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Sandra G. Leggat
School of Psychology and Public Health, La Trobe University, Bundoora, Australia

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Journal article
Published: 04 June 2021 in BMC Psychology
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Background The study explored the role of emotional intelligence (EI) on employees’ perceived wellbeing and empowerment, as well as their performance, by measuring their quality of care. Methods The baseline data for the present project was collected from 78 staff of a Victorian aged care organization in Australia. Self-administered surveys were used to assess participants’ emotional intelligence, general well-being, psychological empowerment, quality of care, and demographic characteristics. The model fit was assessed using structural equation modelling by AMOS (v 24) software. Results The evaluated model confirmed that emotional intelligence predicts the employees’ psychological empowerment, wellbeing, and quality of care in a statistically significant way. Conclusions The current research indicates that employees with higher EI will more likely deliver a better quality of patient care. Present research extends the current knowledge of the psychological empowerment and wellbeing of employees with a particular focus on emotional intelligence as an antecedent in an under-investigated setting like aged care setting in Australia.

ACS Style

Leila Karimi; Sandra G. Leggat; Timothy Bartram; Leila Afshari; Sarah Sarkeshik; Tengiz Verulava. Emotional intelligence: predictor of employees’ wellbeing, quality of patient care, and psychological empowerment. BMC Psychology 2021, 9, 1 -7.

AMA Style

Leila Karimi, Sandra G. Leggat, Timothy Bartram, Leila Afshari, Sarah Sarkeshik, Tengiz Verulava. Emotional intelligence: predictor of employees’ wellbeing, quality of patient care, and psychological empowerment. BMC Psychology. 2021; 9 (1):1-7.

Chicago/Turabian Style

Leila Karimi; Sandra G. Leggat; Timothy Bartram; Leila Afshari; Sarah Sarkeshik; Tengiz Verulava. 2021. "Emotional intelligence: predictor of employees’ wellbeing, quality of patient care, and psychological empowerment." BMC Psychology 9, no. 1: 1-7.

Earlycite article
Published: 09 March 2021 in Journal of Health Organization and Management
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Purpose There is evidence that patient safety has not improved commensurate with the global attention and resources dedicated to achieving it. The authors explored the perspectives of hospital leaders on the challenges of leading safe care. Design/methodology/approach This paper reports the findings of a three-year longitudinal study of eight Australian hospitals. A representative sample of hospital leaders, comprising board members, senior and middle managers and clinical leaders, participated in focus groups twice a year from 2015 to 2017. Findings Although the participating hospitals had safety I systems, the leaders consistently reported that they relied predominantly on their competent well-meaning staff to ensure patient safety, more of a safety II perspective. This trust was based on perceptions of the patient safety actions of staff, rather than actual knowledge about staff abilities or behaviours. The findings of this study suggest this hegemonic relational trust was a defence mechanism for leaders in complex adaptive systems (CASs) unable to influence care delivery at the front line and explores potential contributing factors to these perceptions. Practical implications In CASs, leaders have limited control over the bedside care processes and so have little alternative but to trust in “good staff providing good care” as a strategy for safe care. However, trust, coupled with a predominantly safety 1 approach is not achieving harm reduction. The findings of the study suggest that the beliefs the leaders held about the role their staff play in assuring safe care contribute to the lack of progress in patient safety. The authors recommend three evidence-based leadership activities to transition to the proactive safety II approach to pursuing safe care. Originality/value This is the first longitudinal study to provide the perspectives of leaders on the provision of quality and safety in their hospitals. A large sample of board members, managers and clinical leaders provides extensive data on their perspectives on quality and safety.

ACS Style

Sandra G. Leggat; Cathy Balding; Melanie Bish. Perspectives of Australian hospital leaders on the provision of safe care: implications for safety I and safety II. Journal of Health Organization and Management 2021, ahead-of-p, 1 .

AMA Style

Sandra G. Leggat, Cathy Balding, Melanie Bish. Perspectives of Australian hospital leaders on the provision of safe care: implications for safety I and safety II. Journal of Health Organization and Management. 2021; ahead-of-p (ahead-of-p):1.

Chicago/Turabian Style

Sandra G. Leggat; Cathy Balding; Melanie Bish. 2021. "Perspectives of Australian hospital leaders on the provision of safe care: implications for safety I and safety II." Journal of Health Organization and Management ahead-of-p, no. ahead-of-p: 1.

Journal article
Published: 01 December 2020 in Journal of Hospital Management and Health Policy
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ACS Style

Sandra G. Leggat; Kevin Yap. How are hospitals using artificial intelligence in strategic decision- making?—a scoping review. Journal of Hospital Management and Health Policy 2020, 4, 39 -39.

AMA Style

Sandra G. Leggat, Kevin Yap. How are hospitals using artificial intelligence in strategic decision- making?—a scoping review. Journal of Hospital Management and Health Policy. 2020; 4 ():39-39.

