Educational outcomes and leadership to meet the needs of modern health care.
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If professionals are to be equipped better to meet the needs of modern health care systems and the standards of practice required, significant educational change is still required. Educational change requires leadership, and lack of educational leadership may have impeded change in the past. In practical terms standards refer to outcomes, and thus an outcome based approach to clinical education is advocated as the one most likely to provide an appropriate framework for organisational and system change. The provision of explicit statements of learning intent, an educational process enabling acquisition and demonstration of these, and criteria for ensuring their achievement are the key features of such a framework. The derivation of an appropriate outcome set should emphasise what the learners will be able to do following the learning experience, how they will subsequently approach these tasks, and what, as a professional, they will bring to their practice. Once defined, the learning outcomes should determine, in turn, the nature of the learning experience enabling their achievement and the assessment processes to certify that they have been met. Provision of the necessary educational environment requires an understanding of the close interrelationship between learning style, learning theory, and methods whereby active and deep learning may be fostered. If desired change is to prevail, a conducive educational culture which values learning as well as evaluation, review, and enhancement must be engendered. It is the responsibility of all who teach to foster such an environment and culture, for all practitioners involved in health care have a leadership role in education. (+info)
Decision technologies and the independent professional: the future's challenge to learning and leadership.
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Most references to "leadership" and "learning" as sources of quality improvement in medical care reflect an implicit commitment to the decision technology of "clinical judgement". All attempts to sustain this waning decision technology by clinical guidelines, care pathways, "evidence based practice", problem based curricula, and other stratagems only increase the gap between what is expected of doctors in today's clinical situation and what is humanly possible, hence the morale, stress, and health problems they are increasingly experiencing. Clinical guidance programmes based on decision analysis represent the coming decision technology, and proactive adaptation will produce independent doctors who can deliver excellent evidence based and preference driven care while concentrating on the human aspects of the therapeutic relation, having been relieved of the unbearable burdens of knowledge and information processing currently laid on them. History is full of examples of the incumbents of dominant technologies preferring to die than to adapt, and medicine needs both learning and leadership if it is to avoid repeating this mistake. (+info)
Nursing leadership: bringing caring back to the future.
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Leadership, whether it is nursing, medical or healthcare leadership, is about knowing how to make visions become reality. The vision that many nurses hold dear to their hearts is one where patients are treated with dignity and respect at all times; where systems are designed for the benefit of individual needs; and where the work performed by nurses and other carers is valued and respected. Achieving such a vision will require a paradigm shift in the philosophy, priorities, policies, and power relationships of the health service. Fundamentally, it will require the rhetoric of patient centred care to become a reality. The following scenario is set in the UK in the year 2012 and describes a health service that is on the pathway to achieving this vision. It tells the story from a nursing perspective and outlines the three key foundation stones that helped nursing achieve the vision of a patient centred health service: (1) development of patient centred care measures as part of performance management and the clinical governance agenda; (2) leadership based on personal growth and development principles; (3) new clinical career and competency framework for nursing. (+info)
Strengthening user participation through health sector reform in Colombia: a study of institutional change and social representation.
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The challenge of achieving community participation as a component of health sector reform is especially great in low- and middle-income countries where there is limited experience of community participation in social policy making. This paper concentrates on the social representations of different actors at different levels of the health care system in Colombia that may hinder or enable effective implementation of the participatory policy. The study took place in Cali, Colombia and focused on two institutional mechanisms created by the state to channel citizen participation into the health sector, i.e. user associations and customer service offices. This is a case study with multiple sources of evidence using a combination of quantitative and qualitative social science methods. The analysis of respondents' representations revealed a range of practical concerns and considerable degree of scepticism among public and private sector institutions, consumer groups and individual citizens about user participation. Although participation in Colombia has been introduced on political, managerial and ethical grounds, this study has found that health care users do not yet have a meaningful seat around the table of decision-making bodies. (+info)
International response to the HIV/AIDS epidemic: planning for success.
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More assertive political leadership in the global response to AIDS in both poor and rich countries culminated in June 2001 at the UN General Assembly Special Session on AIDS. Delegates made important commitments there, and endorsed a global strategy framework for shifting the dynamics of the epidemic by simultaneously reducing risk, vulnerability and impact. This points the way to achievable progress in the fight against HIV/AIDS. Evidence of success in tackling the spread of AIDS comes from diverse programme areas, including work with sex workers and clients, injecting drug users, and young people. It also comes from diverse countries, including India, the Russian Federation, Senegal, Thailand, the United Republic of Tanzania, and Zambia. Their common feature is the combination of focused approaches with attention to the societywide context within which risk occurs. Similarly, building synergies between prevention and care has underpinned success in Brazil and holds great potential for sub-Saharan Africa, where 90% reductions have been achieved in the prices at which antiretroviral drugs are available. Success also involves overcoming stigma, which undermines community action and blocks access to services. Work against stigma and discrimination has been effectively carried out in both health sector and occupational settings. Accompanying attention to the conditions for success against HIV/AIDS is global consensus on the need for additional resources. The detailed estimate of required AIDS spending in low- and middle-income countries is US$ 9.2 billion annually, compared to the $ 2 billion currently spent. Additional spending should be mobilized by the new global fund to fight AIDS, tuberculosis and malaria, but needs to be joined by additional government and private efforts within countries, including from debt relief. Commitment and capacity to scale up HIV prevention and care have never been stronger. The moment must be seized to prevent a global catastrophe. (+info)
The Medical Library Association: promoting new roles for health information professionals.
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As the Medical Library Association (MLA) enters its second century, its role in providing leadership and focus for the education of health information professionals in a changing environment will be critical. MLA members face dramatic changes in the health care environment as well as significant opportunities and must position themselves to thrive in the new environment. This paper examines new roles for health information professionals, new approaches to education and training, and related issues of credentialing, certification/and licensure. (+info)
Surviving a merger: how four hospital libraries created a unified system.
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Librarians are acknowledged as leaders in providing information and knowledge management. They recognize the importance of maintaining an awareness of the most cutting-edge information and technology to meet the challenges of new business practices and changes that inevitably occur. Working as a team, the AHS librarians have achieved a level of communication and cooperation that is an example to other departments in the system. The success of the merged libraries has created new opportunities for leadership and growth and an optimistic future. (+info)
The case for more active policy attention to health promotion.
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Until recently, when anthrax triggered a concern about preparedness in the public health infrastructure, U.S. health policy and health spending had been dominated by a focus on payment for medical treatment. The fact that many of the conditions driving the need for treatment are preventable ought to draw attention to policy opportunities for promoting health. Following a brief review of the determinants of population health-genetic predispositions, social circumstances, environmental conditions, behavioral patterns, and medical care-this paper explores some of the factors inhibiting policy attention and resource commitment to the nonmedical determinants of population health and suggests approaches for sharpening the public policy focus to encourage disease prevention and health promotion. (+info)