Successful and Effective Administration in ICU Volume 5 - Issue 2

Evangelia Michail Michailidou^1,2,3*

• ¹Intensive Medicine Department, Hippokration General Hospital, Greece
• ²Senior Student in the Department of Business Administration, University of Macedonia, Greece
• ³Masters Degree, International Medicine-Health Crisis Management, Greece

Received:June 14, 2020;   Published: June 19, 2020

Corresponding author: Evangelia Michailidou, Consultant Anesthesiologist-Intensivist, General Hospital Hippokratio of Thessaloniki, Konstantinoupoleos 46, Thessaloniki, Greece

DOI: 10.32474/SCSOAJ.2020.05.000207

Abstract PDF

Abstract

Background: Leadership is defined as modifying the behavior of the medical and paramedical staff of an intensive care unit so that they tend to meet its goals. Theoretically, behavior modification should be achieved by the will of individuals and not by coercion.

Objective: The behavior of the employee in health services is crucial. Equally important are employee relations - both at the interpersonal and functional levels, that is, cooperation in the performance of their duties. In order to serve the patient effectively, it is necessary to create a chain of service among all ICU staff. The service chain is based on the concept of an internal customer, according to which the ICU employees have a customer relationship with each other.

Conclusion: ICUs are staffed and managed by people. Without employees, there is no ICU. By extension, employees are the most critical performance factor to operate and achieve the goals of an ICU. Successful ICUs are made by people, and especially by their directors, but ICUs are also less efficient when their employees cannot, do not know, or do not want to contribute to their goals. “People make the difference,” whether they’re managing or just executing.

Keywords:Management, Leadership, Doctors, ICU

Definition of Leadership

Leadership is defined as modifying the behavior of the members, in this case of the medical and paramedical staff of an intensive care unit so that they tend to meet its goals. Theoretically, behavior modification should be achieved by the will of individuals and not by coercion. It emphasizes the key role of leadership in developing a (weak) anthropocentric culture and a positive working environment for medical and nursing staff to provide a distinct service to patients and their relatives, as well as the specific knowledge, attitudes and skills that one has to have a career in the field of health services and in the ICU in particular [1-3].
Leader and executive director, differences. The executive uses legal authority, commands and motivates. It focuses on processes, systems, and logic. It controls and moves within specified standard frameworks. That person is interested in how he just manages. The leader embraces reality, emphasizes the now and does things right. Instead, the leader emerges, using his own power. He has vision, inspiration, and persuasion. It focuses on people and emotions. It opens new horizons, cares about why, causes and makes changes. Finally, it emphasizes the future and does the right thing. Productivity and quality. Importance of quality service in modern service delivery to obtain and maintain a competitive edge by identifying and adopting/adapting excellent service standards implemented by distinct medical units.

The Risks and their Approach

Risk is known as one of the usual parameters of our daily lives. Risk affects almost all the activities of medical units. It exists in all those cases in which it is not possible to predict with certainty the outcome of an activity [4-6]. Each unit has to take a position and outline its strategy. It is fated to make assessments of each activity and developments in the field to which it belongs and make difficult strategic decisions, such as:

a. Follow the aggressive or conservative treatment
b. Create new opportunities
c. Notice what others do
d. And accordingly to draft new goals.

However, when uncertainty prevails, the risks of misstatement become greater and often unbearable. In such circumstances, whatever the strategy and objectives, one thing becomes the focus of management, and that is risk management, in the broad sense.

Risks

Risks having outlined the strategy, emerging uncertainty makes the need for identifying the risks of an ICU more pronounced. Information gathering techniques to identify the risk.

Brainstorming

Because brainstorming literally means brainstorming, there are often times when a brainstorming meeting goes completely wrong: “whatever it is, let’s download”. That is to say, turning a “playground” into a very important gathering of ICU doctors looking for new ideas - usually for an incident. The “winding up” of the debate is due to ignorance of the rules and conditions that govern the effectiveness of such an important meeting, in which participants can speak without restriction.

Brainstorming rules: The rules are followed for brainstormings are the following:
a. Do not judge others’ ideas in a negative or positive way.
b. Encourages the imaginative, the impossible and the impossible in the ideas presented.
c. What matters during brainstorming is the number of ideas, not the quality.
d. Continue the ideas put forward by other participants. e. Brainstorming.
f. Every idea and every speaker has the same value.

Delphi Technique

Delphi is a research methodology widely used in a wide range of scientific fields, including in the field of health. This method seeks to obtain the maximum possible consensus of a default group of experts on a topic by providing them with a series of consecutive questions.

