Teaching and learning teamwork: competency requirements for healthcare managers

This paper addresses an essential element of postgraduate health service management education - development of individual competencies to enhance teamwork among health service managers. A survey of qualified health service managers in the state of Victoria, Australia revealed a set of individual competencies that the managers felt made a positive contribution to the success of workplace teams. The identified competencies included skills in leadership and communication; clinical knowledge and knowledge of organizational goals and strategies; motives such as commitment to the organization, to quality, to working collaboratively and to a consumer focus; and respect for others as a trait. Building on acknowledged teaching and learning theories, a teamwork teaching and learning model was successfully introduced into the postgraduate health services management curriculum at La Trobe University in Melbourne.     

Competencies for public health finance: an initial assessment and recommendations.

The purpose of the study in this article was to identify The needs of public health managers with regard to public health finance. A survey of public health practitioners regarding competencies was conducted and a review of course offerings in finance among schools of public health was performed. Most public health practitioners surveyed believe that a broad array of management competencies are required to administer the finances of a public health facility or department. Respondents added 35 competencies to those initially given to them for review. Most added competencies that were more specific than the original competencies or could be viewed as subpoints of the original competencies. Many schools offered no courses specifically addressing public health care finance, with a few offering at most only one public health finance course. All schools offered at least one corporate finance course, and the majority offered two or more courses. We conclude with a number of recommendations for education and competency development, suggesting several next steps that can advance the field of public health's understanding of what managers need to master in public health finance to effectively function as public health managers.     

Identificación de las competencias actuales y futuras de los profesionales de la salud pública

Objectives

To identify current and future competencies (managers and technicians) for public health professionals in Catalonia (Spain).

Methods

Qualitative research with a phenomenological approach. Between November 2009 and February 2010, 31 semistructured interviews were completed with public health professionals working in Catalonia. We purposely used a theoretical sample to include the maximum multiplicity of discourses. We conducted a thematic content analysis.

Results

We obtained a wide range of current professional competencies, as well as those required for the future, classified according to professional profile. The participants highlighted transversal competencies, such as the importance of sharing a general theoretical framework of the discipline and the institution. Among the most frequently reported competencies were knowledge management, communication skills, teamwork, multidisciplinary and intersectoral orientation, legal knowledge, computer skills and languages, particularly English. It was also important for individual professionals to have specific skills in their areas of activity. In terms of differences between managers and technicians, the study showed that technicians prioritize management skills concerning human and material resources, while managers emphasize organizational and professional public health expertise.

Conclusions

There is a need for transversal and specific competencies in distinct areas. Public health is a multidisciplinary field, which collaborates with a wide range of professionals and organizations.     

Incorporating hard boxes and soft bubbles into the dietetics curriculum

Dietitians have been challenged to learn the skills of creative thinking in order to become proficient managers in a rapidly changing world. We reviewed the literature to determine the prerequisites of creative thinking and assessed the management and administrative dietetics curriculum for our dietetic internship to determine whether those prerequisites were being met. A major concern in the dietetics profession is that students are not being adequately prepared to assume top management positions. A review of business school curriculums reveals that an emphasis on management theory and quantitative analysis does not adequately prepare students to function effectively in a world where creative problem solving is required. Effective managers at high levels of responsibility rely on intuition and hunches in addition to logical thought processes. Two thinking models are employed by managers--a rational one (hard box) and an intuitive one (soft bubble). These thinking models, or cognitive styles, can also be defined as left and right brain skills. Effective managers use left and right brain skills plus a combination of the two, or integrative brain skill. We reviewed the competencies, behavioral objectives, and planned experiences for the management level rotations of our dietetic internship to develop a conceptual model for the use of right, left, or integrative thought processes. We discovered that although integrative brain skills are used at all levels of our management rotations, especially the top management rotation, no rotation exclusively fosters right-brain skill development. A dietetic internship offers a fertile environment for developing the creative problem-solving skills that are required in management positions in the health care profession today.(ABSTRACT TRUNCATED AT 250 WORDS)     

Roles, skills, and competencies of middle managers in occupational therapy

This article describes the most essential roles, skills, and competencies needed by middle managers in occupational therapy organizations. Middle-level managers are responsible for a specific segment of the organization. They are uniquely positioned to foster changes in the department. Because of the challenges in the health care environment, it is important to discuss the roles that middle managers need to bring out the viability and growth of their departments and organization. These roles include planner, strategic planner, coordinator, leader, problem solver, and negotiator. To conduct these roles, skills and competencies that are closely linked to the effective performance of those roles are also described. Skills include human relations, marketing, and conceptual skills. Competencies include being able to manage attention, meaning, trust, and self, as well as being competent when conducting utilization reviews, program evaluations, documentation of services for quality and reimbursement purposes, and fiscal management. With these outlined roles, skills, and competencies, middle managers should be able to promote the mission of their organizations, support their employees, and navigate successfully in the competitive and ever-changing health care environment.     

