Browsing by Person "Ball, Jane"

Now showing 1 - 8 of 8

Beyond hierarchy? An assessment of the early phase of implementation of the Beyond Hierarchy Initiative at North Staffordshire NHS Trust
(Queen Margaret College, 1998) Buchan, James; Ball, Jane; O'May, Fiona
Determining skill mix in the health workforce: Guidelines for managers and health professionals
(WHO, 2000) Buchan, James; Ball, Jane; O'May, Fiona
Most health systems are coming under increasing scrutiny with a view to cost containment, often as a direct or indirect result of health sector reform. Health care is labour intensive, and the level and mix of staff deployed is a central element in determining the cost of care and the quality of care. It is important that managers and health professionals in any health care organization strive to identify the most effective mix of staff achievable within available resources and organizational priorities. This report builds on the work already undertaken for WHO in this area, which developed a typology of approaches to skill mix (Buchan, Ball & O'May, 1996; see also Buchan, 1999). It examines the context in which decisions on skill mix are made,drawing from country case studies, and provides practical guidelines for health professionals and managers.
Evaluating the impact of a new pay system on nurses in the UK
(2011-01) Buchan, James; Ball, Jane
Aims and objectives: This study examines the impact of implementing a new pay system (Agenda for Change) on nursing staff in the National Health Service (NHS) in the UK. This new pay system covered approximately 400,000 nursing staff. Its objectives were to improve the delivery of patient care as well as staff recruitment, retention and motivation. Background: The new system aimed to provide a simplified approach to pay determination, with a more systematic use of agreed job descriptions and job evaluation to 'price' individual jobs, linked to a new career development framework. Design: Secondary analysis of survey data. Methods: Analysis of results of large-scale surveys of members of the Royal College of Nursing of the United Kingdom (RCN) to assess the response of nurses to questions about the implementation process itself and their attitude to pay levels. Results: The results demonstrated that there was some positive change after implementation of Agenda for Change in 2006, mainly some time after implementation, and that the process of implementation itself raised expectations that were not fully met for all nurses. Conclusions: There were clear indications of differential impact and reported experiences, with some categories of nurse being less satisfied with the process of implementation. The overall message is that a national pay system has strengths and weaknesses compared to the local systems used in other countries and that these benefits can only be maximised by effective communication, adequate funding and consistent management of the system. Relevance to clinical practice: How nurses' pay is determined and delivered can be a major satisfier and incentive to nurses if the process is well managed and can be a factor in supporting clinical practice, performance and innovation. This study highlights that a large-scale national exercise to reform the pay system for nurses is a major undertaking, carries risk and will take significant time to implement effectively. 2010 Blackwell Publishing Ltd.
If changing skill mix is the answer, what is the question?
(Royal Society of Medicine Press, 2001) Buchan, James; Ball, Jane; O'May, Fiona
Changing skill mix is often identified as a potential solution to health services staffing and resourcing problems, or is related to health sector reform. This paper discusses what is meant by skill mix, provides a typology of the different approaches to assessing skill mix and examines, by means of case studies, the contextual, political, social and economic factors that play a part in determining skill mix. These factors are examined in relation to three factors: the reasons (or drivers) for examining skill mix; the impact of contextual constraints; and the effect of varying spans of managerial control. Case studies conducted in Costa Rica, Finland, Mexico, the UK and the USA are used to explore the reality of assessing skill in different contexts and health care settings. We argue that, although skill mix may be a universal challenge, it is not a challenge that all managers or health professionals can meet in the same way, or with the same resources. Context can have a significant effect on the ability of health service managers to assess and change skill mix. The key determinant is the extent to which these factors are in the locus of control of management nationally, regionally, or locally, within different countries. We emphasise the need to evaluate the problem and examine the context, before deciding if a change in skill mix is the answer. The local managerial span of control and degree of organisational flexibility will be major factors in determining the likely impact of any attempts to change skill mix. Before embarking on a skill mix review, any organisation should ask itself the question: 'If changing skill mix is the answer, what is the question?'
