Patienten i centrum: En ledelsesudfordring

Louise Lund Møller & Marie Fuglsang

Student thesis: Master executive thesis


Background and purpose The Capital Region of Denmark has worked out a policy on patient centered care. The region wants the hospital to put the patients in the center of their own care. The implementation of the policy is measured by 7 indicators. Each indicator is a question in The National Danish Survey of Patient Experience (Danish acronym: LUP). The survey is being carried out as an annual, nationwide survey, investigating the experiences of both inpatients and outpatients. The region has set a goal that the results on each question must be improved with 5 % from 2010 to 2013. In this thesis we will study how directors and managers in two hospitals in the Capital Region try to motivate their staff to fulfill the regional goal about more patient centered care. We will look into the tools the directors and managers’ use and how the different tools influence the staffs’ motivation. Methods and materials We have interviewed managers and staff from two hospitals in the region: Gentofte Hospital and Herlev Hospital. The reason for choosing these hospitals is that Gentofte Hospital was the best performing hospital in the region concerning patient experiences measured by LUP while Herlev Hospital was the lowest performing hospital. In the table you can se who we interviewed and whether it was an individual or group interview. Gentofte Hospital Herlev Hospital Managing Director, individual interview Managing Director, individual interview Head Nurse, individual interview Head Nurse, individual interview Staff Nurse, individual interview Staff Nurse, individual interview Group interview with three nurses and one nurse assistant Group interview with three nurses and one nurse assistant Group interview with two nurses Group interview with two nurses Results Through our interviews we found out that directors and managers in the two hospitals primarily use the following tools to motivate the staff to provide more patient centered care: Leadership attention to patient centered care Communication through different media Control and learning from performance information including results from LUP The directors and Head Nurses from both hospitals find that a change of culture is needed. We have therefore used theory on organizational culture which understates that one of the most powerful tools to embed a new culture is through continuous leadership attention and communication. Both Managing Directors point out leadership attention and communication as tools they use. The directors and managers also use performance information as a tool for implementing patient centered care. Performance information is used both for learning and for control. The challenge is to motivate the nurses to fulfill the regional goal. Many nurses are intrinsic motivated. It is part of their reason for choosing the job that they want to help others, but many of them feel they spend a lot of time on documentation and standard procedures which prevent them from taking care of the patient’s individual needs. Some nurses give examples of situations where they have to ignore patients’ needs because they haven’t got time enough. It is an important part of their professional identity to care for the patients so they find it demotivating when they feel they cannot do it properly. It is important for their motivation to feel autonomy, competence and relatedness. Being controlled can demotivate the nurses and make them crowd out of their intrinsic motivation. Our thesis is focused on a central challenge in leadership: how to make your employees committed to making their best effort and work towards the overall goal of the organization. Employees have different kinds of motivation and also different amounts of motivation and an important part of leadership is to know what motivates each employee and to find a way to balance between management control and autonomy

EducationsMaster of Public Governance, (Executive Master Programme) Final Thesis
Publication date2012
Number of pages94