Self-reported perceptions of Registered Nurses working in Australian hospitals Aim The purpose of... more Self-reported perceptions of Registered Nurses working in Australian hospitals Aim The purpose of this study is to develop an understanding of work environments by analysing the perceptions of a sample of Registered Nurses (RNs). Background Within the context of high staff turnover and a shortage of nurses in the health workforce, it is important that we understand how nurses perceive their work context and view the organisational factors that influence their attitudes towards their workplace. Methods Data was collected using a 160-question survey instrument seeking information from RNs in relation to work and perceptions of the work environment and the organisation. The sample was recruited from a convenience sample of three acute hospitals in Queensland, Australia. A response rate of 41% was achieved (n ¼ 343). Results Respondents across the three survey sites identified a number of variables that had particular impact on their working lives. Team interaction, providing good patient care, communication, and abuse towards RNs elicited strong responses by the study respondents. As well, organisational direction, strategy and management returned strong negative responses. In responding to the questions related to personal and organisational morale it was clear that respondents saw them as two distinct concepts. Conclusions The results of this study have implications for nurse managers in terms of understanding the nursing workforce as well as key organisational factors that have both positive and negative influences on the perceptions of nurses.
Aim: This study examines the performance of healthcare professionals in a variety of high-pressur... more Aim: This study examines the performance of healthcare professionals in a variety of high-pressure scenarios. Methodology: In order to gain a broad, detailed, practical understanding of 'pressure' and its impact on performance, a wide range of clinical scenarios were analysed using a Grounded Theory approach. A total of forty-five interviews were undertaken with key health professionals (medical doctors, nurses, paramedics) in a variety of locations including the Galapagos Islands, the Amazon Region, the Andean Highlands, and the Pacific Coast. Using participants as field observers, diverse scenarios were captured: emergency field work, natural disasters, emergency departments, large and small medical facilities, intensive care units and operating theatres. Results: The research took an 'emic' approach to understanding 'pressure', whereby participants identified scenarios that were important to them and how they experienced 'pressure' personally.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2021
This research aims to better understand performance under pressure as experienced by health and e... more This research aims to better understand performance under pressure as experienced by health and emergency staff in the workplace. Three basic questions underpin the work: (1) how do health and emergency workers experience and make sense of the ‘pressures’ entailed in their jobs? (2) What impacts do these pressures have on their working lives and work performance, both positively and negatively? (3) Can we develop a useful explanatory model for ‘working under pressure’ in complex, volatile and emergency situations? The present article addresses the first question regarding the nature of pressure; a subsequent article will address the question of its impact on performance. Using detailed interviews with workers in a range of roles and from diverse settings across Ecuador, our analysis aims to better understand the genesis of pressure, how people respond to it and to gain insights into managing it more effectively, especially with a view to reducing workplace errors and staff burnout. ...
Aim: This paper will discuss current approaches to performance reporting and whether there are re... more Aim: This paper will discuss current approaches to performance reporting and whether there are real benefits to healthcare organisations or whether it is a time consuming activity that adds little to improving quality healthcare and organisational performance. Most importantly, this paper will argue that performance reporting will not prevent another major healthcare scandal, such as that seen at Bundaberg Hospital or NHS Mid Staffordshire Trust. The paper will also outline learnings for Australia from other health systems where performance reporting is part of management practice. Approach: While performance reporting is largely designed to increase the efficiency and effectiveness of healthcare organisations, this paper will explore the approach from a practical managerial perspective. Context: This paper explores performance reporting across a range of Australian healthcare organisational settings to highlight differing approaches to improving performance. Main findings: Performa...
Health Management Work Integrated Learning is a 40 credit point penultimate course of experientia... more Health Management Work Integrated Learning is a 40 credit point penultimate course of experiential learning in the Master of Advanced Health Services Management M(Adv)HSM now offered by the School of Medicine Health at Griffith University. WIL was initiated in 2009 within the School of Public Health (Lilley et al (2009) based on a Teaching and Learning Grant to meet an existing experiential learning need identified for students studying in the enabling professional area of health management. After 15 semesters of delivery of these courses (completed at December 2016), it is timely to report on the quantitative attributes on the course to inform the post-graduate literature on this type of education. An objective of this review is to influence both curricula and student decision making regarding the future conduct and enhancement of tertiary preparation for health services management HSM employment. WIL has experienced a large increase in student enrolments in recent years suggesting...