Identifying management competencies for health care executives: review of a series of Delphi studies

This analysis reviews a selected body of research that identifies the essential areas of management expertise required of future health care executives. To ensure consistency, six studies are analyzed, utilizing the Delphi technique, to query a broad spectrum of experts in different fields and sites of health care management. The analysis identifies a number of management competencies, i.e., managerial capabilities, which current and aspiring health care executives, in various settings and with differing educational backgrounds, should possess to enhance the probability of their success in current and future positions of responsibility. In addition, this review identifies the skills (technical expertise), knowledge (facts and principles) and abilities (physical, mental or legal power) required to support achievement of these competencies. Leadership and resource management, including cost and finance dimensions, are the highest-rated requisite management competencies. The dominant skills, knowledge and abilities (SKAs) are related to interpersonal skills. The lowest-rated SKAs are related to job-specific, technical skills. Recommendations include the review of this research by formal and continuing education programs to determine the content of their courses and areas for future research. Similarly, current health care executives should assess this research to assist in identifying competency gaps. Lastly, this analysis recommends that the Delphi technique, as a valid and replicable methodology, be applied toward the study of non-executive health care managers, e.g., students, clinicians, mid-level managers and integrated systems administrators, to determine their requisite management competencies and SKAs.     

Senior health managers in the new era: changing roles and competencies in the 1990s and early 21st century

Healthcare reforms and restructuring have been a global phenomenon since the early 1980s, driven by a number of factors such as increasing health expenditure and changing health needs, advancement of medical and information technology, and adoption of the new model of public health. More significant changes worldwide are the development of a new public management paradigm in the public sector. These changes were marked by the adoption of private sector management models and practices. It is widely believed that the healthcare reforms, the process of the reforms, and the instability brought about by the reforms may have not only resulted in the change of senior healthcare management practices, but also in the change of skills and competencies required for senior healthcare managers. In fact, a number of international, national, and local studies have examined the roles, skills, competencies and educational needs of health service managers since the 1980s. There are differences in findings from these studies in the 1980s, and 1990s, and early 2000s. This paper explores the above differences and their implications for further research and education development. The findings not only lead to the development of a number of questions for future research, but also indicate a new direction for healthcare managers in assisting them to acquire new skills and competencies in meeting the challenges in the new era.     

Why a graduate diploma specializing in the management of health projects in Cote d'Ivoire?

The achievement of the "health for all" objectives represents a particular challenge for developing countries where the morbidity rates and the number of deaths are increasing on an annual basis. In order the face this situation in C?te d'Ivoire, health action programmes were initiated on the one hand, and on the other, a type of decentralised responsibility was established for the coverage of the population's health at the health district level where these programmes are administered. However, serious insufficiencies were noted in the management of health projects as well as a lack of follow-up and evaluation by trained staff. Furthermore, it is imperative to have personnel qualified in managing health projects. In fact, this specialised training will allow for the attainment of knowledge and competencies necessary for the effective conception, development, planning, implementation and management of health action programmes at the national level as much as the district level. In addition, these health project specialists will be able to get involved at several levels in positions such as managers of national projects, technical advisors for national health directives, district managers, etc. Such training would contribute to the improvement of the population's health status and thus address the challenge of health for all.     

