Academic literature on the topic 'Clinical directorate governance structure'
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Journal articles on the topic "Clinical directorate governance structure"
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Dwyer, Alison J. "Medical managers in contemporary healthcare organisations: a consideration of the literature." Australian Health Review 34, no. 4 (2010): 514. http://dx.doi.org/10.1071/ah09736.
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Objectives. To consider the literature supporting the evolution of the roles of a Medical Manager within contemporary healthcare organisations. Design. Consideration of available literature. Results. Limited dedicated literature available. Consideration of available studies and expert opinion reveals benefit of doctors in management positions within healthcare organisations. The roles of Medical Managers arise from: organisational structure-theory of healthcare’s ‘professional bureaucracy’; clinical directorate models; clinical governance, legislative and public health requirements; and the duality of combining medical knowledge with business and healthcare management training. Roles identified are: (1) leadership and management of medical staff including appointments and credentialing, and mentoring of medical staff in Clinical Directorate roles; (2) strategy development including Medical Advisory Role to Executive; (3) clinical governance including quality and risk management and legislative requirements; and (4) operational areas that benefit from clinical and management skills. Discussion. Strengths of this review include considering contexts of Medical Managers in medical and healthcare management literature. Weaknesses include drawing inferences from theory. Future recommendations include formal studies and systematic reviews of available literature of the subject. Conclusions. In light of falling Medical Management trainee numbers, this study highlights the value to the health system of a dwindling Medical Management profession, the urgent need to encourage more medical practitioners into management and for organisations to further embrace Medical Managers in key leadership roles. What is known about the topic? Although there is general acknowledgement about the benefits of medical leaders within health services, the exact nature and evidence for the Medical Manager role in current health services has not been comprehensively explored and articulated. What does this paper add? The aim of this consideration of the literature is to explore the evidence-base supporting the roles for Medical Managers within contemporary healthcare organisations, and articulate the exact nature and scope of the role. A concordance of studies and expert opinion highlights the benefits of Medical Managers within contemporary healthcare organisations, illustrating a theoretical basis for the differing roles. The nature of the roles include: leadership and management of medical staff (from organisational structure theory); leadership of the organisation within the executive team; clinical governance oversight; and operational management of medical areas with a business focus. What are the implications for practitioners? In light of falling Medical Management trainee numbers, this study highlights the value to the health system of a dwindling Medical Management profession, the urgent need to encourage more medical practitioners into management and for organisations to further embrace Medical Managers in key leadership roles.
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Stafrace, Simon, and Alan Lilly. "Turnaround in an aged persons' mental health service in crisis: a case study of organisational renewal." Australian Health Review 32, no. 3 (2008): 577. http://dx.doi.org/10.1071/ah080577.
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This case study demonstrates how leadership was harnessed to turn around a decline in the performance of an aged persons? mental health service ? the Namarra Nursing Home at Caulfield General Medical Centre in Melbourne, Australia. In 2000 the nursing home faced a crisis of public confidence due to failings in the management of quality, clinical risk and human resources within the service. These problems reflected structural and operational shortcomings in the clinical directorate and wider organisation. In this article, we detail the process of turnaround from the perspective of senior executive managers with professional and operational responsibility for the service. This turnaround required attention to local clinical accountability and transformation of the mental health program from a collocated but operationally isolated service to one integrated within the governance structures of the auspicing organisation.
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Isherwood, Jim. "Clinical governance in mental health services." Psychiatric Bulletin 23, no. 12 (December 1999): 718–20. http://dx.doi.org/10.1192/pb.23.12.718.
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In this paper, I explain the strategy for achieving clinical governance within the trust's mental health directorate, and describe the role that clinicians and managers would like the chief executive to play in helping us to achieve our targets.
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Romano, Mauro, and Christian Favino. "Broken ties and corporate governance changes under uncertainty conditions. A longitudinal study of Italian boardroom network evolution." Corporate Ownership and Control 11, no. 3 (2014): 399–419. http://dx.doi.org/10.22495/cocv11i3conf2p2.