Chicago/Turabian Style

Sandra G. Leggat; Kevin Yap. 2020. "How are hospitals using artificial intelligence in strategic decision- making?—a scoping review." Journal of Hospital Management and Health Policy 4, no. : 39-39.

Research article
Published: 22 July 2020 in Health Services Management Research
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Significant resources are spent on monitoring and improving the quality and safety of hospital care; however, evidence suggests that this investment is achieving disproportionately limited results. Accreditation and expectations of funders have focused hospital service quality management on compliance, with an over emphasis on the ‘control’ aspect of Juran’s Quality Trilogy. This study compared the impact of the implementation of a strategic quality management system with existing compliance-focused quality management systems in a sample of Australian hospitals. Through action research, mixed methods data were tracked and compared implementation progress and outcomes between four experimental and four control hospitals from 2015 to 2017. While three years was not enough time to observe quality changes resulting from the implementation, three experimental hospitals made high quality care a strategic priority for their organisation and developed organisation-wide processes to achieve it. These hospitals demonstrated that including a strategic quality planning component in quality system design and implementation, as advocated by Juran but absent in many hospital quality systems, was a positive lever for staff commitment to delivering consistently high quality care.

ACS Style

Cathy Balding; Sandra Leggat. Making high quality care an organisational strategy: Results of a longitudinal mixed methods study in Australian hospitals. Health Services Management Research 2020, 34, 148 -157.

AMA Style

Cathy Balding, Sandra Leggat. Making high quality care an organisational strategy: Results of a longitudinal mixed methods study in Australian hospitals. Health Services Management Research. 2020; 34 (3):148-157.

Chicago/Turabian Style

Cathy Balding; Sandra Leggat. 2020. "Making high quality care an organisational strategy: Results of a longitudinal mixed methods study in Australian hospitals." Health Services Management Research 34, no. 3: 148-157.

Journal article
Published: 18 June 2020 in International Journal of Environmental Research and Public Health
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This study assessed the link of patient care outcome to occupational differences in response to human resource management. A cross-sectional survey was conducted in three large regional hospitals in China. A total of 700 questionnaires were distributed to doctors, nurses, allied health workers, and managers and 499 (71%) were completed. Data were analyzed using a final sample of 193 doctors and 180 nurses. Quality of patient care was rated by the participants using a modified version of the Victorian Patient Satisfaction Questionnaire. Human resource management was measured on seven aspects: job security, recruitment, training, transformational leadership, information sharing, job quality, and teams. The differences between doctors and nurses in response to the human resource management practices and their associations with quality of care were compared through independent samples t-tests, correlational analyses, and moderator regressions. Doctors gave a higher rating on quality of patient care than their nurse counterparts. ‘Training’, ‘transformational leadership’, and ‘information sharing’ were more likely to be associated with higher ratings on quality of patient care in nurses. By contrast, a greater association between ‘teams’ and quality of patient care was found in doctors. Although doctors and nurses in China are exposed to the same hospital management environment, professional differences may have led them to respond to management practices in different ways.

ACS Style

Chaojie Liu; Timothy Bartram; Sandra G. Leggat. Link of Patient Care Outcome to Occupational Differences in Response to Human Resource Management: A Cross-Sectional Comparative Study on Hospital Doctors and Nurses in China. International Journal of Environmental Research and Public Health 2020, 17, 4379 .

AMA Style

Chaojie Liu, Timothy Bartram, Sandra G. Leggat. Link of Patient Care Outcome to Occupational Differences in Response to Human Resource Management: A Cross-Sectional Comparative Study on Hospital Doctors and Nurses in China. International Journal of Environmental Research and Public Health. 2020; 17 (12):4379.

Chicago/Turabian Style

Chaojie Liu; Timothy Bartram; Sandra G. Leggat. 2020. "Link of Patient Care Outcome to Occupational Differences in Response to Human Resource Management: A Cross-Sectional Comparative Study on Hospital Doctors and Nurses in China." International Journal of Environmental Research and Public Health 17, no. 12: 4379.

Journal article
Published: 09 June 2020 in International Journal of Environmental Research and Public Health
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(1) Background: The issue of burnout in healthcare staff is frequently discussed in relation to occupational health. In this paper, we report healthcare staff experiences of stress and burnout. (2) Methods: In total, 72 healthcare staff were interviewed from psychiatry, surgery, and emergency departments at an Australian public health service. The sample included doctors, nurses, allied health professionals, administrators, and front-line managers. Interview transcripts were thematically analyzed, with participant experiences interpreted against descriptors of burnout in Maslach’s Burnout Inventory and the International Statistical Classification of Diseases and Related Health Problems (ICD-11). (3) Results: Staff experiences closely matched the ICD-11 description of stress associated with working in an uncongenial workplace, with few reported experiences which matched the ICD-11 descriptors of burnout. (4) Conclusion: Uncongenial workplaces in public health services contribute to healthcare staff stress. While previous approaches have focused on biomedical assistance for individuals, our findings suggest that occupational health approaches to addressing health care staff stress need greater focus on the workplace as a social determinant of health. This finding is significant as organizational remedies to uncongenial stress are quite different from remedies to burnout.

