Netherlands), and Juliette Malley, LSE-PSSRU (the UK). ENEPRI Research Reports present the findin... more Netherlands), and Juliette Malley, LSE-PSSRU (the UK). ENEPRI Research Reports present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 3 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe, funded by the European Commission under the 7 th Framework Programme (FP 7 Health-2007-3.2.2, Grant no. 223483). See back page for more information. The views expressed are attributable only to the authors in a personal capacity and not to any institution with which they are associated. The results and conclusions of this paper are those of the authors and are not attributable to Eurostat, the European Commission or any of the national authorities whose data have been used.
Population aging will provoke a sort of retirement \u201ctsunami\u201d in the coming years all ar... more Population aging will provoke a sort of retirement \u201ctsunami\u201d in the coming years all around Europe and in Italy. Health care and social care, more than other sectors, will be affected by this trend. The retirement of the Ba-by Boomers\u2019 generation entails at least three challenges related to the management of knowledge in health systems: the challenge of knowledge retention, that is the need to keep the expertise of the next retirees within the organization; the challenge of knowledge creation, that is the need to update the skills and competences of the elderly workers; the challenge of knowledge transfer, that is the need to find ways to make different generations share their knowledge. Integrating literature on workforce aging, knowledge management, and human resource management, this article identifies some useful experiences and recommendations to answer the knowledge management challenges linked to workforce aging
he main aim of this paper is to analyze how well Women\u2019s and Children\u2019s Directorates th... more he main aim of this paper is to analyze how well Women\u2019s and Children\u2019s Directorates that successfully balance efficiency and appropriateness monitor their performances. National performance indicators (PNE data by AGENAS and SDO data by the Ministry of Health) may not be sufficient to govern the system. The study presents the literature on performance indicators in clinical directorates and then applies this framework to Italian Directorates. Data have been gathered through an online survey. The target population was identified on the basis of efficiency and appropriateness: Directorates with efficiency scores above a threshold, with less than 30% of primary cesarean sections, and a minimum of 1.000 deliveries per year were chosen. On the basis of these criteria we identified 44 structures belonging to 40 departments. Of these, 26 managers completed the questionnaire and provided results we discuss for policy recommendations
The provision of high quality long-term care (LTC) for the elderly is an important but challengin... more The provision of high quality long-term care (LTC) for the elderly is an important but challenging goal for LTC national systems and LTC providers. Yet, considering the multidimensionality of the concept of quality, the vulnerability of many LTC recipients, the inevitable scarcity of resources (due also to the tightening of public health spending) and the importance of informal care, LTC quality assurance is a complex task. This study analyzes quality assurance indicators used at national level or recommended at local level in selected EU countries for monitoring the service of LTC providers. This analysis has the goal to assess the link between LTC system organization and LTC monitoring of performance measures of LTC providers in the following EU countries: Estonia, France, Germany, Hungary, Italy, Latvia, Slovakia, Slovenia, Spain, Sweden, The Netherlands, and the UK.
In Everyone Leads, Chris Lowney outlines a set of strategies that Roman Catholic Church leaders a... more In Everyone Leads, Chris Lowney outlines a set of strategies that Roman Catholic Church leaders and members can employ to revitalize the Catholic Church. Lowney, a former seminarian, former Managing Director at J.P. Morgan, and now chairman of the board at Catholic Health Initiatives, one of the largest healthcare systems in the US, is the ideal author to build bridges between the Catholic Church and strategic management practice. The need to revive the Catholic Church is a theme addressed in several recent books by Catholic authors, especially from the United States. I think of Rod Dreher's The Benedict Option, Russell Reno's Resurrecting the Idea of a Christian Society, Archbishop Charles Chaput's Strangers in a Strange Land, and Anthony Esolen's Out of the Ashes. Lowney, like the others, reads the signs of the times: priest shortage, lack of pastoral care, lack of engagement of members with the Church, especially the young. When I read this book all these challenges were not new to me but Lowney, as any good management author, makes a good job in creating a sense of urgency to foster change. He claims that the present crisis is the worst in five centuries and that only by collaborating all together we can get out of this. I may sound silly, but all this reminded me of a beautiful movie about leadership, change, and survival: Alive, about the famous airplane crash in the Andes. There is a scene when one of the survivors listens to the radio and hears the news that the authorities, after searching for the survivors for days, decided to call off the search. He calls everyone to share the news. The subsequent dialogue goes like this: 'I got something to tell you. Good news, they called off the search'. 'How is that good news?' 'Cos it means we're going to get out of here on our own'. And, they did. In Everyone Leads, Lowney recognizes that the rescue team, the Church, has lots of problems in finding people to save and to do the job. He claims that the survivors, the Church members, need to help the Church save them: 'God has blessed the Church with all the human talent we could ever need, whether to implement robust financial management techniques or to assess whether our worship services are really helping congregants to grow closer to Jesus' (111). The concept of empowerment and distributed leadership is very much diffused in the business setting. The author claims the same could be done in the Catholic Church-very much like the great Church builders of the past did. In his first book, Heroic Leadership, Lowney described the leadership model of the Jesuits, whose champions (Matteo Ricci, Francis Xavier, Roberto De Nobili, to name a few) achieved incredible results on their own in remote areas. A few motivated, empowered, and trained individuals can change the world, was the main message. In this book Lowney wishes this model to be scaled up to the Church level. The author coins a highly evocative acronym, EASTeR, to define a Church where everyone leads. A Church that is Entrepreneurial, Accountable, Serving, Transforming, and Reaching out. Of all the five themes, the first two, entrepreneurship and accountability, are the most innovative and interesting. Lowney presents some best practices of bottom-up leadership, where entrepreneurial parishioners develop new ways to engage
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial ... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Many countries are seeing a dramatic increase in the average age of their clinicians. The literat... more Many countries are seeing a dramatic increase in the average age of their clinicians. The literature often highlights the challenges of high replacement costs and the need for strategies to retain older personnel. Less discussed are the potential pitfalls of knowledge acquisition and transfer that accompany this aging issue. We propose a conceptual framework for understanding how clinicians' age interact with ability, motivation, and opportunity to predict clinical knowledge transfer and acquisition in health care organizations. This study integrates life-span development perspectives with the ability-motivation-opportunity framework to develop a number of testable propositions on the interaction between age and clinicians' ability, motivation, and opportunity to acquire and transfer clinical knowledge. We posit that the interaction between ability (the knowledge and skills to acquire knowledge), motivation (the willingness to acquire and transfer knowledge), and opportunity...
Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other ... more Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other scientific material when making clinical decisions. Extant research suggests that the clinicians’ pr...
Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other ... more Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other scientific material when making clinical decisions. Extant research suggests that the clinicians' propensity to use evidence-based medicine (EBM) is strongly associated with the professional collaborative networks they establish and maintain with peers. In this paper we explore whether and how the connectedness of primary care physicians with colleagues working in hospital settings is related to their frequency of EBM use in clinical practice. We used survey data from 104 pediatricians working in five local health authorities in the Italian NHS. Social network and attributional data concerning single physicians, as well as their self-reported frequency of EBM use, were collected for three major pathologies in pediatric care: asthmatic, gastro-enteric and urinary pathologies. Ordered regression analysis was employed. Our findings documented a positive association between the number of physicians' relationships with hospital colleagues and the frequency of use EBM. Results also indicated that physicians' organizational affiliations influence the frequency of EBM use. Finally, contrary to our expectations, it was found that clinicians' affiliation to formal collaborative arrangements is at odds with the likelihood of reporting higher frequency of EBM use.
Netherlands), and Juliette Malley, LSE-PSSRU (the UK). ENEPRI Research Reports present the findin... more Netherlands), and Juliette Malley, LSE-PSSRU (the UK). ENEPRI Research Reports present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 3 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe, funded by the European Commission under the 7 th Framework Programme (FP 7 Health-2007-3.2.2, Grant no. 223483). See back page for more information. The views expressed are attributable only to the authors in a personal capacity and not to any institution with which they are associated. The results and conclusions of this paper are those of the authors and are not attributable to Eurostat, the European Commission or any of the national authorities whose data have been used.
Population aging will provoke a sort of retirement \u201ctsunami\u201d in the coming years all ar... more Population aging will provoke a sort of retirement \u201ctsunami\u201d in the coming years all around Europe and in Italy. Health care and social care, more than other sectors, will be affected by this trend. The retirement of the Ba-by Boomers\u2019 generation entails at least three challenges related to the management of knowledge in health systems: the challenge of knowledge retention, that is the need to keep the expertise of the next retirees within the organization; the challenge of knowledge creation, that is the need to update the skills and competences of the elderly workers; the challenge of knowledge transfer, that is the need to find ways to make different generations share their knowledge. Integrating literature on workforce aging, knowledge management, and human resource management, this article identifies some useful experiences and recommendations to answer the knowledge management challenges linked to workforce aging
he main aim of this paper is to analyze how well Women\u2019s and Children\u2019s Directorates th... more he main aim of this paper is to analyze how well Women\u2019s and Children\u2019s Directorates that successfully balance efficiency and appropriateness monitor their performances. National performance indicators (PNE data by AGENAS and SDO data by the Ministry of Health) may not be sufficient to govern the system. The study presents the literature on performance indicators in clinical directorates and then applies this framework to Italian Directorates. Data have been gathered through an online survey. The target population was identified on the basis of efficiency and appropriateness: Directorates with efficiency scores above a threshold, with less than 30% of primary cesarean sections, and a minimum of 1.000 deliveries per year were chosen. On the basis of these criteria we identified 44 structures belonging to 40 departments. Of these, 26 managers completed the questionnaire and provided results we discuss for policy recommendations
The provision of high quality long-term care (LTC) for the elderly is an important but challengin... more The provision of high quality long-term care (LTC) for the elderly is an important but challenging goal for LTC national systems and LTC providers. Yet, considering the multidimensionality of the concept of quality, the vulnerability of many LTC recipients, the inevitable scarcity of resources (due also to the tightening of public health spending) and the importance of informal care, LTC quality assurance is a complex task. This study analyzes quality assurance indicators used at national level or recommended at local level in selected EU countries for monitoring the service of LTC providers. This analysis has the goal to assess the link between LTC system organization and LTC monitoring of performance measures of LTC providers in the following EU countries: Estonia, France, Germany, Hungary, Italy, Latvia, Slovakia, Slovenia, Spain, Sweden, The Netherlands, and the UK.
