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17 records – page 1 of 2.

An approach to the assessment of learning needs for physician-managers.

https://arctichealth.org/en/permalink/ahliterature235444
Source
J Health Adm Educ. 1986;4(4):629-43
Publication Type
Article
Date
1986
Author
T. Myers
P. Leatt
W. Bonus
Source
J Health Adm Educ. 1986;4(4):629-43
Date
1986
Language
English
Publication Type
Article
Keywords
Canada
Data Collection
Hospital Administration - education
Humans
Physician Executives
Psychiatry - education
Public Health - education
Statistics as Topic
Abstract
In recent years physicians have become increasingly involved in the decision-making and policy-making processes in hospitals and other health service organizations. Consequently, there is a growing awareness of the need for specialized education programs for physicians who have managerial responsibilities. While education programs in management for physicians have been available in Britain and the United States for a number of years, relatively few programs have existed in Canada. Typically, physicians who have assumed administrative positions either within the medical staff organization or within the hospital's management structure have received no formal training in management. This article examines reasons for the increased demand for management education for physicians in Canada, specific needs of physicians in the area of management education, and the assessment of needs for management education programs.
PubMed ID
10316142 View in PubMed
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The behavioural outcomes of quality improvement teams: the role of team success and team identification.

https://arctichealth.org/en/permalink/ahliterature195949
Source
Health Serv Manage Res. 2000 May;13(2):78-89
Publication Type
Article
Date
May-2000
Author
D M Irvine
P. Leatt
M G Evans
G R Baker
Author Affiliation
Faculty of Nursing, University of Toronto, Ontario, Canada. d.irvine@UTORONTO.CA
Source
Health Serv Manage Res. 2000 May;13(2):78-89
Date
May-2000
Language
English
Publication Type
Article
Keywords
Health Services Research
Hospitals, Community - organization & administration - standards
Humans
Management Quality Circles
Models, organizational
Ontario
Organizational Culture
Personnel Loyalty
Power (Psychology)
Total Quality Management - organization & administration
Abstract
This study investigates the relationship between hospital quality improvement (QI) team success and changes in empowerment, 'organizational commitment, organizational citizenship behaviour' (OCB) and job behaviour related to QI. Data were collected from administrative staff, healthcare professionals and support staff from four community hospitals. The study involved a field investigation with two data collection points. Structured questionnaires and interviews with hospital management were used to collect data on the study variables. High scores were observed for organizational commitment, OCB and job behaviour related to QI when individuals identified with teams that were successful. Low scores were observed when individuals identified with teams that were unsuccessful. Empowerment was positively related to job behaviour associated with QI. It is concluded that participation on QI teams can lead to organizational learning, resulting in the inculcation of positive 'extra-role' and 'in-role' job behaviour.
PubMed ID
11184012 View in PubMed
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Corporatization and deprivatization of health services in Canada.

https://arctichealth.org/en/permalink/ahliterature235751
Source
Int J Health Serv. 1987;17(4):567-84
Publication Type
Article
Date
1987
Author
B J Fried
R B Deber
P. Leatt
Author Affiliation
Department of Health Administration, University of Toronto, Ontario, Canada.
Source
Int J Health Serv. 1987;17(4):567-84
Date
1987
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care
Health Services - economics
Health Services Administration
Humans
Insurance, Health
National Health Programs
Private Practice
Privatization
Professional Corporations
Abstract
Canada's system of health services has been shaped by the forces and values in the Canadian political, cultural, social, and economic environment; these forces continue to place constraints on future changes. We distinguish between "corporatization" and "privatization", and the implications of each for improved efficiency of the system. Although the organization of health services is, in certain provinces, undergoing significant structural changes, there is evidence that rather than privatizing, the system may actually be continuing to experience what we have termed deprivatization, as the scope of government involvement expands to include a more comprehensive definition of health care. Trends in Canada differ considerably from those in the United States; universal health insurance has curbed the ability and desire of institutions to exclude members of some socioeconomic groups from receiving care. U.S.-based models, if applied to Canada, could lead to both higher costs and lower quality of care. Considerable efficiencies can be realized within Canada's current system.
PubMed ID
3692643 View in PubMed
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Decentralization of decision-making in Canada's health system: the Sunnybrook experience.

