangewend. Die bevindings van die studie het getoon dat ‘n deelnemende bestuurstyl en transformasie-leierskapbenadering die mees aangewese keuse vir al vier doelwitte is. Die toepassing van veral ‘n deelnemende besluitnemingsproses het groot voorrang geniet, Verpleegkundiges wil daarbenewens ook op ‘n gereelde basis geleentheid hê om terugvoering oor die leierskapgedrag van die eenheidsbestuurder te gee (Chi-square toets p = 0.025). Ook verlang die deelnemers dat eenheidsbestuurders nie reëls en regulasies moet verontagsaam nie (Chi-square toets p = 0.016). ‘n Ernstige versoek is gerig ten opsigte van integriteit met pertinente verwysing na eerlikheid, vertroue, onpartydigheid, deursigtigheid, toeganklikheid en dat die leier se woorde en dade moet ooreenstem. Die resultate het verder getoon dat verpleegsters graag bemagtig wil word deur: betrokkenheid in die skedulering van afdienste, leiding in klimaatsvergaderings te wil neem, geleentheid te hê om bestuurvergaderings by te woon (alle kategorieë van verpleegkundiges).. N = 39 (48.2%) van verpleegkundiges het erken dat hulle gedwonge personeeltekorte ten opsigte van geventileerde pasiënte ervaar en dus aan mediese geregtelike risiko’s en onnodige druk blootgestel word. N 39 (47%) van verpleegkundiges het erken dat eenheidsbestuuders kwalifikasies en ondervinding slegs in ag neem indien die werklading in die eenheid dit toelaat..Veilige pasiëntesorg kry dus nie altyd voorkeur nie. N = 99 (96%) van verpleegkundiges het erken dat outokratiese gedrag ( wat met werkstoewysing verband hou) wel voorkom. ‘n Transformasie leierskapsbenadering en deelnemende bestuurstyl is dus aanbeveel. Die hoop word dus uitgespreek dat deur aan die verpleegkundiges se versoeke ten opsigte van die ideale bestuursbenadering en bestuurstyl te voldoen, die werksatmosfeer binne kritieke sorgeenhede toenemend gesonder en dus aangenamer sal word.
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Carey, Malcolm. "The care managers : life on the front-line after social work." Thesis, University of Liverpool, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.417246.
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Westbrook, Linda Oakes. "Cognitive structures of first-line nurse managers in critical care settings /." Thesis, Connect to this title online; UW restricted, 1994. http://hdl.handle.net/1773/7299.
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Dickens, Jonathan. "Local authority social workers, managers and lawyers in child care cases." Thesis, University of East Anglia, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.426771.
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This thesis discusses the relationships between local authority social workers, managers and solicitors in child care cases under the Children Act 1989. The original focus was social workers and lawyers, but as work progressed the importance of the social services manager became clear. The empirical work involved 54 semistructured interviews with members of the three groups between March 2001 and April 2002. The findings show that the relationships usually worked well enough, but that tensions were never far beneath the surface and could break out in resentment and frustration. The tensions are rooted in the disjunction between the popular mantra 'the lawyer advises, the client instructs' and the much more complex relationships that the professionals experience in practice. Lawyers may give their advice very forcefully, and can sometimes resist instructions; social workers sometimes rely on the lawyers more closely than any of the groups consider ideal. Behind these difficulties lie the diverse and potentially incompatible responsibilities held by each group, competing notions of reasonableness, different approaches to risk and the challenges of managing limited resources. The tensions provoke powerful criticisms of each group by the others - lawyers don't fight hard enough, social workers don't analyse their cases properly, managers don't supervise their staff adequately. Flexibility, tact and communication are required to keep relationships working well. At a theoretical level, the tensions between and within the three groups are seen to reflect and construct tensions between and within three key discourses in contemporary child care work welfare, law and managerialism. The relationships between the three professional groups reproduce the relationships between these three paradigmatic approaches to, and technologies of, social and professional regulation. The implication for professional practice and social policy is to recognise and value the challenging benefits of dynamic interaction between the professional groups and the discourses.
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Johnson, Gretchen Eileen. "Self-Care Activities and Nurse Manager Well-Being." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2734.
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The role of the nurse manager is important in organizations and influences outcomes such as the safety and quality of care provided on a unit, satisfaction, turnover of nursing staff, and overall health of the work environment. Stressors for managing nurses can impair physical and emotional health and lead to poor patient and staff satisfaction, safety, and outcomes. The evidence-based practice project will explore nurse managers' well-being and self-care activities. The theoretical framework of the project is the Relationship-Based Care Model as well as Kotter's change theory. The literature suggests that self-care activities can reduce stress and improve well-being. A group of nurse managers who have accountability for inpatient hospital units will be recruited to participate in the project through public discussion boards and email groups of organizations that support nurse leaders. They will be educated through a self-guided learning module about stress and self-care and then will be asked to participate in self-care activities 3 times weekly for 4 weeks. Following the education, the nurse managers will complete a researcher-crafted posteducational assessment to evaluate whether the education and activities met their needs, whether they learned new information, and the helpfulness of the project. Nurse managers participating in regular self-care are able influence positive social change by role modeling healthy coping skills to nurses providing direct care to patients. Self-care promotes effective stress management and contributes a healthier work environment.
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Toms, Anders. "Information Security when Integrating Actors in Health Care Processes." Thesis, University of Skövde, Department of Computer Science, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-825.
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There is a growing interest within organisations today to focus on the core processes, i.e. the processes that create value for the intended customer, in order to stay compatible within the ever-fiercer competition. To have full control of the key processes may be a great step forward towards a more lean and effective organisation, not only for profit seeking companies but also for public welfare institutions like health care. Software aimed at supporting a process focus is continuously being developed and one such family of programs is commonly referred to as process managers.
A process manager lets the people in an organisation who have complete knowledge of the processes model these without requiring them to have expert knowledge of computers and programming. Once a process has been defined graphically according to a predefined modelling language, it can be deployed and monitored. The process manager software takes care of the routing of messages between actors, both human as well as non-human (e.g. other applications), and it drives the individual errand forward according to how the process flow has been defined in the model. However, applying a process manager approach in health care processes requires a certain amount of caution. Messages sent between actors in health care organisations are often of a delicate nature since they may contain sensitive information, such as illness, mental state, family situation and similar, that is related to an identifiable individual. There are also other aspects of security that need to be addressed besides the confidentiality aspect. For example, it must be guaranteed that the information is correct and not altered during transfer, the information must be available when needed and it should be possible to trace a message to its sender, among other things.
