1. Hosp Q. 1998-1999 Winter;2(2):28-34. Healthcare governance in transition: from hospital boards... more 1. Hosp Q. 1998-1999 Winter;2(2):28-34. Healthcare governance in transition: from hospital boards to system boards ... a national survey of chairs of boards. Brunelle F, Leatt P, Leggat S. PMID: 10621172 [PubMed - indexed for MEDLINE]. MeSH Terms: ...
Des exigences concurrentielles de ressources financières au sein du système de santé obligent les... more Des exigences concurrentielles de ressources financières au sein du système de santé obligent les pourvoyeurs de soins de santé à assurer l'utilisation la plus efficace possible de ces ressources. Les résultats provenant des États-Unis, du Royaume-Uni et d'autres ...
Background: This paper provides an overview of the process and tools used to develop and imple- m... more Background: This paper provides an overview of the process and tools used to develop and imple- ment a priority setting framework for the Clinical Senate of South Australia. Established as a clini- cal advisory group to the Minister and Department of Health, the Clinical Senate recognised the need for an open priority setting process to fairly assign planning resources to
affiliations should appear as the following: Department (if applicable); Institution; City; State... more affiliations should appear as the following: Department (if applicable); Institution; City; State (US only); Country. No further information or detail should be included
In this paper, we explore the attitudes of employees to high performance work practices in a medi... more In this paper, we explore the attitudes of employees to high performance work practices in a medium sized rural hospital. As one of the key HPWS is teamwork, we explore the mediating role of social identification on the relationship between HPWS and affective commitment and on the relationship between HPWS and job satisfaction. Findings indicate that social identification mediates the relationship between HPWS and affective commitment and also mediates the relationship between HPWS and job satisfaction. We argue that team leaders and managers play a key role in building social identification within the team and that organizations need to understand this role and provide recognition, reward, education and support to their middle and lower managers. Such support is likely to provide benefits in terms of high performing committed employees and improved employee retention.
This aim of this study was to investigate the interactive effects of psychological empowerment an... more This aim of this study was to investigate the interactive effects of psychological empowerment and job satisfaction on the relationship between high-performance work systems (HPWS) and nurses' perceptions of the quality of patient care they provide. Studies of high-performing organizations in a variety of industries have consistently reported a positive relationship between HPWS and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved patient outcomes have been reported in international health care studies. We used regression analysis with tests of mediation and moderation to analyze survey responses collected in March 2008 of 201 nurses in a large regional Australian health service. Psychological empowerment fully mediated the relationship between HPWS and perceptions of quality of patient care. Job satisfaction moderated the relationship between HPWS and percep...
A systematic literature review identified 41 studies, including four reviews, reporting on proces... more A systematic literature review identified 41 studies, including four reviews, reporting on process redesign interventions in hospitals. Success factors for the changes included mechanisms to facilitate participation throughout the process, clearly documented protocols and expectations for the health professionals which were supported by education, mechanisms to audit and provide feedback on behaviours and performance, as well as being able to hold the participating health professionals accountable. The success of process redesign methodologies is found to be highly dependent on these performance-based human resource management (HRM) practices.
Australian health review: a publication of the Australian Hospital Association
Objective This paper analyses an organisational development project that aimed to change the orga... more Objective This paper analyses an organisational development project that aimed to change the organisational culture and improve people management systems and processes. The questions addressed were: was the change process a success; how was success defined; and what were the barriers to its progress? Methods We examined the process of change over a 3-year period. The organisational development intervention is described and analysed. Qualitative methods, including document review, in-depth interviews and focus groups, participant observation, newsletters and diary entries were used to gather the data. A variant of competing values was used to analyse the data. Results We sought to build trust with all managers and encouraged reflection by conducting feedback sessions, presentations, workshops and one-on-one and group discussions. A cross-site action group was established to encourage organisation-wide participation in the project. However, it was clear that stakeholders had different...
