Competency identification and modeling in healthcare leadership

In line with the current interest in leadership development across many industries today, a number of competency-based educational programming initiatives have been launched in professional education. As well, the National Summit on the Future of Education and Practice in Health Management and Policy in 2001 called for the documentation of learning outcomes for continual educational improvement in health management and policy. The National Center for Healthcare Leadership (NCHL) subsequently launched a comprehensive, multi-stage process for identifying the competencies salient to distinguishing outstanding leadership performance in health management. This article describes the plan and the processes associated with NCHL's specification of a preliminary model of core competencies for leadership in health management, as well as the continued methods for refinement and validation of the model with both educators and practitioners in the field. The initial version of the NCHL Competency Model has facilitated field-wide dialogue regarding outcomes-based learning and assessment for both educational and professional development program planning. Subsequent development of the model will continue to stimulate open exchanges regarding pedagogical practice, as well as facilitate the design of leadership assessments for individuals, programs, organizations, and the field at large.     

四川省疾控系统视频会商系统的建设与现况

目的了解四川省21个市州疾控网络状态、远程会议音视频效果、视频会议室建设情况、网络管理现况等,为尽快完善国家及省级突发公共卫生事件应急反应机制建设,提供基础数据。结果使用国家为四川省省级及市州配备的设备,利用互联网公网建立网关到网关VPN链路,完成省级与市州的连接,结果绝大部分市州达到理想的远程会议音视频效果,其中流量一般为384K、延时在20～80ms之间、静态图像、声音完全满足视频会议的要求;大部分市州疾控机构建有专门视频会议室,但在疾控内部网络管理和规划上,普遍存在轻管理、无规划的现象,网络硬件设施的发展参差不齐,缺乏有实际网络管理经验的人才,这样极不利于单位对网络应用科学、规范、可持续的开发和利用。结论建议各级领导转变意识,加强设备的投入,注重对内部人才的培养,特别是对实际应用性网络管理人才的培养,促进全省疾控内部网络的全面发展,提高疾控机构应对突发公共卫生事件的处置效率。     

Overcoming historical and organizational legacies: AHIMA poises to lead

Considering leadership as both an individual and an aggregate characteristic, the article examines the leadership potential for members of the American Health Information Management Association (AHIMA) and for AHIMA as a professional organization within the field of health information management. AHIMA and its members are uniquely suited for leadership within this occupational field. The long association with paper records and a hospital maintenance function, however, plus the predominance of women within the field result in organizational features and political factors that could block leadership development.     

Building leadership and management competencies of national immunization teams in 16 Gavi-eligible countries through the EPI leadership and management programme

BackgroundStrengthening leadership and management competencies among national Expanded Programme on Immunization (EPI) teams will be critical to achieving global immunization targets and other sustainable developmental goals. However, there is little empirical evidence of the effectiveness of investments in leadership and management capacity in the context of national EPI programs. Therefore, we sought to evaluate the EPI Leadership and Management Programme (EPI LAMP), a nine-month certificate program for EPI teams in national Ministries of Health from Gavi priority countries in Anglophone and Francophone Africa and Asia.MethodsWe used a mixed-methods longitudinal evaluation to describe EPI LAMP at four levels: (1) participant response to the training experience based on program administration records and satisfaction surveys; (2) change in management and leadership skill based on competency surveys and exit interviews; (3) change in behavior in the workplace based on exit interviews; and (4) impact of the training on EPI program performance based on the results of each delegate’s leadership project.ResultsIn the first three cohorts, the programme engaged 16 countries (63 participants) and achieved an 86% graduation rate (54 alumni). Participants demonstrated significant improvement in management and leadership competencies across eight domains with the largest improvement observed in the domain of governance and leadership. Women showed greater increases than men, especially in the domains of Operations Management and Political Advocacy and Dialogue. We observed no difference in the gains made by French-speaking delegates compared to English-speaking participants. Breakthrough projects developed by each team improved EPI program performance, as measured by metrics specific to each project.DiscussionOur results show that team-based leadership programs can foster improvements in management practice, collaboration, and problem-solving, and that engagement the broader policy and organizational context is needed to foster the systems thinking capacity required to address complex challenges and improve system performance.     

