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Microsystems in health care: Part 8. Developing people and improving work life
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2003 (English)In: Joint Commission journal on quality and safety, ISSN 1549-3741, Vol. 29, no 10, 512-22 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The articles in the Microsystems in Health Care series have focused on the success characteristics of high-performing clinical microsystems. Realization is growing about the importance of attracting, selecting, developing, and engaging staff. By optimizing the work of all staff members and by promoting a culture where everyone matters, the microsystem can attain levels of performance not previously experienced.

CASE STUDY: At Massachusetts General Hospital Downtown Associates (Boston), a primary care practice, the human resource processes are specified and predictable, from a candidate's initial contact through each staff member's orientation, performance management, and professional development. Early on, the new employee receives materials about the practice, including a practice overview, his or her typical responsibilities, the performance evaluation program, and continuous quality improvement. Ongoing training and education are supported with skill labs, special education nights, and cross-training. The performance evaluation program, used to evaluate the performance of all employees, is completed during the 90-day orientation and training, quarterly for one year, and annually.

CONCLUSION: Some health care settings enjoy high morale, high quality, and high productivity, but all too often this is not the case. The case study offers an example of a microsystem that has motivated its staff and created a positive and dynamic workplace.

Place, publisher, year, edition, pages
2003. Vol. 29, no 10, 512-22 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-21747PubMedID: 14567260OAI: oai:DiVA.org:hj-21747DiVA: diva2:640635
Available from: 2013-08-14 Created: 2013-08-14 Last updated: 2017-01-16Bibliographically approved
In thesis
1. Improvement Capability at the Front Lines of Healthcare: Helping through Leading and Coaching
Open this publication in new window or tab >>Improvement Capability at the Front Lines of Healthcare: Helping through Leading and Coaching
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

SUMMARY

This thesis addresses improvement capability at the front lines of healthcare with a focus on interprofessional health care improvement teams who provide care and improve care. The overall aim is to explore high performing clinical microsystems and evaluate interventions to cultivate health care improvement capabilities of frontline interprofessional teams.

Methods

Descriptive and evaluative study designs were employed in the five studies which comprise this thesis. A total of 495 interprofessional health care providers from a variety of health care contexts in the United States (Study I, II, III & IV) and Sweden (Study V) participated in the studies. The mixed methods research included qualitative observation, interviews, focus groups and surveys analyzed with qualitative manifest content analysis. The quantitative data were analyzed with statistics appropriate for non-parametric data.

Findings

Study I and II describe how leaders who understand health care improvement can create conditions for interprofessional teams to provide care and simultaneously improve care. Study III evaluates adapted clinical microsystem processes and tools successfully adapted in two different hospitals. Frontline staff reported that they needed help to balance providing care and improving care. Study IV and V explored and tested team coaching to help interprofessional teams to increase their improvement capabilities within improvement collaboratives. The participants perceived team coaching mostly positively and identified supportive coaching actions. In Study V an intervention with “The Team Coaching Model” was tested in Sweden and showed increased acquisition of improvement knowledge in the intervention teams compared to teams who did not receive the coaching model.

Conclusions

The thesis findings show leaders can help cultivate health care improvement capability by designing structures, processes and outcomes of their organizational systems to support health care improvement activities, setting clear improvement expectations of all staff, developing the knowledge of every staff member in the microsystem to know their operational processes and systems to promote action learning in their daily work, and providing help with team coaching using a Team Coaching Model.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2013. 165 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 46
Keyword
Health care improvement, interprofessional teams, leadership of improvement, team coaching, clinical microsystem
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-21751 (URN)978-91-85835-45-4 (ISBN)
Public defence
2013-09-05, Originalet, Qulturum, Hus B4, Ryhov County Hospital, Jönköping, 10:00 (English)
Opponent
Available from: 2013-08-14 Created: 2013-08-14 Last updated: 2013-08-14Bibliographically approved

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Godfrey, Marjorie M.Nelson, Eugene C.Batalden, Paul B.
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