The purpose of this article was to explore the relationships between perceived high performance w... more The purpose of this article was to explore the relationships between perceived high performance work systems, emotional labour, burnout and intention to leave among nurses in Australia. Previous studies show that emotional labour and burnout are associated with an increase in intention to leave of nurses. There is evidence that high performance work systems are in association with a decrease in turnover. There are no previous studies that examine the relationship between high performance work systems and emotional labour. A cross-sectional, correlational survey. The study was conducted in Australia in 2008 with 183 nurses. Three hypotheses were tested with validated measures of emotional labour, burnout, intention to leave, and perceived high performance work systems. Principal component analysis was used to examine the structure of the measures. The mediation hypothesis was tested using Baron and Kenny's procedure and the moderation hypothesis was tested using hierarchical regr...
Journal of health organization and management, 2011
Studies of high-performing organisations have consistently reported a positive relationship betwe... more Studies of high-performing organisations have consistently reported a positive relationship between high performance work systems (HPWS) and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved care delivery and patient outcomes have been reported in international health care studies. The purpose of this paper is to bring together the results from a series of studies conducted within Australian health care organisations. First, the authors seek to demonstrate the link found between high performance work systems and organisational performance, including the perceived quality of patient care. Second, the paper aims to show that the hospitals studied do not have the necessary aspects of HPWS in place and that there has been little consideration of HPWS in health system reform. The paper draws on a series of correlation studies using survey data from hospitals in Austral...
Journal of health organization and management, 2010
This paper aims to explore the attitudes of managers and employees to high performance work pract... more This paper aims to explore the attitudes of managers and employees to high performance work practices (HPWS) in a medium sized rural Australian hospital. The study consists of two stages. Stage one involved a qualitative investigation consisting of interviews and focus group sessions with senior, middle and line management at the hospital. Bowen and Ostroffs framework was used to examine how strategic HRM was understood, interpreted and operationalised across the management hierarchy. Stage one investigates the views of managers concerning the implementation of strategic HRM/HPWS. Stage two consisted of a questionnaire administered to all hospital employees. The mediation effects of social identification on the relationship between high performance work systems and affective commitment and job satisfaction are examined. The purpose of stage two was to investigate the views and effects of SHRM/HPWS on employees. It should be noted that HPWS and strategic HRM are used inter-changeably...
Allied heath professionals are expected to utilize evidence-based practices in their workplaces, ... more Allied heath professionals are expected to utilize evidence-based practices in their workplaces, and there is an increasing expectation that clinicians will become involved in clinical research. With the aim of establishing the level of interest and experience in clinical research among allied health professionals in Australia, 132 allied health professional in Australia were surveyed to determine their level of interest and their level of experience in clinical research. The Research Spider survey tool was used to examine clinicians' level of research experience and level of research interest across ten core areas. These areas included writing a research proposal, using quantitative methods, publishing research, writing and presenting a research report, analysing and interpreting results, using qualitative research methods, critically reviewing literature, finding relevant literature, generating research ideas and applying for research funding. Overall, allied health profession...
Australian health review : a publication of the Australian Hospital Association, 2006
This paper provides an overview of the process and tools used to develop and implement a priority... more This paper provides an overview of the process and tools used to develop and implement a priority setting framework for the Clinical Senate of South Australia. Established as a clinical advisory group to the Minister and Department of Health, the Clinical Senate recognised the need for an open priority setting process to fairly assign planning resources to the large number of clinical issues that needed to be addressed. Using a workbook, developed from the literature and evidence related to priority setting, agreement was reached on the use, components and structure of the priority setting process. The final products included a Gap Finder Tool and a Priority Setting Framework. This paper describes the process used to develop the priority setting tools. Decision makers in other organisations can use similar processes and tools to develop or enhance their priority Setting processes.
Australian health review : a publication of the Australian Hospital Association, 2005
This paper reports on an exploratory study which aims to improve our understanding of how the Chi... more This paper reports on an exploratory study which aims to improve our understanding of how the Chief Executive Officers of Victorian health services monitor strategic and operational performance in their organisations. As a component of a large scale human resource management study, we surveyed 130 Chief Executive Officers (CEOs) of Victorian health sector agencies. Our findings suggest that performance monitoring was more advanced among the larger Victorian health sector organisations, and that there were areas for improvement throughout the system. Overall, the CEOs reported limited use of performance indicators related to service and clinical perspectives, with financial and volume indicators most widely used. There was little evidence that these organisations had processes in place (such as benchmarking and linking required outcomes to staff performance management) to understand the implications of the performance information and translate them into management action. The finding...
