leiderschap in de zorg

REVIEW

Koen Balcaen

LEIDERSCHAP IN DE ZORG

Leiderschap

Context

Definities

literatuur

Opvolging en

monitoring

Context

KB 13/7/2006: functie van hoofdverpleegkundige

Hoofdstuk 1 VERANTWOORDELIJKHEID

Organisatie

Continuïteit

kwaliteit

PARTICIPATIE Uitbouw verpleegkundig beleid

Implementatie op microniveau

BELAST MET Toezicht en evaluatie van team

SAMENWERKING Integratie van verpleegkundige activiteit in het geheel van activiteiten in het ziekenhuis

Context


Hoofdstuk 2 Aligneren op strategische visie van het ziekenhuis

Context


Hoofdstuk 3: m.b.t. zorg Organisatie – coördinatie – toezicht zorgactiviteiten

Doelstellingen team

Patiëntgerichte verpleegkundige zorgorganisatie/ ethiek/ patiëntenrechten

Bijsturen van zorg i.f.v. behoeften en noden van patiënt/

vernieuwingsprojecten

Kwaliteit en continuïteit van zorg

Context


Hoofdstuk 4: personeelsbeleid Nodige personeel kwantitatief en kwalitatief

Werkverdeling

Working environment

Coaching en mentoring

Context


• Hoofdstuk 5: middeleninzet Doeltreffende inzet in functie van kwaliteit van de zorg

• Hoofdstuk 6: opleiding en ontwikkeling Opleidingsbeleidsplan

loopbaanplanning

Studentenbeleid

• Hoofdstuk 7: overleg in functie van interne en externe

informatiedoorstroming

Context

KB 27/4/2007: interne en externe toetsing van kwaliteit van verpleegkundige

zorg

Context Convenant patiëntveiligheid

Context

Visitatie/Accreditatie

The international essentials of health care quality and patient safety

1. Leadership proces and accountabilty

2. Competent and capable workforce

3. Safe environment for staff and patients

4. Clinical care of patients

5. Improving quality and safety

Accreditatie

Section I: Patient-Centered Standards International Patient Safety Goals (IPSG)

Access to Care and Continuity of Care (ACC)

Patient and Family Rights (PFR)

Assessment of Patients (AOP)

Care of Patients (COP)

Anesthesia and Surgical Care (ASC)

Medication Management and Use (MMU)

Patient and Family Education (PFE)

Section II: Health Care Organization Management Standards Quality Improvement and Patient Safety (QPS)

Prevention and Control of Infections (PCI)

Governance, Leadership, and Direction (GLD)

Facility Management and Safety (FMS)

Staff Qualifications and Education (SQE)

Management of Communication and Information (MCI)

JOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR HOSPITALS, 4TH EDITION

Standard of QPS. 1

Those responsible for governing and managing the organization participate in planning and measuring a quality

improvement and patient safety program.

• Intent of QPS.1

If an organization is to initiate and to maintain improvement and to reduce risks to patients and staff, leadership

and planning are essential. This leadership and planning come from the governing body of the organization

along with those who manage the clinical and managerial activities of the organization on a daily basis.

Collectively they represent the leadership of the organization. The leadership is responsible for establishing the

organization’s commitment, approach to improvement and safety, and program management and oversight.

The leadership develops the quality and patient safety plan and, through its vision and support, shapes the

quality culture of the organization.

The governing body holds ultimate accountability for quality and patient safety in the organization, and,

thus, it approves the quality and patient safety plan (also see GLD.1.6); on a regular basis, it receives and acts

on reports related to the organization’s program to improve quality and patient safety (also see GLD.1.6).

• Measurable Elements of QPS.1

❏ 1. The organization’s leadership participates in developing the plan for the quality improvement and

patient safety program.

❏ 2. The organization’s leadership participates in measuring the quality improvement and patient safety

program.

❏ 3. The organization’s leadership establishes the oversight process or mechanism for the organization’s

quality improvement and patient safety program.

❏ 4. The organization’s leadership reports on the quality and patient safety program to governance.

Standard QPS.10

Improvement and safety activities are undertaken for the priority areas identified by the organization’s leaders.

• Intent of QPS.10

The organization uses appropriate resources and involves those individuals, disciplines, and departments closest

to the processes or activities to be improved. Responsibility for planning and carrying an improvement is

assigned to individuals or a team, any needed training is provided, and information management or other

resources are made available.

Once planned, data are collected during a test period to demonstrate that the planned change was actually an

improvement. To ensure that the improvement is sustained, measurement data are then collected for ongoing

analysis. Effective changes are incorporated into standard operating procedure, and any necessary staff education

is carried out. The organization documents those improvements achieved and sustained as part of its

quality management and improvement program.