https://arctichealth.org/en/permalink/ahliterature217123
Source
Health Serv Manage Res. 1994 Nov;7(4):235-49
Publication Type
Article
Date
Nov-1994
Author
P. Leatt
M. Murray
L. Lemieux-Charles
Author Affiliation
Department of Health Administration, University of Toronto.
Source
Health Serv Manage Res. 1994 Nov;7(4):235-49
Date
Nov-1994
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Canada
Data Collection
Decision Making, Organizational
Evaluation Studies as Topic
Hospital Bed Capacity, 500 and over
Hospital Departments - organization & administration
Hospitals, Teaching - organization & administration
Humans
Models, organizational
Ontario
Physician Executives - statistics & numerical data - trends
Power (Psychology)
Product Line Management
Abstract
Though there is a significant literature which notes that physicians are fast becoming organizational members, there has been little research evidence to suggest that the adoption of new management models have actually facilitated their involvement. This study sought to examine whether a conscious effort at decentralizing decisions at the clinical unit level would actually result in increased involvement of physicians and other clinicians in decision-making at that level. Two major surveys examining individual roles and responsibilities and unit relationships with other units were conducted, at two points in time, in a large Canadian tertiary care centre. Results suggest that physicians had experienced an increase in administrative discretion. There was an overall increase of many groups in influencing clinical unit decisions with a perceived decrease in senior management influence in budget administration at the unit level. Lessons learned in conducting this type of research are described.
PubMed ID
10161125 View in PubMed
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Ethical issues faced by clinician/managers in resource-allocation decisions.

https://arctichealth.org/en/permalink/ahliterature220692
Source
Hosp Health Serv Adm. 1993;38(2):267-85
Publication Type
Article
Date
1993
Author
L. Lemieux-Charles
E M Meslin
C. Aird
R. Baker
P. Leatt
Author Affiliation
Department of Health Administration, University of Toronto, Ontario.
Source
Hosp Health Serv Adm. 1993;38(2):267-85
Date
1993
Language
English
Publication Type
Article
Keywords
Canada
Community-Institutional Relations
Conflict of Interest
Decision Making, Organizational
Ethics, Institutional
Evaluation Studies as Topic
Focus Groups
Health Care Rationing - organization & administration - standards
Health Services Research
Hospitals, Teaching - organization & administration - standards
Humans
Interprofessional Relations
Moral Obligations
Nurse Administrators - psychology - standards
Patient Advocacy
Physician Executives - psychology - standards
Quality of Health Care
Resource Allocation
Social Responsibility
Abstract
This article explores the ethical issues faced by clinicians with management responsibilities (clinician/managers) when making decisions related to resource allocation and utilization at a Canadian teaching hospital. Using a focus group method, 28 individuals participated in four homogeneous groups that included nurse managers, managers from other professional groups, and physician managers. Ethical issues that recurred throughout the discussions included fairness, concern with preventing harm, consumer/patient choice, balancing needs of different groups of patients, conflict between financial incentives and patient needs, and professional autonomy. The particular issue of conflict is analyzed from two perspectives--a theory of professional-bureaucratic roles and of obligation--that illustrate how both management and philosophical issues are related. The findings suggest that decentralizing resource allocation and utilization decisions does raise ethical issues for clinician/managers and that a better understanding of these issues can be obtained using an interdisciplinary perspective.
PubMed ID
10160949 View in PubMed
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Integrated delivery systems: has their time come in Canada?

https://arctichealth.org/en/permalink/ahliterature212379
Source
CMAJ. 1996 Mar 15;154(6):803-9
Publication Type
Article
Date
Mar-15-1996
Author
P. Leatt
G H Pink
C D Naylor
Author Affiliation
Department of Health Administration, University of Toronto, Ontario.
Source
CMAJ. 1996 Mar 15;154(6):803-9
Date
Mar-15-1996
Language
English
Publication Type
Article
Keywords
Canada
Capitation Fee
Community Health Services
Continuity of Patient Care
Cost Control
Delivery of Health Care, Integrated - economics - methods - organization & administration
Feasibility Studies
Health Care Coalitions
Health planning
Health Services Accessibility
Health status
Hospital-Physician Relations
Humans
Income
Leadership
Outcome Assessment (Health Care)
Physician Incentive Plans
Pilot Projects
Primary Health Care
Professional Autonomy
Quality of Health Care
Referral and Consultation
Abstract
In the 1990s every Canadian province is struggling to reduce health care expenditures without jeopardizing access to health care or quality of care. The authors propose a new model for health care delivery: the Canadian Integrated Delivery System (CIDS). A CIDS is a network of health care organizations; it would provide, or arrange to provide, a coordinated continuum of services to a defined population and would be held clinically and fiscally accountable for the outcomes in and health status of that population. A CIDS would serve 100,000 to 2 million people; the care it would provide would be funded on a capitation basis. For providers, there would be explicit financial incentives to minimize costs. At the same time, service quality and consumer choice of primary care practitioner would be maintained. Primary care physicians and specialists would work with other health care service providers to offer a full spectrum of care. CIDS providers would form strategic alliances with community agencies, hospitals, the private sector and other health care services not managed by the CIDS, as needed. For physicians, affiliation with a CIDS that provided strong clinical leadership could be beneficial to their income stability and autonomy. Pilot projects of this model in several communities would determine whether this concept is feasible in the Canadian health care context.
Notes
Cites: Hosp Health Serv Adm. 1993 Winter;38(4):447-6610130607
Cites: CMAJ. 1994 Sep 15;151(6):763-78087752
Cites: N Engl J Med. 1993 Jan 14;328(2):148-528416437
Cites: Healthc Exec. 1995 May-Jun;10(3):12-710141875
Cites: Front Health Serv Manage. 1995 Spring;11(3):3-37; discussion 51-210161157
PubMed ID
8634958 View in PubMed
Less detail