Health services management research : an official journal of the Association of University Programs in Health Administration / HSMC, AUPHA, 1998
As health care organizations look for ways to ensure cost-effective, high quality service deliver... more As health care organizations look for ways to ensure cost-effective, high quality service delivery while still meeting patient needs, organizational performance assessment (OPA) is useful in focusing improvement efforts. In addition, organizational performance assessment is essential for ongoing management decision-making, operational effectiveness and strategy formulation. In this paper, the roles and impact of OPA models in use in health care are reviewed, and areas of potential abuse, such as myopia, tunnel vision and gaming, are identified. The review shows that most existing OPA models were developed primarily as sources of information for purchasers or consumers, or to enable providers to identify areas for improvement. However, there was little conclusive evidence evaluating their impact. This review of existing OPA models enabled the establishment of principles for the development, implementation and prevention of abuse of OPA specific to health care. The OPA models currentl...
Health services management research : an official journal of the Association of University Programs in Health Administration / HSMC, AUPHA, 1998
Organizational performance remains an elusive concept despite its importance to health care organ... more Organizational performance remains an elusive concept despite its importance to health care organizations' (HCOs') management and analysis. This paper uses Parsons' social system action theory to develop a comprehensive theoretically grounded framework by which to overcome the current fragmented approach to HCO performance management. The Parsonian perspective focuses on four fundamental functions that an HCO needs to ensure its survival. Organizational performance is determined by the dynamic equilibrium resulting from the continual interaction of, and interchange among, these four functions. The alignment interchanges allow the creation of bridges between traditional models of organizational performance that are usually used as independent and competing models. The attraction of the Parsonian model lies in its capacity to: (1) embody the various dominant models of organizational performance; (2) present a strong integrative framework in which the complementarity of var...
1. Hosp Q. 1998-1999 Winter;2(2):28-34. Healthcare governance in transition: from hospital boards... more 1. Hosp Q. 1998-1999 Winter;2(2):28-34. Healthcare governance in transition: from hospital boards to system boards ... a national survey of chairs of boards. Brunelle F, Leatt P, Leggat S. PMID: 10621172 [PubMed - indexed for MEDLINE]. MeSH Terms: ...
Des exigences concurrentielles de ressources financières au sein du système de santé obligent les... more Des exigences concurrentielles de ressources financières au sein du système de santé obligent les pourvoyeurs de soins de santé à assurer l'utilisation la plus efficace possible de ces ressources. Les résultats provenant des États-Unis, du Royaume-Uni et d'autres ...
Background: This paper provides an overview of the process and tools used to develop and imple- m... more Background: This paper provides an overview of the process and tools used to develop and imple- ment a priority setting framework for the Clinical Senate of South Australia. Established as a clini- cal advisory group to the Minister and Department of Health, the Clinical Senate recognised the need for an open priority setting process to fairly assign planning resources to
affiliations should appear as the following: Department (if applicable); Institution; City; State... more affiliations should appear as the following: Department (if applicable); Institution; City; State (US only); Country. No further information or detail should be included
In this paper, we explore the attitudes of employees to high performance work practices in a medi... more In this paper, we explore the attitudes of employees to high performance work practices in a medium sized rural hospital. As one of the key HPWS is teamwork, we explore the mediating role of social identification on the relationship between HPWS and affective commitment and on the relationship between HPWS and job satisfaction. Findings indicate that social identification mediates the relationship between HPWS and affective commitment and also mediates the relationship between HPWS and job satisfaction. We argue that team leaders and managers play a key role in building social identification within the team and that organizations need to understand this role and provide recognition, reward, education and support to their middle and lower managers. Such support is likely to provide benefits in terms of high performing committed employees and improved employee retention.
