RESUMEN
PURPOSE: Women continue to be disproportionately represented in top leadership positions. Leadership development programs typically focus on skills attainment. The purpose of this paper is to explore the perceptions and experiences of academic leaders in order to inform how leadership development programs may more effectively address the gender gap in leadership. DESIGN/METHODOLOGY/APPROACH: A sequential mixed methods study design was used. Participants completed the Leadership Practice Inventory ®(LPI) survey followed by individual interviews of a subset of participants. The survey results were analyzed and compared by gender using the t-test. Thematic analysis was used to compare themes across and between genders. Quantitative and qualitative findings were integrated in the final analysis. FINDINGS: In total, 65 leaders (38 women; 27 men) (37.7 percent response rate) participated in the survey. There were no significant demographic or statistical differences between women and men on any of the LPI® components. Five women and five men were interviewed. Thematic analysis revealed common leadership aspirations and values. Gender differences were noted in leadership attainment, mentorship and the influence of gender on leadership. While the male narratives reflected cognitive awareness of gender inequities, the female narratives also included lived experiences. Male participants focused on the importance of meritocracy whereas the female participants emphasized the gendered social and structural influences on leadership attainment. PRACTICAL IMPLICATIONS: Leadership development programs need go beyond generic "skills-building" in order to conceptualize leadership within a gendered social context. This framework will enable critical awareness and tools for developing both women and men's fullest leadership potential. ORIGINALITY/VALUE: This study was conducted in order to better understand how academic health leaders experience the intersection of gender and leadership. The findings contribute to the current literature by providing insight into perceptual gaps that exist at the level of practice between women and men leaders. In doing so, the authors discuss how leadership development programs may play a more effective role in addressing gender equity in leadership.
Asunto(s)
Liderazgo , Sexismo , Universidades , Adulto , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Encuestas y Cuestionarios , Mujeres TrabajadorasRESUMEN
AIM: To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. BACKGROUND: Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. DESIGN: Concept analysis. DATA SOURCES: Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. METHODS: Rodgers' evolutionary method for concept analysis. RESULTS: The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. CONCLUSION: Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed.
Asunto(s)
Actitud del Personal de Salud , Enfermedad Crónica/terapia , Manejo de la Enfermedad , Personal de Salud/psicología , Vida Independiente/normas , Relaciones Interprofesionales , Guías de Práctica Clínica como Asunto , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
It is acknowledged internationally that chronic disease management (CDM) for community-living older adults (CLOA) is an increasingly complex process. CDM for older adults, who are often living with multiple chronic conditions, requires coordination of various health and social services. Coordination is enabled through interprofessional collaboration (IPC) among individual providers, community organizations, and health sectors. Measuring IPC is complicated given there are multiple conceptualisations and measures of IPC. A literature review of several healthcare, psychological, and social science electronic databases was conducted to locate instruments that measure IPC at the team level and have published evidence of their reliability and validity. Five instruments met the criteria and were critically reviewed to determine their strengths and limitations as they relate to CDM for CLOA. A comparison of the characteristics, psychometric properties, and overall concordance of each instrument with salient attributes of IPC found the Collaborative Practice Assessment Tool to be the most appropriate instrument for measuring IPC for CDM in CLOA.
Asunto(s)
Enfermedad Crónica/terapia , Conducta Cooperativa , Manejo de la Enfermedad , Relaciones Interprofesionales , Encuestas y Cuestionarios/normas , Actitud del Personal de Salud , Comunicación , Toma de Decisiones , Humanos , Grupo de Atención al Paciente , Psicometría , Reproducibilidad de los ResultadosRESUMEN
AIM: To examine health-care leaders' initial response to the implementation of orthopaedic quality based procedures (QBPs) in hospitals across Ontario, Canada. BACKGROUND: In 2012, Ontario, Canada shifted 91 hospitals to a patient-based funding (PBF) approach. This approach funds health-care organisations based on the number of patients treated with select procedures known as QBPs. METHODS: An exploratory descriptive design was employed to better understand health-care leaders' early implementation experiences. Seventy organisational leaders from 20 hospitals participated in six focus groups and four interviews to discuss their initial responses to the implementation of two QBPs (primary unilateral hip replacement and primary unilateral knee replacement). Qualitative data underwent content analysis. FINDINGS: Three key major themes emerged; (1) responding to change, (2) leading the change and (3) managing the change. Within each of these themes, barriers and benefits were identified. CONCLUSION: Leaders are accepting of PBF and QBPs. However, challenges exist that require further exploration including the need for a strong infrastructure, accurate and timely clinical and financial data, and policies to prevent unintended consequences. IMPLICATIONS FOR NURSING MANAGEMENT: Implementing QBPs requires careful planning, adequate and appropriate resources, vertical and horizontal communication strategies, and policies to ensure that unintended consequences are avoided and positive outcomes achieved.
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Atención a la Salud/métodos , Atención a la Salud/normas , Liderazgo , Garantía de la Calidad de Atención de Salud/métodos , Grupos Focales , Humanos , Ontario , Evaluación de Procesos, Atención de Salud/métodos , Evaluación de Procesos, Atención de Salud/normas , Investigación CualitativaRESUMEN
AIM: To determine the factors that attract and retain Registered Nurses in the first-line nurse manager role. BACKGROUND: The first-line nurse manger role is pivotal in health-care organisations. National demographics suggest that Canada will face a first-line nurse manager shortage because of retirement in the next decade. Determination of factors that attract and retain Registered Nurses will assist organisations and policy makers to employ strategies to address this shortage. METHODS: The study used an exploratory, descriptive qualitative approach, consisting of semi-structured individual interviews with 11 Registered Nurses in first-line nurse manager roles. RESULTS: The findings revealed a discrepancy between the factors that attract and retain Registered Nurses in the first-line nurse manager role, underscored the importance of the mentor role and confirmed the challenges encountered by first-line nurse managers practicing in the current health-care environment. CONCLUSIONS: The first-line nurse manager role has been under studied. Further research is warranted to understand which strategies are most effective in supporting first-line nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies to support nurses in the first-line nurse manager role are discussed for the individual, programme, organisation and health-care system/policy levels.
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Enfermeras Administradoras/educación , Rol de la Enfermera , Enfermeras y Enfermeros , Humanos , Liderazgo , Investigación CualitativaRESUMEN
Challenges continue to exist in bridging the safety gap to ensure that consistent, high-quality nursing care is provided based on the best scientific knowledge available. This paper examines findings from nursing research presented at the symposium Advancing Nursing Leadership for a Safer Healthcare System, held in Toronto, Ontario in 2007. Four central themes emerged: (1) place the patient in safety; (2) generate a broader knowledge base on safety across the continuum of care; (3) create a safe culture and healthy work environment to mitigate current threats to patient safety; and (4) advance translation of evidence to practice at the organizational and clinical levels. The aim of this exchange of knowledge was to equip nursing leaders and their decision partners with evidence that can become a catalyst for mobilizing change in practice to address the safety chasm.