Focus on case management: linking outcomes and accountability

The ability of case managers to rely on the traditional intuitive appreciation for the value of case management is declining. Case managers must accept the challenge of identifying, measuring, and reporting their outcomes, and clearly link outcomes with accountability. Practicing case managers must be as familiar with outcomes measurement and selecting relevant measures as their managers. The Case Management Society of America (CMSA) sponsored the development of the Council for Case Management Accountability (CCMA) to provide leadership in the development of outcomes. The work and mission of CCMA includes the creation of the "Spectrum of Accountability" and sponsoring three "State of the Science" papers addressing key case management outcomes areas.     

Time management and leadership styles: an empirical study of long-term health care administrators

Is there a relationship between the type of leadership style employed by long-term health care administrators and the effective use and management of time? This paper describes a 1989 study of 188 administrators of skilled nursing facilities and intermediate care facilities in Connecticut. Two self-rating instruments were employed: the Executive Time Management Inventory (Hartley, Kramer, et al.) and the LEAD-Self instrument (Hersey and Blanchard). Four hypotheses were tested at the .05 level of significance to examine relationships among time management, leadership style, size of facility, administrator experience, and cost factors. Statistical procedures included Pearson Product-Moment correlations, analysis of variance, t-tests, and partial correlations. Results of the study included (1) time management effectiveness increased as administrators gained more experience; (2) no significant relationship existed between type of leadership style and time management effectiveness; (3) women administrators perceived themselves as significantly more effective time managers than men did; (4) most health care administrators employed the same primary leadership style: "selling," which is defined as high relationship/high task; and (5) institutional size was not related to the time management effectiveness of the administrator. The findings have implications for pre-service and in-service training and for future studies in health administration education.     

自贡市医院感染管理现状

目的：了解自贡市医疗机构医院感染管理现状，为进一步抓好此项工作提供科学依据。方法：按卫生部《医院感染管理规范》内容和标准，对各级医疗机构医院感染管理进行调查。结果：各级医疗机构医院感染管理发展不平衡，市级医院好于区县级，区县级医院好于民营。重点科室，重点环节存在医院感染隐患。结论：领导重视，加大投入，建立有效的院感控制系统和持续长效的培训系统，减少医院感染的发生。     

Development of the Diabetes Indicators and Data Sources Internet Tool (DIDIT)

Developing a Web-based tool that involves the input, buy-in, and collaboration of multiple stakeholders and contractors is a complex process. Several elements facilitated the development of the Web-based Diabetes Indicators and Data Sources Internet Tool (DIDIT). The DIDIT is designed to enhance the ability of staff within the state-based Diabetes Prevention and Control Programs (DPCPs) and the Centers for Disease Control and Prevention (CDC) to perform diabetes surveillance. It contains information on 38 diabetes indicators (measures of health or factors associated with health) and 12 national- and state-level data sources. Developing the DIDIT required one contractor to conduct research on content for diabetes indicators and data sources and another contractor to develop the Web-based application to house and manage the information. During 3 years, a work group composed of representatives from the DPCPs and the Division of Diabetes Translation (DDT) at the CDC guided the development process by 1) gathering information on and communicating the needs of users and their vision for the DIDIT, 2) reviewing and approving content, and 3) providing input into the design and system functions. Strong leadership and vision of the project lead, clear communication and collaboration among all team members, and a commitment from the management of the DDT were essential elements in developing and implementing the DIDIT. Expertise in diabetes surveillance and software development, enthusiasm, and dedication were also instrumental in developing the DIDIT.     

A proposed adaptation of the EFQM fundamental concepts of excellence to health care based on the PATH framework.

