Ebook ABC of clinical leadership: Part 2
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Ebook ABC of clinical leadership: Part 2
CHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2atient care. Leaders of Improvement need a system-wide perspective. The dinical team is at the heart of quality improvement•Establish ng an organisational ctfture of continual improvement IS Crucial to success•leaders of improvement need to understand and use quaMy metrics•Quality improvement requir Ebook ABC of clinical leadership: Part 2es healthcare professionals and managers to work collaboratively•Clinical leaders must have the courage to challenge the status quo and set ambitiousEbook ABC of clinical leadership: Part 2
goabIntroductionUnderstanding the relationship between the patient experience, clinical outcomes and the organisation of care is the key to effective CHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2nslation of a concern for individuals intoan appreciation of how the whole system of care contributes to the well-being and care of patients. Professional autonomy and clinical freedom are highly valued by clinicians, but the real benefits of these aspects of clinical practice must be balanced again Ebook ABC of clinical leadership: Part 2st the benefits of being cared for within an effective organisation. Clinical leaders have a role in defining what professionalism means in an organisEbook ABC of clinical leadership: Part 2
ational context: managing dedicated cliniciansand ensuring the alignment of purpose between managers and healthcare professionals so that care is safeCHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2s of successes and sustained improvements. Generating step changes in improvements across the system of care requires a combination of clinical knowledge and understanding coupled with organisational authority and aABC of Clinical Leadmhip. 1st edition.Edited by Tim Swanwick and Judy McKmim & 2011 B Ebook ABC of clinical leadership: Part 2lackwell Publishing Ltd.range of organisational skills. The clinical leader is well placed to be at the centre of quality improvement. Indeed, it coulEbook ABC of clinical leadership: Part 2
d be argued that improving the quality and the safety of care should be the clinical leader's main objective and metrics of quality and safety improveCHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2elivered in 3 timely, patient-centred manner. Research shows, however, that such high-quality care is not delivered consistently and that poor-quality care remains a concern in al) healthcare systems. This includes, for examplc.under-use of effective interventions or use of inappropriate treatments Ebook ABC of clinical leadership: Part 2or patients experiencing care that is impersonal. Furthermore, we know that healthcare is endemically unsafe with around 14% of patients harmed by theEbook ABC of clinical leadership: Part 2
system that sets out to help and heal them. In the United Kingdom. until 1991 when medical audit was introduced, the delivery of good-quality care waCHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2audit as recognition that improvements in care need the input of the wholeclinical team. The more recent introduction of clinical governance is an acknowledgement of a 'whole system’ responsibility for the quality and safety of care and. by implication, for improvements in care. Quality is dearly no Ebook ABC of clinical leadership: Part 2w a responsibility shared by clinicians and managers, and it falls to the clinical leader to ensure that the objectives of both groups of professionalEbook ABC of clinical leadership: Part 2
s are aligned and that their efforts are synergistic.The quality of leadership will profoundly affect the quality of patient care (Berwick, 1989). GooCHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2ry for significant and sustained improvements in the quality and safety of care are often complex and time-consuming. The time that it takes to embed organisational change often frustrates clinicians who. even when caring for people with chronic disease, are used to shorter timescales. Effective cli Ebook ABC of clinical leadership: Part 2nical leaders will seek to sustain clinical colleagues through the ups and downs of the organisational changes that are needed for improvement.SettingEbook ABC of clinical leadership: Part 2
the culture and establishing goalsBroadly, there are two approaches to quality and safety improvement: one that sets out to develop a culture of contCHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2lishing a culture in which staff continually seek improvement is a complex but crucial leadership task, one that can only be met if there is a clearly articulated vision and the establishment of a system of organisational values that nurtures and supports individuals, but is intolerant of systemic m Ebook ABC of clinical leadership: Part 2istakes. Clinical leaders must work closely with colleagues in human resources to work through, often long-established, cultural barriers to change anEbook ABC of clinical leadership: Part 2
d to develop an environment in which seeking improvement and expecting demonstrable and sustainable improvements is perceived by all as 'what we do arCHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2gets set centrally or a local need to reduce length of stay or to improve patient information or to improve access to diabetic service. Good leadership in this context will ensure that teams understand why targets have been set, work together to make the changes and do not simply 'hit the target but Ebook ABC of clinical leadership: Part 2 miss the point".Team working: the heart of quality improvementThe individual clinician-patient relationship is at the heart of healthcare provision.Ebook ABC of clinical leadership: Part 2
But, as described in Chapter 4, at the heart of quality improvement is the leant. Teams that work well and whose members experience low stress levels CHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2nment of healthcare this may not Ise straightforward. Some teams arc ‘rear, hut many a re virtual. For example, routine secondary care investigation of a patient found to have a shadow on a chest radiograph may touch the work of over 20 people, some of whom may not know each other some will not have Ebook ABC of clinical leadership: Part 2 seen the patient and yet all must work well together to provide high-quality safe care for this and other patients.Managing people and supporting theEbook ABC of clinical leadership: Part 2
development of the workforce are responsibilities of clinical leaders. Performance management frameworks that link an individual's goals to those of CHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2bers belong to several different teams. Furthermore, line management may follow professional hierarchies more closely than it does organisational ones. Continuing and personal development for some staff, in particular doctors and other clinical professionals, may be linked to their speciality and to Ebook ABC of clinical leadership: Part 2 outside bodies rather than to the immediate needs of the organisation. Such ambiguities that can arise from professionals' different sets of loyaltieEbook ABC of clinical leadership: Part 2
s and identities may have benefits to the organisation, but need to be recognised and acknowledged - and managed. Understanding and resolving such conCHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2kills that include skills for leading and managing teams, the ability to understandwork as a series of interdependencies and to lead change across internal and external boundaries (Berwick er al.. 1992). Leadership in healthcare systems is distributed, that is within the complexity of healthcare the Ebook ABC of clinical leadership: Part 2re are many teams and so some individuals will have leadership roles in some but not all aspects of their work. So. the skills needed for quality imprEbook ABC of clinical leadership: Part 2
ovement (Box 8.1) are required by many. Ensuring that everyone understands the nature of improvement and has the necessary skill set should be part ofCHAPTER 8Leading and Improving Clinical ServicesFiona MossNHS London. London. UKOVERVIEW. c inical leadership can profound)1/ affect the quality of pa Ebook ABC of clinical leadership: Part 2 interdependencies•Ability to work in teams•Ability to understand work as a processGọi ngay
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