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The recent systemic crisis that has affected the financial markets and real economies of major industrialized countries has had significant effects on the corporate governance and key organizational choices of large firms. In this context, the present study aims to verify whether the international crisis has significantly changed the structure of the interlocking directorate network that links large firms in the regulated Italian market. Furthermore the paper, which is a development of a preceding research study, also investigates the changes that have occurred in the interpersonal network of directors of the same firms previously observed. To this end, we present a preliminary analysis of the evolution of corporate governance in the main European regulated markets through a dynamic comparison of some synthetic statistical data observed at the end of the years 2006, 2008 and 2010. In the second part, after framing the interlocking directorate concept, we examine the evolution of the interlocking directorate network during the aforementioned observation period (2006-2010) with respect to larger Italian listed companies (FTSE MIB) and their directors
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Romano, Mauro, and Christian Favino. "Board composition and interlocking directorate evolution as a consequence of the recent financial crisis: evidence from Italian listed companies." Corporate Ownership and Control 11, no. 1 (2013): 175–92. http://dx.doi.org/10.22495/cocv11i1c1art5.
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The recent systemic crisis that has affected the financial markets and real economies of major industrialized countries has had significant effects on the corporate governance and key organizational choices of large firms. In this context, the present study aims to verify whether the international crisis has significantly changed the structure of the interlocking directorate network that links large firms in the regulated Italian market. To this end, the first part of the paper presents an analysis of the evolution of corporate governance in the main European regulated markets through a comparative analysis of some synthetic statistical data observed at the end of the years 2006, 2008 and 2010. In the second part, after framing the concept of interlocking directorate in a theoretical perspective, we examine the evolution of the network of personal ties between large Italian listed companies in the period of observation (2006-2010) using Social Network Analysis
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Sheard, David John, Gregory Clydesdale, and Gillis Maclean. "Governance structure and public health provision." Journal of Health Organization and Management 33, no. 4 (June 28, 2019): 426–42. http://dx.doi.org/10.1108/jhom-11-2018-0336.
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Purpose A key question in the provision of public health concerns how that provision is governed. The purpose of this paper is to examine the governance structure of a public health board and its perceived impact on the efficacy of clinical operations. Design/methodology/approach Structural issues examined the level of centralisation and public participation, and whether governance should occur through elected boards or appointed managers. These issues were examined through multiple lenses. First was the intention of the structure, examining the issues identified by parliament when the new structure was created. Second, the activities of the board were examined through an analysis of board meetings. Finally, hospital clinicians were surveyed through semi-structured interviews with both quantitative and qualitative questioning. Findings A contradiction was revealed between intention, perception and actual activities. This raises concerns over whether the public are significantly informed to elect the best-skilled appointees to governance positions. Practical implications This research holds implications for selecting governance structures of public health providers. Originality/value Few studies have looked at the role of a publicly elected healthcare governance structure from the perspective of the clinicians. Hence, this study contributes to the literature on healthcare structure and its impact on clinical operations, by including a clinician’s perspective. However, this paper goes beyond the survey and also considers the intention of the structure as proposed by parliament, and board activities or what the board actually does. This enables a comparison of intention with outcomes and perception of those outcomes.
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Johnston, P., R. Blackburn, C. Causton, L. Davis, B. Dela Cruz, and J. Jewell. "Improving clinical and operational outcomes through a shared governance practice council structure." Biology of Blood and Marrow Transplantation 10 (February 2004): 94–95. http://dx.doi.org/10.1016/j.bbmt.2003.12.226.
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Mirza, M. S., J. Madill, W. Parsons, and H. Gajraj. "Safe introduction of the VNUS Closure procedure: a multidisciplinary approach." Phlebology: The Journal of Venous Disease 21, no. 3 (September 15, 2006): 122–26. http://dx.doi.org/10.1258/026835506778253300.