Press, 2011 ISBN: 9780195574647; xvii+387 pages * Primary care services; * Specialised health ser... more Press, 2011 ISBN: 9780195574647; xvii+387 pages * Primary care services; * Specialised health services; and * Aged care and disability services.
RE viE w ARtiCLE Conclusions: This systematic literature review investigated the interrelationshi... more RE viE w ARtiCLE Conclusions: This systematic literature review investigated the interrelationship between communication and medication errors. In regards to patient safety, the research highlights that structured communication is effective in preventing medication errors. These errors can occur within the medication management cycle at any point of the drug distribution chain. This is due to the involvement of different health professionals, and different steps in the cycle from the correct prescription through to correct administration. Thus, to effectively prevent medication errors and reduce the rate of patient harm, structured communication (verbally and non-verbally) is highly recommended.
Using indigenous techniques to reduce the dependency on outside resources. Background: Andhra Pra... more Using indigenous techniques to reduce the dependency on outside resources. Background: Andhra Pradesh (AP) is a state that has suffered the most from the adverse effects of severe cyclones, floods, and drought. It is estimated that about 90% of AP's total territory are vulnerable to tropical storms, floods, and related hazards, while the coastal belt is even more vulnerable to natural disasters, and the state's population is compounded by the recurrent impact of disasters. Methods: Vulnerability Analysis, Situational Analysis, Participatory Vulnerability Capacities Assessment, Hazard Hunt Capacity building. Results: The project is a model to all the vulnerable communities; capacities of vulnerable communities are increased and confident of combating the disaster situations. Innovative elements and results: Horizontal trainings by trained taskforce members in other vulnerable villages are conducted on their own initiation. Cost Effectiveness: There is no need to purchase anything from outside to implement this initiative at vulnerable villages. Workshop with the Education Department officials: Workshops with the department and regular one-on-one meetings have been organized. Lessons Learned: Flexibility and patience in order to survive and grow the structures, admit to mistakes, and correct them. Conclusion: CHALLENGES: Initially, there was no response from the government as well as from the local communities. How to improve similar initiatives in the future? A similar intervention can be implemented in other villages overcoming the above mentioned challenges, involving the trained children and task force groups of this project. Replication: This intervention can be replicated in any part of the world, at a vulnerable village or school based on the type of disaster-but same methodology can be adopted for any type of disaster. This can be replicated to any context either for Tsunami or Cyclone prone, floods or flash floods, fire accident zone, or in a peacetime.
In a 2013 televised address the Chief of the Australian Army, Lt. Gen. David Morrison, said 'The ... more In a 2013 televised address the Chief of the Australian Army, Lt. Gen. David Morrison, said 'The standard you walk past is the standard you accept'. 1 While Morrison was talking about unacceptable behaviour in the Australian Army at the time, equally there are messages here for those who are involved in managing and leading health services. What is the standard of healthcare expected in Australia today? The alternative questions could be: What standards do we walk past in relation to patient safety and quality or compassionate care? or What standards do we walk past in terms of bridging the gap in Indigenous health disadvantage?, among others. If there is a commitment to improving health care in Australia, the system can be viewed in terms of examining five interconnected elements: patients (or clients), processes, people, priorities and partnerships. Focussing on these five elements provides a framework to understand critical health service components if there is a desire to make systems improvement.
To navigate the complexity of the industry and national and international factors it is not enoug... more To navigate the complexity of the industry and national and international factors it is not enough to just be a good manager or a good leader. Being successful, as a manager, leader or a health professional, requires a combination of both management and leadership skills and aptitudes. ‘Leading and Managing Health Services: An Australasian Perspective’ provides a critical and concise overview of the important skills, aptitudes and content areas required to successfully lead and manage in a wide range of health care settings no matter where you sit in in the organisational structure. This book provides insights into aspects of health care leadership and management applicable to Australasian health systems from highly experienced health care managers, leaders and academics.
This brief paper describes a recent exercise undertaken within a hospital and health service in s... more This brief paper describes a recent exercise undertaken within a hospital and health service in south-east Queensland to attempt to link patient records between general practice and hospital services. It describes the technical and governance processes undertaken to achieve this link and the challenges experienced to date in linking the two data sources.
FROM TIME TO TIME, the Australian Health Review will include multiple reviews regarding the same ... more FROM TIME TO TIME, the Australian Health Review will include multiple reviews regarding the same publication. This has been undertaken where the publication may be useful to different groups of readers and to provide readers of the AHR with different perspectives. To provide further information, a 5-star rating based on readability, useability and content has been included as part of the review. Happy reading!