This work identifies a set of security requirements from the literature that need to be fulfilled in health care organisations when applying a process manager approach. With these requirements as a basis, a process manager system is evaluated with regards to security and the conclusion is that future versions need improvement on some points. Future work is also suggested that could help to explore the area further.
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Vie, Ola Edvin. "Shadowing managers engaged in care: Discovering the emotional nature of managerial work." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for industriell økonomi og teknologiledelse, 2009. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-5676.
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Within the Managerial Work and Behaviour tradition, researchers have for nearly 60 years studied what managers do in their everyday work. However, these studies have to a little extent acknowledged the emotional nature of managerial work. In this thesis, I examine why and how managers engage in care towards their subordinates. Based on empirical data derived from shadowing four managers for a complete week each, supplemented with interview data from the manager and their co-workers, I show that managers accomplish care through mundane activities like listening and chatting. It is also evident that shadowing is a well-suited method for studying the emotional reactions from managers and others in organizations. The research question “Why do managers engage in care?” is explored at three different levels of analysis. On the individual level I find that managers engage in care by observing that it can immediately reduce tension in a relationship. On the interpersonal level I find that managerial care affects co-workers both directly and indirectly through social influence processes. On the institutional level I find that managers engage in care because of authority derived from their formal position. Together these three explanations integrate the phenomena managerial care across micro and macro levels of analysis. I argue that the managerial authority also includes certain duties, which is influenced by the legal framework and more importantly by the employees’ expectations. To manage other people, and especially having personnel responsibility, makes the manager more inclined to perform emotional labour. It is therefore important to recognize the positive aspects of care and also to observe the flip side of this coin. My study shows that managerial care can be experienced as burden for those that must engage in it. My findings should encourage managers, management educators, and scholars to acknowledge emotions in organizations and particular to recognize the emotional burdens of being a manager. It is time to acknowledge that managers are human beings with emotions, both positive and negative, and that an understanding of these is necessary to understand the total nature of managerial work.Innenfor forskningstradisjonen kjent som Lederarbeid og lederatferd, har forskere i mer enn 60 år studert hva leder gjør i sitt daglige arbeid. Disse studiene har i liten grad anerkjent lederarbeidets emosjonelle natur. I denne avhandlingen har jeg undersøkt hvorfor og hvordan ledere viser omsorg ovenfor medarbeidere. Basert på empiri fra å fotfølge fire leder for en hel uke hver, samt intervjudata fra lederne og deres medarbeidere, viser jeg at ledere utfører omsorg gjennom hverdagslige aktiviteter som lytting og å slå av en prat. Jeg viser også at fotfølging er en godt tilpasset forskningsmetode for å studere emosjonelle reaksjoner hos både ledere og andre i organisasjoner. Forskningsspørsmålet om hvorfor ledere viser omsorg blir diskutert på tre ulike analysenivåer. På det individuelle nivået finner jeg at ledere kan vise omsorg etter å ha observert at det umiddelbart kan redusere spenningsnivået i en relasjon. På det mellommenneskelige nivået finner jeg at lederomsorg påvirker andre både direkte og indirekte gjennom sosiale innflytelsesprosesser. På et institusjonelt nivå finner jeg at ledere viser omsorg på grunn av autoriteten de har gjennom sin formelle posisjon. Til sammen integrer disse forklaringene fenomenet lederomsorg på tvers av mikro- og makroanalysenivåer. Jeg argumenterer for at lederes autoritet fører med seg bestemte plikter. Disse pliktene påvirkes både av det juridiske rammeverket, og i enda større grad av medarbeidernes forventninger. Å lede andre mennesker, og spesielt personalansvar, krever at ledere må utføre emosjonelt arbeid. Det er derfor viktig og ikke bare anerkjenner de positive sidene ved å vise omsorg, men også synliggjøre medaljens bakside. Min studie viser at lederomsorg kan oppfattes som en byrde for de som må utøve det, og at omsorg er en viktig og integrert del av ledelse i organisasjoner. Mine funn bør oppmuntre ledere og forskere til å ikke bare anerkjenne følelser i organisasjoner, men også å anerkjenne byrdene av å være leder. Det er på tide å erkjenne at også ledere er mennesker med følelser, både positive og negative, og at en forståelse av disse er nødvendig for å forstå totaliteten av lederarbeidets natur.
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Dunham-Taylor, Janne, Joseph Z. Pinczuk, and Jo-Ann Marrs. "Ethics in Nursing Administration in Health Care Financial Management for Nurse Managers." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etsu-works/7105.
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Hess, Edward Alan. "The impact of diabetes nurse care managers in outlying medical offices on quality of care: An empirical investigation." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1744.
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The objective of this study is to evaluate the impact of the Diabetes Nurse Care Manager on an at-risk diabetic population using a Primary Group Visit Model in Outlying Medical Offices within the Kaiser-Permanente Health Care System upon the process and outcome of care in this population.
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Marshall, Max. "The effectiveness of case managers - a randomised controlled trial (an application of a standardised assessment of need)." Thesis, University of Bristol, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260896.
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Steele, R. H. "Management in social care : a cause for concern or an adapting professional identity?" Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/25041.
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Managers in social care are being relied upon to lead and implement substantial change within the sector. Yet the prevailing view is that the pressure being put on managers by managerialism and the increase in the business aspects of their role is in conflict with social care managers’ values, causing concern and challenging managers’ identity. Additionally, managers in social care are presented as being part of the same homogenous group as social work managers, a potential misrepresentation, which again has consequences for how managers identify with their role. This study aimed to explore and explain how social care managers are experiencing their manager identity and how they categorise themselves from a group perspective. This research was undertaken using a critical realist philosophical approach. The key theoretical framework used is social identity theory. The study findings have achieved the overall aim of the research, establishing that social care managers appear not to be experiencing any conflict in their identities, that managerialism is accepted by managers and seen to be necessary, and that managers’ values, formed in childhood, are a key aspect of how they undertake their managerial role. In addition, social care managers are not the same as social work managers, their social identity is a synthesis of the multiple groups they are members of with the dominant group being social care, because of this they cannot be viewed as being within the same homogenous group. Neither is the social care manager role distinctive from manager roles in other sectors, however how they undertake the role is. The significance of the study is the contribution to both the existing social care literature and the literature on social identity theory.
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Österholm, Johannes H. "Assessment meetings between care managers and persons living with dementia : Citizenship as practice." Doctoral thesis, Linköpings universitet, NISAL - Nationella institutet för forskning om äldre och åldrande, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-127392.