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Objectives: The National Institute for Health and Clinical Excellence supports the use of radiofrequency ablation (VNUS Closure) of the long saphenous vein (LSV) as an alternative to stripping. An increase in interest in the procedure is anticipated. The technique can produce serious complications not commonly associated with conventional surgery, and safety is a major concern with its introduction. The aim was to introduce the new technique into a district hospital, without major complications or failures. Methods: A multidisciplinary team was developed consisting of consultant surgeon, vascular technologist and theatre nurse, who received intensive training and mentoring from a group with considerable experience. All members attended operating theatre and duplex imaging sessions over a period of six months. Approval for the introduction of the technique into our institution was sought from the Medical Director and Clinical Governance Directorate. The results of VNUS Closure surgery were included in the monthly clinical governance and audit meetings. During the consent process, the first patient was informed that the team had not yet undertaken the procedure, but had taken all necessary measures to ensure its competence. Subsequently, patients were advised of our experience and the results. Results: Of the 18 patients who consented for the study, 13 (72%) were found on duplex scanning to have saphenofemoral reflux suitable for VNUS Closure. VNUS Closure was attempted in 22 LSVs in 13 patients; 21 LSVs (95%) in 12 patients were closed at surgery and 19 (86%) remained completely closed at a median of 12 months (range 3–24 months). There were no deaths and no major complications. Conclusion: The safe introduction of VNUS Closure in a district hospital can be accomplished through intensive training and a process of mentoring from experienced practitioners, a multidisciplinary approach with a vascular technologist in theatre and attention to governance issues, in particular audit and consent.
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Joarder, Taufique, Md Aslam Parvage, Lal B. Rawal, and Syed Masud Ahmed. "A Policy Analysis Regarding Education, Career, and Governance of the Nurses in Bangladesh: A Qualitative Exploration." Policy, Politics, & Nursing Practice 22, no. 2 (January 18, 2021): 114–25. http://dx.doi.org/10.1177/1527154420988003.
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Nurses, short in production and inequitable in the distribution in Bangladesh, require the government’s efforts to increase enrolment in nursing education and a smooth career progression. Given the importance of an assessment of the current nursing scenario to inform the decision makers and practitioners to implement the new policies successfully, we analyzed relevant policies on education, career, and governance of nurses in Bangladesh. We used documents review and qualitative methods such as key informant interviews ( n = 13) and stakeholder analysis. We found that nursing education faced several backlashes: resistance from diploma nurses while attempting to establish a graduate (bachelor) course in 1977, and the reluctance of politicians and entrepreneurs to establish nursing institutions. Many challenges with the implementation of nursing policies are attributable to social, cultural, religious, and historical factors. For example, Hindus considered touching the bodily excretions as the task of the lower castes, while Muslims considered women touching the body of the men immoral. Nurses also face governance challenges linked with their performance and reward. For example, nurses have little voice over the decisions related to their profession, and they are not allowed to perform clinical duties unsupervised. To improve the situation, the government has made new policies, including upliftment of nurses’ position in public service, the creation of an independent Directorate General, and improvement of nursing education and service. New policies often come with new apprehensions. Therefore, nurses should be included in the policy processes, and their capacity should be developed in nursing leadership and health system governance.
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Aljohani, Eman H., Ghada M. Hamouda, and Maram A. Banakhar. "Nurses' Perception toward Shared Governance in Clinical Practice at General Hospitals in Jeddah City." Evidence-Based Nursing Research 2, no. 3 (July 17, 2020): 11. http://dx.doi.org/10.47104/ebnrojs3.v2i3.143.
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Context: Shared governance is an evidence-based approach. The characteristics of the work environment of shared governance are autonomous and empowering, where nurses providing direct care have a voice in influencing areas that have been controlled previously by the managers. Shared governance structure aims to improve communication, increases personal growth and nurse satisfaction, and improves patient outcomes.
Aim: To assess nurses' perception toward shared governance at general hospitals in Jeddah city.
Methods: A quantitative descriptive cross-sectional study design was conducted. The study was carried out at three general ministry of health hospitals in Jeddah city. The study sample involved 321 registered nurses using stratified random sampling. The data were collected by using one tool. The index of the Professional Nursing Governance (IPNG) tool was used to measure the nurses' perceptions of governance.
Results: The overall mean score of nurses' perceptions toward shared governance was 118.70±40.85, which scored within the shared governance range. The highest mean score was Resources subscale with 24.74±7.75, while the Goals subscale had the lowest mean score (12.54±5.12). Statically significant differences were found in nurses' perceptions toward shared governance according to their educational degree, current position title, and the working unit at p-value ≤ 0.05.