This aim of this study was to investigate the interactive effects of psychological empowerment an... more This aim of this study was to investigate the interactive effects of psychological empowerment and job satisfaction on the relationship between high-performance work systems (HPWS) and nurses' perceptions of the quality of patient care they provide. Studies of high-performing organizations in a variety of industries have consistently reported a positive relationship between HPWS and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved patient outcomes have been reported in international health care studies. We used regression analysis with tests of mediation and moderation to analyze survey responses collected in March 2008 of 201 nurses in a large regional Australian health service. Psychological empowerment fully mediated the relationship between HPWS and perceptions of quality of patient care. Job satisfaction moderated the relationship between HPWS and percep...
A systematic literature review identified 41 studies, including four reviews, reporting on proces... more A systematic literature review identified 41 studies, including four reviews, reporting on process redesign interventions in hospitals. Success factors for the changes included mechanisms to facilitate participation throughout the process, clearly documented protocols and expectations for the health professionals which were supported by education, mechanisms to audit and provide feedback on behaviours and performance, as well as being able to hold the participating health professionals accountable. The success of process redesign methodologies is found to be highly dependent on these performance-based human resource management (HRM) practices.
Australian health review: a publication of the Australian Hospital Association
Objective This paper analyses an organisational development project that aimed to change the orga... more Objective This paper analyses an organisational development project that aimed to change the organisational culture and improve people management systems and processes. The questions addressed were: was the change process a success; how was success defined; and what were the barriers to its progress? Methods We examined the process of change over a 3-year period. The organisational development intervention is described and analysed. Qualitative methods, including document review, in-depth interviews and focus groups, participant observation, newsletters and diary entries were used to gather the data. A variant of competing values was used to analyse the data. Results We sought to build trust with all managers and encouraged reflection by conducting feedback sessions, presentations, workshops and one-on-one and group discussions. A cross-site action group was established to encourage organisation-wide participation in the project. However, it was clear that stakeholders had different...
The purpose of this article was to explore the relationships between perceived high performance w... more The purpose of this article was to explore the relationships between perceived high performance work systems, emotional labour, burnout and intention to leave among nurses in Australia. Previous studies show that emotional labour and burnout are associated with an increase in intention to leave of nurses. There is evidence that high performance work systems are in association with a decrease in turnover. There are no previous studies that examine the relationship between high performance work systems and emotional labour. A cross-sectional, correlational survey. The study was conducted in Australia in 2008 with 183 nurses. Three hypotheses were tested with validated measures of emotional labour, burnout, intention to leave, and perceived high performance work systems. Principal component analysis was used to examine the structure of the measures. The mediation hypothesis was tested using Baron and Kenny's procedure and the moderation hypothesis was tested using hierarchical regr...
Journal of health organization and management, 2011
Studies of high-performing organisations have consistently reported a positive relationship betwe... more Studies of high-performing organisations have consistently reported a positive relationship between high performance work systems (HPWS) and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved care delivery and patient outcomes have been reported in international health care studies. The purpose of this paper is to bring together the results from a series of studies conducted within Australian health care organisations. First, the authors seek to demonstrate the link found between high performance work systems and organisational performance, including the perceived quality of patient care. Second, the paper aims to show that the hospitals studied do not have the necessary aspects of HPWS in place and that there has been little consideration of HPWS in health system reform. The paper draws on a series of correlation studies using survey data from hospitals in Austral...
Journal of health organization and management, 2010
This paper aims to explore the attitudes of managers and employees to high performance work pract... more This paper aims to explore the attitudes of managers and employees to high performance work practices (HPWS) in a medium sized rural Australian hospital. The study consists of two stages. Stage one involved a qualitative investigation consisting of interviews and focus group sessions with senior, middle and line management at the hospital. Bowen and Ostroffs framework was used to examine how strategic HRM was understood, interpreted and operationalised across the management hierarchy. Stage one investigates the views of managers concerning the implementation of strategic HRM/HPWS. Stage two consisted of a questionnaire administered to all hospital employees. The mediation effects of social identification on the relationship between high performance work systems and affective commitment and job satisfaction are examined. The purpose of stage two was to investigate the views and effects of SHRM/HPWS on employees. It should be noted that HPWS and strategic HRM are used inter-changeably...