THIS BOOK AIMS to be a comprehensive insight into community nursing in Australia. The text largel... more THIS BOOK AIMS to be a comprehensive insight into community nursing in Australia. The text largely achieves this claim and in doing so has provided one of the first texts of its type contextualised specifically at Australian community nursing issues. The book comprises 24 well organised and clear chapters around the three primary elements: the organisation of community nursing in Australia; the rapidly changing environment of community health delivery; and the specific practice elements of community nursing care. The chapters are well set out and include a focussed conclusion that really distils the essential elements. The text makes appropriate use of case studies, and scenarios add to the quality of the overall product. One area that could have been given more prominence would have been a specific chapter on issues concerning the community nursing care of Australia?s Indigenous population, as well as a chapter on community nursing approaches to stigmatised and marginalised groups....
THIS IS THE THIRD edition of one of the seminal local texts on the Australian health care system.... more THIS IS THE THIRD edition of one of the seminal local texts on the Australian health care system. Over the last seven years, this text has proved a basis for helping students, casual readers and health professionals understand Australia?s sometimes difficult to understand health care system. The text is divided into ten chapters that deal with key aspects of Australia?s health care system, namely: � Frameworks for analysis � The Australian population and its health � Financing health care � The health workforce � Departmental and intergovernmental structures � Hospitals � Public health � Primary and community care � Pharmaceuticals � Policy challenges for the Australian health care system. There are several key reasons why this text has been widely used in the past and will continue to be of value well into the future. The author has been able to accurately describe the complexities of the Australian health care system in an easily digestible way. This is a feat in itself and worthy...
There is increasing attention to nursing workforce issues such as recruitment, retention, turnove... more There is increasing attention to nursing workforce issues such as recruitment, retention, turnover, workplace health and safety issues and their impact on quality patient care. A number of these problems have been linked to poor morale. While there has been a lack of consensus on the determinants of morale, it is clear that the outcomes of poor morale not only add considerable cost to the organisation but also impact negatively on patient care. This article provides a systematic overview of the literature surrounding nursing morale and the variables identified in the literature that impact upon morale, and discusses the implications for future research.
Self-reported perceptions of Registered Nurses working in Australian hospitals Aim The purpose of... more Self-reported perceptions of Registered Nurses working in Australian hospitals Aim The purpose of this study is to develop an understanding of work environments by analysing the perceptions of a sample of Registered Nurses (RNs). Background Within the context of high staff turnover and a shortage of nurses in the health workforce, it is important that we understand how nurses perceive their work context and view the organisational factors that influence their attitudes towards their workplace. Methods Data was collected using a 160-question survey instrument seeking information from RNs in relation to work and perceptions of the work environment and the organisation. The sample was recruited from a convenience sample of three acute hospitals in Queensland, Australia. A response rate of 41% was achieved (n ¼ 343). Results Respondents across the three survey sites identified a number of variables that had particular impact on their working lives. Team interaction, providing good patient care, communication, and abuse towards RNs elicited strong responses by the study respondents. As well, organisational direction, strategy and management returned strong negative responses. In responding to the questions related to personal and organisational morale it was clear that respondents saw them as two distinct concepts. Conclusions The results of this study have implications for nurse managers in terms of understanding the nursing workforce as well as key organisational factors that have both positive and negative influences on the perceptions of nurses.
Aim: This study examines the performance of healthcare professionals in a variety of high-pressur... more Aim: This study examines the performance of healthcare professionals in a variety of high-pressure scenarios. Methodology: In order to gain a broad, detailed, practical understanding of 'pressure' and its impact on performance, a wide range of clinical scenarios were analysed using a Grounded Theory approach. A total of forty-five interviews were undertaken with key health professionals (medical doctors, nurses, paramedics) in a variety of locations including the Galapagos Islands, the Amazon Region, the Andean Highlands, and the Pacific Coast. Using participants as field observers, diverse scenarios were captured: emergency field work, natural disasters, emergency departments, large and small medical facilities, intensive care units and operating theatres. Results: The research took an 'emic' approach to understanding 'pressure', whereby participants identified scenarios that were important to them and how they experienced 'pressure' personally.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2021
This research aims to better understand performance under pressure as experienced by health and e... more This research aims to better understand performance under pressure as experienced by health and emergency staff in the workplace. Three basic questions underpin the work: (1) how do health and emergency workers experience and make sense of the ‘pressures’ entailed in their jobs? (2) What impacts do these pressures have on their working lives and work performance, both positively and negatively? (3) Can we develop a useful explanatory model for ‘working under pressure’ in complex, volatile and emergency situations? The present article addresses the first question regarding the nature of pressure; a subsequent article will address the question of its impact on performance. Using detailed interviews with workers in a range of roles and from diverse settings across Ecuador, our analysis aims to better understand the genesis of pressure, how people respond to it and to gain insights into managing it more effectively, especially with a view to reducing workplace errors and staff burnout. ...