In Everyone Leads, Chris Lowney outlines a set of strategies that Roman Catholic Church leaders a... more In Everyone Leads, Chris Lowney outlines a set of strategies that Roman Catholic Church leaders and members can employ to revitalize the Catholic Church. Lowney, a former seminarian, former Managing Director at J.P. Morgan, and now chairman of the board at Catholic Health Initiatives, one of the largest healthcare systems in the US, is the ideal author to build bridges between the Catholic Church and strategic management practice. The need to revive the Catholic Church is a theme addressed in several recent books by Catholic authors, especially from the United States. I think of Rod Dreher's The Benedict Option, Russell Reno's Resurrecting the Idea of a Christian Society, Archbishop Charles Chaput's Strangers in a Strange Land, and Anthony Esolen's Out of the Ashes. Lowney, like the others, reads the signs of the times: priest shortage, lack of pastoral care, lack of engagement of members with the Church, especially the young. When I read this book all these challenges were not new to me but Lowney, as any good management author, makes a good job in creating a sense of urgency to foster change. He claims that the present crisis is the worst in five centuries and that only by collaborating all together we can get out of this. I may sound silly, but all this reminded me of a beautiful movie about leadership, change, and survival: Alive, about the famous airplane crash in the Andes. There is a scene when one of the survivors listens to the radio and hears the news that the authorities, after searching for the survivors for days, decided to call off the search. He calls everyone to share the news. The subsequent dialogue goes like this: 'I got something to tell you. Good news, they called off the search'. 'How is that good news?' 'Cos it means we're going to get out of here on our own'. And, they did. In Everyone Leads, Lowney recognizes that the rescue team, the Church, has lots of problems in finding people to save and to do the job. He claims that the survivors, the Church members, need to help the Church save them: 'God has blessed the Church with all the human talent we could ever need, whether to implement robust financial management techniques or to assess whether our worship services are really helping congregants to grow closer to Jesus' (111). The concept of empowerment and distributed leadership is very much diffused in the business setting. The author claims the same could be done in the Catholic Church-very much like the great Church builders of the past did. In his first book, Heroic Leadership, Lowney described the leadership model of the Jesuits, whose champions (Matteo Ricci, Francis Xavier, Roberto De Nobili, to name a few) achieved incredible results on their own in remote areas. A few motivated, empowered, and trained individuals can change the world, was the main message. In this book Lowney wishes this model to be scaled up to the Church level. The author coins a highly evocative acronym, EASTeR, to define a Church where everyone leads. A Church that is Entrepreneurial, Accountable, Serving, Transforming, and Reaching out. Of all the five themes, the first two, entrepreneurship and accountability, are the most innovative and interesting. Lowney presents some best practices of bottom-up leadership, where entrepreneurial parishioners develop new ways to engage
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial ... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Many countries are seeing a dramatic increase in the average age of their clinicians. The literat... more Many countries are seeing a dramatic increase in the average age of their clinicians. The literature often highlights the challenges of high replacement costs and the need for strategies to retain older personnel. Less discussed are the potential pitfalls of knowledge acquisition and transfer that accompany this aging issue. We propose a conceptual framework for understanding how clinicians' age interact with ability, motivation, and opportunity to predict clinical knowledge transfer and acquisition in health care organizations. This study integrates life-span development perspectives with the ability-motivation-opportunity framework to develop a number of testable propositions on the interaction between age and clinicians' ability, motivation, and opportunity to acquire and transfer clinical knowledge. We posit that the interaction between ability (the knowledge and skills to acquire knowledge), motivation (the willingness to acquire and transfer knowledge), and opportunity...
Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other ... more Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other scientific material when making clinical decisions. Extant research suggests that the clinicians’ pr...
Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other ... more Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other scientific material when making clinical decisions. Extant research suggests that the clinicians' propensity to use evidence-based medicine (EBM) is strongly associated with the professional collaborative networks they establish and maintain with peers. In this paper we explore whether and how the connectedness of primary care physicians with colleagues working in hospital settings is related to their frequency of EBM use in clinical practice. We used survey data from 104 pediatricians working in five local health authorities in the Italian NHS. Social network and attributional data concerning single physicians, as well as their self-reported frequency of EBM use, were collected for three major pathologies in pediatric care: asthmatic, gastro-enteric and urinary pathologies. Ordered regression analysis was employed. Our findings documented a positive association between the number of physicians' relationships with hospital colleagues and the frequency of use EBM. Results also indicated that physicians' organizational affiliations influence the frequency of EBM use. Finally, contrary to our expectations, it was found that clinicians' affiliation to formal collaborative arrangements is at odds with the likelihood of reporting higher frequency of EBM use.
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