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

Citation

Iedema, R and Sorensen, R, Accounting for health-care outcomes: implications for intensive care unit practice and performance, Health Services Management Research, 23, (3) pp. 97-102. ISSN 0951-4848 (2010) [Refereed Article]

DOI: doi:10.1258/hsmr.2009.009020

Abstract

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.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Health Care Administration
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health Policy Evaluation
Author:Iedema, R (Professor Rick Iedema)
ID Code:94255
Year Published:2010
Deposited By:Health Sciences B
Deposited On:2014-09-04
Last Modified:2014-09-04
Downloads:0

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