Aim: This paper will discuss current approaches to performance reporting and whether there are re... more Aim: This paper will discuss current approaches to performance reporting and whether there are real benefits to healthcare organisations or whether it is a time consuming activity that adds little to improving quality healthcare and organisational performance. Most importantly, this paper will argue that performance reporting will not prevent another major healthcare scandal, such as that seen at Bundaberg Hospital or NHS Mid Staffordshire Trust. The paper will also outline learnings for Australia from other health systems where performance reporting is part of management practice. Approach: While performance reporting is largely designed to increase the efficiency and effectiveness of healthcare organisations, this paper will explore the approach from a practical managerial perspective. Context: This paper explores performance reporting across a range of Australian healthcare organisational settings to highlight differing approaches to improving performance. Main findings: Performa...
Health Management Work Integrated Learning is a 40 credit point penultimate course of experientia... more Health Management Work Integrated Learning is a 40 credit point penultimate course of experiential learning in the Master of Advanced Health Services Management M(Adv)HSM now offered by the School of Medicine Health at Griffith University. WIL was initiated in 2009 within the School of Public Health (Lilley et al (2009) based on a Teaching and Learning Grant to meet an existing experiential learning need identified for students studying in the enabling professional area of health management. After 15 semesters of delivery of these courses (completed at December 2016), it is timely to report on the quantitative attributes on the course to inform the post-graduate literature on this type of education. An objective of this review is to influence both curricula and student decision making regarding the future conduct and enhancement of tertiary preparation for health services management HSM employment. WIL has experienced a large increase in student enrolments in recent years suggesting...
Press, 2011 ISBN: 9780195574647; xvii+387 pages * Primary care services; * Specialised health ser... more Press, 2011 ISBN: 9780195574647; xvii+387 pages * Primary care services; * Specialised health services; and * Aged care and disability services.
RE viE w ARtiCLE Conclusions: This systematic literature review investigated the interrelationshi... more RE viE w ARtiCLE Conclusions: This systematic literature review investigated the interrelationship between communication and medication errors. In regards to patient safety, the research highlights that structured communication is effective in preventing medication errors. These errors can occur within the medication management cycle at any point of the drug distribution chain. This is due to the involvement of different health professionals, and different steps in the cycle from the correct prescription through to correct administration. Thus, to effectively prevent medication errors and reduce the rate of patient harm, structured communication (verbally and non-verbally) is highly recommended.
Using indigenous techniques to reduce the dependency on outside resources. Background: Andhra Pra... more Using indigenous techniques to reduce the dependency on outside resources. Background: Andhra Pradesh (AP) is a state that has suffered the most from the adverse effects of severe cyclones, floods, and drought. It is estimated that about 90% of AP's total territory are vulnerable to tropical storms, floods, and related hazards, while the coastal belt is even more vulnerable to natural disasters, and the state's population is compounded by the recurrent impact of disasters. Methods: Vulnerability Analysis, Situational Analysis, Participatory Vulnerability Capacities Assessment, Hazard Hunt Capacity building. Results: The project is a model to all the vulnerable communities; capacities of vulnerable communities are increased and confident of combating the disaster situations. Innovative elements and results: Horizontal trainings by trained taskforce members in other vulnerable villages are conducted on their own initiation. Cost Effectiveness: There is no need to purchase anything from outside to implement this initiative at vulnerable villages. Workshop with the Education Department officials: Workshops with the department and regular one-on-one meetings have been organized. Lessons Learned: Flexibility and patience in order to survive and grow the structures, admit to mistakes, and correct them. Conclusion: CHALLENGES: Initially, there was no response from the government as well as from the local communities. How to improve similar initiatives in the future? A similar intervention can be implemented in other villages overcoming the above mentioned challenges, involving the trained children and task force groups of this project. Replication: This intervention can be replicated in any part of the world, at a vulnerable village or school based on the type of disaster-but same methodology can be adopted for any type of disaster. This can be replicated to any context either for Tsunami or Cyclone prone, floods or flash floods, fire accident zone, or in a peacetime.
