Purpose – The purpose of this paper is to find underlying causes of leadership failure in NPM-based reforms in the public service, and propose leadership principles to guard against such failure as leaders meet the demands of a changing, complex public service environment. Design/methodology/approach – An analysis of the managerial philosophy of Dr Berwick and its effects on CMS overall performance and employee morale. Findings – NPM-based reforms create an environment in which administrative wrongdoing can occur. The principles of leadership found in NPLT, which advocates values-based, relationship-based distributed leadership provide a template for effective leadership that can reverse and possibly prevent leadership failure due to NPM-based reforms. Research limitations/implications – The authors used a single case to demonstrate NPLT leadership principles can reverse leadership failure in a Federal Agency. No quantitative analysis is attempted in this paper. The authors choice of papers to use in the literature review was subjective. Originality/value – This paper identifies NPM-based reforms as a partial explanation for leadership failure in the public service, and also identifies the leadership principles needed to address and prevent such failures. It provides support for the use of NPLT as a template for effective public service leadership.
The historical aversion to effective leadership in American public administration literature imposes a troubling controversy over the appropriateness of nonelected public leaders being allowed to exercise the authority and capability to make decisions regarding the direction, focus, and intensity of their organizational efforts. Using principles from distributed, transformational, and authentic leadership theories, we propose a new public leadership theory that addresses the emerging unique characteristics of the public sector and test this theory using three administrations of the Federal Human Capital Survey. Results show strong support for the application of these theories in the public service. We advocate for the research and teaching of modern leadership of these theories in the public administration field. Copyright © 2012 John Wiley & Sons, Ltd.
Over a decade ago, Dr. Robin expressed concern regarding overdiagnosis and overtreatment of pulmonary embolism. Since that time, significant advances have been forthcoming in the diagnosis and treatment of venous thromboembolic disease. Using Continuous Quality Improvement concepts, this study revisits Robin's concerns and assesses the conformance of clinical practice at one institution with established requirements for the diagnosis and treatment of venous thromboembolic disease to identify remaining opportunities to improve care. The study design is a retrospective chart review. Medical records of all patients (N = 63) discharged from a university-affiliated teaching hospital from 7/1/89 to 6/30/90 with a diagnosis of primary venous thromboembolic disease were studied. Requirements for the diagnosis and treatment were established through review of the medical literature. Conformance to these requirements was assessed and described. Descriptive statistics were used. Only 7 of 63 charts (11%) met all requirements for the diagnosis and treatment of venous thromboembolic disease. Fifty-six charts (89%) failed to meet at least one criterion. There was no evidence of overdiagnosis of venous thromboembolic disease in patients with a discharge diagnosis of pulmonary embolism (N = 17). Eight of 62 patients (13%) demonstrated potential overdiagnosis of venous thromboembolic disease involving the lower extremities. Nine of 60 (15%) heparin therapies demonstrated significant nonconformance to recommendations. Fifty-four of 59 (91%) warfarin therapies failed to conform to recommendations. Eighty-three percent of these warfarin errors were considered to be technical. However, 17% were determined to be clinically significant. Of 5 patients treated with a transvenous filter device, 1 failed to meet therapeutic requirements. No patients received thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.