ACS Style

Madeleine Kendrick; Kevin Kendrick; Peter Morton; Nicholas F. Taylor; Sandra G. Leggat. Hospital Staff Report It Is Not Burnout, but a Normal Stress Reaction to an Uncongenial Work Environment: Findings from a Qualitative Study. International Journal of Environmental Research and Public Health 2020, 17, 4107 .

AMA Style

Madeleine Kendrick, Kevin Kendrick, Peter Morton, Nicholas F. Taylor, Sandra G. Leggat. Hospital Staff Report It Is Not Burnout, but a Normal Stress Reaction to an Uncongenial Work Environment: Findings from a Qualitative Study. International Journal of Environmental Research and Public Health. 2020; 17 (11):4107.

Chicago/Turabian Style

Madeleine Kendrick; Kevin Kendrick; Peter Morton; Nicholas F. Taylor; Sandra G. Leggat. 2020. "Hospital Staff Report It Is Not Burnout, but a Normal Stress Reaction to an Uncongenial Work Environment: Findings from a Qualitative Study." International Journal of Environmental Research and Public Health 17, no. 11: 4107.

Original research
Published: 01 April 2020 in Journal of Multidisciplinary Healthcare
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Purpose: This study investigated the practical and cultural barriers of reporting patient safety incidents in three accredited public hospitals in East Java, Indonesia. Methods: This study employed a mixed methods approach using a convergent parallel design. We surveyed 1121 health workers and interviewed 27 managerial staff members from the sampled hospitals. A chi-square analysis was performed to evaluate differences in demographic factors, barriers to reporting, and practices of reporting between those who had reported an incident and those who had witnessed an incident but had not reported it. NVivo 11 software was used to perform the qualitative data analysis. Results: This study had a 76.53% response rate. The quantitative evaluation identified significant differences in professions and work units and in participation in quality and safety training between the reporting group and the non-reporting group. The analysis of practical barriers displayed significant differences between the groups with the following responses: “did not know how to report,” “did not know where to report,” and “lack of feedback”. For cultural barriers, a significant difference was shown only for the response “did not want conflict.” In the qualitative assessment, most of the interview participants reported lack of knowledge and lack of socialization or training as practical barriers in reporting incidents. Furthermore, reluctance and fear to report were mentioned as cultural barriers by most of the interviewees. Conclusion: Because there were conflicting findings in the barriers of reporting incidents, these barriers must be identified, discussed, and resolved by health workers and their managers or supervisors to improve incident reporting. Managers must foster open communication and build positive connections with health workers. Further research is necessary to focus on possible ways of addressing the barriers to reporting.

ACS Style

Inge Dhamanti; Sandra Leggat; Simon Barraclough. Practical and Cultural Barriers to Reporting Incidents Among Health Workers in Indonesian Public Hospitals. Journal of Multidisciplinary Healthcare 2020, ume 13, 351 -359.

AMA Style

Inge Dhamanti, Sandra Leggat, Simon Barraclough. Practical and Cultural Barriers to Reporting Incidents Among Health Workers in Indonesian Public Hospitals. Journal of Multidisciplinary Healthcare. 2020; ume 13 ():351-359.

Chicago/Turabian Style

Inge Dhamanti; Sandra Leggat; Simon Barraclough. 2020. "Practical and Cultural Barriers to Reporting Incidents Among Health Workers in Indonesian Public Hospitals." Journal of Multidisciplinary Healthcare ume 13, no. : 351-359.

Research article
Published: 01 January 2020 in Australian Health Review
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ObjectiveThis study examined whether the management competency framework for health service managers developed in the Victorian healthcare context is applicable to managers in other Australian states. MethodsAn online questionnaire survey of senior and middle-level health service managers in both community health services and hospitals was conducted in New South Wales and Queensland. ResultsThe study confirmed that the essential tasks for senior and middle-level managers are consistent across health and social care sectors, as well as states. Core competencies for health services managers identified in the Victorian healthcare context are relevant to other Australian states. In addition, two additional competencies were incorporated into the framework. ConclusionThe Management Competency Assessment Program competency framework summarises six competencies and associated behaviours that may be useful for guiding performance management and the education and training development of health service managers in Australia. What is known about the topic?The evidence suggests that competency-based approaches can enhance performance and talent management, and inform education and training needs, yet there has been no validated competency framework for Australian health service managers. What does the paper add?This paper explains the process of the finalisation of the first management competency framework for guiding the identification of the training and development needs of Australian health service managers and the management of their performance. What are the implications for practice?The Management Competency Assessment Program competency framework can guide the development of the health service management workforce in three Australian states, and may be applicable to other jurisdictions. Further studies are required in the remaining jurisdictions to improve the external validity of the framework.