In a 2013 televised address the Chief of the Australian Army, Lt. Gen. David Morrison, said 'The ... more In a 2013 televised address the Chief of the Australian Army, Lt. Gen. David Morrison, said 'The standard you walk past is the standard you accept'. 1 While Morrison was talking about unacceptable behaviour in the Australian Army at the time, equally there are messages here for those who are involved in managing and leading health services. What is the standard of healthcare expected in Australia today? The alternative questions could be: What standards do we walk past in relation to patient safety and quality or compassionate care? or What standards do we walk past in terms of bridging the gap in Indigenous health disadvantage?, among others. If there is a commitment to improving health care in Australia, the system can be viewed in terms of examining five interconnected elements: patients (or clients), processes, people, priorities and partnerships. Focussing on these five elements provides a framework to understand critical health service components if there is a desire to make systems improvement.
To navigate the complexity of the industry and national and international factors it is not enoug... more To navigate the complexity of the industry and national and international factors it is not enough to just be a good manager or a good leader. Being successful, as a manager, leader or a health professional, requires a combination of both management and leadership skills and aptitudes. ‘Leading and Managing Health Services: An Australasian Perspective’ provides a critical and concise overview of the important skills, aptitudes and content areas required to successfully lead and manage in a wide range of health care settings no matter where you sit in in the organisational structure. This book provides insights into aspects of health care leadership and management applicable to Australasian health systems from highly experienced health care managers, leaders and academics.
This brief paper describes a recent exercise undertaken within a hospital and health service in s... more This brief paper describes a recent exercise undertaken within a hospital and health service in south-east Queensland to attempt to link patient records between general practice and hospital services. It describes the technical and governance processes undertaken to achieve this link and the challenges experienced to date in linking the two data sources.
FROM TIME TO TIME, the Australian Health Review will include multiple reviews regarding the same ... more FROM TIME TO TIME, the Australian Health Review will include multiple reviews regarding the same publication. This has been undertaken where the publication may be useful to different groups of readers and to provide readers of the AHR with different perspectives. To provide further information, a 5-star rating based on readability, useability and content has been included as part of the review. Happy reading!
THIS BOOK AIMS to be a comprehensive insight into community nursing in Australia. The text largel... more THIS BOOK AIMS to be a comprehensive insight into community nursing in Australia. The text largely achieves this claim and in doing so has provided one of the first texts of its type contextualised specifically at Australian community nursing issues. The book comprises 24 well organised and clear chapters around the three primary elements: the organisation of community nursing in Australia; the rapidly changing environment of community health delivery; and the specific practice elements of community nursing care. The chapters are well set out and include a focussed conclusion that really distils the essential elements. The text makes appropriate use of case studies, and scenarios add to the quality of the overall product. One area that could have been given more prominence would have been a specific chapter on issues concerning the community nursing care of Australia?s Indigenous population, as well as a chapter on community nursing approaches to stigmatised and marginalised groups....
THIS IS THE THIRD edition of one of the seminal local texts on the Australian health care system.... more THIS IS THE THIRD edition of one of the seminal local texts on the Australian health care system. Over the last seven years, this text has proved a basis for helping students, casual readers and health professionals understand Australia?s sometimes difficult to understand health care system. The text is divided into ten chapters that deal with key aspects of Australia?s health care system, namely: � Frameworks for analysis � The Australian population and its health � Financing health care � The health workforce � Departmental and intergovernmental structures � Hospitals � Public health � Primary and community care � Pharmaceuticals � Policy challenges for the Australian health care system. There are several key reasons why this text has been widely used in the past and will continue to be of value well into the future. The author has been able to accurately describe the complexities of the Australian health care system in an easily digestible way. This is a feat in itself and worthy...
There is increasing attention to nursing workforce issues such as recruitment, retention, turnove... more There is increasing attention to nursing workforce issues such as recruitment, retention, turnover, workplace health and safety issues and their impact on quality patient care. A number of these problems have been linked to poor morale. While there has been a lack of consensus on the determinants of morale, it is clear that the outcomes of poor morale not only add considerable cost to the organisation but also impact negatively on patient care. This article provides a systematic overview of the literature surrounding nursing morale and the variables identified in the literature that impact upon morale, and discusses the implications for future research.
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