Nurse retention, leadership, and the Toyota System Model: Building leaders and problem solvers for better patient care

Kowalski, Karren; Bradley, Kathleen; Pappas, Sharon

doi:10.1016/j.mnl.2006.09.005

Cited by 11 publications

(7 citation statements)

References 14 publications

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“…Five health care systems (Virginia Mason Kirkland Clinic, USA, ThedaCare Health Care System, USA, NHS Bolton, UK, Michigan University Hospital, USA and Flinders Medical Center, Australia) were the subject of at least two papers each. Multiple authors defined some of these specific organisations as pioneers in applying lean production principles in health care (Kowalski, Bradley, & Pappas, ; Radnor et al., ; Skeldon et al., ). In 14 articles (18.6%), the health care organisations were not named.…”

Section: Resultsmentioning

confidence: 99%

How much of Toyota's philosophy is embedded in health care at the organisational level? A review

et al. 2018

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Section: Resultsmentioning

confidence: 99%

How much of Toyota's philosophy is embedded in health care at the organisational level? A review

et al. 2018

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“…It adopted the TPS to create the VMPS. The research on VMMC has included work by Weber,92 who investigated how improved logistics and productivity reduced costs and defects; Furman and Caplan, 93 who outlined the patient safety alert system; Nelson-Peterson and Leppa, 94 who described the elimination of waste in nursing procedures; McCarthy 95 on the application of the TPS; Bush 96 on eliminating waste; Kowalski et al 97 on nurse retention and leadership development; and Pham et al…”

Section: Fillinghammentioning

confidence: 99%

A mixed-methods evaluation of transformational change in NHS North East

Hunter

Erskine

Hicks

et al. 2014

Health Services and Delivery Research

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BackgroundThe North East Transformation System (NETS) was conceived as an experiment in adopting large-scale transformational change across a NHS region in England. Although the NHS in the North East performs well, the health of the population ranks among the poorest in the country. The NETS was viewed as a means of addressing this conundrum. It comprised three components: Vision, Compact and Method.ObjectivesThe evaluation study comprised six elements: a literature review; an evaluation of the evolution and impact of the NETS; an identification of the factors facilitating, and/or acting as barriers to, successful change; an assessment of the role of the NETS project team; establishing how far the changes introduced through the NETS became embedded and sustained; and an evaluation of the impact of the NETS on end users.DesignThe research comprised a longitudinal mixed-methods study conducted over 3.5 years. Research methods included 68 semistructured interviews, observation, two focus groups, documentary analysis and interrupted time series (ITS) analysis. The ITS component comprised analysis of five rapid process improvement workshops in two of the sites.SettingThe research setting was the NHS North East region until its abolition in April 2013 following the UK government’s NHS changes. Fourteen sites were selected for the study, comprising primary care trusts as commissioners, and provider trusts including mental health, community, acute care and ambulance services.ParticipantsThe study respondents were members of staff in the 14 sites drawn from different levels of their organisations.InterventionsThe NETS comprised a complex set of interventions aimed at improving the efficiency and effectiveness of care pathways for staff and patients.Main outcome measuresThe ‘receptive contexts for change’ framework was used to evaluate the transformational change process and its outcomes.Data sourcesQualitative parts of the study drew on semistructured interviews, focus groups, observation and documents. Quantitative parts of the study used routinely collected NHS data.ResultsTransformational change in a complex system takes time and demands consistency, constancy of purpose and organisational stability. The NETS was seriously disrupted by the NHS changes announced in July 2010. Progress was sustained at four of the study sites, but slowed or ceased at the other sites. Leadership style was found to be critical to the success of transformational change.ConclusionsThe NETS was a bold and ambitious initiative which succeeded in bringing about real and lasting change in some parts of the North East. However, it was unable to fully realise its vision and purpose partly because of the widespread reorganisation of the NHS by the new coalition government.Future workThere is a need to develop new methods to understand how change occurs, or fails, in complex settings like the NHS. There is a need for more in-depth studies in those sites that were able to implement and sustain change. This would inform future policy and practice. The results of the quantitative analyses were less conclusive than those obtained by qualitative methods. Further development of mixed-methods approaches would provide additional support for evidence-based decision-making.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…Nurse retention and leadership is a contentious topic within the healthcare sector, with rich examples of the relationship between nursing turnover, retention, nurse leadership, the autonomous role of nurses and the satisfaction of the patient. 13 Chenoweth et al 14 completed a systematic review on the retention and recruitment of nurses into aged care in order to identify the best strategy for this crisis. The review described the culture and experiences of the nurses in the working environment that identified an area in need of improvement in organisational recruitment and retention.…”

Section: Introductionmentioning

confidence: 99%

Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review

Dwyer¹

2011

International Journal of Evidence-Based Healthcare

112

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Overall the themes presented in the review reported the negative experiences of nurses in residential aged care and geriatrics. Nurses will continue to be devalued if there is no professional identity and support for their roles and need to have a career pathway when making the decision to enter into aged and geriatric practice. Clinical leadership training is needed for nurses to transition through practice into specialised roles such as the RN team leader and Geriatric Nurse Practitioner (GNP). Providing a career structure and choice in the industry for the nurse to become a clinical leader or a manager of health services will improve recruitment and retention. IMPLICATION FOR RESEARCH: More research is needed to identify the skills gaps experienced by nurses in aged care and geriatric care. This research could lead to the design and implementation of a skills audit to identify candidates for specialised courses so that clinical leadership and governance in aged care are improved. More research is needed for role construction and the professional development of the GNP. Organisations can benefit from research currently being conducted on the role of the RN in aged care and geriatrics, by mapping the skills mix of candidate RNs to the key performance indicators in the role. Organisations must change their perception and value of RNs as clinical leaders in care teams.

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Nurse retention, leadership, and the Toyota System Model: Building leaders and problem solvers for better patient care

Cited by 11 publications

References 14 publications

How much of Toyota's philosophy is embedded in health care at the organisational level? A review

How much of Toyota's philosophy is embedded in health care at the organisational level? A review

A mixed-methods evaluation of transformational change in NHS North East

Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review

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