Health care management review
-
Health Care Manage Rev · Oct 2021
Professional faultlines and interprofessional differentiation in multidisciplinary team innovation: The moderating role of inclusive leadership.
Interprofessional health care teams are increasingly employed to solve complex problems through innovative solutions. However, there is evidence that such teams are not always successful. The impact of profession and professional divides is likely to be particularly important in health care teams as team membership and contribution typically derive from member's unique professional expertise. Yet, there remains a dearth of research exploring the role of professional faultlines in multidisciplinary teams. In an effort to address this research gap, we explore the role of professional faultlines in interprofessional team innovation. ⋯ A number of strategies to increase innovation in interprofessional teams are indicated by our findings. In particular, the role of inclusive leadership is highlighted as a useful approach, particularly when profession aligns with biodemographic attributes, such as gender.
-
Health Care Manage Rev · Nov 2020
Practices to support relational coordination in care transitions: Observations from the VA rural Transitions Nurse Program.
Ensuring safe transitions of care around hospital discharge requires effective relationships and communication between health care teams. Relational coordination (RC) is a process of communicating and relating for the purpose of task integration that predicts desirable outcomes for patients and providers. RC can be measured using a validated survey. ⋯ The impact of practices to support RC can be assessed using the RC Survey. Our findings suggest scale-up time is a likely mechanism to the development of high-quality relationships and communication within teams.
-
Health Care Manage Rev · Apr 2020
Advancing theory on the multilevel role of leadership in the implementation of evidence-based health care practices.
Top managers' transformational leadership is associated with significant influence on subordinates. Yet little is known about the extent to which top managers' transformational leadership influences middle managers' implementation leadership and, ultimately, frontline staff delivery of evidence-based health care practices. ⋯ Our findings have implications for developing a multilevel leadership approach to implementation in health care. Leadership development should build on different competencies based on managers' level but align managers' priorities on the same implementation goals.
-
Health Care Manage Rev · Apr 2020
Goal importance, use of performance measures, and knowledge exchange: An empirical study on general practitioners' performance.
In many health systems, general practitioners (GPs) exhibit high levels of isolation and, at the same time, low levels of organizational identification, which can hinder their individual performance. The extant health care literature suggests that the physicians' belief that organizational goals are important, the adoption of performance measurement systems, and knowledge-sharing practices affect their individual performance. Most research has investigated these constructs in isolation, however, rather than explored their collective impact on GPs' individual performance. ⋯ Executives could improve GPs' individual performance through interventions that reinforce their belief that organizational goals are important, facilitate a more intensive use of performance measures, and encourage knowledge exchange practices.
-
Health Care Manage Rev · Apr 2019
Clinical coordination in accountable care organizations: A qualitative study.
Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs are using to change care and reduce costs. Knowledge of ACOs' clinical efforts can provide important context for understanding ACO performance, particularly to distinguish arenas where ACOs have and have not attempted care transformation. ⋯ Results suggest that cost reductions associated with ACOs in the first years of contracts may be related to primary care. Although in the long term many hope ACOs will achieve coordination across a wide array of care settings and providers, in the short term providers under ACO contracts are focused largely on primary care-related strategies. Our work provides a template of the common areas of clinical activity in the first years of ACO contracts, which may be informative to providers considering becoming an ACO. Further research will be needed to understand how these strategies are associated with performance.