Effective Health Care Management An

Effective Health Care Management presents the principles and criteria necessary to evaluate and enhance the quality of health care services in the NHS today. It provides an overview of health care management and health care policy, explores evidence based practice, and examines the ongoing need for management evaluation. The authors discuss the role of outcome measures, performance indicators, benchmarking, and individual performance review. They also address clinical governance, accountability and professional autonomy, and the problems underlying 'seamless service provision'.

Colin Palfrey (BA MA MEd PhD PGCE) is a lecturer in the School of Health Science, University of Wales.

Ceri Phillips (BSc PhD) is a Reader in the School of Health Science, University of Wales.

Paul Thomas (BA MSc) is an External Fellow at the University of Glamorgan.

Preface

xi

Abbreviations

xiii

Chapter 1 Introduction

1

(22)

Early thoughts about evaluative criteria

1

(2)

A conceptual framework

3

(6)

Evaluation: the issues

9

(4)

Fourth-generation evaluation

13

(4)

Realistic evaluation

17

(1)

Summary

18

(5)

Chapter 2 The Nature of Health Care Management

23

(26)

The policy context

23

(3)

What is 'health care management'?

26

(4)

Public versus private sector management

30

(1)

The skills, attributes and competences of managers

31

(4)

Health care managers as reflective practitioners

35

(4)

Future directions for health care management

39

(5)

Summary

44

(5)

Chapter 3 Multiple Perspectives and Decision Making

49

(24)

Introduction

49

(1)

Making rational decisions

50

(4)

Strategic choice

54

(1)

Quality

55

(6)

Differing perspectives

61

(2)

Evidence-based practice

63

(4)

Testable assertions

67

(2)

Summary

69

(4)

Chapter 4 Performance Management: Concepts and Approaches

73

(32)

Background to performance management

73

(4)

Performance indicators

77

(7)

'Best value' and what followed

84

(5)

Individual performance review/staff appraisal

89

(4)

The quality movement

93

(6)

Summary

99

(6)

Chapter 5 The Evidence-based Organisation

105

(34)

Foundations of evidence-based decision making

108

(9)

What constitutes good evidence?

117

(3)

Reporting evidence

120

(2)

Presentation of evidence

122

(2)

Application of evidence

124

(2)

Outcomes

126

(6)

Summary

132

(7)

Chapter 6 Politics, Ethics and Health Care Management

139

(38)

Commissioning evaluation research

141

(1)

The politics of evaluation in the health care system

142

(10)

Structural interests

152

(7)

Ethical perspectives on health care management

159

(14)

Summary

173

(4)

Chapter 7 Developing an Evaluative Approach to Health Care Management

177

(12)

Introduction

177

(1)

The past

178

(3)

The present

181

(3)

The future

184

(2)

Summary

186

(3)

Index

189

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Effective Health Care Management An Evaluative Approach

Summary

Author Biography

Table of Contents

Supplemental Materials