Priority setting in the provincial health services authority: survey of key decision makers

Teng, Flora F.; Mitton, Craig; MacKenzie, Jennifer

doi:10.1186/1472-6963-7-84

Cited by 47 publications

(47 citation statements)

References 22 publications

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“…Both academic opinion, and many assessments of what decision makers view as the ‘ideal’, support the idea of more formalized resource allocation processes in the health sector [16,20,37-39]. In our survey, about half of respondents claimed to observe formal processes of resource allocation at the senior management level.…”

Section: Discussionmentioning

confidence: 64%

“…Literature suggests that in Canada and elsewhere, healthcare organizations typically allocate resources on the basis of historical patterns –‘locking in’ to past budget choices [26] -- and/or political rationales [7,33,34], and there are powerful institutional and cultural reasons why this is so [35,36]. However, senior decision makers reportedly desire increased formalization or rationality in priority setting practice [16,20,37-39]. Our aim in the survey was to explore the balance between these different modes in a quantifiable way.…”

Section: Introductionmentioning

confidence: 99%

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Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

Smith

Mitton

Bryan

et al. 2013

BMC Health Serv Res

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BackgroundResource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons.MethodsBetween January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating.ResultsAbout one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as ‘good’ or ‘very good’. This paper explores these findings in greater detail and assesses them in context of the larger literature.ConclusionData from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada’s health system leadership teams.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

Smith

Mitton

Bryan

et al. 2013

BMC Health Serv Res

Self Cite

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“…International studies examining PHC and hospital management teams found competency gaps in planning and priority setting, which have negative consequences for health service delivery (7, 25, 43, 48). Studies in LMICs note that planning and priority setting is a skill confined to lists of activities rather than coordinated processes with measurable outcomes and procedures for monitoring performance of PHC clinics (7, 49).…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

Munyewende

Levin

Rispel

2016

Global Health Action

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BackgroundManagerial competencies to enhance individual and organisational performance have gained currency in global efforts to strengthen health systems. Competent managers are essential in the implementation of primary health care (PHC) reforms that aim to achieve universal health coverage.ObjectiveTo evaluate the competencies of PHC clinic nursing managers in two South African provinces.DesignA cross-sectional study was conducted in two South African provinces. Using stratified random sampling, 111 PHC clinic nursing managers were selected. All supervisors (n=104) and subordinate nurses (n=383) were invited to participate in the survey on the day of data collection. Following informed consent, the nursing managers, their supervisors, and subordinate nurses completed a 40-item, 360-degree competency assessment questionnaire, with six domains: communication, leadership and management, staff management, financial management, planning and priority setting, and problem-solving. Standard deviations, medians, and inter-quartile ranges (IQRs) were computed separately for PHC nursing managers, supervisors, and subordinate nurses for competencies in the six domains. The Tinsley and Weiss index was used to assess agreement between each of the three possible pairs of raters.ResultsA 95.4% response rate was obtained, with 105 nursing managers in Gauteng and Free State completing the questionnaires. There was a lack of agreement about nursing managers’ competencies among the three groups of raters. Overall, clinic nursing managers rated themselves high on the five domains of communication (8.6), leadership and management (8.67), staff management (8.75), planning and priority setting (8.6), and problem-solving (8.83). The exception was financial management with a median score of 7.94 (IQR 6.33–9.11). Compared to the PHC clinic managers, the supervisors and subordinate nurses gave PHC nursing managers lower ratings on all six competency domains, with the lowest rating for financial management (supervisor median rating 6.56; subordinate median rating 7.31).ConclusionThe financial management competencies of PHC clinic nursing managers need to be prioritised in continuing professional development programmes.

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“…We purposively sought informants who had previous exposure to formal priority setting processes -in this case, with the PBmA framework, which has been used widely by decision-makers in British Columbia and elsewhere (dionne et al 2008;Teng et al 2007;urquhart et al 2008;Patten et al 2006;Halma et al 2004) -and those who had not had such exposure. decision-maker partners in the two health authorities helped us identify and approach potential participants.…”

Section: Methodsmentioning

confidence: 99%

Moral Distress among Healthcare Managers: Conditions, Consequences and Potential Responses

Mitton

Peacock²,

Storch³

et al. 2010

hcpol

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moral distress -the physical and emotional response to feeling prevented from carrying out ethically proper action -can have serious consequences for health professionals and healthcare organizations. We investigated perceived moral distress qualitatively with managers in two BC health authorities. Respondents described conditions under which they experienced distress: when they set priorities within highly resource-constrained environments, when they observed inequities between budget allocations and management responsibilities, and when organizational priorities did not align with their personal values. When coping proved insufficient, managers would respond by leaving positions, organizations or the healthcare field altogether. Respondents asked for leadership development and the creation of spaces in which moral distress could be openly discussed. However, formal training in priority setting did not appear to be helpful on its own. Rather, it increased managers' awareness of the ethical dimensions of resource allocation without (in this instance) entrenching supports that would help them resolve these concerns. RésuméLa souffrance morale -réaction physique et émotionnelle liée au fait de se sentir incapable d' accomplir éthiquement une action -peut avoir de sérieuses conséquences pour les professionnels de la santé et les organismes de soins de santé. Nous avons étudié la perception qualitative de la souffrance morale chez les gestionnaires de deux autorités sanitaires en Colombie-Britannique. Les répondants ont décrit les conditions dans lesquelles ils éprouvent de la souffrance : quand ils établissent des priorités dans un contexte où les ressources sont très restreintes, quand ils observent des iniquités entre l' engagement des dépenses et les responsabilités de gestion et quand les priorités organisationnelles ne concordent pas avec leurs valeurs personnelles. s'ils se sentent incapables de faire face à la situation, les

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Priority setting in the provincial health services authority: survey of key decision makers

Cited by 47 publications

References 22 publications

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

An evaluation of the competencies of primary health care clinic nursing managers in two South African provinces

Moral Distress among Healthcare Managers: Conditions, Consequences and Potential Responses

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