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This thesis deals with encounters between persons living with dementia and care managers. Dementia often results in progressive care needs that must be met by different social care services. The person’s care needs are assessed in an assessment meeting where the person and their relatives meet with a care manager to negotiate needs and social care services. The assessment is conducted through one or several conversations where the person with dementia meets the care manager; relatives are often present in the meetings. Dementia is a syndrome that involves a cognitive decline and a decreased ability to communicate and interact with others. It may therefore be difficult for a person with dementia to take part in discussions about their care needs and social care services. 15 audio recorded meetings have been studied to explore and understand how persons with dementia use their remaining communicative, cognitive and linguistic resources to invoke, negotiate, and use their rights as citizens in the institutional context where their care needs are assessed. The analysis concerns the organization of talk as a joint activity; the production of social actors in talk-in-interaction; the relation to institutional features of discourse. This dissertation concludes that the practice of citizenship is situation based and varies depending on the participants present. Care managers can facilitate for persons with dementia to overcome communication problems by using different discursive strategies and to make it possible for them to participate or at least be included in the negotiation. Persons with dementia are positioned as less competent than other persons participating in the assessment meeting. This might have an impact on the participation of people with dementia in negotiations regarding their future care. Furthermore, stories told in assessment meetings often position the person as dependent on others, which could undermine the identity and sense of self of the person with dementia.Den här avhandlingen berör möten mellan personer med demenssjukdom och biståndshandläggare. Demenssjukdomar medför ofta komplexa omsorgsbehov, vilka kan mötas med hjälp av olika stödinsatser. Personens omsorgsbehov bedöms i ett biståndshandläggningssamtal där personen och dennes anhöriga träffar en biståndshandläggare för att förhandla dennes behov och eventuella insatser. Konversation är centralt i dessa möten. Demenssjukdomar medför kognitiva nedsättningar och nedsatt förmåga att kommunicera och interagera med andra. Det kan därför vara svårt för personer med demenssjukdom att deltaga i diskussioner om behov och insatser. 15 ljudinspelade samtal har studerats för att förstå hur personer med demens använder sina kvarvarande kommunikativa, kognitiva och språkliga resurser för att åberopa, förhandla och använda sina rättigheter som medborgare i den institutionella kontext där deras omsorgsbehov bedöms. I samtalet medverkar personen med demens, handläggaren samt ofta någon familjemedlem. Analysen fokuserar på organiseringen av samtal som en gemensam aktivitet; hur sociala aktörer skapas i samtal; hur det institutionella samtalets särdrag påverkar konversationen. Sammanfattningsvis visar denna avhandling på att hur medborgarskap praktiseras är situationsbaserat och varierar beroende på vilka som deltar i mötet. Biståndshandläggare kan underlätta för personer med demenssjukdom att övervinna kommunikativa problem genom att använda olika samtalsstrategier och göra det möjlig för dem att delta eller att åtminstone inkluderas i förhandlingen angående olika stödinsatser. Personer med demenssjukdom positioneras ofta som mindre kompetenta än andra personer som deltar i behovsbedömningssamtal, vilket kan medföra konsekvenser på personens delaktighet i planerandet av framtida insatser. Berättelser i dessa samtal positionerar ofta personen med demenssjukdom som beroende av andra, vilket kan underminera deras identitet och uppfattning av sig själva.
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Foster, David William. "Structuring the self-development of nurse managers as an organizational imperative." Thesis, London South Bank University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265590.
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Young, Ann P. "Unfinished business : a study of how middle managers with nursing and accountancy backgrounds manage identity in changing UK health care." Thesis, University of East London, 2005. http://roar.uel.ac.uk/3406/.
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People need to maintain or adopt identities that enable them to feel comfortable within the social structures that make up their world. However, frequent organisational change makes this self management project increasingly difficult, particularly for the middle manager who is neither a worker nor an executive but moves between a plurality of organisational positions. This thesis takes a social constructionist interpretation of reality and links this to hegemonic power relations in order to provide some insights into the management of identity. In order to test out this theoretical approach, the empirical work for the thesis was set in one NHS trust and one private health care/insurance company. The study was about middle managers who were also professionals, with a nursing or an accountancy background. The results showed that these managers were able to exercise choice on the identities adopted from amongst a number available to them. The structural organisational features of the private company were more constraining than the NHS trust while the preferred personal styles of the managers were also influential on how identity was managed. Articulations between ideological clusters were important in forming group alliances that protected identities. There were hints that the current hegemonic groupings of male, old managerialist and old professional identities were being undermined by the development of updated maternal identities and the growth of a new entrepreneurial managerialism. Conclusions suggest that a focus on ideological alliances is useful in adding to the literature on identity management in times of change. A hegemonic perspective explains not only how current alliances preserve threatened identities but also how the development of new alliances can better serve the interests of many middle managers in their search for secure identities. In this way, Berger and Luckman's theoretical approach to identity is strengthened.
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Norouzi, Nathalie. "Biståndshandläggare inom äldreomsorgen : Med fokus på hälsa*." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-38669.
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Biståndshandläggning är ett högst aktuellt ämne som diskuteras världen över och som forskas mycket om i Sverige. Syftet med studien var att undersöka hur biståndshandläggare upplever sin egen hälsa av att fatta beslut. Åtta biståndshandläggare intervjuades, varav två var män och sex kvinnor med ett åldersspann på 32–42 år. Sex av dessa hade en socionomexamen och två av de en beteendevetenskaplig kandidatexamen på högskolenivå. I analys av resultatet identifierades fyra grundkategorier: negativa upplevelser, stressupplevelser, positiva upplevelser och förhållningssätt. Resultatet visade att de biståndshandläggare som hade låg arbetserfarenhet upplevde stress genom handläggningsprocessen medan de som hade flera års erfarenhet inte påverkades i lika hög grad. Studien ligger till grund för framtida studier där framtida forskning kan breddas med hjälp av ett större urval för att kunna få en insyn i bredare perspektiv. Undersökningens slutsats var att individens hälsa påverkas genom beslutsprocessen både positivt som negativt.
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Johansson, Ellinor. "Enhetschefer : En studie om ledarskap inom äldreomsorgen." Thesis, Linnéuniversitetet, Institutionen för socialt arbete (SA), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-25246.