ACS Style

Zhanming Liang; Felicity Blackstock; Peter Howard; Geoffrey Leggat; Alison Hughes; Janny Maddern; David Briggs; Godfrey Isouard; Nicola North; Sandra G. Leggat. A health management competency framework for Australia. Australian Health Review 2020, 44, 958 .

AMA Style

Zhanming Liang, Felicity Blackstock, Peter Howard, Geoffrey Leggat, Alison Hughes, Janny Maddern, David Briggs, Godfrey Isouard, Nicola North, Sandra G. Leggat. A health management competency framework for Australia. Australian Health Review. 2020; 44 (6):958.

Chicago/Turabian Style

Zhanming Liang; Felicity Blackstock; Peter Howard; Geoffrey Leggat; Alison Hughes; Janny Maddern; David Briggs; Godfrey Isouard; Nicola North; Sandra G. Leggat. 2020. "A health management competency framework for Australia." Australian Health Review 44, no. 6: 958.

Research article
Published: 01 January 2020 in Australian Health Review
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ObjectiveEnsuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual and organisational performance, there have been few studies exploring these concepts in the public healthcare sector. This study addresses this gap by exploring the perceived differences in demonstration of core competencies between average and higher-performing managers in public sector healthcare organisations. MethodsMixed methods were used to define and measure a set of competencies for health service managers. In addition, supervisors of managers were asked to identify the differences in competence between the average and high-performing managers reporting to them. ResultsSupervisors could clearly distinguish between average and higher-performing managers and identified related competencies. ConclusionsThe consistent pattern of competence among community health and hospital public sector managers demonstrated by this study could be used to develop a strategic approach to talent management for the public healthcare sector in Australia. What is known about this topic?Although there are validated competency frameworks for health service managers, they are rarely used in practice in Australia. What does this paper add?This paper illustrates the perceived differences in competencies between top and average health services managers using a validated framework. What are the implications for practitioners?The public health sector could work together to provide a more effective and efficient approach to talent management for public hospitals and community health services.

ACS Style

Sandra G. Leggat; Zhanming Liang; Peter F. Howard. Differentiating between average and high-performing public healthcare managers: implications for public sector talent management. Australian Health Review 2020, 44, 434 .

AMA Style

Sandra G. Leggat, Zhanming Liang, Peter F. Howard. Differentiating between average and high-performing public healthcare managers: implications for public sector talent management. Australian Health Review. 2020; 44 (3):434.

Chicago/Turabian Style

Sandra G. Leggat; Zhanming Liang; Peter F. Howard. 2020. "Differentiating between average and high-performing public healthcare managers: implications for public sector talent management." Australian Health Review 44, no. 3: 434.

Original research
Published: 01 December 2019 in Risk Management and Healthcare Policy
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Background: Incident reporting is widely acknowledged as one of the ways of improving patient safety and has been implemented in Indonesia for more than ten years. However, there was no significant increase in the number of reported incidents nationally. The study described in this paper aimed at assessing the extent to which Indonesia’s patient safety incident reporting system has adhered to the World Health Organization (WHO) characteristics for successful reporting. Methods: We interviewed officials from 16 organizations at national, provincial and district or city levels in Indonesia. We reviewed several policies, guidelines and regulations pertinent to incident reporting in Indonesia and examined whether the WHO characteristics were covered in these documents. We used NVivo version 9 to manage the interview data and applied thematic analysis to organize our findings. Results: Our study found that there was an increased need for a non-punitive system, confidentiality, expert-analysis and timeliness of reporting, system-orientation and responsiveness. The existing guidelines, policies and regulations in Indonesia, to a large extent, have not satisfied all the required WHO characteristics of incident reporting. Furthermore, awareness and understanding of the reporting system amongst officials at almost all levels were lacking. Conclusion: Despite being implemented for more than a decade, Indonesia’s patient safety incident reporting system has not fully adhered to the WHO guidelines. There is a pressing need for the Indonesian Government to improve the system, by putting specific regulations and by creating a robust infrastructure at all levels to support the incident reporting.

ACS Style

Inge Dhamanti; Sandra Leggat; Simon Barraclough; Benny Tjahjono. Patient Safety Incident Reporting In Indonesia: An Analysis Using World Health Organization Characteristics For Successful Reporting. Risk Management and Healthcare Policy 2019, ume 12, 331 -338.

AMA Style

Inge Dhamanti, Sandra Leggat, Simon Barraclough, Benny Tjahjono. Patient Safety Incident Reporting In Indonesia: An Analysis Using World Health Organization Characteristics For Successful Reporting. Risk Management and Healthcare Policy. 2019; ume 12 ():331-338.

Chicago/Turabian Style

Inge Dhamanti; Sandra Leggat; Simon Barraclough; Benny Tjahjono. 2019. "Patient Safety Incident Reporting In Indonesia: An Analysis Using World Health Organization Characteristics For Successful Reporting." Risk Management and Healthcare Policy ume 12, no. : 331-338.