Swot analysis

Swot analysis is a strategic planning tool used to analyze the internal and external environment of a business, in our case an ICU when a decision needs to be made regarding the goals it has set or to achieve. SWOT acronym comes from the words: Strengths, Weaknesses, Opportunities, and Threats

As a tool, SWOT analysis is not a full study of a topic under consideration but a useful and complementary tool that often helps in preliminary examination and inference. The ICU must consciously know what bets its strategy contains, what can go wrong, what the impacts and costs are, how to track them and how to counterbalance them. And all management decisions must be made after assessing the risks involved. Especially in the areas of risk monitoring, information to Management is of prime importance and must necessarily be complete, detailed, timely and reliable. The uncertain environment does not necessarily mean that it has a negative impact on all sectors. For any area of activity, uncertainty can bring future risks and opportunities. Precisely because the future is unpredictable, the beneficiaries will be those who have taken steps so that when opportunities arise they are able to grab them.
Therefore any administrative effort should answer the above question: Which is the risk in the effort and which it is the management. The worker in the ICU - Productivity and quality of Health.
Production of quality services is an issue, the other concerns how the service is provided. The behavior of the employee in health. services are crucial. Equally important are employee relations - both at the interpersonal and functional levels, that is, cooperation in the performance of their duties. In order to serve the patient effectively, it is necessary to create a chain of service among all ICU staff. In this chain, each employee or group of employees will add value to the workpiece delivered by the previous one until the final service is provided to the patient.
The service chain is based on the concept of an internal customer, according to which the ICU employees have a customer relationship with each other in which each employee should see his or her colleague in the same department or another as an (internal) customer to him/her. Which delivers part of all the work in accordance with the specified specifications and procedures.
Employee-oriented health care provision is considered to be one that creates such a work environment in which adequate and qualified employees (after selecting their technical competence and willingness to serve and having been placed in the appropriate positions will be able (due to training) will they want (due to reward, motivation and empowerment systems) and will feel obliged (due to commitment, values , and culture) to produce and provide quality services.
It is worth noting here that the GTAT tests are concerned with controlling the attitudes of service providers. The third necessary orientation of modern service delivery is the development of measurement and continuous improvement systems and processes (result-oriented management) since the core of modern administration is the assumption that you cannot improve something if you cannot measurements it first.

The measurement relates to:
a. Deviations from standards
b. Comparison of processes and results with those of the ICU unit partners that are industry benchmarks (benchmarking)
c. Record the opinion and satisfaction level of patients and their relatives
d. Take corresponding corrective actions

The strategy of an ICU needs to be understandable. Many people understand the word strategy differently. It’s the answer to three one-sided questions- What, who and how. That is: What staff do we have, what patients do we treat, and how do we do this to succeed. Includes many topics such as behavior culture, diversification (in terms of quality, service, speed, safety, trust, consistency, etc.), technology strategic partnerships, outsourcing and much more depending on the management style chosen by the individual ICU director.
ICUs are staffed and managed by people. Without employees, there is no ICU. By extension, employees are the most critical performance factor to operate and achieve the goals of an ICU. Successful ICUs are made by people, and especially by their director, but ICUs are also less efficient when their employees cannot, do not know, or do not want to contribute to their goals. “People make the difference,” whether they’re managing or just executing. Effectively managing a team is no easy task. If everyone knew how to do it, everyone would become leaders.

Declarations

Ethics approval and consent to participate: Not applicable.

Consent for publication

Not applicable

Availability of data and materials

It’s allowed

Competing Interests

No one

Funding

No one

Authors’ Contributions

No one

References

1. Dessler G (2012) Διαχείριση ανθρώπινου Δυναμικού, Εκδόσεις Κριτική.
2. Ξυροτύρη Κουφίδου Σ (2010)/Δ΄ έκδοση, Διοίκηση ανθρωπίνων Πόρων-Κτίζοντας τα Θεμέλια για τη Στρατηγική Διοίκηση των Ανθρώπων. Εκδόσεις Ανικούλα, Θεσσαλονίκη.
3. Τερζίδη Κ, και Τζωρτζάκης Κ (2004) Διοίκηση Ανθρωπίνων Πόρων, Εκδόσεις Rosili, Γέρακας Αττικής.
4. Keeney S, Hasson F, MCKENNA H (2006) Consulting the oracle: Ten lessons from using the Delphi technique in nursing research. JAdv Nurs 53: 205-212.
5. Wang CC, Wang Y, Zhang K, Fang J, Liu W, et al. (2003) Reproductive health indicators for China's rural areas. Soc Sci Med 57: 217-225.
6. Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, et al. (2005) Global prevalence of dementia: A Delphi consensus study. Lancet 366: 2112-2117.