Better information for the board

Healthcare managers are making quicker, riskier decisions in an increasingly competitive and regulated environment. Questions have been raised regarding the accountability and performance of boards of these organizations, as board members are not always selected based on their competencies to guide such decisions. Adapting mission and strategy and monitoring organizational performance require information that boards get mostly from management. The purpose of this study was to examine the information that boards regularly get to carry out their functions. I obtained board documents from four not-for-profit hospitals and health systems in different boroughs of New York City. At each institution, I conducted one-hour interviews with at least three board members and three top managers. I also attended at least one board or executive committee meeting and one additional meeting, usually of the finance committee. Principal findings were that the boards get too much data, the same data that management gets, and little comparative data on performance of similar benchmarked organizations. Board members and managers are satisfied with the information that board members get and have no plans to improve their system of shaping, or the quality of, information. Key recommendations to boards and managers are: (1) boards must take greater responsibility for identifying the information that they get and how they wish to get it, (2) managers must ensure that measurable objectives are developed, against which organizational performance can be evaluated, (3) boards must get information that is targeted and shaped to better fit board functions, (4) managers must develop information sets for main service lines, (5) boards must get information on the expectations and satisfaction levels of key stakeholders, (6) boards must get better and more focused information on performance of benchmarked institutions, and (7) boards must get less hospital operating data on a monthly basis.     

The Joint Commission has provided a tool to change your work force: are you paying attention?

Most health care managers wonder how to change employee "attitudes" so that their staff will be more accountable for patient satisfaction, cost reduction, and quality of care. Employees were trained to function in an industry where the power players were the physician and the administrator and now it is exceedingly difficult to get them to switch their attention to the patient and the payer in a market-driven economy. For hospital managers, the answer may be right at their fingertips: The Joint Commission on Accreditation of Healthcare Organizations' standards demanding that employee competence be objectively measured, proven, tracked & trended, improved, and age specific. A comprehensive competence assessment system can save the health care manager enormous work in measuring fewer things, focusing performance assessment on the 20 percent of things that are true problems, and helping to specifically define certain competencies such as customer focus and cost consciousness so that coaching, training, and giving performance feedback is easier. Developing a comprehensive competence assessment system is a powerful tool to change the culture of organizations. Consequently, it is important that managers be aware of those possibilities before they embark on developing "competencies" or before their organizations get too carried away on redesigning systems to satisfy standards.     

Development of financial management competencies for entry-level and advanced-level dietitians.

The major purposes in this study were to develop a list of financial management competencies for entry- and advanced-level dietitians, determine hospital foodservice directors'/chief dietitians' (practitioners) perceived importance of these competencies at both levels of practice, and determine educators' perceived importance of these competencies at the entry level. Drawing from the literature and the judgment of eight experts, we developed a list of 50 financial management competencies. Written questionnaires that included importance scales for the competencies were mailed to (a) practitioners in a random sample of 1,500 member hospitals of the American Hospital Association and (b) directors of Plan IV/V, Approved Preprofessional Practice, and Dietetic Internship programs. Response rates were 34% for the practitioners and 47% for the educators. Practitioners rated 8 competencies as important or very important for entry-level dietitians and 26 as important or very important for advanced-level dietitians. Practitioners rated all competencies higher for advanced-level dietitians than for those at the entry level, and educators rated all competencies higher than did practitioners. Content areas, identified by factor analysis, were similar for both levels of practice. Our findings indicate that emphasis in undergraduate and practice programs should be given to the eight competencies identified by practitioners and educators as most important. Our results also may be used for development and evaluation of graduate and continuing education programs and for specialty certification in foodservice management.     

Consultant appraisals. With due respect

Consensus is needed on which management competencies should be included in doctors' appraisals. One trust employed management consultants to find out the views of senior doctors, managers, directors and patients. Common themes included concern for standards, effective use of information, openness, integrity and insight. The results will be used to guide future recruitment.     

Applying learning principles to the development of health services managers

An Australian health services management program which leads to an M.H.A. for experienced managers was designed with a strong basis in principles of adult learning and management development. The program emphasizes management competencies, self-managed learning methodologies, team learning, learning contract processes, work-based projects, and choice for participants to undertake learning activities most relevant to their evolving careers.     

Healthcare managers' roles,competencies, and outputs in organizational performance improvement

Healthcare CEOs recognize that managers are under increasing pressure to work smarter and more efficiently with fewer available resources. Jobs in the healthcare industry are in a constant state of change, requiring a workforce that is not only prepared to adjust quickly to the changing environment but to simultaneously maintain or improve overall organizational performance. Traditionally, trainers were viewed as the people with the primary responsibility for improving organizational performance. Today some CEOs believe healthcare managers should own that responsibility, and other CEOs believe the responsibility should be shared among healthcare managers and trainers. This shift in how accountability is viewed poses at least two important questions. Are managers aware of the various roles they need to enact to achieve successful organizational performance improvement? Do managers possess the competencies associated with those roles? The seven most contemporary trainer roles, now referred to as workplace learning and performance roles, are examined in this article to help managers increase their knowledge of the roles, competencies, and outputs expected of them. Based on findings of a study conducted to examine CEO's perceptions of managers' roles in the performance improvement process, this article provides theoretical backgrounds, includes verbatim study comments, and offers practical recommendations or tips for managers.     