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My purpose is to describe and analyse how care managers experience their position as middle managers in the public sector. I have used a qualitative interview method to answer this question and also to capture my six interview persons opinion and understanding of their own position as middle managers. From my six interviews I noticed some difference in their opinions about how it is being a care manger. The results show that the role as care managers have challenges such as to intertwine their own notion how the caring of the elder should be with strict politic decisions. Other challenges are the limitation of economic recourses and reorganisations. Within the public service care mangers have opportunities to be part of the new changes with interesting comments or directives that the government would like to implement. My result can be understood with the street level bureaucracy and the difference between the concepts leadership and management. Finally I should clarify that my definition between the management and leadership was important to the respondent’s view of themselves and situations in their professional role as care managers. To have and be a manager could be understood with the help of the employment. As care manager you know what you get and can do, and also how the limitations impact them currently in difference situations.
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Goodwyn, Sherry Elizabeth. "The work of long-term care case managers, the two faces of case management." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ32664.pdf.
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Dawson, Jane. "Accountability and Quality Assurance in health care : the perceptions of nurses, midwives and managers." Thesis, University of Southampton, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.315299.
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Elliott, Chastidy. "Strategies Middle Managers of Nonprofit Health Care Organizations Use to Motivate Their Administrative Workforce." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7923.
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Despite the awareness of employee motivation among scholars and business leaders, many American workers attest to being unmotivated. A lack of employee motivation can lead to negative business outcomes. Therefore, middle managers may experience challenges in identifying strategies to motivate their staff. Grounded in the path-goal theory, the purpose of this qualitative multiple case study was to explore nonprofit health care organization middle managers' motivational strategies for the administrative workforce. The participants were comprised of 13 middle managers in the United States who supervised administrative teams of 4 or more members for over 2 years and effectively implemented motivational strategies. The data collection methods were telephonic semistructured interviews and reflective journaling. Through thematic analysis, 3 themes emerged: utilization of various leadership behaviors, awareness of motivational factors, and employee performance. The implications for positive social change include the potential to stimulate personal drive, improve career development, and allow individuals the opportunity to increase the quality of their home lives and communities. By understanding effective motivational strategies, health care leaders may realize tactical solutions to business goals through the development of their managerial staff's inspirational approaches.
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Masiye, Brighton. "An investigation of the perceived impact of performance management systems on managers and care assistants in private care of the elderly in care homes in Scotland." Thesis, Edinburgh Napier University, 2017. http://researchrepository.napier.ac.uk/Output/979188.
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Literature on performance management (PM) indicates that the concept has gained momentum in its use by organisations, with the ultimate goal of improving business performance. It is argued that PM makes significant contributions to individual employees and organisational performance by enabling expectations to be defined and agreed in terms of the role, responsibilities and accountabilities, and providing opportunities for individuals to identify their own goals and to develop their skills and competencies. However, there has been much debate as to whether PM optimises or leads to improved overall business performance as other factors other than human resources policies, such as personality, job role experiences, and structural factors, may have a detrimental influence on job performance. Moreover, several studies have shown that PM, and performance management systems (PMS) has resulted in unintended impacts, both positive and negative, in addition to those sought by organisations. This research is an investigation into the perception of managers and care assistants in private care of the elderly in care homes in Scotland on the impact of performance management systems. Use is made of both PM literature and empirical research to understand the perceived impact of the PMS with the ultimate aim of developing an enhanced PMS framework. In addition to documents review, twenty-four in-depth interviews were conducted, comprising of eight managers and sixteen care assistants drawn from eight different private care homes. The interviews focused on eight key PM elements, the PM concept, goal-setting, performance reviews, performance measurement, supporting performance, rewards system, training and development, and managing underperformance. The interview results from managers and care assistants were compared with the normative/ideal PM practice from the PM literature to determine how PMS is being implemented in the private care homes. The research findings reveal an overall positive perception towards PMS implementation by managers. However, the care assistants raised many of concerns which influenced a negative perception towards the PMS implementation. This was used as the basis for developing recommendations for an enhanced PMS framework. Therecommendations are centred around the identified two main problem areas: management/leadership style and the communication process. In addition to staff involvement in performance planning, and a fair underperformance management process, three other theories: power distance, vertical and horizontal trust, and the principal-agent problem were recommended to private care homes. This would help change the negative perception towards PMS implementation by care assistants.
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Slominski, Emily Ann. "Perspectives of Case Managers in Community-Based Elder Care: Work Roles, Stresses, Mediators, and Rewards." Oxford, Ohio : Miami University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1218046656.
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Stanley, Michael J. "The effect of change on the National Health Service general managers' information needs." Thesis, Sheffield Hallam University, 2001. http://shura.shu.ac.uk/20820/.
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The research enquiry using a sample of 20 NHS organisations with similar revenue and population characteristic profiles sets out to identify the information needs of the NHS General Managers and in doing so highlight the information that they need to meet their organisations' key success factors. The research identifies through the enquiry process the General Managers' information needs and describes the categories of those needs, the pressures and influences of the General Managers' working environment on those needs and the links to the influences that have been reflected in their information needs. In particular the external influence of the Department of Health and the business environment has not only changed the General Managers' information needs but affected the balance of power between the stakeholders, which in turn has affected those information needs. These organisational and environmental changes, health policies, stakeholder demands, and changes in the balance of power between the stakeholders has resulted in a change in the way in which the General Managers work with information, which has in turn increased the need for more accurate, timely and complex information. The research analyses the General Managers' understanding of their roles in the General Manager/patient/doctor relationship and analyses the potential areas of conflict arising when the patients' interests clash with the market-led (business) interests of the healthcare organisations and the diverse needs of the Provider, Purchaser and Regional Executive General Managers. These problems together with the effects of organisational resistance, organisational culture clash and system requirements and its effect on the information needs of the General Managers were examined for associated links with the difficulties that the General Managers experience in defining their information requirements. The research provides an understanding of the links between a market-led healthcare environment, the General Managers' information needs, and their attitude towards information as well as an understanding as to whether the patient, a key stakeholder, has benefited in the healthcare empowerment stakes as a result of the re-delineation of the General Managers' information needs and the impact upon their decision making. The information needs identified as a result of the research have shown them to have become business orientated with financial targets as a key measure and clinical performance (outcomes) increasingly being seen as the other key factor as an indication of success for the organisation. The hypothesis (Null Hypothesis) of the research asserts that it is not possible to link a market-led healthcare environment, the General Managers' information needs, their attitudes and behaviour towards information, and patient empowerment in such a way as to develop a model of information needs that is common across the Purchaser, Provider and the NHS Executive organisations. However, the research has developed as a first step, a series of outline models of information needs that will lead to a more complex and common model of information needs across the General Managers' organisational groups that will allow, when assessed against key success factors, a judgmental view of the ability of both the General Managers and their organisations to deliver their aims and objectives.
