Management Symposium 2011 - WCPT Amsterdam
Learning Objectives
1. To understand key concepts of management quality including review and evaluation, how this can be implemented and to consider its impact on provision of excellent physiotherapy services.
2. To learn and share knowledge and experience from three WCPT regions around the World (similarities and differences) and facilitate active audience participation and views on the relationship between leadership/management and clinical practice. To understand the benefits of collaborative working.
3. To encourage innovative thinking and action planning for symposium participants to take back to their own work places.
Description
If quality and excellence are to be at the heart of service provision and the goals which physiotherapy managers and clinicians strive to achieve for their services, it is essential to be able to measure and evaluate performance in order to determine whether the identified criteria for quality and excellence are being met and whether there is alignment between performance and the strategy, vision, objectives and desired outcomes.
We introduce a Management Quality Matrix designed by Robert Jones and Fiona Jenkins for the purpose of evaluating a wide range of performance parameters. How management quality can be measured through metrics and review, how we can learn from this and how patient care can be improved through providing an evidence base for management of high quality services and the evidence base for clinical service provision will be discussed by the presenters. Major themes such as; leadership, Clinical Governance, evidence based practice, collaborative working and communication will be considered. The Evaluation Matrix was developed in the context of management quality and strategy drawing on a wide range of concepts with a view to ensuring the provision of quality clinical services as well as achieving high quality leadership and management. It comprises fifteen standards, each incorporating several components for management quality impacting on physiotherapy services.
Robert will introduce the symposium team and present an overview of the topic introducing concepts of management quality and its relationship to patient care, measurement, delegation, integration, communication, participation and staff development.
Fiona will introduce the Management Quality Evaluation Matrix explaining how this can be used to measure and achieve excellence in physiotherapy provision and the management and leadership of services. Fiona will discuss standards involved in management quality.
Janice Mueller will present aspects of Clinical Governance and how leadership and evaluation are important to management quality and how this supports excellence in physiotherapy practice.
Ina Diener will explore concepts of evidence-based practice, the importance of managing the process as part of management quality and how leadership and management of this is an essential element of excellence in physiotherapy.
Rosalie Boyce will conclude the presentations with a discussion of communication issues and the importance of collaborative working in the context of management quality, including her analysis of how structure influences function and quality of services.
The symposium team will show how systematic review and evaluation enables physiotherapy managers, leaders and clinicians, not simply to engage in 'box ticking' exercises, but rather to measure using metrics indicative of progress towards value, responsiveness and excellence for patients. Evaluation - and learning from this - facilitates best possible managerial and clinical outcomes, effectiveness, efficiency and optimal resource use, whilst acknowledging and using National targets (where these exist) without merely being subservient to them. Targets are not goals in themselves; value for the patient is the goal.
Bringing their International perspectives - from three continents - the speakers will demonstrate that developing strategy and measuring performance requires engagement at all levels throughout the service, incorporating discussion of some important related questions:
Is everyone in the team 'pulling' in the same direction?
Does the direction benefit the patient?
Are we measuring so that we know whether we are improving
Do staff have the training, motivation and respect to provide value and bring about improvement?
Are tensions around fear of change recognised and managed?
Are problems/mistakes treated as opportunities to improve?
Fiona Jenkins will facilitate discussion between delegates and speakers and Robert Jones will summarise and draw the symposium to its conclusion.
Implications / Conclusions:
An important implication is that there is an essential link between management quality - its evaluation and management - and provision of 'best' qualtiy physiotherapy services for our patients and service users.
Management quality impacts on all aspects of physiotherapy practice from the development of the 'evidence base' and outcome measurement to Clinical Goverance, information management and communication, developing new and different ways of working, through to staff deployment, development and resource use.
It is concluded that management quality is essential to the provision of quality physiotherapy services.
Click here for the WCPT web site.
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Robert Jones and Fiona Jenkins
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Ina Diener
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Janice Mueller
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Rosalie Boyce
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Management Symposium 2007 - WCPT Vancouver
Management Symposium, led by Robert Jones.
Changes in health care are driven by several factors: financial, political, economic and social. Consumer changes, with increasing life expectancy, the increasing number of people with long term illnesses, widespread access to health information and increasing demand for both quality and quantity of health care has required health strategists to re-evaluate the organisation and structure of health care services worldwide. In response to the increasingly competitive and demanding health environment, physiotherapy managers have frequently been required to consider what might be the "best" organisational structures for their services, in order to manage effective clinical service provision and improve patient outcomes within resource constraints.
Structural changes have caused concerns for physiotherapy services. These have related to service fragmentation into small teams often managed by directorates, divisions or general managers. The individual issues included; fears that staff would not get the professional support needed and professional standards would drop, difficulties with recruiting and retaining staff, lack of career progression and the Head of Service being accountable for professional standards without authority.
The introduction of relatively decentralised management units based largely on medical speciality groupings has often been perceived by physiotherapists as a need to "make them fit" with a desire for neat organisational boxes on organisational charts. Management arrangements for physiotherapists are not uniform. In some places a single Head of Service manages each of the Allied Health Professions as individual entities. In others they are managed in a variety of different groupings, for example in directorate structures, combined AHP groups or matrix management models.
Despite the recognised contribution to patient care, research into physiotherapy management has been limited. The AHPs have lacked influence in comparison with medical and nursing colleagues in the larger policy process of structural reforms at national, regional and local levels throughout the world. Thus, the potential for strategic influence has been fragmented and diluted. Organisational structures for AHP services appear to have "swung" between full devolution to localities and centralisation to AHP directorates, without full consideration for the impact of these decisions on patient care and the many factors affecting clinical governance.
Implications/conclusions
The importance of organisational structures cannot be ignored. They establish the context for many aspects of healthcare; commissioning, patient flows, cross-organisational boundary working, information management, communication processes, clinical governance and the management of risk.
Management structures should be defined after the functions of a service are determined. Organisational structure directly influences the provision of patient care, affecting both staffing and service issues.
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Robert Jones
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Fiona Jenkins
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Rosalie Boyce
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Janice Mueller
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