Conclusion: This study has shown that nurses perceived the governance in the first level of shared governance, which indicates that the decision is made primarily by management with some staff input. Therefore, continuous education and training are needed for nurses to increase their knowledge about shared governance, conflict management, and decision-making skills.
Dissertations / Theses on the topic "Clinical directorate governance structure"
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Keenan, Marina Grace. "Exploring the Role of Communication Structures and Networks of Senior Staff in a Public Hospital’s Clinical Directorate." Thesis, 2019. https://vuir.vu.edu.au/41289/.
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The clinical directorate (CD) governance structure of contemporary tertiary healthcare facilities was introduced to Australian hospitals three decades ago. The principle reasons for the change from the previous traditional professional model were to streamline patient care, reduce the costs of providing healthcare, and to ensure a patient-centred approach to healthcare for all Australians. Thirty years on, hospital executives continue to refine structures while paying close attention to the strategic aims and goals of their organisations. However, the effect of these structures on communication between executives, and the likely impact on their managerial roles and relationships, has received limited attention. To address this problem, this study employed a mixed methods approach to understand the influence of the CD structure on executive communication behaviours.
The focus of enquiry was the communication structures and networks of senior staff. The approach enabled an interactional view of executive communication networks in a tertiary healthcare facility in Melbourne. Three theories underpinned the study design that methodologically employed a social constructivist and social network analysis approach to answer the research questions. The constructivist position was taken because the focus was individuals’ understanding of processes. Internally generated understandings of the world are distinct from social constructionism where understanding processes is an interactive, collaborative domain (Raskin & Debany 2018). Ten members of the facility’s executive team provided data, which when analysed showed that communications were an intricately balanced phenomenon influenced by the structure of the organisation, their own agency, and that of their colleagues and peers. The project was undertaken in a time of change for the project organisation. The structure of the organisation was evolving under focused refinements by the executive team to create a fit for purpose. Findings suggest that apart from structural rebuilding, executives were personally challenged in establishing communication relationships with others in the context of a changing hospital structure. Noting the importance of wider hierarchical communication, this study focused on intra- executive team communication within the CD, the rationale being that if the executive team communicated well, a consistent message would be conveyed to reports (Keyton et al. 2013). Outcomes from the project demonstrated the importance of trust relationships to achieve effective communication and diffuse information. Effective communication is defined as having skills to transfer knowledge in a complex, cross-functional environment and to be competent in the transfer of knowledge to engage others (Waldeck et al. 2012). Enabling communication was dependent on established relationships, which were influenced by previous work collaborations, proximity, and familiarity. Hindrances to communication were excessive workloads, less time to establish and maintain contact between peers, geographical separation, presence of silos, and behavioural factors, which included limiting contact with other disciplines, exclusion from meetings, and limiting avenues for the development of long-term relationships. The findings contribute to the extant literature by developing the inchoate knowledge of agentive human behaviours within the CD. The emphasis on theoretical integration provides a robust account on which to build further research. Communication pathways and processes have implications for leadership effectiveness, which in turn affects the practice of teams and subsequent staff, system, and patient outcomes. Recommendations for action and future research are discussed.
Books on the topic "Clinical directorate governance structure"
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Pilcher, T. A. An exploratory study examining nurse managers role experiences within the clinical directorate structure. Oxford: Oxford Brookes University, 1997.
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Gardiner, Matthew, and Venki Sundaram. Professional skills and behaviour. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199237593.003.0011.
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This chapter discusses the key professional skills, including good medical practice, communication, judgement and decision-making, clinical governance and patient safety, audit, appraisal, and revalidation, consent and confidentiality in the UK, education, training, and research, child protection in the UK, NHS structure and economics, and the Ophthalmic Trainees’ Group, as well as the key clinical skills, breaking bad news and dealing with complaints.
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Peck, Marcus, and Peter MacNaughton, eds. Focused Intensive Care Ultrasound. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198749080.001.0001.
