What are the effective ways to translate clinical leadership into healthcare quality improvement?

Robert McSherry,1 Paddy Pearce2 1School of Health and Social Care, University of Teesside, Middlesbrough, 2PKP Consulting, Yarm, United Kingdom Abstract: The presence and/or absence of effective leaders in health care can have a stark consequence on the quality and outcomes of care. The delivery of safe, quality, compassionate health care is dependent on having effective clinical leaders at the frontline. In light of the Kirkup and Francis reports, this article explores some ways of translating clinical leadership into health care quality improvement. This is achieved by exploring what is clinical leadership and why and how this is important to health care quality improvement, clinical leadership, and a duty of candor, along with the importance clinical leadership plays in the provision of quality care improvement and outcomes. Clinical leaders are not predefined roles but emerge from the complex clinical setting by gaining an acquired expertise and from how they then internalize this to develop and facilitate sound relationships within a team. Clinical leaders are effective in facilitating innovation and change through improvement. This is achieved by recognizing, influencing, and empowering individuals through effective communication in order to share and learn from and with each other in practice. The challenge for health care organizations in regard to creating organizational cultures where a duty of candor exists is not to reinvent the wheel by turning something that is simple into something complex, which can become confusing to health care workers, patients, and the public. By focusing on the clinical leader's role and responsibilities we would argue they play a crucial and pivotal role in influencing, facilitating, supporting, and monitoring that this duty of candor happens in practice. This may be possible by highlighting where and how the duty of candor can be aligned within existing clinical governance frameworks. Keywords: governance, candor, safety, outcomes&nbsp

Health Care Workers Perceptions of Organizational Culture and the Impact on the Delivery of Compassionate Quality Care

This paper explores the qualitative outcomes as part of a larger feasibility study which was developed to test a Cultural Health Check toolkit designed to assist healthcare workers and organisations in the provision of safe, dignified and compassionate quality care for older people. For the qualitative part of this project, 11 healthcare workers agreed to participate in a one-to-one semi-structured interview. The primary aim of the research was to identify the experiences of staff in relation to the different factors they feel contribute to the culture of the organisation. These data were analysed using Attride-Stirling thematic analysis. The data were coded and four global themes were evident: professional practice, support, workforce and service delivery. Professional practice included organisational themes of quality, communication and collaboration and how these impact on a health worker’s ability to carry out their role and the impact on the delivery of compassionate quality care. Support included organisation themes of personal and professional development, and facilitation by leaders and managers to access the available support. Workforce centred on the importance of having adequate levels of all staffing groups to be able to deliver safe, quality person-centred care and services. Service delivery identified the organisational themes of care, person-centred care and communication where staff have the desire, determination and enthusiasm to deliver safe, high quality compassionate person-centred care and services. These themes are key in the impact analysis relating to the delivery of compassionate quality care. </jats:p

Exploring the emotional experience of lean

Purpose – This research aims to contribute to the literature on Lean implementation in healthcare by studying the emotional experiences of the relevant actors related to a Rapid Process Improvement Workshop (RPIW) in a UK healthcare context. The purpose of this study was to go beyond what people think about Lean and towards an exploration of their subjective, emotional and “feeling” experience and whether that emotional experience influenced Lean implementation. Design/methodology/approach – A phenomenological and symbolic interactionist qualitative case study was undertaken. Data related to participants’ emotional experience were collected through non-participant observation and semi-structured interviews. Data were analysed using thematic network analysis. Findings – This paper provides novel insights into the emotional experience of Lean as experienced through an RPIW. The findings reveal that participation in an RPIW is much more than a technical process. It influences how people feel about themselves, is based on relationships with others, and requires mental, physical and emotional effort. All of these factors influence engagement with, initiation of and sustainability of the RPIW. Research limitations/implications – A new conceptual framework for the planning and implementation of RPIWs has been developed. However, because of the chosen research approach, the results may lack generalisability. Therefore, researchers are encouraged to test the framework and proposed practice implications. Originality/value – Despite emotions being an integral part of individual and social everyday life, emotional experience has not been studied in relation to Lean. This study is the first to explore emotions in relation to Lean, with implications for practice as to how RPIWs are managed with a new framework for implementation being proposed

Mentoring and you

This research based case study explores and illustrates the benefits of mentoring and the place of clinical governance in enhancing dental care practice