Allied heath professionals are expected to utilize evidence-based practices in their workplaces, ... more Allied heath professionals are expected to utilize evidence-based practices in their workplaces, and there is an increasing expectation that clinicians will become involved in clinical research. With the aim of establishing the level of interest and experience in clinical research among allied health professionals in Australia, 132 allied health professional in Australia were surveyed to determine their level of interest and their level of experience in clinical research. The Research Spider survey tool was used to examine clinicians' level of research experience and level of research interest across ten core areas. These areas included writing a research proposal, using quantitative methods, publishing research, writing and presenting a research report, analysing and interpreting results, using qualitative research methods, critically reviewing literature, finding relevant literature, generating research ideas and applying for research funding. Overall, allied health profession...
Australian health review : a publication of the Australian Hospital Association, 2006
This paper provides an overview of the process and tools used to develop and implement a priority... more This paper provides an overview of the process and tools used to develop and implement a priority setting framework for the Clinical Senate of South Australia. Established as a clinical advisory group to the Minister and Department of Health, the Clinical Senate recognised the need for an open priority setting process to fairly assign planning resources to the large number of clinical issues that needed to be addressed. Using a workbook, developed from the literature and evidence related to priority setting, agreement was reached on the use, components and structure of the priority setting process. The final products included a Gap Finder Tool and a Priority Setting Framework. This paper describes the process used to develop the priority setting tools. Decision makers in other organisations can use similar processes and tools to develop or enhance their priority Setting processes.
Australian health review : a publication of the Australian Hospital Association, 2005
This paper reports on an exploratory study which aims to improve our understanding of how the Chi... more This paper reports on an exploratory study which aims to improve our understanding of how the Chief Executive Officers of Victorian health services monitor strategic and operational performance in their organisations. As a component of a large scale human resource management study, we surveyed 130 Chief Executive Officers (CEOs) of Victorian health sector agencies. Our findings suggest that performance monitoring was more advanced among the larger Victorian health sector organisations, and that there were areas for improvement throughout the system. Overall, the CEOs reported limited use of performance indicators related to service and clinical perspectives, with financial and volume indicators most widely used. There was little evidence that these organisations had processes in place (such as benchmarking and linking required outcomes to staff performance management) to understand the implications of the performance information and translate them into management action. The finding...
Health services management research : an official journal of the Association of University Programs in Health Administration / HSMC, AUPHA, 1998
As health care organizations look for ways to ensure cost-effective, high quality service deliver... more As health care organizations look for ways to ensure cost-effective, high quality service delivery while still meeting patient needs, organizational performance assessment (OPA) is useful in focusing improvement efforts. In addition, organizational performance assessment is essential for ongoing management decision-making, operational effectiveness and strategy formulation. In this paper, the roles and impact of OPA models in use in health care are reviewed, and areas of potential abuse, such as myopia, tunnel vision and gaming, are identified. The review shows that most existing OPA models were developed primarily as sources of information for purchasers or consumers, or to enable providers to identify areas for improvement. However, there was little conclusive evidence evaluating their impact. This review of existing OPA models enabled the establishment of principles for the development, implementation and prevention of abuse of OPA specific to health care. The OPA models currentl...
Health services management research : an official journal of the Association of University Programs in Health Administration / HSMC, AUPHA, 1998
Organizational performance remains an elusive concept despite its importance to health care organ... more Organizational performance remains an elusive concept despite its importance to health care organizations' (HCOs') management and analysis. This paper uses Parsons' social system action theory to develop a comprehensive theoretically grounded framework by which to overcome the current fragmented approach to HCO performance management. The Parsonian perspective focuses on four fundamental functions that an HCO needs to ensure its survival. Organizational performance is determined by the dynamic equilibrium resulting from the continual interaction of, and interchange among, these four functions. The alignment interchanges allow the creation of bridges between traditional models of organizational performance that are usually used as independent and competing models. The attraction of the Parsonian model lies in its capacity to: (1) embody the various dominant models of organizational performance; (2) present a strong integrative framework in which the complementarity of var...
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