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Moffat, Mary I. "Certified Case Managers’ Lived Experiences in Hospital Networks: A Phenomenological Inquiry." Ohio University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1510574423348934.
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Bridge, Gillian. "Parents as care managers : the experiences of those caring for young children with cerebral palsy." Thesis, London School of Economics and Political Science (University of London), 1997. http://etheses.lse.ac.uk/2476/.
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Recent legislation has drawn attention to the increasing number of children with disabilities being cared for at home by their parents (the Department of Health estimates 98.5%). These children meet the criteria for 'children in need' in Part III of the Children Act 1989, and for care management introduced under the National Health and Community Care Act 1990. This study undertaken in the early 90's at the cusp of these reforms, seeks to explore the probable gap between the carefully argued and eminently logical proposals of the Department of Health in their policy objectives for children with disabilities and the practice implications for carers. Existing research in this area has concentrated on the impact of having a disabled child on the family and as a financial liability. Evaluation of community care has been directed towards organisational change and the implications for public spending. The intention here is to examine parents' experiences as care managers of their children's health, education and social care provisions, since consumer experiences are integral to the market philosophy underpinning the reforms. Young children with cerebral palsy have been chosen as an example of a severely disabling condition, and attention has been restricted to children of under 8 in the north London area. The research methods used are direct, non-participatory child observation, a postal questionnaire and semi-structured interviews. In total, 58 families participated in this study. In addition, facilities in 3 London boroughs and 2 specialist treatment centres were examined in depth. The findings are discussed in 4 sections (cerebral palsy as a disabling condition, health, education and personal social services) in accordance with the Children Act Guidance Volume 6, which emphasises the contribution of each of these areas and the need to take into account interdisciplinary collaboration. As there is a wide-ranging, relevant literature crossing many professional disciplines and subject areas, literature reviews are included in each of the sections. In conclusion, the findings are discussed in relation to improving service provision; future research potential, and the training needs of professionals involved in 'normalising' the lives of children with cerebral palsy and their families.
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Masoumi, Roza. "Effectiveness of Clinicians as First-Time Managers| A Systematic Review of the Evidence." Thesis, University of Maryland University College, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13806583.
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The purpose of this systematic review was to examine the factors associated with clinicians' effectiveness as first-time healthcare managers. The high demand for clinicians to become healthcare managers has been predicated on their strong clinical knowledge and their credibility among their peers. While existing medical expertise and credibility among peers are crucial when transitioning into management, there are other factors that could impact clinicians' effectiveness as first-time managers. Utilizing a conceptual framework that incorporates motivation theory, social identity theory, leader–follower theory, and leader–member exchange theory, this research sought to identify factors associated with the effectiveness of clinicians as first-time healthcare managers. Evidence from 67 studies was analyzed using a thematic synthesis approach. The following six major factors were identified as factors that are associated with clinicians' effectiveness as first-time healthcare managers: (1) clinicians' motivation to transition into management, (2) clinicians' ability to detach from their social identity as clinicians and adopt a new social identity associated with their new role, (3) quality and convenience of formal developmental programs, (4) utilization of succession planning, and (5) cultural alignment. Based on the findings of this study, implementation of evidence-based succession planning programs would allow organizations to identify current and future open management positions, to systematically screen high-potential clinicians who are motivated to solve healthcare issues and achieve excellence, and to provide convenient and high-quality in-house management training and mentorship programs prior to role transition.
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Ross, Frances M. "Managerial career development for women in health contexts : metamorphosis from quandary to confidence." Curtin University of Technology, School of Nursing, 1997. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=10880.
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The aim of this study was to construct a theory for women's managerial career development that explained how women in health care services and health science faculties achieved senior management positions and developed their careers. It sought to discover the main barriers to career progress and achievement of senior level positions by women in health related organisations and to identify how women managers dealt with obstacles. In-depth interviews with 35 women managers in senior positions in 19 different organisations from three different cultural regions formed the major data source; observations, field notes, personal and operational journals, documents, and literature supplemented this data.This research was conducted in two phases. In phase one a descriptive approach was used to develop propositions about women managers and their careers. These propositions formed the guidelines for phase two. The second phase used grounded theory methods, incorporating feminist and interpretative perspectives to identify the previously inarticulated core problem shared by participants. The barriers that women encountered were the contradictory, inconsistent and incompatible assumptions about their potential to have long term careers and ability to move into senior level management positions.These assumptions had been received during their life and educational experiences, as well as from their organisations. The gendered context of health care organisations and university educational institutions contributed to the limited career aspirations and career progress of women with health professional qualifications. By applying grounded theory strategies for analysis of the data, it was discovered that the women managers dealt with this problem through a core process, labelled metamorphosis, a four stage process for overcoming assumptions. This core variable was the way these women ++managers moved from managing without confidence to managing with confidence and assurance.This process occurred over time having four stages, each involving different activities and strategies. The progressive spiral stages were: being in a quandary (struggling with incompatible and contradictory assumptions); observing, examining and reflecting (on the impact of internal and external assumptions on their behaviour in organisational contexts, then realising that opportunities existed); learning and reframing (the managerial skills in order to re-frame their assumptions about the traditional characteristics of a manager); and finally change and transformation into being confident managers, so developing women's presence in management.The findings generated a theory which proposed a managerial career development model for enabling women to manage with confidence and assurance. The outcome was a theoretical model which recognised the dynamic interaction between contexts (professional, organisational, political, economic, cultural, and research); a picture of women managers (personal beliefs, skills, characteristics, attributes of life long learning, relationship between life and career roles, and ways of changing contexts); and the inner energy force creating women's presence in health related organisations (core process and power of their metamorphosis).Contributing to the development of this theory of metamorphosis was the recognition that being and doing research with women involved valuing the personal learning process. This thread has been integrated into the research fabric to strengthen the reflective and personal experiences of research. Using and valuing women's stories enabled their voices and visibility to be taken out of the shadows and demonstrated that they can be pioneers in their own lives. The sense of collaboration in research, education, and community ++
healing will gain from encouraging women to aspire to leadership and management positions.
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Wall, Francis Joseph. "The natural managers? : a study of the evolving role of NHS doctors in management." Thesis, Durham University, 1999. http://etheses.dur.ac.uk/4294/.
