The need for time management training is universal: evidence from Turkey

In many developing countries, healthcare administrators are currently facing challenges that are representative of those in the United States. Most healthcare administrators here are physicians with no formal training in healthcare administration, and this is perhaps most apparent in their difficulties with time management. The authors' purpose in this study was to characterize the time management difficulties of administrators working in primary healthcare facilities of the Ministry of Healthcare. In the study, 67 healthcare administrators each completed a 31-item time management questionnaire. Of the participants, 79.1% reported that they have never attended time management courses or workshops. Although 76.1% said they were free to choose the priority of their daily tasks, only 44.8% felt they knew how much time they should allow for each activity in their daily life. These and other findings in the study suggest that the need for time management education is a well-defined target for intervention, both in university-based programs for future healthcare administrators and in workplace-based programs, such as in-service training for healthcare administrators who are already working.

Clinical management: learning to lead

Doctors are learning how to be clinical leaders on a course which teaches them about the wider NHS functions and how they fit in with them. One element of the course--the Skills Factory workshop--aims to empower doctors to make change to improve patient care. Participants have praised the programme for improving their 'ability and influence'.

Managing medical groups: 21st century challenges and the impact of physician leadership styles

Physician group managers and administrators charged with leading medical groups in the 21st century face a set of old and new challenges and opportunities. Leadership is assumed to make the difference between a successful and not-so-successful medical group. Yet, there is little research about how physician manager leadership styles contribute to the success of medical group practices. This article is a study of physician leadership styles using the DiSC, based upon a sample of 232 physician managers. Dominance (D) and conscientiousness (C) were the two dominant styles found in this study. Moreover, the two dominant combination leadership styles fall under the categories of the "creative" and the 'perfectionist." The article formulates practical recommendations for both physician managers and administrators for leading medical groups to respond more effectively to the challenges and opportunities facing medical groups in the 21st century.

Leadership and the emergency department

Emergency medicine, as the nation's health care system's safety net, is facing ever increasing demands on its resources and infrastructure. Classic and modern theories of leadership, which include broader based models that in corporate team responsibilities, should be studied by anyone wearing the mantle of leadership in emergency medicine, and the Realpolitik of the modern hospital must be accommodated if leadership efforts are to succeed.

Enhancing Collaborative Communication of Nurse and Physician Leadership in Two Intensive Care Units

OBJECTIVE

To test an intervention to enhance collaborative communication among nurse and physician leaders (eg, nurse manager, medical director, clinical nurse specialist) in two diverse intensive care units (ICUs).

BACKGROUND

Collaborative communication is associated with positive patient, nurse, and physician outcomes. However, to date, intervention-focused research that seeks to improve collaborative communication is lacking.

METHODS

A pretest-posttest repeated measures design incorporated baseline data collection, implementation of the intervention over 8 months, and immediate and 6-months-post data collection.

FINDINGS

Communication skills of ICU nurse and physician leaders improved significantly. Leaders also reported increased satisfaction with their own communication and leadership skills. In addition, staff nurse and physician perceptions of nursing leadership and problem solving between groups increased. Staff nurses reported lower personal stress (eg, more respect from co-workers, physicians, and managers), even though they perceived significantly more situational stress (eg, less staffing and time).

CONCLUSION

Study findings provide evidence that nurse-physician collaborative communication can be improved.

Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students

Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.

Managerial skills of principal physicians assessed by their colleagues

The purpose of this paper was to discover the views of doctors regarding the managerial skills of their principal physicians and the views of doctors of their postgraduate specialist training in management. This was done by sending out a questionnaire to every second physician registered in 1977-1986 in Finland. They were asked to evaluate their principal physician's managerial skills using a visual analogue scale. A five-point Likert scale was used to inquire how much training doctors had received for different professional tasks, including management, during their specialist training. Of all the 318 principal physicians in this study, 85 percent reported that they had had too little training for managerial skills. It was found that doctors in leading positions, both in public hospitals and the primary health care sector, are aware of the need of training for managerial and leadership skills.

