Practical Solutions for Healthcare Management and Policy (Collection)
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They should be capable of advising on:. Accident and ill health data are important, as they are a direct indicator of safety and health performance. However, some cautions relating to their use are:. Healthy, Safe and Productive Lives. Managing Safety and Health in Schools. Teacher Support and Classroom Resources.
Safety and Health Initiatives in Education. Health and Safety Courses Online. Taking Care of Business. Workplace Transport Safety Load Securing. Accidents and Behaviour Bullying at Work. Strategy in Workplace Health Workplace Stress. What issues should a review of the safety and health management system cover? A safety statement should have a safety and health policy incorporated into it. Can I get an example of a safety and health policy anywhere? How can an organisation control safety and health aspects of contractors work? Should the management of safety and health be audited in addition to monitoring performance?
What should be contained in system audit protocols and procedures? How does the employer train staff to ensure they have the skills, knowledge and attitudes to make them competent in the safety and health aspects of their work? What is the role of the safety and health advisor What information should be covered in accident and incident reports What is a Safety and Health Management System?
A safety and health management system means the part of the Organisation's management system which covers: The key elements of a successful safety and health management system are: Policy and commitment The workplace should prepare an occupational safety and health policy programme as part of the preparation of the Safety Statement required by Section 20 of the Safety, Health and Welfare at Work Act Planning The workplace should formulate a plan to fulfil its safety and health policy as set out in the Safety Statement.
Implementation and operation For effective implementation, organisations should develop the capabilities and support mechanisms necessary to achieve the safety and health policy, objectives and targets. These arrangements should be: Measuring performance The organisation should measure, monitor and evaluate safety and health performance.
The objectives of active and reactive monitoring are: Auditing and reviewing performance The organisation should review and improve its safety and health management system continuously, so that its overall safety and health performance improves constantly. Performance should be assessed by: The initial review should compare existing safety and health practice with: Is the Safety Statement available at the workplace to which it relates and are workers given relevant extracts where they are at specific risk?
Is the overall safety and health policy of the organisation and the internal structure for implementing it adequate, e. Does the Safety Statement contain a systematic identification of hazards and an assessment of risks for the workplace s it covers? Are Risk Assessments being carried out on a regular basis as risks change and are the necessary improvements made to keep the safety and health management system up to date?
Are the necessary safety control measures required for a safe workplace identified and implemented, e. Are written safe procedures for those operations that require them available, e. Are procedures available for monitoring the implementation of safety systems and control measures, e. Is safety and health training being carried out and does the training give adequate information to workers on risks they might be exposed to? Is the impact of this training and the level of understanding of the information assessed by anyone? Do safety consultation, employee participation and representation procedures exist and are these procedures effective, e.
Is there a safety committee in existence and if so does it comply with the Act requirements? Are safety committee meetings constructive with meeting reports and follow-up action lists? Is the safety representative or representatives involved at every stage of the safety consultation process? The safety and health policy must: Organisations achieving high standards of safety and health develop policies that recognise the: Critical safety and health issues, which should be addressed and allocated resources, in the safety and health policy, include the: These people need to ensure that all their decisions reflect their safety and health intentions, as articulated in the Safety Statement, which should cover: For example such changes could introduce: Senior managers responsibilities include: Such arrangements should cover the: Emergency planning should cover: The emergency plan itself should include: The following are some key questions for employers to assist in determining the adequacy of their safety and health management in the organisation: Does your executive board of directors or senior management team ensure all their decisions reflect the safety and health intentions in your Safety Statement?
Does your executive board of directors or senior management team recognise the need to involve all staff in issues that affect their safety and health? Do your directors and senior managers provide daily safety and health leadership in the organisation? Do you have an agreed safety and health policy? Is it written into your Safety Statement? Have you allocated responsibilities for safety and health to specific people - are they clear on what they have to do and are they held accountable?
Is safety and health always considered before any new work is started or work equipment is bought? Did you consult and involve your staff and your safety representatives effectively? Have you identified the hazards and assessed the risks to your own staff, to others and to the public in the workplaces you control? Do you set standards for the premises, plant, substances, procedures and people you control or the products you produce?
Health Management | RSU
Are these standards in place and the risks effectively controlled? Do you have an emergency plan to deal with serious or imminent danger, e. Does your staff have sufficient information about the risks they are exposed to and the preventive measures they must take? Do you have the right levels of safety and health expertise? Are your employees properly trained and do they attend the training provided by you?
Do you need specialist safety and health advice from outside and if so have you arranged to obtain it? Does all your staff accept their responsibilities under safety and health law? Two types of monitoring are required: Active Systems , that monitor the design, development, installation and operation of management arrangements, safety systems and workplace precautions.