Issues in the use of the Alberta Patient Classification System to fund Ontario long term care.

https://arctichealth.org/en/permalink/ahliterature217433
Source
Can J Nurs Adm. 1994 Sep-Oct;7(3):7-28
Publication Type
Article
Author
G H Pink
L L O'Brien-Pallas
P. Leatt
Source
Can J Nurs Adm. 1994 Sep-Oct;7(3):7-28
Language
English
Publication Type
Article
Keywords
Humans
Inpatients - classification
Long-Term Care - economics
Models, Econometric
Ontario
Reproducibility of Results
Abstract
The purpose of this paper is to assess some of the issues surrounding the use of the Alberta Patient Classification System for Long Term Care Facilities (APCS) to fund Ontario long term care by attempting to answer the following questions: 1) Is the APCS valid for classifying Ontario long term care patients?; 2) Is it appropriate to use the APCS to fund Ontario long term care?, and; 3) What is required to develop a valid long term care patient classification and funding system appropriate for Ontario? The paper discusses why it may be inappropriate to use the APCS to classify Ontario long term care patients, some of the important financial consequences to a long term care facility if the APCS is inappropriate, and what might be necessary for a better patient classification and funding strategy. The potential and pitfalls of adopting patient classification systems developed in a different health system should be of interest to nurse managers in all provinces.
PubMed ID
7880847 View in PubMed
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Is the grass any greener? Canada to United States of America nurse migration.

https://arctichealth.org/en/permalink/ahliterature149377
Source
Int Nurs Rev. 2009 Jun;56(2):198-205
Publication Type
Article
Date
Jun-2009
Author
L. McGillis Hall
G H Pink
C B Jones
P. Leatt
M. Gates
J. Peterson
Author Affiliation
University of Toronto, Toronto, ON Canada. l.mcgillishall@utoronto.ca
Source
Int Nurs Rev. 2009 Jun;56(2):198-205
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Attitude of Health Personnel - ethnology
Canada - ethnology
Career Mobility
Cross-Sectional Studies
Education, Nursing, Continuing
Emigrants and Immigrants - education - psychology - statistics & numerical data
Employment - psychology - statistics & numerical data
Female
Foreign Professional Personnel - education - psychology - supply & distribution
Humans
Male
Middle Aged
Motivation
Nursing Administration Research
Nursing Methodology Research
Nursing Staff - education - psychology - supply & distribution
Personnel Selection - organization & administration
Retrospective Studies
Salaries and Fringe Benefits
United States
Abstract
Little or no attempt has been made to determine why nurses leave Canada, remain outside of Canada, or under what circumstances might return to Canada. The purpose of this study was to gain an understanding of Canadian-educated registered nurses working in the USA.
Data for this study include the 1996, 2000 and 2004 USA National Sample Survey of Registered Nurses and reports from the same time period from the Canadian Institute for Health Information.
This research demonstrates that full-time work opportunities and the potential for ongoing education are key factors that contribute to the migration of Canadian nurses to the USA. In addition, Canada appears to be losing baccalaureate-prepared nurses to the USA.
These findings underscore how health care policy decisions such as workforce retention strategies can have a direct influence on the nursing workforce. Policy emphasis should be on providing incentives for Canadian-educated nurses to stay in Canada, and obtain full-time work while continuing to develop professionally.
Findings from this study provide policy leaders with important information regarding employment options of interest to migrating nurses.
This study describes and contrasts nurses in the data set, thus providing information on the context of nurse migration from Canada to the USA. Data utilized in this study are cross-sectional in nature, thus the opportunity to follow individual nurses over time was not possible.
PubMed ID
19646169 View in PubMed
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17 records – page 1 of 2.