Managing Clinical Processes

Rick Iedema, Roslyn Sorensen

Description

This book will provide clinicians, clinical managers and corporate managers with a practical guide to managing clinical processes and managing change in health services. It also provides the theory behind the practice.

Sujets

• Médecine
• Spécialités médicales
• Medical
• Nursing
• Leadership
• Management

Informations

• Publié par: Churchill Livingstone Australia
• Date de parution: 08 octobre 2008
• Nombre de lectures: 0
• EAN13: 9780729578257
• Langue: English

Extrait

Table of Contents

Cover image
Front Matter
Copyright
Preface
Contributors
Reviewers
PART 1 Setting the context
Chapter 1. Managing clinical processes: objectives, evidence and context
Chapter 2. Operations management: the search for value in healthcare organisation and performance
Chapter 3. The politics of healthcare: managing the healthcare workforce
PART 2 The operational environment
Chapter 4. Producing health
Chapter 5. Putting the patient in the middle: managing chronic illness across organisational boundaries
Chapter 6. The collectivity of healthcare: multidisciplinary team care
Chapter 7. Co-producing care
Chapter 8. Integrating performance: linking healthcare domains
PART 3 Accounting for outcomes
Chapter 9. Quality and patient safety: How do we get there from here?
Chapter 10. Organising for quality improvement and patient safety
Chapter 11. Managing risks to patient safety in clinical units
Chapter 12. The changing dynamic of policy and practice in Australian healthcare
Chapter 13. Involving communities in decision making
CONCLUSION. Implications for practice
RESOURCES. Moving forward
Index
Front Matter

Managing Clinical Processes in Health Services
Roslyn Sorensen
Rick Iedema

Sydney Edinburgh London New York Philadelphia St Louis Toronto
Copyright

Mosby is an imprint of Elsevier
Elsevier Australia. ACN 001 002 357
(a division of Reed International Books Australia Pty Ltd)
Tower 1, 475 Victoria Avenue, Chatswood, NSW 2067
© 2008 Elsevier Australia
This publication is copyright. Except as expressly provided in the Copyright Act 1968 and the Copyright Amendment (Digital Agenda) Act 2000, no part of this publication may be reproduced, stored in any retrieval system or transmitted by any means (including electronic, mechanical, microcopying, photocopying, recording or otherwise) without prior written permission from the publisher.
Every attempt has been made to trace and acknowledge copyright, but in some cases this may not have been possible. The publisher apologises for any accidental infringement and would welcome any information to redress the situation.
This publication has been carefully reviewed and checked to ensure that the content is as accurate and current as possible at time of publication. We would recommend, however, that the reader verify any procedures, treatments, drug dosages or legal content described in this book. Neither the author, the contributors, nor the publisher assume any liability for injury and/or damage to persons or property arising from any error in or omission from this publication.
National Library of Australia Cataloguing-in-Publication data
Sorensen, Roslyn
Managing clinical processes in health services / Roslyn Sorensen ; Rick Iedema.
Chatswood, NSW: Elsevier, 2008.
ISBN: 9780729538251 (pbk.)
Includes index.
Bibliography.
Health services administration--Australia.
Medical care--Evaluation.
Health facilities--Australia--Administration.
Medical protocols--Australia.
Total quality management--Australia.
Reengineering (Management)--Australia.
Organizational change--Australia.
Iedema, Rick.
362.10680994
Publisher: Luisa Cecotti
Publishing Services Manager: Helena Klijn
Edited by Matt Davies
Proofread by Tim Learner
Internal and cover design by Toni Darben
Index by Master Indexing
Typeset by TnQ
Printed by Ligare
Preface
Health services worldwide are under pressure to perform and expectations are strengthening about what they can and should deliver. Patients, consumers and communities expect health services to meet standards of service quality, responsiveness and accountability; clinicians expect to have a strong voice in decisions about the healthcare system; and policymakers expect health services to meet standards of cost effectiveness. Even though these key stakeholders don't necessarily agree about health services' goals, the demand for health services grows, costs continue to escalate and high-profile failures in quality of care mount raising concerns about the safety of the system and whether it can deliver value for money. Taken together, these pressures bring an urgency to improving the underlying systems on which good care is based.
Strategies to respond to these expectations range from top-down managerial approaches that often uncritically apply generic private sector performance-improvement principles to the public health sector, to isolated technical interventions at the individual patient level in clinical workplaces. These levels of the organisation work largely independently, and for health service performance to improve, the two domains must integrate. This book is positioned between these two domains, that is, between the abstract performance focus of corporate management and the clinical particularities of individual patient care. It is not specifically intended for ‘managers’ or ‘clinicians’ but for all those who seek to understand how health services work, or could work better.
The book takes an international perspective. In doing so, we take account of the health systems of developed countries to acknowledge the international influence on healthcare and health systems improvement, and to compare key points across countries with similar health systems.