Journal article
Published: 03 May 2019 in BMC Health Services Research
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Specific Timely Appointments for Triage (STAT) is an intervention designed to reduce waiting time in community outpatient health services, shown to be effective in a large stepped wedge cluster randomised controlled trial. STAT combines initial strategies to reduce existing wait lists with creation of a specific number of protected appointments for new patients based on demand. It offers an alternative to the more traditional methods of demand management for these services using waiting lists with triage systems. This study aimed to explore perceptions of clinicians and administrative staff involved in implementing the model. Semi-structured interviews with 20 staff members who experienced the change to STAT were conducted by an independent interviewer. All eight sites involved in the original trial and all professional disciplines were represented in the sample. Data were coded and analysed thematically. Participants agreed that shorter waiting time for patients was the main advantage of the STAT model, and that ongoing management of caseloads was challenging. However, there was variation in the overall weight placed on these factors, and therefore the participants' preference for the new or previous model of care. Perceptions of whether the advantages outweighed the disadvantages were influenced by five sub-themes: staff perception of how much waiting matters to the patient, prior exposure to the management of waiting list, caseload complexity, approach and attitude to the implementation of STAT and organisational factors. The STAT model has clear benefits but also presents challenges for staff members. The findings of this study suggest that careful preparation and management of change and active planning for known fluctuations in supply and demand are likely to help to mitigate sources of stress and improve the likelihood of successful implementation of the STAT model for improving waiting times for patients referred to community outpatient services.

ACS Style

Katherine E. Harding; David A. Snowdon; Annie K. Lewis; Sandra G. Leggat; Bridie Kent; Jennifer J. Watts; Nicholas F. Taylor. Staff perspectives of a model of access and triage for reducing waiting time in ambulatory services: a qualitative study. BMC Health Services Research 2019, 19, 283 .

AMA Style

Katherine E. Harding, David A. Snowdon, Annie K. Lewis, Sandra G. Leggat, Bridie Kent, Jennifer J. Watts, Nicholas F. Taylor. Staff perspectives of a model of access and triage for reducing waiting time in ambulatory services: a qualitative study. BMC Health Services Research. 2019; 19 (1):283.

Chicago/Turabian Style

Katherine E. Harding; David A. Snowdon; Annie K. Lewis; Sandra G. Leggat; Bridie Kent; Jennifer J. Watts; Nicholas F. Taylor. 2019. "Staff perspectives of a model of access and triage for reducing waiting time in ambulatory services: a qualitative study." BMC Health Services Research 19, no. 1: 283.

Journal article
Published: 24 April 2019 in Healthcare
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(1) Background: A patient safety incident reporting system was introduced in Indonesian hospitals in 2006; however, under-reporting of patient safety incidents is evident. The government plays a vital role in the implementation of a national system. Therefore, this study focuses on how the Indonesian government has been undertaking its role in patient safety at provincial and city/district levels, including incident reporting according to the National Guideline for Hospital Patient Safety. (2) Methods: This study employed a qualitative approach with interviews of 16 participants from seven organizations. The data were managed using NVivo and thematically analyzed. (3) Results: The findings revealed several problems at the macro-, meso-, and micro-level as the government was weak in monitoring and evaluation. The District Health Office (DHO) and Provincial Health Office (PHO) were not involved in incident reporting, and there was a lack of government support for the hospitals. (4) Conclusions: The DHO and PHO have not carried out their roles related to patient safety as mentioned in the national guidelines. Lack of commitment to and priority of patient safety, the complexity of the bureaucratic structure, and a lack of systematic partnership and collaboration are problems that need to be addressed by systematic improvement. To ensure effective and efficient national outcomes, the three levels of government need to work more closely.

ACS Style

Inge Dhamanti; Sandra G. Leggat; Simon Barraclough. The Role of Governments in the Implementation of Patient Safety and Patient Safety Incident Reporting in Indonesia: A Qualitative Study. Healthcare 2019, 7, 64 .

AMA Style

Inge Dhamanti, Sandra G. Leggat, Simon Barraclough. The Role of Governments in the Implementation of Patient Safety and Patient Safety Incident Reporting in Indonesia: A Qualitative Study. Healthcare. 2019; 7 (2):64.

Chicago/Turabian Style

Inge Dhamanti; Sandra G. Leggat; Simon Barraclough. 2019. "The Role of Governments in the Implementation of Patient Safety and Patient Safety Incident Reporting in Indonesia: A Qualitative Study." Healthcare 7, no. 2: 64.