New Role, New Country: introducing US physician assistants to Scotland
(BioMed Central, 2007-05-04) Buchan, James; O'May, Fiona; Ball, Jane
This paper draws from research commissioned by the Scottish Executive Health Department (SEHD). It provides a case study in the introduction of a new health care worker role into an already well established and mature workforce configuration It assesses the role of US style physician assistants (PAs), as a precursor to planned piloting of the PA role within the National Health Service (NHS) in Scotland. The evidence base for the use of PAs is examined, and ways in which an established role in one health system (the USA) could be introduced to another country, where the role is new and unfamiliar, are explored. The history of the development of the PA role in the US also highlights a sometimes somewhat problematic relationship between P nursing profession. The paper highlights that the concept of the PA role as a 'dependent practitioner' is not well understood or developed in the NHS, where autonomous practice within regulated professions is the norm. In the PA model, responsibility is shared, but accountability rests with the supervising physician. Clarity of role definition, and engendering mutual respect based on fair treatment and effective management of multi-disciplinary teams will be pre-requisites for effective deployment of this new role in the NHS in Scotland.
Physician Assistants in NHS Scotland: Reviewing the Issues. Report for the Scottish Executive Health Department.
(Queen Margaret University College, 2006) Buchan, James; Ball, Jane; O'May, Fiona
This paper was commissioned by the Scottish Executive Health Department (SEHD). It provides background information on the role of physician assistants (PAs), and on their deployment in the United States and in England. The SEHD is planning to recruit and deploy a small number of US educated PAs in the NHS in Scotland in 2006. The primary focus of the paper is to identify lessons for consideration during planning and implementation of the planned pilot-. This paper highlights key lessons from the literature, and from key informants, on the employment of PAs. Readers who wish a comprehensive assessment and description of the development of the PA role in the USA, should consult the American Academy of Physician Assistants (AAPA) website (www.aapa.org) and also the core book by Hooker and Cawley (2003). Given constraints of time and resources the focus of the review was on identifying key messages for Scotland; it was not structured as a systematic review (no systematic review of physicians assistants was identified during the search). The review was supported by follow up contact with key individuals and representatives of organisations in the US and with UK organisations working with PAs. The purpose was to identify the issues that need be considered in the lead up to the recruitment and deployment of PAs in the NHS in Scotland. The remainder of the paper is in two sections: Section 2 reports key findings from the literature review; and Section 3 reports of follow up findings, and focuses on key messages for Scotland.
The right profile? a review of approaches to determining personnel mix in healthcare
(Queen Margaret College, 1996-10) Buchan, James; Ball, Jane; O'May, Fiona
Transformative impact of Magnet designation: England case study
(Wiley, 2008-12) Aiken, Linda H.; Buchan, James; Ball, Jane; Rafferty, A. M.
Aims. To test the impact of the implementation of Magnet principles of improving nurses' work environments. Background. Magnet hospital designation developed in the USA in the 1980s to recognise hospitals that had created excellent patient care environments and supported the professional practice of nursing. A pilot initiative in England was the first test of the applicability of Magnet standards outside the USA. Methods. Research methods included surveys of nurses in the demonstration hospital in a predesign and postdesign and comparisons to survey results of nurses practicing in a national sample of 30 National Health Service Trusts. Results. Prior to beginning the Magnet journey, the demonstration hospital had a nurse work environment that was somewhat less positive than the national sample NHS hospitals. Nurses practicing in the demonstration hospital were somewhat less satisfied with their jobs than nurses in other NHS hospitals. Following a two-year period during which the evidence-based Magnet standards were implemented and Magnet Designation was awarded, the quality of the nurse practice environment had improved significantly, as had job satisfaction of nurses and their appraisals of the quality of patient care. The quality of the nurse practice environment after Magnet designation was better than that of a national sample of NHS trusts. Improved nurse outcomes were because of the improved practice environment rather than staffing enhancements. Conclusions. Implementation of the Magnet hospital intervention was associated with a significantly improved nursing work environment as well as improved job-related outcomes for nurses and markers for quality of patient care. Relevance to clinical practice. Nurses can use Magnet principles to improve the quality of their work environments. 2008 Blackwell Publishing Ltd.