Reactive Systems , that monitor accidents, ill health, incidents and other evidence of deficient safety and health performance. Active monitoring Every organisation should collect information to investigate the causes of substandard performance or conditions adequately. The monitoring system should include: Techniques that should be used for active measurement of the safety and health management system include: Reactive monitoring A system of internal reporting of all accidents which includes ill health cases and incidents of non-compliance with the safety and health management system should be set up so that the experience gained may be used to improve the management system.
Those responsible for investigating accidents, and incidents should be identified and the investigation should include plans for corrective action, which incorporate measures for: The protocols and procedures for the audit on the health and safety management system should include the following: The key questions that an employer should ask when measuring, reviewing and auditing their safety and health performance are: Do you know how well you perform in safety and health?
Are your executive board, your directors and senior management team kept informed of your safety and health performance and do you report on this performance in your annual report? How do you know if you are meeting your own objectives and standards for safety and health? Are your controls for risks good enough? How do you know you are complying with the safety and health laws that affect your business?
Do your accident or incident investigations get to all the underlying causes - or do they stop when you find the first person that has made a mistake? Do you have accurate records of injuries, ill health, bullying complaints and accidental loss? Do you report on safety and health failures to your board and your directors? How do you learn from your mistakes and your successes?
Do you carry out safety and health audits at least annually?
If you do, what action do you take on audit findings? Do the audits involve staff at all levels? Do you involve your safety representative and safety committee, where it exists, in the audits? When did you last review your Safety Statement and your safety and health performance?
Does your executive board of Directors or senior management team review your safety and health performance and ensure safety and health risk management systems are in place and remain effective? Has your executive board and your Directors or senior management team appointed someone at Director level to ensure safety and health risk management issues are properly addressed and is this person competent to do so? Training needs may be organisational, job-related and individual: Training needs vary over time, and assessments should cover: Organisations should ensure they have access to sufficient safety and health knowledge, skills or experience to identify and manage safety and health risks effectively, and to set appropriate objectives by: They should be capable of advising on: To do this properly, safety and health advisers should: Key information to be covered in accident, ill-health and incident reports include: Details of any injured person, including age, sex, experience, training, etc.
A description of the circumstances, including the place, time of day and conditions. Details of the event, including: Was it dealt with promptly? Were continuing risks dealt with promptly and adequately? Was the first-aid response adequate? Were emergency procedures followed? What was the worst that could have happened? What prevented the worst from happening? How many people could the event have affected the ' Population Potential'? Prioritised actions with responsibilities and targets for completion Whether the risk assessments need to be reviewed and the safety statement updated.
Learning from and communicating results from investigations: The organisation, having learnt from its investigations, should: Cautions in using accident and ill health data: However, some cautions relating to their use are: Levels of reporting can change. They can improve as a result of increased workforce awareness and better reporting and recording systems. Moreover, many occupational diseases have long latent periods.
Management should not wait for harm to occur before judging whether safety and health management systems are working. Enter your email address in the box below to receive an email each time we post a new issue of our newsletter: Enter your email address in the box below to receive an email each time we post a new issue of our newsletter:.
How can the conundrum noted above be explained? How can a rhetorical commitment to evidence-informed policy proceed in tandem with a complete disregard for unwelcome evidence and a highly selective approach to evidence which purports to support a particular policy? Why do market mechanisms and neoliberal thinking persist in dominating the policy debate even when their solutions are known to fail 8?
Although Chinitz and Rodwin do not explicitly mention it, of all the social sciences, political science perhaps has the most to offer both in understanding the increasingly complex world of health systems and in accounting for the failure of policy-makers to reform their health systems effectively and in ways which draw on the evidence.
Senior healthcare managers must share the responsibility for this state of affairs. A factor accounting for their refusal to do so has been their growing politicisation They have been the chief beneficiaries of market reforms and have gained most, both materially and in terms of additional power. In this respect, managers are different from other healthcare professions whose values and expertise flow from a mix of evidence-based training and their craft as professionals. Little wonder that the challenges involved in improving health and healthcare remain unresolved and intractable problems.
The political nature of the policy process is therefore central to any understanding of a complex system characterised by various vested interests exerting power to maintain their perks and privileges. Largely ignored and unappreciated, political science has much to offer those seeking a deeper understanding of current health systems, how they operate, and what needs to occur if they are to undergo effective and sustainable change.
Political science is concerned with professional values, organisational cultures and with why things happen, or not, and for what reasons. Health is inescapably political. The theories and insights offered by political science 12 are well suited to providing a deeper understanding of the context of policy-making. It is all too easy to oversimplify complexity by ignoring or understating the interplay between politics and power.