Research article
Published: 01 January 2019 in Australian Health Review
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Objective To explore the impact of the organisational quality systems on quality of care in Victorian health services. Methods During 2015 a total of 55 focus groups were conducted with more than 350 managers, clinical staff and board members in eight Victorian health services to explore the effectiveness of health service quality systems. A review of the quality and safety goals and strategies outlined in the strategic and operating plans of the participating health services was also undertaken. Results This paper focuses on the data related to the leadership role of health service boards in ensuring safe, high-quality care. The findings suggest that health service boards are not fully meeting their governance accountability to ensure consistently high-quality care. The data uncovered major clinical governance gaps between stated board and executive aspirations for quality and safety and the implementation of these expectations at point of care. These gaps were further compounded by quality system confusion, over-reliance on compliance, and inadequate staff engagement. Conclusion Based on the existing evidence we propose five specific actions boards can take to close the gaps, thereby supporting improved care for all consumers. What is known about this topic? Effective governance is essential for high-quality healthcare delivery. Boards are required to play an active role in their organisation’s pursuit of high quality care. What does this paper add? Recent government reports suggest that Australian health service boards are not fully meeting their governance requirements for high quality, safe care delivery, and our research pinpoints key governance gaps. What are the implications for practitioners? Based on our research findings we outline five evidence-based actions for boards to improve their governance of quality care delivery. These actions focus on an organisational strategy for high-quality care, with the chief executive officer held accountable for successful implementation, which is actively guided and monitored by the board.

ACS Style

Sandra G. Leggat; Cathy Balding. Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care. Australian Health Review 2019, 43, 126 .

AMA Style

Sandra G. Leggat, Cathy Balding. Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care. Australian Health Review. 2019; 43 (2):126.

Chicago/Turabian Style

Sandra G. Leggat; Cathy Balding. 2019. "Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care." Australian Health Review 43, no. 2: 126.

Multicenter study
Published: 18 December 2018 in BMC Health Services Research
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Competent managers are essential to the productivity of organisations and the sustainability of health systems. Effective workforce development strategies sensitive to the current competency development needs of health service managers (HSMs) are required. To conduct a 360° assessment of the competence of Australian HSMs to identify managerial competence levels, and training and development needs. Assessment of 93 middle-level HSMs from two public hospitals (n = 25) and five community health services (CHS) (n = 68), using the Managerial Competency Assessment Partnership (MCAP) framework and tool, conducted between 2012 and 2014 in Victoria, Australia. Mean competency scores from both self- and combined colleagues' assessments indicated competence (scores greater than five but less than six) without guidance, but many HSMs have not had extensive experience. Around 12% of HSMs were unable to demonstrate the competency of 'evidence-informed decision-making' and 4% of HSMs were unable to demonstrate the competency of 'enabling and managing change'. The assessments confirmed managerial competence for the majority of middle-level HSMs from hospitals and CHS in Victoria, but found competency gaps. In addition, the assessment confirmed managerial strengths and weaknesses varied across management groups from different organisations. These findings suggest that the development of strategies to strengthen the health service management workforce should be multifaceted. A focus on competency in performance evaluation and development using the MCAP framework and tool not only provides insights into performance of HSMs, but also has the potential to provide an organisation strategic advantage through succession planning and advancing managers' competence via learning needs analysis and targeted professional development. Linking competencies of HSMs to organisational objectives and strategies provides optimal use of the human resource capacity, improving the organisation's productivity and sustainability.

ACS Style

Zhanming Liang; Felicity C. Blackstock; Peter F Howard; David S Briggs; Sandra G Leggat; Dennis Wollersheim; David Edvardsson; Aziz Rahman. An evidence-based approach to understanding the competency development needs of the health service management workforce in Australia. BMC Health Services Research 2018, 18, 976 .

AMA Style

Zhanming Liang, Felicity C. Blackstock, Peter F Howard, David S Briggs, Sandra G Leggat, Dennis Wollersheim, David Edvardsson, Aziz Rahman. An evidence-based approach to understanding the competency development needs of the health service management workforce in Australia. BMC Health Services Research. 2018; 18 (1):976.

Chicago/Turabian Style

Zhanming Liang; Felicity C. Blackstock; Peter F Howard; David S Briggs; Sandra G Leggat; Dennis Wollersheim; David Edvardsson; Aziz Rahman. 2018. "An evidence-based approach to understanding the competency development needs of the health service management workforce in Australia." BMC Health Services Research 18, no. 1: 976.

Original article
Published: 13 November 2018 in British Journal of Management
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This paper investigates the role of medical professionals in the success and longevity of the implementation of workplace innovation and organizational change in the Accident and Emergency (A&E) Departments of two large public hospitals, in Australia and Canada, during the introduction of process improvement using Lean Management (LM) methodologies. We ask why and how doctors resist, influence or enable LM initiatives in healthcare. Using a qualitative methodology, we contribute to institutional work theory by unpacking the complex forms of boundary and practice work undertaken by key actors who effectively use their professional status and power to enable practice changes to be embedded. Our findings lend support to the importance of the involvement and ownership of senior doctors in the design, introduction and implementation of successful workplace innovation and organizational change. Senior doctors use their professional expertise, positional and political power at the industry, organization and workplace levels to influence strategically the use of resources designated for workplace innovation to improve efficiencies, quality of patient care and maintain their dominance. The significant organizational change achieved reflected the ownership and leadership of the workplace innovation by senior doctors in ‘hybrid roles’ who captured the rhetoric and minimized adversarialism among key stakeholders.

