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Management development for nurses is a neglected area. A management development programme at one trust has improved communication and team work, introduced simple practice changes, and saved money without impacting on patient care. Costs have been met through commercial sponsorship, recentralising training budgets and careful forward planning to make internal cover possible.
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When the local area experienced tremendous growth and change, the radiology department at Maury Hospital in Columbia, Tennessee looked seriously at its orientation process in preparation for hiring additional personnel. It was an appropriate time for the department to review its orientation process and to develop a manual to serve as both a tool for supervisors and an ongoing reference for new employees. To gather information for the manual, supervisors were asked to identify information they considered vital for new employees to know concerning the daily operations of the department, its policies and procedures, the organizational structure of the hospital, and hospital and departmental computer systems. That information became the basis of the orientation manual, and provided an introduction to the hospital and radiology department; the structure of the organization; an overview of the radiology department; personnel information; operating procedures and computer systems; and various policies and procedures. With the manual complete, the radiology department concentrated on an orientation process that would meet the needs of supervisors who said they had trouble remembering the many details necessary to teach new employees. A pre-orientation checklist was developed, which contained the many details supervisors must handle between the time an employee is hired and arrives for work. The next step was the creation of a checklist for use by the supervisor during a new employee's first week on the job. A final step in the hospital's orientation program is to have each new employee evaluate the entire orientation process. That information is then used to update and revise the manual.
Integrated delivery systems (IDSs) face many challenges in implementing information systems. An IDS's senior management staff can meet these challenges by choosing the right information systems design team and ensuring that information systems staff have sufficient training and expertise to successfully assemble the needed information systems capabilities. To effectively fulfill its role, the information systems design team needs to understand the IDS's managed care strategy, know the level of information systems functionality required, obtain components from a limited number of vendors while using technology that integrates disparate components, build or enhance communication networks, consolidate where possible, and be willing to adopt new tools.
An increasing number of admissions of patients requiring complex and acute care coupled with a decreasing number of pediatric postgraduate trainees has caused a shortage of house staff available to provide after-hours on-call coverage in the Department of Pediatrics at Toronto's Hospital for Sick Children. The Clinical Assistant program created to deal with this problem was short on staff, did not provide adequate continuity of care and was becoming increasingly unaffordable. The Clinical Departmental Fellowship program was created to address the problem of after-hours clinical coverage. The program is aimed at qualified pediatricians seeking additional clinical or research training in one of the subspecialty divisions in the Department of Pediatrics. We describe the hiring process, job description and evolution of the program since its inception in 1996. This program has been mutually advantageous for the individual fellows and their sponsoring divisions as well as the Department of Pediatrics and the Hospital for Sick Children. We recommend the introduction of similar programs to other academic medical departments facing staff shortages.
This article details the process used in one state to determine the financial costs to the child welfare agency accrued over the course of one year that were directly attributable to CPS staff turnover. The formulas and process for calculating specific cost elements due to separation, replacement and training are provided. The practical considerations inherent in this type of analysis are highlighted, as well as the use of this type of data to inform agency human resource strategies.
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