What this book offers
Clinical process management is an emerging field of study. This book attempts to set a foundation for what is known about the topic based on evidence from the literature and related research. Methods of clinical process management are described and discussed and, where available, supported by evidence. Significant points are highlighted throughout the chapters in captions titled Implications for practice . Although clinical process management is becoming a separate field of study, it critically links policy, managerial and clinical activity as an integrated entity. The book also addresses what is not yet known, and presents this information as a series of questions titled Points for reflection .
Each contributor to the book is a specialist in their field. Through their contributions, their expertise is directed to understanding the way health services work and the context in which healthcare is delivered, and applying this knowledge to managing clinical processes in health services. Each chapter is set out using major themes as content headings. The content is designed to apply equally to public and private health services and to tertiary, secondary and primary healthcare sectors. We believe that the types of clinical processes that need to be managed to achieve the objectives of healthcare are common across all health services, and differ in degree rather than kind.

Rationale
The book is intended to provide clinicians, clinical managers and corporate managers with a practical guide to transforming health services by managing clinical processes and, in doing so, to link theory to practice. The need for such a text is supported by the growing awareness of the limitations that increasing specialisation of clinical work can bring and the importance of coordinating complex clinical and administrative healthcare processes, as multidisciplinary clinicians and managers care for populations of acutely ill people with multiple comorbidities and care needs. It is intended to consolidate new knowledge as clinical and administrative processes integrate vertically and horizontally within the organisation, so as to overcome the fragmentation of knowledge located in clinical specialties and management units.

The structure of the book
The book is structured in three parts. The first part addresses the environment within which health services are delivered and managed. The second part describes the operational aspects of managing clinical processes. The third part considers issues of accountability for health service outcomes.
In Part 1 , we outline the scope of the book and describe the objectives, evidence and context for managing clinical processes. Leggat introduces the fundamentals of operations management as a means of gaining value in terms of outputs and outcomes from health service inputs. Stanton discusses the politics of healthcare, the challenges and opportunities involved in managing the healthcare workforce, and the strategic opportunities for health service improvement that can arise from managing human resources.
In Part 2 Claridge & Cook conceptualise the health system as a production process, and delineate the tools and rules needed to transform health into a process-oriented sector. Kerosuo considers the place of the patient in healthcare and mechanisms to incorporate the patient into decision-making processes about their care. Willis and colleagues analyse healthcare as a collectivity, specifically the role of multidisciplinary teams in engaging with patients and families in sharing decisions about care outcomes and treatment processes. We join Jorm & Piper to extend this collectivity, to explore the co-productive nature of healthcare. Berg et al reconsider the organisation of complex health services and propose care programs as a way of integrating these critical clinical and organisational elements to achieve performance outcomes.
In Part 3 Boaden & Harvey discuss the types of organisation needed in health services to improve quality and patient safety. Merry takes this issue to the level of clinical units to delineate the types of issues, processes and outcomes clinicians and managers need to engage in to manage risk and to ensure patient safety. Jorm et al analyse policy approaches to health improvement, and show the extent of change in policymaking by comparing policy developed in 1990 with that of today. Mooney advocates for the place of the community in healthcare decision making, including citizens' juries through which community values can become known and used as the basis for prioritisation and resource allocation.
Finally, we bring these building blocks tog