Executive skills for medical faculty: a workshop description and evaluation

As the healthcare system continues to change, healthcare professionals will need to assume an increasing number of administrative and management responsibilities. The goal of this article is to describe a two-day workshop on Executive Skills for Medical Faculty and the results of an evaluation conducted one year later. This workshop consisted of specific modules on analyzing time-management skills, determining goals and priorities, improving time-management strategies, assessing leadership styles and skills, and conducting effective meetings. The workshop evaluation consisted of an immediate post-workshop questionnaire administered to all of the participants, and semi-structured interviews, conducted on the telephone, with half of the attendees. Both evaluations were designed to assess perceptions of the workshop's usefulness and areas of individual change. Feedback from the participants immediately after the workshop indicated an overall satisfaction with the workshop content and methodology and a desire to try new time-management strategies. Evaluation of the workshop one year later indicated that the majority of the participants had determined their priorities more clearly, altered their time-management strategies, and planned more effective meetings. Less change was noted in the area of leadership styles and skills. Both the immediate and delayed workshop evaluations indicated that the most useful sessions were those devoted to determining goals and priorities, time management and effective meetings. These results suggest that a two-day workshop can improve health care professionals' administrative and management skills in certain areas. A longer workshop and built-in 'follow-up' activities would enhance the potential for change.

Emergency medical services in rural areas: the supporting role of state EMS agencies

CONTEXT

EMS is an integral part of health care and is especially important in less densely populated areas. What is known about EMS in rural areas is limited because of fragmentation in the system and rudimentary data collection efforts.

PURPOSE

The goal of this study is to identify important issues faced by rural EMS systems and describe the support of rural EMS providers by state EMS agencies.

METHODS

A telephone survey of state EMS directors (response rate 95.7%) asked questions regarding issues in medical direction, programs, and initiatives by state EMS agencies that target rural and volunteer EMS providers, integration initiatives, and anticipated effects of the new Medicare fee schedule.

FINDINGS

Medical direction in rural EMS was identified as a major issue for a majority of states. Integration in EMS is seen as a possible solution but does not occur very commonly. The survey found substantial variation in the state approach to EMS issues. Less than a third of the states in the study have a statewide EMS plan. State EMS agencies address rural EMS provider needs in a limited manner. EMS state agencies focus on regulation and funding of EMS providers, with only approximately a third providing technical assistance to EMS providers.

CONCLUSIONS

The range in approaches to EMS issues at the state level will need to be taken into account in formulating national EMS policy. The limited provision of technical assistance leaves a void that may be addressed by other agencies and organizations in some states. In the absence of major federal funding initiatives, the development of EMS has become a state and local issue. A new national initiative may help address EMS issues and stimulate the development of EMS as a system beyond its current fragmented state.

Strategic planning: it's worth the effort. Homework makes retreats work

Medical groups that achieve superior operational and financial performance frequently have leaders who take time to hold strategic planning retreats. These gatherings allow practice leaders to address difficult issues such as expansion, compensation structure and governance--away from the workplace and facilitated by an outsider. The result: organizational direction that all leaders help shape and commit to.

Are you on the right track?

Physicians in early or mid-level leadership positions need different skills than those at the top. What are the skills they need and what are the risks of focusing on the wrong skills?

A prescription for change: the need for qualified physician leadership in public health

A key element missing in the federal bioterrorism preparedness plan is qualified physician leadership at the local level. Physicians now lead fewer than one-fourth of local health departments. When appointed leaders are not physicians, leadership falls on elected officials or non-medical administrators who become managers of outbreaks. As illustrated in recent case examples, these leaders may find themselves in medical emergencies that they are not qualified to handle. In serious disease outbreaks, unprepared leadership could contribute to unnecessary illness and death. Here I propose strategies to increase qualified physician leadership in state and local public health infrastructures.