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This book is written for clinicians who are new to ultrasound and those who want to progress further from the basics to more advanced-level scanning. Consequently, it covers a broad range of subjects, and its text is divided into five sections. Section 1 is imaging-based. Chapters in Section 1, such as physics, machine setting, and sonoanatomy, provide the foundation that underpins the rest of the book. Section 2 is structure-based. Chapters in Section 2 cover cardiac, lung, abdominal, and vascular anatomy and enable the reader to start scanning in these areas. Section 3 is problem-based. Chapters in Section 3 cover the major differential diagnoses and algorithmic approaches to ultrasound assessment of the most common clinical presentations, including shock, dyspnoea, trauma, cardiac arrest, sepsis, acute respiratory distress syndrome, and many more. Section 4 is procedure-based. Chapters in Section 4, such as thoracocentesis, lumbar puncture, and percutaneous tracheostomy, cover the technical and non-technical aspects of invasive procedures performed in critically ill patients. Section 5 is governance-based and covers how to deliver a safe and effective service.
Book chapters on the topic "Clinical directorate governance structure"
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Warren, Jeffrey S. "Effective Governance Structure and Management of Utilization Programs." In Utilization Management in the Clinical Laboratory and Other Ancillary Services, 31–37. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-34199-6_3.
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Ferguson, Catriona. "Processes and policies: Directorate level." In An Introduction to Clinical Governance and Patient Safety, 179–88. Oxford University Press, 2010. http://dx.doi.org/10.1093/acprof:oso/9780199558612.003.0020.
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Coleman, Nick. "Trust boards structure, responsibilities, and communication." In An Introduction to Clinical Governance and Patient Safety, 399–406. Oxford University Press, 2010. http://dx.doi.org/10.1093/acprof:oso/9780199558612.003.0045.
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Crelinsten, Linda. "Governance and Administration of Simulation Programs: Providing the Structure and Strategic Foundation for Excellence." In Clinical Simulation, 799–812. Elsevier, 2019. http://dx.doi.org/10.1016/b978-0-12-815657-5.00052-8.
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Raine, Tim, George Collins, Catriona Hall, Nina Hjelde, James Dawson, Stephan Sanders, and Simon Eccles. "Being a doctor." In Oxford Handbook for the Foundation Programme, 1–66. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198813538.003.0001.
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This chapter explores what is involved in being a doctor. It includes details of the Foundation Programme and how to apply, the curriculum and assessment, healthcare in the UK, starting life as an F1, what to do before you start, your first day, occupational health, what to carry, organization and efficiency, patient-centred care, communication and conduct, breaking bad news, cross-cultural communication, outside agencies, quality and ethics, clinical governance/quality, medical ethics, patient confidentiality, capacity, consent, what to do when things go wrong, medical errors, complaints, incident reporting, colleagues and problems, hating your job, relaxation, causes of stress, pay and contracts, making more money, debt, NHS entitlements, career, specialty training applications, options, and competition, career structure, choosing a job, specialties in medicine, your curriculum vitae, post-Foundation Programme CV, interviews, membership exams, continuing your education, audit, presentations and teaching, teaching medical students, and research and academia.
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Ricci, Fabrizio L., and Oscar Tamburis. "Predictive Modeling as guide for Health Informatics Deployment." In Advances in Business Information Systems and Analytics, 128–62. IGI Global, 2017. http://dx.doi.org/10.4018/978-1-5225-0654-6.ch008.
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The present research work shows the main steps conducted towards the exploitation of the LUMIR project, aiming at realizing an EHR framework in the Italian Region of Basilicata (also known as Lucania). It relates to a structure of network–enabled services capable of integrating the ICT solutions used by the operators of the Healthcare System of Basilicata Region. The adoption process of the LuMiR system was meant to address the issues connected to the design features as well as to the EHR diffusion and the acceptance aspects. The mathematical modeling approach introduced aimed at making possible to get to a measure “ex–ante” of both adequacy and significance of the adoption process itself. The final intent is to work out a scalable and exportable model of advanced management of clinical information, towards a stronger cooperation among the provider organizations and a better governance of care processes, as crucial element within the more general path of modernization of the healthcare sector.