ACS Style

Timothy Bartram; Pauline Stanton; Greg J. Bamber; Sandra G. Leggat; Ruth Ballardie; Richard Gough. Engaging Professionals in Sustainable Workplace Innovation: Medical Doctors and Institutional Work. British Journal of Management 2018, 31, 42 -55.

AMA Style

Timothy Bartram, Pauline Stanton, Greg J. Bamber, Sandra G. Leggat, Ruth Ballardie, Richard Gough. Engaging Professionals in Sustainable Workplace Innovation: Medical Doctors and Institutional Work. British Journal of Management. 2018; 31 (1):42-55.

Chicago/Turabian Style

Timothy Bartram; Pauline Stanton; Greg J. Bamber; Sandra G. Leggat; Ruth Ballardie; Richard Gough. 2018. "Engaging Professionals in Sustainable Workplace Innovation: Medical Doctors and Institutional Work." British Journal of Management 31, no. 1: 42-55.

Review
Published: 08 October 2018 in International Journal of Health Care Quality Assurance
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Purpose The purpose of this paper is to review the implementation of seven components of quality systems (QSs) linked with quality improvement in a sample of Australian hospitals. Design/methodology/approach The authors completed a systematic review to identify QS components associated with measureable quality improvement. Using mixed methods, the authors then reviewed the current state of these QS components in a sample of eight Australian hospitals. Findings The literature review identified seven essential QS components. Both the self-evaluation and focus group data suggested that none of the hospitals had all of these seven components in place, and that there were some implementation issues with those components that were in use. Although board and senior executives could point to a large number of quality and safety documents that they felt were supporting a vision and framework for safe, high-quality care, middle managers and clinical staff described the QSs as compliance driven and largely irrelevant to their daily pursuit of safe, high-quality care. The authors also found little specific training in quality improvement for staff, lack of useful data for clinicians on the quality of care they provide and confusion about how organisational QSs work. Practical implications This study provides a clearer picture of why QSs are not yet achieving the results that boards and executives want to achieve, and that patients require. Originality/value This is the first study to explore the implementation of QSs in hospitals in-depth from the perspective of hospital staff, linking the findings to the implementation of QS component identified in the literature.

ACS Style

Sandra G. Leggat; Cathy Balding. Effective quality systems: implementation in Australian public hospitals. International Journal of Health Care Quality Assurance 2018, 31, 1044 -1057.

AMA Style

Sandra G. Leggat, Cathy Balding. Effective quality systems: implementation in Australian public hospitals. International Journal of Health Care Quality Assurance. 2018; 31 (8):1044-1057.

Chicago/Turabian Style

Sandra G. Leggat; Cathy Balding. 2018. "Effective quality systems: implementation in Australian public hospitals." International Journal of Health Care Quality Assurance 31, no. 8: 1044-1057.

Journal article
Published: 12 February 2018 in Journal of Health Organization and Management
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Purpose The purpose of this paper is to report on the validation of a management competency assessment tool for health services managers (HSM), which resulted from the development and validation of the framework, addressed by a previous paper. Design/methodology/approach The management competency assessment tool (MCAP Tool) was validated using assessment data from a sample of 117 senior and middle managers working in two public hospitals and five community services in Victoria, Australia. The assessments were conducted between January 2013 and September 2014. Findings Both validity and reliability of the MCAP Tool were demonstrated. Practical implications The MCAP Tool has the potential to assist in the measurement of the competencies of HSM. Further research is required to determine if the framework and tool are applicable to HSM in other settings. Originality/value This is the first published study outlining the validity and reliability of an assessment tool to measure the management competencies of Australian health service managers.

ACS Style

Peter F. Howard; Zhanming Liang; Sandra Leggat; Leila Karimi. Validation of a management competency assessment tool for health service managers. Journal of Health Organization and Management 2018, 32, 113 -134.

AMA Style

Peter F. Howard, Zhanming Liang, Sandra Leggat, Leila Karimi. Validation of a management competency assessment tool for health service managers. Journal of Health Organization and Management. 2018; 32 (1):113-134.

Chicago/Turabian Style

Peter F. Howard; Zhanming Liang; Sandra Leggat; Leila Karimi. 2018. "Validation of a management competency assessment tool for health service managers." Journal of Health Organization and Management 32, no. 1: 113-134.

