Quantifying culture gaps between physicians and managers in Dutch hospitals: a survey

Background: The demands in hospitals for safety and quality, combined with limitations in financing health care require effective cooperation between physicians and managers. The complex relationship between both groups has been described in literature. We aim to add a perspective to literature, by developing a questionnaire which provides an opportunity to quantitatively report and elaborate on the size and content of differences between physicians and managers. Insight gained from use of the questionnaire might enable us to reflect on these differences and could provide practical tools to improve cooperation between physicians and managers, with an aim to enhance hospital performance.\ud \ud Methods: The CG-Questionnaire was developed by adjusting, pre-testing, and shortening Kralewski's questionnaire, and appeared suitable to measure culture gaps. It was shortened by exploratory factor analysis, using principal-axis factoring extraction with Varimax rotation. The CG-Questionnaire was sent to all physicians and managers within 37 Dutch general hospitals. ANOVA and paired sample T-tests were used to determine significant differences between perceptions of daily work practices based in both professional cultures; culture gaps. The size and content of culture gaps were determined with descriptive statistics.\ud \ud Results: The total response (27%) consisted of 929 physicians and 310 managers. The Cronbachs alpha's were 0.70 - 0.79. Statistical analyses showed many differences; culture gaps were found in the present situation; they were even larger in the preferred situation. Differences between both groups can be classified into three categories: (1) culture gaps in the present situation and not in the preferred, (2) culture gaps in the preferred situation and not in the present, and (3) culture gaps in both situations.\ud \ud Conclusions: With data from the CG-Questionnaire it is now possible to measure the size and content of culture gaps between physicians and managers in hospitals. Results gained with the CG-Questionnaire enables hospitals to reflect on these differences. Combining the results, we distinguished three categories of increasing complexity. We linked these three categories to three methods from intergroup literature (enhanced information, contact and ultimately meta cognition) which could help to improve the cooperation between physicians and managers

Gas Source Molecular Beam Epitaxy of Compound Semiconductors

Contains an introduction and reports on seven research projects.Defense Advanced Research Projects Agency Subcontract 284-25041Joint Services Electronics Program Contract DAAL04-95-1-0038National Center for Integrated Photonic Technology Contract 542-381U.S. Army Research Office/ AASERT Contract DAAH04-93-G-0175National Science Foundation Grant DMR 92-02957Joint Services Electronics Program Grant DAAL04-95-1-0038National Science Foundation Grant DMR 90-22933National Science Foundation Grant DMR 92-02957National Center for Integrated Photonic Technology Contract 542-381MIT Lincoln LaboratoryNational Center for Integrated Photonic Technology Subcontract 542-383National Science Foundation DMR 94-0033

Practice development in the primary school Collaboration and conflict

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN006330 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Location, location, location: what do league tables really tell us about primary schools?

This paper examines the use of 'league tables', based upon 'performance data', by the government to distinguish between primary schools. Date concerning one Northern Local Education Authority, were analysed. It was found that the position of a school in the League Tables of unadjusted scores tended to reflect the background characteristics, in particular the socio-economic status (SES), of its pupil population. Furthermore, the 'value-added' measure whilest enhancing our understanding of the differences between schools does not do so in a way that sufficiently takes into account the background factors influencing pupils performance. Currently the League Tables present a simplistic, even potentially misleading picture of primary schools

The decision-making process of nurses when extubating patients following cardiac surgery: An ethnographic study

Background The movement towards research and evidence-based practice in health care demands that the best available evidence is applied to practice. At the same time, changes to role boundaries mean that nurses are assuming increased responsibility, especially in relation to decision making. While increasing, there has been limited consideration about the application of best evidence and decision making by nurses in the context of their clinical work. Objectives This study sought to explore the realities of research and evidence-based practice through an examination of the decision making of nurses when extubating patients following cardiac surgery. Design The tradition of qualitative research and, more specifically, ethnography were used for the study. Setting Data were gathered over an 18-month period during 1998 and 1999 within a Cardiothoracic Intensive Care Unit (CICU). Participants The sample comprised 43 nursing, 16 medical and two managerial staff. A purposive sample of five nurses, a cardiac surgeon, intensivist, CICU manager and Deputy Divisional Manager were included in interviews. Methods All staff were included in participant observation. Semi-structured interviews were conducted with a purposive sample of nurses during the 6th and 14th months and with a purposive sample of other staff during the 16th month. Data were analysed using progressive focusing, data source triangulation and sensitising concepts to identify themes and categories. Results The findings indicated that, despite the use of an unwritten physiologically based protocol for weaning and extubation, factors other than best evidence were significant in nurses’ decision making. A range of personal, cultural and contextual factors including relationships, hierarchy, power, leadership, education, experience and responsibility influenced their decision making. Conclusion This study revealed, often disregarded, cultural, contextual and personal characteristics which combined to form a complex process of decision making. Providing new insight into research and evidence-based practice, the findings have implications for policy makers, educators, managers and clinicians and for the continued professional development of nursing

Conceptualisations of professional practice and interprofessional collaboration

Period of award 1 Mar 1995 - 31 Oct 1995SIGLEAvailable from British Library Document Supply Centre-DSC:3739.0605(R000221542) / BLDSC - British Library Document Supply CentreGBUnited Kingdo