OBJECTIVE: The use of the European Foundation for Quality Management (EFQM) Model in health care has found that this model is useful in promoting quality improvement, but its use in health care organizations is challenging because being a generic model, it does not cover the clinical aspects or the specifics of this field. For that reason, this article aims to bring the EFQM fundamental concepts of excellence closer to health care, using a specific model as a reference to this field: the Performance Assessment Tool for quality improvement in Hospitals (PATH) conceptual framework, developed by the WHO Regional Office for Europe. METHOD: A content analysis was performed to independently identify the contents that defined the elements of both frameworks. Then, using defined criteria, two independent researchers compared the contents of the elements of both frameworks. The elements from both frameworks that were equivalent were aggregated. Several experts discussed the aspects with discrepancies between the two comparisons. Finally, the EFQM framework is adapted to health care by adding to those aggregated elements the aspects that were exclusive from one of the models. RESULTS: The EFQM framework has many correspondences to a health care-specific framework. The EFQM-health care-adapted framework has eight quality dimensions, two of them (customer focus and safety) being overlapped with the other six (staff, results orientation, responsive governance, leadership and constancy of purpose, clinical effectiveness, and partnership development). This model also has two methodological dimensions (management by processes and facts and continuous learning; improvement and innovation). CONCLUSION: This adapted model seems useful for health care organizations, but it needs to be further used to corroborate this preliminary finding.     

Optimizing diabetes screening frequencies for at-risk groups

Health Care Management Science - There is strong evidence that diabetes is underdiagnosed in the US: the Centers for Disease Control and Prevention (CDC) estimates that approximately 25% of...     

Transforming towards sustainable health and wellbeing systems: Eight guiding principles based on the experiences of nine Dutch Population Health Management initiatives

IntroductionPopulation Health Management initiatives are increasingly introduced, aiming to develop towards sustainable health and wellbeing systems. Yet, little is known about which strategies to implement during this development. This study provides insights into which strategies are used, why, and when, based on the experiences of nine Dutch Population Health Management initiatives.MethodsThe realist evaluation approach was used to gain an understanding of the relationships between context, mechanisms and outcomes when Population Health Management strategies were implemented. Data were retrieved from three interview rounds (n = 207) in 2014, 2016 and 2017. Data was clustered into guiding principles, underpinned with strategy-context-mechanism-outcome configurations.ResultsThe Dutch initiatives experienced different developments, varying between immediate large-scale collaborations with eventual relapse, and incremental growth towards cross-sector collaboration. Eight guiding principles for development towards health and wellbeing systems were identified, focusing on: 1. Shared commitment for a Population Health Management-vision; 2. Mutual understanding and trust; 3. Accountability; 4. Aligning politics and policy; 5. Financial incentives; 6. A learning cycle based on a data-infrastructure; 7. Community input and involvement; and 8. Stakeholder representation and leadership.ConclusionDevelopment towards a sustainable health and wellbeing system is complex and time-consuming. Its success not only depends on the implementation of all eight guiding principles, but is also influenced by applying the right strategies at the right moment in the development.     

CDC's 60th anniversary: director's perspective--David Satcher, M.D., Ph.D., 1993-1998

One of the important legacies at CDC is continuity of leadership. Like runners in a relay race, each CDC leader passes the baton of leadership smoothly to the next without disrupting the important programs necessary to protect the health of the nation. This perspective provides reflections on three aspects of CDC during the mid-1990s: first, continuing momentum in several important programs; second, strengthening CDC's infrastructure in terms of resources, programs, and organization; and third, responding to the emerging epidemic of overweight and obesity and the need to encourage healthy lifestyle choices.     

Performance measurement for case management: principles and objectives for developing standard measures

Developing standardized performance measurements for case management (CM) has become the holy grail of the field. The Council for Case Management Accountability (CCMA), a leadership committee of the Case Management Society of America (CMSA), has been grappling with the concept since early 2003. This article lays out a theoretical framework for performance measurement and then outlines the progress on a specific initiative begun by CCMA to correlate CM practices with improved outcome measures.     