Validation study
Published: 09 February 2018 in Journal of Health Organization and Management
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Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to introduce a validated process in management competency identification and development applied in Australia – a process leading to a management competency framework with associated behavioural items that can be used to measure core management competencies of health service managers. Design/methodology/approach The management competency framework development study incorporated both qualitative and quantitative methods, implemented in four stages, including job description analysis, focus group discussions and online surveys. Findings The study confirmed that the four-stage process could identify management competencies and the framework developed is considered reliable and valid for developing a management competency assessment tool that can measure management competence amongst managers in health organisations. In addition, supervisors of health service managers could use the framework to distinguish perceived superior and average performers among managers in health organisations. Practical implications Developing the core competencies of health service managers is important for management performance improvement and talent management. The six core management competencies identified can be used to guide the design professional development activities for health service managers. Originality/value The validated management competency identification and development process can be applied in other countries and different industrial contexts to identify core management competency requirements.

ACS Style

Zhanming Liang; Peter F. Howard; Sandra Leggat; Timothy Bartram. Development and validation of health service management competencies. Journal of Health Organization and Management 2018, 32, 157 -175.

AMA Style

Zhanming Liang, Peter F. Howard, Sandra Leggat, Timothy Bartram. Development and validation of health service management competencies. Journal of Health Organization and Management. 2018; 32 (2):157-175.

Chicago/Turabian Style

Zhanming Liang; Peter F. Howard; Sandra Leggat; Timothy Bartram. 2018. "Development and validation of health service management competencies." Journal of Health Organization and Management 32, no. 2: 157-175.

Review
Published: 01 January 2018 in Australian Health Review
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Objective The aim of the present study was to investigate whether the content of annual Victorian quality of care reports had an increased consumer participation focus following the introduction of the National Safety and Quality Health Service (NSQHS) Partnering with Consumers standard. Methods A mixed-methods approach comprising a comparative descriptive observational study design with quantitative data analysis was used. Nine large Victorian metropolitan public health services’ annual quality of care reports from 2011 and 2014 were analysed using a newly devised analysis framework consisting of elements of the NSQHS ‘Partnering with Consumers’ standard and minimal requirements for Quality of Care reporting by the Department of Health and Human Services. Results Of the nine 2014 quality of care reports, in only three were total scores higher compared with scores in the 2011 reports; in one of the 2014 reports, the total scores remained the same, and in the remaining five reports total scores were lower than in the 2011 reports. Overall, there was an improved total score for the 2014 reports compared with the 2011 reports, corresponding to a higher consumer participation focus. Conclusion Overall, the present study demonstrated mixed findings and, in some cases, lower scores for the 2014 reports, which was after the introduction of the Partnering with Consumers NSQHS standard, compared with the 2011 reports. Overall, there is future scope to enhance the degree of consumer participation evident within the quality of care reports. What is known about the topic? Partnering with consumers has been associated with improved clinical outcomes, decreased readmission rates and rates of hospital-acquired infections, and improved adherence to treatment recommendations and health literacy. Engaging consumers has been recognised as a means to increase the accessibility and appropriateness of healthcare to individuals. Public reporting is a tool through which health services communicate with and engage their consumers in order to improve the quality of care they provide, and is a key element in Australia of the NSQHS Partnering with Consumers standard. What does the paper add? This paper links the principles of consumer participation with public reporting. The paper highlights the potential for healthcare organisations to use their public reporting media to engage with consumers and communicate about the quality of care they deliver. What are the implications for practitioners? The unexpected findings of a lower emphasis on consumer participation suggests the need for Victorian health services to review the purpose and processes for developing the publicly reported quality of care reports in order to improve their compliance.

ACS Style

Charissa Zaga; Sandra Leggat; Sophie Hill. Partnering with consumers in the public reporting of quality of care: review of the Victorian quality of care reports. Australian Health Review 2018, 42, 550 .

AMA Style

Charissa Zaga, Sandra Leggat, Sophie Hill. Partnering with consumers in the public reporting of quality of care: review of the Victorian quality of care reports. Australian Health Review. 2018; 42 (5):550.

Chicago/Turabian Style

Charissa Zaga; Sandra Leggat; Sophie Hill. 2018. "Partnering with consumers in the public reporting of quality of care: review of the Victorian quality of care reports." Australian Health Review 42, no. 5: 550.

Review
Published: 28 November 2017 in BMC Health Services Research
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To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience. Seventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience. Clinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health outcomes. While few studies found a direct effect on patient health outcomes, when provided to mental health professionals clinical supervision may be associated with a reduction in psychological symptoms of patients diagnosed with a mental illness. There was no association found between clinical supervision and the patient experience. CRD42015029643.

ACS Style

David A. Snowdon; Sandra G. Leggat; Nicholas F. Taylor. Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review. BMC Health Services Research 2017, 17, 1 -11.

AMA Style

David A. Snowdon, Sandra G. Leggat, Nicholas F. Taylor. Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review. BMC Health Services Research. 2017; 17 (1):1-11.

Chicago/Turabian Style

David A. Snowdon; Sandra G. Leggat; Nicholas F. Taylor. 2017. "Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review." BMC Health Services Research 17, no. 1: 1-11.