186,387 research outputs found
The structural prerequisites for clinical leadership
No full textFollowing a critical review of the conceptual foundations of current calls for leadership, this paper assesses the extent to which the preconditions for clinical leadership are evident in health settings. In detail, it examines how prevailing professional cultures may be affecting the followership of clinical leaders. It then assesses the extent to which existing health policies, structures and methods are aligned to structurally underpin the authority that leaders are meant to exercise
Mediating the cultural boundaries between medicine, nursing and management: the central challenge in hospital reform
No full textThis paper documents the resilience of medical and nursing profession-based subcultures and the extent of the differences between them. Against this background, we assess the capacity and willingness of medical and nursing managers to promote changes that will extend the accountability of clinicians and engender more evidence-based, financially driven and output-oriented approaches to service delivery
The impact of CHI: evidence from Wales
No full textThe Commission for Health Improvement (CHI) recently published an overview of 175 clinical governance reviews that suggests that it is having little impact on the NHS. This paper overviews the content and context of CHI's message to trusts in an attempt to shed some light on why this may be so. Content is examined through an overview of policy documents. We deduce that CHI's message is strong on the individual elements of clinical governance but lacks a framework to integrate these elements where it matters most, the individual clinical unit. Context is examined using survey and focus group data from six Welsh trusts in 2000. The data indicate that the various professional groups in Welsh trusts have very different experience with, understandings of, and evaluations of, clinical governance. Further, each professional group's evaluation is influenced by its professional culture and stances on key issues of the modernisation agenda. The paper argues that, to be more effective, CHI needs to increase its awareness of how staff perceive and evaluate clinical governance and be clearer about the specific changes in practices and cultures it is seeking to promote
Medicine, management, and modernisation: a "danse macabre"?
No full textTo break their destructive antagonism over issues of health service modernisation, doctors and managers should engage more directly with nursing and allied health professionals when responding to reform initiatives
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
How important are quality and safety for clinician managers? Evidence from triangulated studies
No full textAims to discover the work hospital clinician managers think they do and observe them in practice. A total of 14 managerial interests and concerns were identified in focus group discussions. Clinician managers’ jobs are pressurised, and are more about negotiation and persuasion than command and control. Their work is of considerable complexity, pace and responsibility and it is predicated more on managing inputs (e.g. money and people) than care processes, systems, outputs and outcomes. Thus the capacity of clinicians in these roles to respond to reforms such as those envisaged in the Bristol Inquiry may be problematic. Qualitative studies are re-affirmed as important in providing grounded insights into not only clinical activities, but also organisational behaviour and processe
Appropriate Similarity Measures for Author Cocitation Analysis
No full textWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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