ABSTRACT
AIM: To discuss the theoretical concept of strategic management and explore its relevance for healthcare organisations and nursing management. BACKGROUND: Despite being a relatively new approach, the growth of strategic management within organisations has been consistently and increasingly promoted. However, comprehensive definitions are scarce and commonalities of interpretation are limited. METHOD: This paper presents an exploratory discussion of the construct of strategic management, drawing on the literature and questioning its relevance within health-care organisations. EVALUATION: Literature relating to strategic management across a number of fields was accessed, drawing primarily on meta-studies within management literature, to identify key concepts and attempt to present a consistent definition. The concept within health care is explored in relation to nursing management. CONCLUSIONS: Inconsistency in definitions and utilisation of key concepts within this management approach results in the term being loosely applied in health-care organisations without recourse to foundational principles and a deep understanding of the approach as a theory as opposed to an applied term. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers are increasingly asked to adopt the 'next-best-thing' in managerial theories, yet caution needs to be taken in nurses agreeing to use systems that lack an evidence base in terms of both efficacy and relevance of context.
Subject(s)
Health Planning/methods , Midwifery/organization & administration , Models, Organizational , Nurse Administrators/organization & administration , Nursing/organization & administration , Health Policy , Humans , State Medicine , United KingdomSubject(s)
Leadership , Nurse Administrators/organization & administration , Patient Participation/methods , Quality Assurance, Health Care/organization & administration , Community Participation , Cooperative Behavior , Humans , Models, Nursing , Models, Organizational , Nurse Administrators/psychology , Nurse's Role/psychology , Patient Participation/psychology , Power, Psychological , State Medicine/organization & administration , United KingdomABSTRACT
AIMS: The overall aims of the paper are to provide an overview of the subject, illustrate the need for further research and to raise awareness of the ongoing limitations of existing knowledge and present these to those involved in skill mix decision making. BACKGROUND: Over the last 20 years health care organizations across the globe have seen an increase in the pace of change. The continuing drive towards cost-effectiveness, quality of care and the clinical governance agenda are causing more and more managers to examine closely the mix of staff skills. This paper demonstrates that, despite 20 years of research and skill mix management in practice, there continues to be a tension between the use of qualified and unqualified staff, particularly, the cost and quality dimensions. CONCLUSION: The evidence which currently exists offers some limited support for the suggestion that redistribution of certain tasks in nursing could be possible and could contribute to strategies for meeting the demands of changes within health care delivery. Any reallocation of task, and substitution of qualified by unqualified staff, should be based on sound evidence and not merely on staff availability, service demand or apparent costs.
Subject(s)
Clinical Competence , Licensure, Nursing , Nursing Staff , Personnel Staffing and Scheduling/organization & administration , Career Mobility , Cost-Benefit Analysis , Decision Making, Organizational , Evidence-Based Medicine , Humans , Nurse's Role , Nursing Administration Research , Nursing Assistants/education , Nursing Assistants/supply & distribution , Nursing Methodology Research , Nursing Staff/education , Nursing Staff/supply & distribution , Nursing, Supervisory/organization & administration , Nursing, Team/organization & administration , Personnel Delegation/organization & administration , Quality of Health Care/standards , Research Design , WorkloadABSTRACT
In this paper, Frank Crossan argues that the distinction between quantitative and qualitative philosophies and research methods is sometimes overstated, and that triangulation of methods in contemporary research is common. It is, therefore, important to understand the strengths and weaknesses of each approach, and this paper aims to provide the novice researcher with a basis for developing that understanding. A descriptive analysis of the philosophies of positivism and post-positivist thinking in relation to research methodology is presented both as an introduction to the philosophical basis of research, and as a sound basis from which to discuss the 'quantitative-qualitative' debate.
Subject(s)
Nursing Research/methods , Philosophy, Nursing , Research Design , Bias , Existentialism , Humans , Knowledge , Logic , Nursing Research/standards , Nursing Theory , Qualitative Research , Reproducibility of Results , Social SciencesABSTRACT
Effective strategic management is the means by which organizations achieve their desired levels of performance. There is a need to explore and describe the relationship between the profession of nursing and strategic management, with particular reference to nurses' participation in the field of strategy development and implementation. This paper aims to 'set the scene' in relation to such an exploration. The concept of strategic management is discussed and some possible definitions are explored. The need for nurses to be involved in strategic management is then considered, drawing on literature from nursing and general management sources. The overall aim of the paper is to provide a basis for further discussion and to generate ideas for research in the area.
