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Biomedical subjects

Sandra G Leggat

Publications and source records attributed to Sandra G Leggat.

10 recordsLinked to original sources
PubMed2006

Tools for priority setting: lessons from South Australia.

BACKGROUND: This paper provides an overview of the process and tools used to develop and implement a priority setting framework for the Clinical Senate of South Australia. Established as a clinical advisory group to the Minister and Department of Health, the Clinical Senate recognised the need for an open priority setting process to fairly assign planning resources to the large number of clinical issues that needed to be addressed. DISCUSSION: Using a workbook, developed from the literature and evidence related to priority setting, agreement was reached on the use, components and structure of the priority setting process. The final products included a Gap Finder Tool and a Priority Setting Framework. SUMMARY: This paper describes the process used to develop the priority setting tools. Decision makers in other organisations can use similar processes and tools to develop or enhance their priority Setting processes.

Health Priorities↗
PubMed2005

Performance monitoring in the Victorian health care system: an exploratory study.

This paper reports on an exploratory study which aims to improve our understanding of how the Chief Executive Officers of Victorian health services monitor strategic and operational performance in their organisations. As a component of a large scale human resource management study, we surveyed 130 Chief Executive Officers (CEOs) of Victorian health sector agencies. Our findings suggest that performance monitoring was more advanced among the larger Victorian health sector organisations, and that there were areas for improvement throughout the system. Overall, the CEOs reported limited use of performance indicators related to service and clinical perspectives, with financial and volume indicators most widely used. There was little evidence that these organisations had processes in place (such as benchmarking and linking required outcomes to staff performance management) to understand the implications of the performance information and translate them into management action. The findings suggest that the sector requires technical expertise and support in data reporting, benchmarking and quality improvement in order to improve performance monitoring and ensure its relevance to strategic control, but further study is required.

Accreditation↗
PubMed2005

A case study on easing an institutional bottleneck in aged care.

This is a case study about a cross-sector Interim Health Care Strategy (IHCS) developed by a Victorian metropolitan health service in partnership with a private residential facility and a community agency to provide a range of transitional or interim care initiatives for public hospital patients awaiting permanent residential care after completing acute or subacute treatment, Australia. The aims were to improve access to emergency and acute inpatient services, while meeting the needs of residential care clients in the metropolitan suburbs. The components included care within a residential care facility, community-based interim care and a subsequent Extended Rehabilitation Program. This IHCS has shown how a cross-sector initiative can improve care and outcomes of patients awaiting residential care placement. The case study shows how a multifaceted strategy that built upon existing relationships with strong planning, organisational commitment and a facilitating structure was successful in improving care integration.

Aged↗
PubMed2005

Improving hospital performance: culture change is not the answer.

An inappropriate culture is often presented as the reason why hospitals throughout the world have been unable to achieve best practice. Many have concluded that the organizational culture of hospitals limits the ability of these organizations to improve performance, particularly in relation to improving quality and safety. Establishment of a "better" culture is often presented as the resolution to quality, safety, financial and productivity issues in hospitals. Our research indicates that certain management conditions are required before culture change can be contemplated. This paper suggests that we have underestimated the importance of people management in improving practice within hospitals, with the three most important aspects being the development of teamwork, performance management and sophisticated training. We present evidence of the potential contribution good people management can make to high performance, and argue that better people management is a cause, not an outcome, of cultural change.

Canada↗
PubMed2004

Healthy children, healthy country: the use of governing instruments in shifting the policy paradigm.

The evidence on early childhood strongly suggests the need to shift child health policy from the current focus on social welfare to a socio-ecologically based approach. This paper reviews three governing instruments, exhortation, expenditure and regulation, that have been used by governments in Australia and discusses the relative effectiveness of these approaches in shifting the child health policy paradigm.

Editorial↗
PubMed2003

Turning evidence into wisdom.

The evidence on evidence is conclusive. Incorporating evidence in decision-making processes can improve decision-making outcomes (Davies and Nutley 1999), but few healthcare systems have embraced the use of evidence to the extent needed to achieve the potential benefits. Throughout the world, health systems have "not delivered the desired health outcomes that are possible with current professional knowledge" (Ibrahim and Majoor 2002),. Browman, Snider and Ellis have suggested that there has been a lack of systems-level uptake of evidence-based healthcare: While systems may have access to the evidence, existing structures and processes have not facilitated effective transfer to operations.

Decision Making, Organizational↗
PubMed2003

The role of teaching and research hospitals in improving global health (in a globalized world).

Globalization is impacting on Hong Kong and Australia in different ways, but the experience of the public healthcare systems in both jurisdictions suggests a need for teaching and research hospitals to refocus from the management of international patients to better meet the needs for global health. Traditional globalization suggests a stockpiling of capital--a focus on improving global health suggests dismantling the stockpiles and sharing access to the necessary data, information, knowledge and discoveries to further develop local health expertise. Consistent with its position as a leading healthcare provider, the University Health Network (UHN) has been reflecting on the impact of increasing globalization on hospitals. The goals of the UHN paper on globalization are threefold--to suggest how the external and internal environments of hospitals will change as a result of globalization; to suggest a role for hospitals in a globalized world; and to stimulate discussion and debate. Given our perspective, from the other side of the world, we are pleased to contribute to the discussion and debate but will limit our comments to the future role of teaching and research hospitals based on some of the experiences of Australia and Hong Kong. The citizens of Hong Kong have been acutely aware of the issue of globalization--the excellent deep-water harbour has ensured the position of Hong Kong as a major trading hub. Hong Kong has also had a continually evolving role as a financial centre and gateway to China, and with China's accession to the World Trade Organization the impact of globalization will be even greater. On the other hand, the citizens of Australia have lived with geographic isolation, relatively limited natural resources and a small population, all of which have limited their role in global trade and financial markets. However, both Hong Kong and Australia have seen recent benefits from the increasing speed of communication and information transfer and exchange. While it may still take close to a month for Australian practitioners to receive the hard copy of the journal in the mail, a electronic transfer is instantaneous. The globalization of knowledge and practice is one of the largest impacts of the Internet. With one of the most connected populations in the world, Hong Kong is very active in the sharing of knowledge with international experts.

Academic Medical Centers↗
PubMed2002

Innovation in Australian hospitals.

This paper examines the challenge of innovation, and reports on innovation in the Australian hospital sector. Through review of both published and 'grey' literature, the analysis of the innovative record of Australian hospitals is focused on two key questions: How has the hospital sector made use of opportunities for renewal and improved effectiveness in its ongoing response to the challenges it faces? And are the conditions for effective innovation in place? To be truly innovative, the Australian hospital sector requires greater supporting mechanisms including: a consistent policy and funding framework, greater ability to harness the power of information, and development of innovation skills. The government has an important role to play in stimulating the creative capacities of hospitals and their staff.

Australia↗