LOOKING GOOD OR DOING BETTER? PATTERNS OF DECOUPLING IN THE IMPLEMENTATION OF CLINICAL DIRECTORATES

2011 ◽  
Vol 2011 (1) ◽  
pp. 1-6
Author(s):  
Daniele Mascia ◽  
Federica Morandi ◽  
Americo Cicchetti
Keyword(s):  
Clinical Directorates

scholarly journals Involving clinicians in management: assessing views of doctors and nurses on hybrid professionalism in clinical directorates

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Prenestini ◽  
Marco Sartirana ◽  
Federico Lega
Keyword(s):  
Management Practices ◽  
Healthcare Professionals ◽  
Clinical Work ◽  
Local Health Authority ◽  
Local Health ◽  
Policy Makers ◽  
Polarity Index ◽  
Validated Questionnaire ◽  
Clinical Directorates ◽  
Doctors And Nurses

Abstract Background Hybrid professionalism is one of the most effective ways to involve clinicians in management practices and responsibilities. With this study we investigated the perceptions of doctors and nurses on hybridization in clinical directorates (CDs) in hospitals. Methods We investigated the attitudes of healthcare professionals (doctors and nurses) towards eight hospital CDs in the Local Health Authority (LHA) of Bologna (Emilia Romagna, Italy) 6 years after their implementation. We used a validated questionnaire by Braithwaite and Westbrook (2004). Drawing on Palmer et al. (2007), we added a section about the characteristics of department heads. In all, 123 healthcare professionals in managerial roles completed and returned the questionnaire. The return rate was 47.4% for doctors and 31.6% for nurses. Results Doctors reported an increase in clinical governance, interdisciplinarity collaboration, and standardization of clinical work. Hybridization of practices was noted to have taken place. While doctors did not see these changes as a threat to professional values, they felt that hospital managers had taken greater control. There was a large overlap of attitudes between doctors and nurses: inter-professional integration in CDs fostered alignment of values and aims. The polarity index was higher for responses from the doctors than from the nurses. Conclusion The study findings have implications for policy makers and managers: mission and strategic mandate of CDs; governance of CDs, leadership issues; opportunities for engaging healthcare professionals; changes in managerial involvement during the COVID-19 pandemic. We also discuss the limitations of the present study and future areas for research into hybrid structures.

Clinical directorates

1991 ◽  
Vol 5 (19) ◽  
pp. 19-21
Author(s):  
Christine Hancock
Keyword(s):  
Clinical Directorates

Clinicians into Management. The Experience in Context

1993 ◽  
Vol 6 (4) ◽  
pp. 248-259 ◽  
Author(s):  
John Burgoyne ◽  
Anna Lorbiecki
Keyword(s):  
Historical Context ◽  
Management Control ◽  
Point Of View ◽  
Professional Groups ◽  
Business Units ◽  
Medical Need ◽  
Service Organisation ◽  
Management Hierarchy ◽  
Medical Involvement ◽  
Clinical Directorates

This paper interprets the experience of a sample of 60 clinicians becoming involved in formal management, mainly at hospital unit level, in the historical context of changing health service organisation. This includes the introduction of managerialism and the evolution of the NHS into a structured network based around purchaser/provider relationships. The conclusion is that these clinicians are becoming involved in management, and making the personal and social adjustments necessary for this, but in a way that leaves medical culture, and their allegiance to it, at the present largely intact. This is achieved largely through the organisational mechanism of clinical directorates, which promise to function as professional groups from the clinical point of view and as business units from the managerial perspective. An argument is put forward, based on a theoretical view compatible with the data from the clinicians' experience, that this mode of medical involvement in management may operate without undue conflict in the longer term if: (a) clinicians accept the degree of local professional regulation that this model applies; and (b) the conflict between medical need and available resource can be dealt with elsewhere in the system without passing it back to hospitals and clinical directorates. On the other hand it is possible that conflict will increase if the consequences of management control systems and objectives percolate down through the management hierarchy and cross into the medical domain, via clinical directorates.

Clinical directorates: Author's reply

BMJ ◽  
1990 ◽  
Vol 300 (6727) ◽  
pp. 813-813 ◽  
Author(s):  
J N Johnson
Keyword(s):  
Clinical Directorates

Clinical directorates

BMJ ◽  
1990 ◽  
Vol 300 (6727) ◽  
pp. 812-813
Author(s):  
H M Saxton
Keyword(s):  
Clinical Directorates

Clinical directorates

BMJ ◽  
1990 ◽  
Vol 300 (6732) ◽  
pp. 1141-1141 ◽  
Author(s):  
A P Brooks
Keyword(s):  
Clinical Directorates
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