Improving resource efficiency through management science

Optimal management of resources is a very complex and difficult task for healthcare systems. Nevertheless, healthcare providers can employ data-driven methodologies and management science tools, coupled with managerial insights, to significantly improve both their resource effectiveness and efficiency. Understanding the full technical complexities of management science models is a daunting task for healthcare managers, but they can be aided by the increased availability of management science software. Readily available software does not require extensive technical competencies and is easily adaptable to resource changes. This article reports how a large healthcare system improved the cost effectiveness and service efficiency of its laboratory courier service through the use of management science techniques and readily available software. The laboratory courier system existed to serve a large multihospital healthcare system located in a major Texas metropolis. The routing and scheduling solution reported in this article yielded a very substantial 16.4 percent reduction in annual laboratory courier costs and a significant improvement in service levels. This study indicates that management science techniques and software are readily adaptable to the healthcare environment and are amenable to use by healthcare administrators.     

The new health care paradigm: roles and competencies of leaders in the service line management approach

PURPOSE: The purpose of this paper is to discuss the need for the service line management approach in health care. Service line management is increasingly utilized by US health care organizations as an innovative method for providing the needed stimulus to increase viability and profitability for the ailing health care sector. DESIGN/METHODOLOGY/APPROACH: Using current literature, this study describes a paradigm shift from traditional health care management approaches to focus on the importance of a service line management approach with its specific emphasis on competencies of leaders. RESEARCH LIMITATIONS/IMPLICATIONS: Four essential competencies--conceptual, participation, interpersonal, and leadership--must be gained by leaders to bring about organizational growth. PRACTICAL IMPLICATIONS: Health care managers must understand and practice these four key competencies to become effective health care leaders. ORIGINALITY/VALUE: This paper provides useful information on the need for the service line management approach in health care.     

The Changing Nature of Management in Child Care Centres in Queensland: A Review of Directors' Perspectives

The aim of this paper is to produce an understanding of directors' work; perceptions of their role as managers in the centre; their experiences; and the nature of management within the context of the child care field in a complex social, legislative and economic climate. In the current context of the delivery of child care services in a market-driven climate, the language of business and organisational theory has entered the lexicon of the early childhood field. The findings indicate that the director of a child care centre needs to have knowledge, skills and experience in business management to enhance their competencies for management of centres in today's competitive environment.     

Identifying the core competencies for clinical supervision at a youth-focused social services agency

ABSTRACT

The purpose of this article is to present a framework outlining competencies required for effective clinical supervision within the context of community-based multidisciplinary service agencies. The clinical supervision competency framework was developed through a literature review and input from the supervisors and senior managers of a community-based youth-focused service agency. The framework includes nine domains of clinical supervision competencies. Within each domain, the competencies are further categorized into Values, Knowledge, and Skills. Practical implications of the clinical supervision competency framework for multi-disciplinary, community-based agencies are discussed.     

Competencies of foodservice directors/managers required in health care operations

The purpose of this research was to determine competencies of foodservice directors/managers as required by health care administrators and to ascertain the degree to which dietetic curriculums address those competencies. Validated questionnaires were mailed to a random sample of 376 health care administrators and 154 dietetic educators from various types of educational programs. Each questionnaire included 57 competencies representing the following areas: financial, technical, personnel management, nutrition services, production, and marketing. Health care administrators were asked to rate the degree of importance for each competency. Dietetic educators assessed the degree to which each competency was addressed in their curriculums. Of the 288 returned questionnaires, 243 contained usable data. Health care administrators' mean ratings were compared with dietetic educators' mean ratings. Significant differences were noted in 44 of the 57 competencies. Dietetic educators placed significantly greater emphasis on competencies related to nutrition services and significantly less on financial competencies than did health care administrators. Significant differences also were observed for selected competencies classified as technical and production. Results indicated that dietetic educators must continually evaluate curriculums and respond to the changing needs of the health care industry.