- La calma insicurezza: La percezione sociale del rischio di criminalità a Roma a cura di Fulvio Beato (Città e sicurezza) (Italian Edition).
- Healthcare Policy, Innovation and Management | Maastricht University.
- Safety and Health Managment - Health and Safety Authority?
- La genèse de lidée de temps (Les introuvables) (French Edition)?
Many frameworks can be enlisted to understand the politics of health systems but two are briefly reviewed here for their particular relevance. Made up of three groups of structural interests — dominant professional interests, challenging corporate and managerial interests, and the repressed community interests — Alford shows how the shifting relationship between the three groups lie at the heart of the changing shape and fortunes of health systems In recent decades, the rise of the challenging managerial interests have been a key feature of health systems and accounts for much of the malaise in the field of health policy and management to which Chinitz and Rodwin draw attention.
But Alford goes further and characterises health system reformers as falling into one of two camps: The history of health systems is one marked by a constant oscillation between these reform models with the dominance of microeconomic thinking and market mechanisms, which Chinitz and Rodwin note, being especially pervasive since the s.
If politics is about power and who gets what when and how, then the Advocacy Coalition Framework ACF is useful to explain changes in public, including health, policy Policies are the product of the belief systems of those actors present in a policy subsystem and they include not only politicians but civil servants, interest group representatives, academics and the media. Policies then emerge from the negotiations between different coalitions of actors. The value of the ACF lies in its ability to offer an explanation of why inducing significant change in policies is so difficult in the face of deeply held core beliefs which are hard to shift but also why external events, and changes therein, provide opportunities to shift the power balance between actors and offer a chance of achieving significant change.
If the dominance of microeconomic theory is to be challenged, as advocated by Chinitz and Rodwin, the ACF sets out what has to happen to assemble a coalition of interests of the willing to achieve such a goal. It is also a testament to how difficult it is in practice to put such a coalition in place. Despite the vast outpouring of books and academic papers on the subject, what we understand by and want from leadership in complex settings has, if anything, become fuzzier and less enlightened.
Leadership is not about generic competencies which simply require aspiring leaders to tick the boxes. In complex settings, leadership is contextual and is about understanding, influencing and shaping organisational politics to achieve sustainable solutions to wicked problems. The challenges of change and transformation cannot be driven from the top via a directive or mandate. Successful leadership in one situation or setting may not occur or survive in a different context - one size does not fit all.
The health challenge requires an end to silo-thinking and the shoring up of potentially failing organisations at the cost of inappropriate patient care. Leaders should be recruited with knowledge and understanding of complex systems and whole system approaches to transformational change.
Frequently Asked Questions
They must be able to work with, and through, others to influence and bring about intra- and inter-organisational change and do so utilising a range of leadership forms and styles, including adaptive, engaged and collaborative leadership. Leadership trends follow societal changes. The economic downturn, coupled with big failures in the banking and business sectors, means that the age of the individual organisational leader working in isolation has gone.
Consequently, leaders are required who do not assume they know it all and have all the answers but who are able to ask questions and draw on a range of knowledge and skills to address problems for which there are no simple or easy answers. Above all, leaders should be working to ensure that trust and not suspicion exists between health system professionals and managers, and between the workforce and government. Only then is there a likelihood of transformational change taking root across a whole system rather than in isolated pockets.
Given the centrality of the political nature of the policy process and the importance of leadership in bringing about sustainable change, being able to practice political astuteness is an essential skill future leaders will require. The successful leader appreciates that they act within a social and political context These political forces operate both locally and nationally. All that has been said above about the leadership challenge in complex systems, like health, points to the need for political awareness at various levels but especially when it comes to challenging policy failures and advocating a different approach Health systems have never been more complex or politically driven.
Through a political science lens, it is possible both to illuminate and explain not only what has gone wrong in health systems in recent years and why but also to chart a different way forward identifying the factors and obstacles which need to be navigated if the default option of path dependency is to be avoided. It is no longer sufficient to produce leaders of healthcare services — we need leaders and leadership which can add value to health through adopting a whole systems approach which embraces the upstream factors impacting on health as well as those contributing to illness and disease.
But it is also beholden on those leaders to demonstrate political astuteness and acquire coalition-building skills if they are to succeed in their ambition to transform health systems. Seeking to reduce these complex requirements to a set of simple precepts to be resolved by a range of competencies is both simplistic and seriously misses the point about what is required of, and from, leadership for health in the 21st century.
Health Policy and Management: Int J Health Policy Manag ; 4: National Center for Biotechnology Information , U. Int J Health Policy Manag. Published online Mar