Chapter 2 Really managing people Working with others. Chapter 3 Really managing peopleWorking for others. Chapter 4 Really managing resources. Chapter 5 Really managing change. Chapter 6 Really managing yourself. Chapter 7 Really managing organizations.
Chapter 8 Case studies. It is the mutual aim of the Institute and each partner membership organisation to promote and support excellence in healthcare and by working together we can achieve more and therefore make greater progress. Where opportunities arise, the IHM and each of the above organisations have agreed to work together to share access to activities and resources which support our members and their professional communities.
This will, for example, include:.
The partnership agreements recognise the independence of each organisation and seek to create an environment of working together to achieve better health and social care. For further information please contact: contact ihm. Membership of IHM brings real professional benefits developed to meet the changing needs of the healthcare sector. We welcome anyone with or progressing towards, a management role in an organisation which commissions, provides or supports health and care in its broadest sense.
Our diverse and inclusive membership includes managers from the NHS, social care, public health, private sector, military, charity and voluntary sectors, as well as a thriving overseas representation — across all management levels and disciplines.
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Our membership options include reduced rates for students and retired members. We also offer Corporate membership. The IHM is going from strength to strength with over new members having joined us in the last few months alone. So why not join us today and start enjoying the benefits your membership can bring? Hospitals report it is important to include senior leadership to help secure resources and connect the team to other helpful staff and departments.
Because hospitals are organized differently, the exact titles and roles of the people you invite to the team may be different from these examples. Changing routine processes and procedures to alter the ways people conduct their everyday work is a major challenge. Successful implementation teams—teams that achieve their goals and sustain improved performance—pay attention to the development of routines that make the new practices for fall prevention better than existing practices.
Really managing health care
They identify and implement new practices that are easier, more reproducible not reliant on memory , and more efficient than old practices. The Implementation Team itself needs structure to achieve its objectives.
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Items to settle on early include:. The remainder of this section discusses activities that the Implementation Team will typically be charged with, but the Implementation Team cannot carry out the entire program alone. The Implementation Team will need to collaborate with at least the staff who provide routine patient care in any unit where changes are to be implemented.
These staff may be physically based on the unit e. We call these staff the Unit Team. Both teams have unique responsibilities but communicate and work together to make the program a success. The Implementation Team will look at the big picture, including strengths and opportunities in current practices and the current status of prevention and fall incident reporting. This team will then identify needed changes and the specific practices, tools, and resources needed to implement these changes.
Unit Teams, with members also represented on the Implementation Team, will actually implement the changes, integrating them into existing workflows and providing feedback about how the changes work. The Unit Team should include staff from all shifts and will have ongoing responsibility for maintaining effective fall prevention practices. No single team can make the program a success by itself. To help develop the Unit Team, the Implementation Team should:. Keep in mind that there is more than one way to organize.
A useful guide is to consider how Implementation Teams for other clinical change efforts have operated successfully within your organization. Your organization's quality improvement or performance improvement experts are likely to have expertise in how to best organize and coordinate such teams. In many hospitals, the training and development area may also be a resource for team organization expertise. In this section, we identify the steps the Implementation Team needs to take to assess the current state of policy, procedures, and practice, and we indicate tools that may be useful in this process.
These steps are based on the principles of quality improvement, defined broadly to include system redesign and process improvement. These methods are appropriate for an effort that seeks to prevent falls by improving quality of care. For the Implementation Team, the work of redesign has already begun through gathering the information about organizational readiness go to section 1 and defining the team's members and structure. This quality improvement process may already be familiar to your organization. If you are not sure about the strength of your organization's quality improvement infrastructure, you may want to complete Tool 2B, "Quality Improvement Process.
Committees that oversee quality improvement for the hospital may go by different names, such as Quality Council or Patient Safety Committee.
Reframing Management: as distributed beyond the “top”
If some of the quality improvement processes listed in this inventory are not fully operational or present in your organization, you may need to build your team's improvement capability. In addition to identifying team members with improvement expertise, the Implementation Team can develop basic improvement skills through an education process.
Improvement efforts tend to be most successful when teams follow a systematic approach to analysis and implementation, and there are multiple approaches to consider. Team leaders and members may want to consult more general resources for approaches to quality improvement projects, such as information on the Plan, Do, Study, Act PDSA approach described below in "Practice Insights".
If your organization already has well-established quality improvement processes and structures, it will be beneficial to connect the fall prevention program with those processes. For example, if you have an established reporting structure to leadership, including this program will help keep it on the leadership agenda. If managers are already evaluated based on their quality improvement efforts and results, making this program a part of the large quality improvement enterprise in your organization will help ensure managers' interest. PDSA is an iterative process based on the scientific method in which it is assumed that not all information or factors are known at the outset; thus, repeated cycles of change and evaluation will be needed to achieve the goal, each cycle closer than the previous one.
With the improved knowledge, you may choose to refine or alter specific goals. A Guide for Action , available at www. This model elaborates a specific strategy for researchers, clinicians, and managers to collaborate in quality improvement. The model uses 4 "E's" Engage, Educate, Execute, and Evaluate and has been successfully applied in both large-scale quality improvement QI collaboratives and small-scale, clinically focused QI projects at the individual unit or hospital level.
Latest available findings on quality of and access to health care
Translating evidence into practice: a model for large scale knowledge translation. BMJ ;a Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil ;17 4 Developed at Motorola, Six Sigma methodology is based on the careful analysis of data on process deviations from prespecified levels of quality and use of redesign to bring about measurable changes in those rates.
Six Sigma incorporates a specific infrastructure of personnel with different levels of training in the method e. For more information, read "What Is Six Sigma? TPS is an integrated set of practices designed to systematically and continuously identify problems at the point of production and empower workers to identify and fix problems when they are identified. The work of redesign requires an assessment of your organization's current practices. In addition to the tools suggested below, you may want to look ahead to section 5 for additional tools for assessing current fall rates and care processes to prevent falls.
For example:. If your hospital is large and complex enough that you suspect variation in current practice across units, the Implementation Team may want to start by focusing on one or two units. As a preliminary step in documenting prevention practices on the units, the team will need to review the organizational context for the practices. Among the questions to consider:.
Institute of Healthcare Management
To change practice, it is critical to understand what the current practices are. The fact that fall prevention has taken on new urgency reflects one or more perceived performance problems in this area. Thus, it is important to identify any gaps between current best practices and actual work practices. For example, staff may report a policy of accompanying all patients with abnormal gait to the bathroom but may not always do this.