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This study traces the evolving role of NHS doctors in management, from the early years of informal, but highly influential involvement, to the formalised and accountable positions they now occupy in management. The study attempts to assess whether doctors are "the natural managers" of the NHS and, if so, the implications of this. The associated argument, which is pursued throughout the study, is that power and authority need to be brought together in order for management to be effective and argues that the involvement of doctors in management is the only realistic way to bring this about. A qualitative research approach has been used to explore through interviews, the views, opinions and experiences of 30 key informants, including Consultant Medical staff, (many of whom occupy Medical/Clinical Director positions). General Medical Practitioners, Chief Executives, senior NHS Executive and Health Authority officials, and other health professionals. The study, which is mainly centred on the operational level in secondary care, concludes that the active, formal involvement of doctors in management does bring about the blend of power and authority which was previously missing, but no over-riding view was expressed by informants to suggest that this means doctors are "the natural managers." In order to make better use of clinical and other resources, a shared partnership in decision making at the top of the management structure between the senior doctor manager and the lay Chief Executive is required. More encouragement is needed to develop the present fragile role of doctors in management in order to secure the relatively untapped source of managerial power and authority which the involvement of doctors in management can bring about.
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Chon, Yongho. "The access and use of services in the long-term care insurance in Korea : The view from Carers, Care Managers and Service providers." Thesis, University of York, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.516572.
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Mbidoaka, Kate Chinyere. "Strategies to Reduce Effects of Organizational Stress in Health Care Workplaces." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4311.
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Workplace stress has become a frequent occurrence in the race for competitive business advantage. This stress leads to negative physiological consequences in the workplace, causing productivity and profitability to suffer. The purpose of this single case study was to explore the stress management strategies that some health care business leaders used to reduce the effects of work-related stress on their employees to improve productivity. The interview process included 3 managers employed at a health care institution in Houston, Texas, with records of implementing successful strategies for mitigating the effects of workplace stress. The conceptual framework was job demands-resources model, pertinent to the research question to shape this study. Data collection occurred through: (a) face-to-face semistructured interviews, (b) document reviews including the policy and procedure manual, employee annual evaluations, returned satisfaction surveys; and (c) direct observations, using observational protocol. Using the exploratory standard data analysis process, coded input of interview transcripts produced emergent themes to reduce workplace stress including: (a) adequate work resources, (b) work-life balance, and (c) sound management responsibilities. Findings from this study indicate that business managers using these themes could mitigate some of the negative consequences of organizational stress. The data from this study may contribute to social change through conveying to healthcare functionaries anti-stress strategies, increasing community awareness, and making members of the communities healthier.
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McHattie, Lorna W. "The impact of interventions on food hygiene knowledge and behaviour of social care staff and managers." Thesis, University of Aberdeen, 2005. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU199940.
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This was a multi-disciplinary thesis to examine the impact of current interventions (health education material, training, HACCP and inspection) on food hygiene knowledge and behaviour in social care organisations (SCOs), reviewing current practice and recommending the most effective food hygiene intervention. A systematic review identified and critically appraised the evidence for the effectiveness of current food hygiene interventions. Quantitative and qualitative methods of data collection were employed, such as structured and semi-structured postal questionnaires, focus groups of stakeholders and follow-up telephone interviews, to investigate the food hygiene knowledge and behaviour of SCO staff and managers. The systematic review found that many interventions are not based on epidemiological evidence of the main causative factors associated with food-borne disease, or designed to change behaviour and as a result their effect is limited. Although food hygiene training of managers in SCOs is of a lower level than staff, critical control points are recorded in over 80% of workplaces. Following a review of health promotion theories, no single intervention resulted in effective behavioural change to safer food safety practices. All interventions should be evidence and competence based. Improved teaching of theoretical models and closer collaboration between practitioners and academics is recommended to achieve more effective interventions, and research using robust study designs.
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Smith, Sheila M. "Retention of Staff Nurses and Nurse Managers in an Acute-Care Hospital| A Qualitative Case Study." Thesis, University of Phoenix, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10623625.
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Nursing is the largest health care profession in the United States, and health care organizations rely heavily on the services of registered nurses to provide quality care to patients. Unfortunately, the nursing shortage makes it critical for health-care leaders to identify potential issues that may be influencing nurses to leave the nursing profession and to develop solutions for retaining nurses in the nursing profession. The purpose of this qualitative case study was to explore the perceptions of three groups of RNs in an acute-care hospital setting regarding perceived issues that might influence nurses? intentions to leave the nursing profession and possible solutions to mitigate these issues. The three groups of nurses were (a) staff nurses with less than 5 years of nursing experience, (b) staff nurses with 5 or more years of nursing experience, and (c) nurse managers in the acute-care hospital setting. Exploring the perceptions of nurses was a practical means of seeking a better understanding of the lived experiences of staff nurses and managers to understand the issue of nurse retention in an acute-care hospital setting. Data were collected using a structured questionnaire that included demographic and open-ended, in-depth interview questions. Results indicated the importance of staff nurses and nurse managers? perceptions of issues influencing nurses to leave or remain in the nursing profession and perceived solutions to the issues and the need for further research to explore how different groups of nurses perceive different issues influencing their intent to leave the nursing profession.
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Despres, Kimberly Katherine. "Perceived leadership styles of nurse managers' and nurses' job satisfaction| A correlational study." Thesis, University of Phoenix, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3538848.
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The problem addressed was the low job satisfaction levels of nurses and subsequent nurses' decision to leave the organization. The quantitative correlational survey study involved determining whether a relationship exists between nurses’ perceptions of nurse managers’ leadership style and nurses’ job satisfaction. Eighty-three fulltime medical surgical intensive care nurses in two hospitals in Phoenix, Arizona, completed the Job Description Index for Jobs in General (JID/JIG) and the Multifactor Leadership Questionnaire (MLQ, Form 5X). The results suggest a significant, positive correlation between job satisfaction and perceptions of nurse managers' leadership style by nurses. Nurses with the highest satisfaction scores in three of the six subscales perceived their managers used the transformational leadership style. The mean score for nurses whose managers were rated as transactional was higher than the mean score for nurses whose managers were rated as passive-avoidant. The promotion and supervision subscales and the job in general scale showed a significant relationship with transformational leadership. Implications for healthcare administrative leaders include hiring transformational managers to increase job satisfaction in nurses and offer nurses opportunities for promotion and training.
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Tegelberg, Alexander. "Managers and health professionals in the acute care chain : – A need for a shared understanding in the care of patients with acute abdominal pain." Licentiate thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-437640.