Academy of Nutrition and Dietetics: Revised 2021 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent,Proficient, and Expert) in Management of Food and Nutrition Systems

Management of food and nutrition systems (MFNS) encompasses the varied roles of registered dietitian nutritionists (RDNs) with administrative responsibilities for food and nutrition services within an organization. RDNs in MFNS are frequently employed in acute care, but also expand into a multitude of other settings in which management of nutrition and foodservice is required, for example, foodservice departments in assisted living and post-acute and long-term care; colleges and universities, kindergarten through grade 12 and pre-kindergarten schools and childcare; retail foodservice operations; correctional facilities; and companies that produce, distribute, and sell food products. RDNs in MFNS aim to create work environments that support high-quality customer-centered care and services, attract and retain talented staff, and foster an atmosphere of collaboration and innovation. The Management in Food and Nutrition Systems Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has revised the Standards of Professional Performance (SOPP) for RDNs in MFNS for 3 levels of practice: competent, proficient, and expert. The SOPP describes 6 domains that focus on professional performance: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Indicators outlined in the SOPP depict how these standards apply to practice. The standards and indicators for RDNs in MFNS are written with the leader in mind—to support an individual in a leadership role or who has leadership aspirations. The SOPP is intended to be used by RDNs for self-evaluation to assure competent professional practice.     

Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program

This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The series of six articles has been contributed by Management Sciences for Health (MSH) and will be published article-by-article over the next few weeks.     

Leveraging Geospatial Data,Technology, and Methods for Improving the Health of Communities: Priorities and Strategies from an Expert Panel Convened by the CDC

In 2008, CDC convened an expert panel to gather input on the use of geospatial science in surveillance, research and program activities focused on CDC’s Healthy Communities Goal. The panel suggested six priorities: spatially enable and strengthen public health surveillance infrastructure; develop metrics for geospatial categorization of community health and health inequity; evaluate the feasibility and validity of standard metrics of community health and health inequities; support and develop GIScience and geospatial analysis; provide geospatial capacity building, training and education; and, engage non-traditional partners. Following the meeting, the strategies and action items suggested by the expert panel were reviewed by a CDC subcommittee to determine priorities relative to ongoing CDC geospatial activities, recognizing that many activities may need to occur either in parallel, or occur multiple times across phases. Phase A of the action items centers on developing leadership support. Phase B focuses on developing internal and external capacity in both physical (e.g., software and hardware) and intellectual infrastructure. Phase C of the action items plan concerns the development and integration of geospatial methods. In summary, the panel members provided critical input to the development of CDC’s strategic thinking on integrating geospatial methods and research issues across program efforts in support of its Healthy Communities Goal.     

Teachers’ perceptions of the effect of selected leadership practices on pre-primary children’s learning in Hong Kong

ABSTRACT

This study attempts to identify the leadership practices in Hong Kong pre-primary schools, and to examine their impact on children's learning. A total of 287 key stakeholders, including principals, curriculum leaders and teachers, completed the questionnaires. The study adopted a structural equation model to examine the dimensions of leadership practices. The results of confirmatory factor analyses suggest that core leadership practices can be measured in accordance with the following four dimensions: setting directions for curriculum design and development; developing people in schools; building a collaborative and reflective culture; and improving teaching effectiveness. Multiple regression analysis reveals that the implementation of those leadership practices has a positive influence on children's whole-person development in terms of knowledge, skills, and attitudes. This evidence confirms the findings of previous studies that children's development and learning are enhanced through teacher leadership practices in schools.     

Management education at the Nordic School of Public Health

This article introduces the Program of Health Services Management at the Nordic School of Public Health in Gothenburg, Sweden, after its reorganization in 1987. The school is a joint effort of the governments of Denmark, Finland, Norway, Iceland, and Sweden. As background, some research on the effects of management training for physicians and on the significance of leadership is presented. This article focuses on the relationship between administration, management, and leadership. The program aims at a holistic approach. The appendix presents the main purposes and content of the program.     

Towards a common vocabulary for identifying management issues in health projects.

Management issues are one of the most important constraints in achieving social sector development objectives. The practice of labeling a variety of operational weaknesses as management problems hinders diagnostic power and, hence induces a low probability of removing or reducing management constraints. Moreover terms related to management are used differently. The set of terms presented here disaggregates the concept of management into nine discrete measurable management tasks: planning systems, beneficiary analysis, provision of goods and services, procurement and logistics of materials, financing and budgeting, organizational design, personnel, leadership, and control systems. The nine functional management areas are applied to three stages of a project cycle, viz. sector analysis/project identification, project design/project appraisal, and project implementation/project supervision. The set of terms proposed is seen as a first step towards developing a common vocabulary for identifying management issues in health projects.