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Accounting for health-care outcomes: implications for intensive care unit practice and performance

Version 2 2024-09-17, 02:11
Version 1 2023-05-18, 03:02
journal contribution
posted on 2024-09-17, 02:11 authored by R Iedema, R Sorensen
The aim of this study was to understand the environment of health care, and how clinicians and managers respond in terms of performance accountability. A qualitative method was used in a tertiary metropolitan teaching intensive care unit (ICU) in Sydney, Australia, including interviews with 15 clinical managers and focus groups with 29 nurses of differing experience. The study found that a managerial focus on abstract goals, such as budgets detracted from managing the core business of clinical work. Fractures were evident within clinical units, between clinical units and between clinical and managerial domains. These fractures reinforced the status quo where seemingly unconnected patient care activities were undertaken by loosely connected individual clinicians with personalized concepts of accountability. Managers must conceptualize health services as an interconnected entity within which self-directed teams negotiate and agree objectives, collect and review performance data and define collective practice. Organically developing regimens of care within and across specialist clinical units, such as in ICUs, directly impact upon health service performance and accountability.

History

Publication title

Health Services Management Research

Volume

23

Issue

3

Pagination

97-102

ISSN

0951-4848

Department/School

Nursing

Publisher

Sage Publications Ltd.

Publication status

  • Published

Place of publication

United Kingdom

Socio-economic Objectives

200205 Health policy evaluation

UN Sustainable Development Goals

3 Good Health and Well Being

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