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Background: Managers and health professionals, so-called stakeholders, at the system and clinical level in the acute care chain, are responsible for providing safe and high-quality care encompassing both nursing and medical aspects. In patients with acute abdominal pain (AAP), high-quality nursing care has been described as not always being delivered across the entire acute care chain. This patient group frequently seeks care across the acute care chain and the care procedures and quality may differ widely. The quality of nursing care provided to patients can be understood through the framework Fundamentals of Care. The framework is divided into three dimensions: establishing a relationship with the patient, integration of the patient’s fundamental care needs, and context of care. Stakeholders are one important part of the context of care and a prerequisite for delivery of high-quality care. Aim: The overall aim was to explore managers’ and health professionals’ understanding of managing and conducting care of patients with AAP across the acute care chain. Method: Individual interviews with open-ended questions were used in two studies and data were analysed with a conventional qualitative content analysis method. Participants represented ambulance services, emergency departments, and surgical departments. Managers at head nurse level (n=11) and operational level (n=6) at four hospitals were included in Study I. Registered nurses (n=11) and physicians (n=8) at five hospitals were included in Study II. Results: In Study I, managers described the adult patient group as challenging and heterogenous. The managers reflected on themselves as role models. Guidelines were used to organise care, but they often had a medical focus and the managers referred to others as being responsible for the guidelines. Managers who were registered nurses focused on the medical care of patients with AAP, while managers who were physicians underlined the value of nursing care to improve patient outcome. In Study II, health professionals described dedication to applying evidence-based practices. However, they used personal experience over guidelines in care provision. They described organisational barriers to delivering high-quality care, such as varying competence among colleagues, lack of available patient beds, and lack of collaboration across the acute care chain. Conclusion: The stakeholders’ perspectives complemented each other, but their descriptions of managing and conducting care of patients with AAP did not always fit together, which revealed a gap in the everyday clinical practices as well as structural issues at the system level. These empirical descriptions of differing understanding may reveal some of the reasons why patients with AAP do not always experience high-quality care. To optimise patient care across the acute care chain, stakeholders need a shared understanding to meet patients’ fundamental care needs and enable provision of high-quality nursing and medical care.
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Åkerlind, Charlotta. "eHomecare – for safety and communication in everyday life : The perspectives of older users, relatives and care managers." Doctoral thesis, Mälardalens högskola, Hälsa och välfärd, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-36717.
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The overall aim of this thesis was to examine how eHomecare affects the daily lives of older users and their relatives, with a focus on safety and communication. A further aim was to explore care managers’ perspectives, expectations and experiences of eHomecare and its implementation. Methods: Participants in study one and two were older people with granted eHomecare and eight relatives and, care managers in study three and four. Data were collected through four qualitative studies, using individual interviews in the first and second studies before the introduction and after six months’ use of eHomecare, by individual vignette-based interviews in the third study, and with focus-group interviews in the fourth study. Data were analysed using different qualitative content analyses. Results: The participants described safety as a part of everyday life. eHomecare was found to facilitate a ‘new safety’ for older people and a ‘re-established safety’ for relatives, yet its use raised concerns about ethical considerations and reduced human contact. Participants could attain feelings of togetherness and affection through communication, although this was also considered a vulnerable activity due to physical changes and loss of other people. Used correctly, eHomecare increased communication and thus closeness and participation for the participants. For older participants unable to use the technology as hoped, eHomecare led to disappointment. Care managers expressed that eHomecare can increase older peoples’ everyday life-quality if they receive the right tools at the right time. Care managers, however, have difficulties with eHomecare’s management process. While they struggle with their own attitudes, lack of time and high workloads, their decisions are also influenced by surrounding organisations and the older people’s relatives. Care managers’ own organisations, work situations, relevant stakeholders and society in general can hinder them in managing eHomecare as a new homecare service. Widespread information about eHomecare and opportunities for relevant stakeholders to participate in its implementation are good preconditions for fulfilling the mission of care managers. Conclusions: The findings describe eHomecare from the perspectives of its older users, their relatives and the care managers responsible for managing the service. Used correctly, eHomecare increases possibilities for communication and provides safety. However, care managers have a complex mission when managing the service and they express a need for support and knowledge. The findings can be used clinically to develop older peoples’ utilization of eHomecare and to develop support for the fulfilment of care managers’ mission. Keywords: care managers, content analysis, communication, eHomecare, experiences, information and communication technology, older people, participation, perceptions, relatives, safety, welfare technology
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Shanley, Chris. "Navigating the change process : the experience of, and ways forward for, facility managers in the residential aged care industry /." Electronic version, 2005. http://adt.lib.uts.edu.au/public/adt-NTSM20060427.184742/index.html.
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Odera, Vivian. "The Impact of Job Satisfaction on Home and Family Life for Female Managers in Health Care Food Service." Thesis, University of North Texas, 1996. https://digital.library.unt.edu/ark:/67531/metadc277873/.
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This research study evaluated the impact specific work-related factors have on home and family life for female managers in the health care food service industry. A random sample of 333 (33%) of the population was chosen to participate in this study. Each participant was a member of the American Dietetic Association's Management in Health Care Systems dietetic practice group. The work aspects with the most negative impact were number of hours worked per week, work schedule, and job security. Two variables found to significantly predict the overall impact of work on home and family life were number of hours worked per week (p-value .002) and annual gross income (p-value .002).
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Chang, Hui-Chen. "Evidence-based practice in nursing homes a study of Taiwanese nurses' and nursing managers' perceptions /." Connect to full text, 2008. http://hdl.handle.net/2123/3572.
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Thesis (Ph. D.)--University of Sydney, 2008.Title from title screen (viewed 11 February 2009). Includes tables and questionnaires. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.
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Karlsson, Jonna, and Larsson Ebba Maddumage. "Biståndshandläggare inom äldreomsorgens upplevelse av sin arbetssituation : En kvalitativ studie ur ett salutogent perspektiv." Thesis, Karlstads universitet, Institutionen för sociala och psykologiska studier, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-42016.
