Hospital leadership for quality: theory and practice: II. Quality performance evaluation.

Hospitals need excellent leadership to be efficient in the use of scarce stakeholder resources and to be effective in the competitive provision of services to multiple customers. This paper is the second report on a study conducted with cooperation of the executive team at a large government-funded hospital in Brisbane, Australia. The overall study focused on linking the leadership concepts and attributes of the members of the executive with an overall evaluation of quality practice in the hospital. The first paper reported the leadership results. This paper reports the quality practice and its links with leadership. The study revealed use of data, understanding of processes and the formation of supplier partnerships as the areas of hospital activity most limiting the ability to improve. Little impact of leadership attributes was found, contrary to studies conducted elsewhere. This may be due to the strong influence of different professional groups within the hospital, since domains of leadership influence largely coincided with these groups.

Effective hospital leadership for quality: theory and practice.

Hospitals need excellent leadership to be efficient in the use of scarce stakeholder resources and to be effective in the competitive provision of services to multiple customers. This study was conducted with the cooperation of the executive team at a large government-funded hospital in Brisbane. It focused on understanding the conceptual models of leadership held by members of the executive and comparing this model with an externally derived model of leadership. Performance on the local model was estimated by cross-linking performance assessment on the external model. Members of the executive espoused, and were also rated by others in the hospital as practising, to a moderate degree, a transformational style of leadership. An overall evaluation of quality practice in the hospital revealed the use of data, the understanding of processes and the formation of supplier partnerships as the areas of hospital activity most limiting the ability to improve. The implications of the conceptual model and performance levels are discussed in relation to the introduction of quality management practice in the hospital, and in terms of management development. A complementary paper focusing on quality implementation as perceived at different staff levels in the hospital is in preparation.

Effect of vertical food-trough dividers on the feeding and agonistic behaviour of layer hens.

1. Opaque, vertical dividers were used to create either one or two feeding spaces in front of each cage. Three hens were housed in each 310 x 510 mm cage. 2. The effects of these dividers on feeding, extending head out of the cage front and agonistic behaviour were compared with undivided areas. Body weights were also recorded. 3. Compared with controls (unmodified feeding space), birds with two feeding spaces per cage spent less time feeding and head out, had fewer feeding bouts, received fewer agonistic head pecks overall and weighed less at the end of lay. 4. Access to the food trough was through 5 spaces separated by the vertical wire divisions of the cage front. Regardless of treatment group, most activity at the cage front occurred through the second space in from either side of the cage. 5. The data are discussed in relation to the social controls which may affect trough use, the potential for improving cage design by modifying the design of the feeding area, and the validity of research trials which use food trough dividers to separate treatment groups.

Movement of broiler chickens reared in commercial conditions.

1. Bird movement was studied at various ages in two flocks of 18,200 broiler chickens. 2. One-d-old chicks placed in corners of a 29 x 14 m brooding area dispersed evenly over the whole area in a period of 48 h. 3. At 15 d of age, when released from the brooding area, birds which were among the first to move to the far end of the house did not necessarily remain in that area of the house. 4. Starting at 4 and 5 weeks of age, birds marked individually were variable in their movement throughout the house during a 16- and 9-d period respectively. Even the least mobile individual covered an area of the house containing several thousand birds. 5. Closer scrutiny of movement by individual birds showed that some moved over areas of 20 m2 in an hour. Birds moved further than was necessary simply to reach food and water. No agonistic interactions were observed and there was no evidence that crowding was a physical restraint on bird movement. 6. Results indicated that birds were not generally attached to a particular site in the shed and that social factors did not restrict movement. Some implications of bird movement are discussed with regard to performance, welfare and leg abnormalities.

Food availability and the feeding and drinking behaviour of broiler chickens grown commercially.

1. Field observations were made on the effect of food depth in pans on the feeding and drinking behaviour of commercially grown broiler chickens aged between 17 and 43 d. 2. The group of birds receiving less food in pans had longer visits to the pans, occupied their feeding space more completely, evicted each other more often from pans and were more 'competitive' and less 'relaxed' when feeding. 3. These observations provide data about the feeding and drinking behaviour of broiler chickens reared in commercial conditions and emphasise how environmental factors, particularly food management, can influence bird behaviour. 4. The potential for qualitative and quantitative changes of feeding behaviour to affect performance is also discussed.

Location in the cage and diurnal distribution of feather pecking by caged layers.

1. Most feather pecking occurred between birds in the same cage rather than between birds in neighbouring cages during both morning (81%) and afternoon (92%) observations. 2. In the afternoon feather pecking and cage pecking were respectively 3.6 and 4.4 times more prevalent than in the morning. The proportion of severe feather pecking (19%) was unaffected by time of day. 3. These findings are discussed with regard to the possibility that feather pecking in the afternoon may reflect attempts by hens to adapt to an unstimulating environment and the limited potential for control of feather pecking by modification of the design of conventional cages, unless between--cage transmission of the behaviour is important in the development of feather pecking.

Restricted feeding time and the behaviour of caged laying hens.

1. Layers housed as pairs in cages were denied access to food from 07.30 to 15.30 h each day. Analyses of video records of daily activity patterns showed several behaviour changes compared with the patterns shown by similar birds allowed ad libitum (AL) access to food. 2. Birds given restricted access (RA) to food spent more time sitting and cage pecking while unable to feed than those feeding ad libitum during the same period. They also engaged in less agonistic pecking and the lengths of bouts of drinking were reduced during the period of food denial compared with the AL treatment. 3. After the food troughs were uncovered birds on the RA treatment showed fewer bouts of feather pecking but more bouts of drinking than the AL treatment. 4. Improvements previously reported in the efficiency of food utilisation of birds on the RA treatment may have been the result of additional sitting, although other activities requiring energy expenditure were performed. 5. It is concluded that restricting access to food on a time basis has both positive and negative effects on the welfare of caged layers.