Purpose -The largest organisation in the western world, the UK National Health Service (NHS), might be best viewed as a network of interdependent organisations. However, the public has only recently begun to see it as a living network. Public reforms and financial crises have increased the need for professionals to innovate and improve their role. The overarching question is how this new clinical leadership can positively affect the functioning of the system and its performance. Therefore, the purpose of this paper is to clarify how leaders can be most effective in managing health networks. Design/methodology/approach -A pragmatic approach was taken because of the topical and strategic importance of networks and leadership in the current climate, and hence a need for greater understanding of this largely unknown phenomenon. A focus group interview with Organisational Development experts from the Centre for Innovation and Health Management (CIHM) at Leeds University Business School was followed by three scoping reviews and high-level follow-up conversations with CIHM members, network leaders from the NHS and third sectors. Findings -Issues that have emerged include: how networks are designed; which factors enhance its likelihood of success and predicate its failure; discussions of illuminating effective leadership.Research limitations/implications -The Stories of Effective Leadership Networks were provided by the network founders, who may have sought to emphasise the benefits (as opposed to downside) of their network. An ideal scenario would have been the inclusion of patients and carers and perhaps administrative staff to reduce bias. Originality/value -Considering the limited evidence base from the literature about medical leadership for network management, the involvement of network leaders and the ability to draw-upon CIHMs knowledge and expertise has been fundamental for determining lessons that may enhance the leadership function of the UK's health system network.
L’assistenza primaria in Italia sta subendo una radicale riforma con l’introduzione delle Aggregazioni Funzionali Territoriali (AFT), ovvero gruppi obbligatori di medici di medicina generale che si associano per rispondere insieme sia ai bisogni della popolazione assistita, sia per implementare le logiche del governo clinico. La Toscana già a partire del 2014 è stata una delle prime Regioni a formalizzare le AFT negli Accordi Regionali e Aziendali e a nominare i coordinatori di AFT, ovvero medici di medicina generale che hanno il compito di guidare l’AFT nella programmazione e revisione di obiettivi di governo. A partire da un questionario rivolto ai coordinatori di AFT toscani, gli autori hanno analizzato la percezione dei coordinatori rispetto all’innovazione rappresentata dalla AFT, sia in termini di fiducia verso la logica di integrazione monoprofessionale (fiducia verso l’organizzazione), sia in termini di difficoltà percepita rispetto all’assolvimento del proprio incarico (fiducia verso il ruolo). Sulla base di tali criteri, gli autori hanno delineato, per il contesto della Toscana, 4 differenti gruppi di coordinatori con percezioni simili verso l’innovazione manageriale e organizzativa della medicina generale
Background: Healthcare-associated infections (HAIs) represent a serious burden to individual safety and healthcare sustainability. Identifying which patients, procedures and settings are most at risk would offer a significant contribution to HAI management and prevention. The purpose of this study is to estimate 1) orthopaedic implantable device-related infection (OIDRI) prevalence in Italian hospitals and 2) the gap between the remuneration paid by the Italian healthcare system and the real costs sustained by Italian hospitals to treat these episodes. Methods: This is a cross-sectional study based on hospital discharge forms registered in 2012 and 2014. To address the first goal of this study, the national database was investigated to identify 1) surgical procedures associated with orthopaedic device implantation and 2) among them, which patient characteristics (age, sex), type of admission, and type of discharge were associated with a primary diagnosis of infection. To address the second goal, 1) each episode of infection was multiplied by the remuneration paid by the Italian healthcare system to the hospitals, based on the diagnosis-related group (DRG) system, and 2) the total days of hospitalization required to treat the same episodes were multiplied by the average daily cost of hospitalization, according to estimates from the Ministry of the Economy and Finance (MEF). Results: In 2014, 1.55% of the total hospitalizations for orthopaedic device implantation procedures were associated with a main diagnosis of infection, with a negligible increase of 0.04% compared with 2012. Hip and knee replacement revisions, male patients and patients older than 65 years were more exposed to infection. A total of 51.63% of patients were planned admissions to the hospital, 68.75% had an ordinary discharge to home, and 0.9% died. The remuneration paid by the healthcare system to the hospitals was € 37,519,084 in 2014, with 3 DRGs covering 70.6% of the total. The cost of the actual days of hospitalization to treat these episodes was 17.5 million more than the remuneration received. Conclusions: The OIDRI prevalence was lower than that described in recent surveys in acute care settings, although the numbers were likely underestimated. The cost of treatment varied significantly depending on the remuneration system adopted.
L'emergenza pandemica ha accelerato l'adozione delle tecnologie digitali e il potenziamento dell'assistenza territoriale. Il contributo analizza come la ASL di Sassari stia gestendo il processo di digitalizzazione e innovazione dei servizi territoriali, sulla spinta del PNRR e secondo i criteri del D.M. n. 77/2022 e delle direttive regionali. Il caso studio è particolarmente rilevante in quanto l'azienda è chiamata a gestire massicci investimenti e profondi cambiamenti di sistema, all'interno di una fase estremamente complessa, derivante dalla riforma regionale in atto e dal conseguente disallineamento dei processi istituzionali, organizzativi e tecnologici. Il lavoro evidenzia come la ASL di Sassari si trovi davanti a una duplice sfida: implementare in modo efficace e rapido le strategie del PNRR, secondo un approccio top-down; sviluppare dal basso l'innovazione dei servizi territoriali collegati all'uso delle nuove tecnologie digitali e al nuovo modello di medicina di prossimità.
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.