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Syftet med denna uppsats var att genom ett salutogent perspektiv få en ökad förståelse för, inom äldreomsorgen verksamma, biståndshandläggares arbetssituation samt att undersöka vad som kan bidra till att biståndshandläggares arbetssituation upplevs som lättare och mindre påfrestande. Metoden som använts är kvalitativa intervjuer där sex biståndshandläggare verksamma i Värmland har intervjuats. Intervjuerna analyserades genom teman ur KASAM och resulterade i kategorier under varje tema. Under temat begriplighet framkom att biståndshandläggare får stöd från sina kollegor men att de också önskar att det fanns mer resurser för handledning. Biståndshandläggare utför mer än vad som ingår i arbetsbeskrivningen. Under temat hanterbarhet framgår att hög arbetsbelastning hanteras genom att biståndshandläggarna måste planera, strukturera och prioritera. Kollegornas stöd gör arbetet lättare att hantera då de genom att prata med varandra bearbetar känslomässigt påfrestande delar av arbetet. De uttryckte olika behov av att reflektera över sitt arbete. Biståndshandläggare har en stor frihet att planera sin egen arbetsdag och de samverkar med andra professioner. Under temat meningsfullhet framgår att biståndshandläggare finner mening i att göra skillnad för den enskilde. Vårt resultat visar att biståndshandläggarna är utsatta för stress i sitt arbete och att de också har förmåga att möta stressen, men förmågan att möta stressen minskar när arbetsbelastningen blir för hög.The purpose of this paper was to, by using a salutogenic perspective, achieve a better understanding of eldercare, care managers’ work situation and to explore which factors contribute to the administrator's job situation being experienced as easier and less stressful. The method used were qualitative interviews where six care managers active in Värmland were interviewed. The interviews were analyzed by themes from the Sence Of Coherense and led to categories under each theme. Under the theme comprehensibility was found that care managers receive support from their colleagues but they wish for more resources for professional guidance counselling. Care managers perform more duties than what is included in their job description. Under the theme manageability it shows how administrators have to manage their, high workloads by planning, structurizing and prioritizing. The work is easier to handle when they recieve support from colleagues by talking to each other about strenuous parts of the work. They expressed different needs to reflect on their work. Care managers have a freedom to plan their own and they do collaborate and interact with other professionals. Under the theme meaningfulness the results show that care managers find meaning when they make a difference for their clients. Our results show that care managers are exposed to stress in their work and that they have their own resources cope with. The ability to handle stress is reduced when they feel that the work load is too high.
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Colwell, Floyd Jordan. "Leadership Strategies to Improve Nurse Retention." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6780.
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The nursing shortage and high turnover rates are a problem in the United States. The purpose of this multiple case study was to explore leadership strategies that hospital senior nurse managers in the Rocky Mountain states use to improve nurse retention. Participants were 6 hospital senior nurse managers including 3 chief nursing officers, 1 assistant chief nursing officer, and 2 directors who had demonstrated effective leadership strategies in retention of nurses. The leadership-motivated excellence theory was the conceptual framework. Semistructured interviews with open-ended interview questions were used to collect data; organization websites and documents were used to help corroborate evidence for triangulation. Data were analyzed using Yin's data analysis method. The major themes were leadership and retention strategies. The leadership strategies were senior nurse managers guiding, coaching, and mentoring registered nurses, and the retention strategies were tools used to motivate and retain registered nurses. The results may bring about positive social change by providing hospitals with leadership strategies to retain nurses. Improved retention rates of registered nurses may enhance the competitive advantage for hospitals by improving patient satisfaction scores and improving care. This improvement may result in increased hospital reimbursements and may influence organizational commitment to improving patient outcomes.
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Fjällström, Anneli, and Kristina Fällman. "Erfarenheter av socialt stöd bland mellanchefer i hälso- och sjukvården." Thesis, Umeå universitet, Institutionen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-80167.
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Syftet med denna studie var att beskriva erfarenheter av socialt stöd bland mellanchefer i hälso- och sjukvården. Bakgrund Mellanchefer i hälso- och sjukvården har ett betydelsefullt och krävande uppdrag. Stöd i olika former kan reducera risken för ohälsa orsakad av stress i arbetet och organisationens stöd är viktigt. Genom att stärka mellancheferna erhålls en positiv effekt för både patienter och medarbetare. Metod Studien baserades på semi-strukturerade intervjuer med nio mellanchefer, vilka arbetade inom slutenvården vid två sjukhus i norra Sverige. Intervjuerna spelades in, skrevs ut ordagrant och analyserades med kvalitativ innehållsanalys. Resultat Analysen resulterade i tre huvudkategorier; Erfarenheter av fungerande stöd inom organisationen, erfarenheter av bristande stöd inom organisationen och andra faktorer av betydelse för erfarenheter av stöd. Sammanfattning De flesta mellanchefer hade goda erfarenheter av stöd i organisationen, men påtalade behovet av en tidig och mer strukturerad introduktion när de påbörjade sitt uppdrag. För att förebygga ohälsa föreslås förbättrad introduktion och tidiga utbildningsinsatser, förbättrad feedback från överordnad, samt utvecklat mentorskap. Implikationer Studiens resultat kan användas i syfte att sträva efter att bibehålla det stöd som fungerar och förbättra bristande stöd för mellanchefer i hälso- och sjukvården.
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van, der Walt Nicolette. "Health managers’ experiences and perceptions of intersectoral collaboration at the primary health care level in two urban sub-districts of the Western Cape Province, South Africa." University of the Western Cape, 2020. http://hdl.handle.net/11394/8079.
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Magister Public Health - MPHBackground: Actions on addressing the social determinants of health are necessary for reducing health inequities and improving health outcomes. These actions can, however, fall outside the scope of the health sector alone and require collaborative actions across sectors. Through the Western Cape Government’s stated commitment to following a whole-of-society approach to increase the wellness of people, this Province has committed to exploring intersectoral collaboration and action for health. This study is therefore aimed at exploring the experiences and perceptions of intersectoral collaboration and action for health amongst mid-level and frMethodology: The study design was qualitative and explorative in nature, using non-probability sampling to deliberately select study participants that were both relevant to the study and represented a diversity of views. Semi-structured interviews were conducted with seven health managers and non-participant observation of one intersectoral meeting was utilised to observe interactions that were relevant to the study. A thematic coding analysis approach was followed to inductively determine themes and analyse the data.ontline health managers working at the primary health care level in two sub-districts within the City of Cape Town, Western Cape Province. Results: Intersectoral collaboration for health at the primary health care level tends to take the form of collaborations between government departments, between the department of health and non-governmental organisations, between the public and private health sectors and between the Department of Health and the communities it serves. These collaborations overwhelmingly focus on expanding health services provision rather than addressing the social determinants of health. Conclusion: The concept of intersectoral collaboration and partnerships at the primary health care level in two sub-districts of the City of Cape Town, Western Cape, is perceived by health managers as being critical in addressing the social determinants of health. In practice, however, intersectoral collaboration and partnerships tend to focus on expanding health service provision and have limited value for addressing social determinants of health.