Health services management research : an official journal of the Association of University Programs in Health Administration
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The paper reports the results of a study on benchmarking activities undertaken by the procurement organization within the National Health Service (NHS) in Scotland, namely National Procurement (previously Scottish Healthcare Supplies Contracts Branch). NHS performance is of course politically important, and benchmarking is increasingly seen as a means to improve performance, so the study was carried out to determine if the current benchmarking approaches could be enhanced. A review of the benchmarking activities used by the private sector, local government and NHS organizations was carried out to establish a framework of the motivations, benefits, problems and costs associated with benchmarking. ⋯ Nine of the 16 Scottish Health Boards surveyed reported carrying out benchmarking during the last three years. The findings of the research were that there were similarities in approaches between local government and NHS Scotland Health, but differences between NHS Scotland and other UK NHS procurement organizations. Benefits were seen as significant and it was recommended that National Procurement should pursue the formation of a benchmarking group with members drawn from NHS Scotland and external benchmarking bodies to establish measures to be used in benchmarking across the whole of NHS Scotland.
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This paper presents a conceptual framework and tool kit, generated from the evaluation of five primary care research networks (PCRNs) funded by the then London, National Health Service (NHS) Executive. We employed qualitative methods designed to match the most important characteristics of PCRNs, conducting five contextualized case studies covering the five networks. A conceptual evaluation framework based on a review of the organization science literature was developed and comprised the broad, but inter-related organizational dimensions of structure, processes, boundaries and network self-evaluation as input factors and strategic emphasis as epitomized by network objectives. ⋯ We considered the congruence, or fit, between network objectives and input factors: greater congruence implied greater ability to achieve implicit and overt objectives. We conclude that network evaluation must take place, over time, recognizing stage of development and potential for long-term viability, but within a generic framework of inputs and outputs. If there is a good fit or congruence between their input factors and network objectives, networks will be internally coherent and able to operate at optimum effectiveness.
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Health Serv Manage Res · May 2007
The psychological contract: is the UK National Health Service a model employer?
The UK National Health Service (NHS) is facing recruitment challenges that mean it will need to become an 'employer of choice' if it is to continue to attract high-quality employees. This paper reports the findings from a study focusing on allied health professional staff (n = 67), aimed at establishing the expectations of the NHS inherent in their current psychological contract and to consider whether the government's drive to make the NHS a model employer meets those expectations. ⋯ Although the degree of employee satisfaction with the relational content of the psychological contract was relatively positive, there was, nevertheless, a mismatch between levels of importance placed on such aspects of the contract and levels of satisfaction, with employees increasingly placing greater emphasis on those items the NHS is having the greatest difficulty providing. Despite this apparent disparity between employee expectation and the fulfilment of those expectations, the overall health of the psychological contract was still high.
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Health Serv Manage Res · May 2007
Improving operational efficiency in an inner-city emergency department.
Saving lives in a high-volume, high-acuity inner-city trauma centre demands operational excellence. We conducted our research in an emergency department where treatment of Acute Coronary Syndrome is a critical operation. Our study results in a better understanding of patient flow, analysis of the waiting lines and an optimization model for labour cost minimization.
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Health Serv Manage Res · Nov 2006
Patient reciprocity and physician burnout: what do patients bring to the patient-physician relationship?
Despite its criticality to the provision of health care, little is known about how the patient-physician relationship influences burnout. This article seeks to understand how patient performance (e.g. being informative about needs) during office visits is associated with perceived reciprocity in the patient-physician relationship, which is in turn associated with physician burnout. To that end, we report the results of a cross-sectional survey of 252 matched pairs of patients and their primary care physicians about a recent office visit. ⋯ Interestingly, patients' perceptions of their performance differed from physicians' perceptions; physicians' perceptions of performance fit the social exchange model better than patients' perceptions of performance. The present work suggests that while they are a source of demands, patients also provide resources that are critical to the patient-physician relationship. To the extent that we can encourage these resources, we can improve perceived reciprocity and reduce burnout in physicians.