• Measurable Elements of QPS.10

❏ 1. The priority areas identified by the organization’s leaders are included in improvement activities. (Also

see QPS.3, ME 1)

❏ 2. Human and other resources needed to carry out an improvement are assigned or allocated.

❏ 3. Changes are planned and tested.

❏ 4. Changes that resulted in improvements are implemented.

❏ 5. Data are available to demonstrate that improvements are effective and sustained.

❏ 6. Policy changes necessary to plan, to carry out, and to sustain the improvement are made.

❏ 7. Successful improvements are documented.

JOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR HOSPITALS, 4TH EDITION

Context

RN4CAST

Working environment

- Adequacy of nursing staff

- Collaboration between nurses

- Working climate

- Participation in hospital affairs

- The administrative support

- Patient documentation is continuously updated

Quality and saftety

- quality of patient care

- quality improvement last year

- patient safety on the ward

- psycho-social attention

- patient ability to manage care after discharge

Statisfaction and emotional exhaustion

Context

Economische toestand

Crisis:

1. Nationaal

2. Europees

3. Wereldwijd

Kostenbeheersing

Efficiëntie

Lean management

Kwaliteit= Meerwaarde / cost

Leiderschap

Context

Definities

literatuur

Opvolging en

monitoring

Definities

• Leadership: the process of influencing

people to accomplish goals

• Strong leadership: the empowering of

individuals and instilling the belief and

confidence in their ability to achieve and

succeed

D,L,Huber; Leadership and nursing care management; 2006 third edition

Definities

• Management: the process of influencing

employees work towards the goals of the

organization by integrating resources through

planning, organizing, coordinating, directing

and controlling


Definities

5 aspects of leadership

1. The leader

2. The follower

3. The situation

4. The communication process

5. The goals


Definities

• Transformational leadership: activate

followers to perform to their full potential and

provide a sense of direction

C.A.Wong, H.K.Laschinger, G.G.Cummings; athentic leadership ansd nurses voice, behaviour and perceptions

of care; journal of nursing management;2010

Definities

• Authentic leadership: building trust,

sound work environments by special attention

to honesty, integrety and ethical standards in

the relationship of leader-follower


Leiderschap

Context

Definities

literatuur

Opvolging en

monitoring

P.B.Germain, G.G.Cummings; The influence of nursing leadership on nurse performance: a systematic review; Journal

of Nursing Management; 2010; 425-439

Systematic review:

2 doelstellingen

1.Welke factoren worden door de verpleegkundige gepercipieerd als

beïnvloedend op hun motivatie om goed te presteren?

– Autonomie

– Working relationship

– Access to resources

– Individual nurse characteristics

– Leadership practices

2.Welke leiderschapsgedragingen correleren met verpleegkundige

performantie?

G.G. Cummings, T. McGregor, M. Davey,H.Lee, C.A. Wong, E. Lo, M. Muise, E. Stafford; Leadership styles and outcome

patterns for the nursing workforce and work environment; A systematic review; 2010; International Journal of Nursing

Studies 47; 363-385

Systematic review:

2 conclusies:

1.Negatieve relatie tussen taakgeörienteerd

leiderschap en optimale verpleegkundige outcomes

2.Transformationeel leiderschap en relationeel

leiderschap beïnvloedt verpleegkundige job

satisfactie, recruitment, retentie en gezonde

werkomgeving

T. Cowden, G.G. Cummings, J.P.Mc-Grath; Leadership practices and staff nurses intent tot stay: a systematic review;

Journal of Nursing Management; 2011; 19; 461-477

Systematic review:

Conclusie:

Positieve relatie tussen transformationeel leiderschap,

ondersteunende werkomgeving en intentie van

verpleegkundige staf om te blijven werken in huidige

werkomgeving

Leiderschap

Context

Definities

literatuur

Opvolging en

monitoring

Ondersteunende instrumenten voor

ontwikkeling van leiderschap

• Primaire ontwikkeling van klinisch

leiderschap in basisopleiding

• Specifieke focus in master-

opleiding

• In house detectie van talent

• Loopbaanontwikkeling

• Training/ verdieping

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• Duidelijke visie van het ziekenhuis

• Betrokken bij operationele invulling

• Communicatie

• Duidelijke doelstellingen (SMART)

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• Mentorship

• Coaching & feedback

• Loopbaangeleiding

• 360° FB

• POP

• FG

S

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• Balanced score card

– Activiteiten

– Middelen (personeel/

verbruiksgoederen)

– Investeringen

– Q-indicatoren

• Structuur/proces/outcome

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leiderschap in de zorg

Documents