1. LEIDERSCHAP IN DE ZORG
REVIEW
Koen Balcaen

3. Context
Opvolging
en Leiderschap Definities
monitoring
literatuur

5. Context
KB 13/7/2006: functie van hoofdverpleegkundige
Hoofdstuk 1
 VERANTWOORDELIJKHEID
 Organisatie
 Continuïteit
 kwaliteit
 PARTICIPATIE
 Uitbouw verpleegkundig beleid
 Implementatie op microniveau
 BELAST MET
 Toezicht en evaluatie van team
 SAMENWERKING
 Integratie van verpleegkundige activiteit in het geheel van activiteiten in het ziekenhuis

6. Context
KB 13/7/2006: functie van hoofdverpleegkundige
Hoofdstuk 2
 Aligneren op strategische visie van het ziekenhuis

7. Context
KB 13/7/2006: functie van hoofdverpleegkundige
Hoofdstuk 3: m.b.t. zorg
 Organisatie – coördinatie – toezicht zorgactiviteiten
 Doelstellingen team
 Patiëntgerichte verpleegkundige zorgorganisatie/ ethiek/ patiëntenrechten
 Bijsturen van zorg i.f.v. behoeften en noden van patiënt/
vernieuwingsprojecten
 Kwaliteit en continuïteit van zorg

8. Context
KB 13/7/2006: functie van hoofdverpleegkundige
Hoofdstuk 4: personeelsbeleid
 Nodige personeel kwantitatief en kwalitatief
 Werkverdeling
 Working environment
 Coaching en mentoring

9. Context
KB 13/7/2006: functie van hoofdverpleegkundige
• Hoofdstuk 5: middeleninzet
 Doeltreffende inzet in functie van kwaliteit van de zorg
• Hoofdstuk 6: opleiding en ontwikkeling
 Opleidingsbeleidsplan
 loopbaanplanning
 Studentenbeleid
• Hoofdstuk 7: overleg in functie van interne en externe
informatiedoorstroming

11. Context
KB 27/4/2007: interne en externe toetsing van kwaliteit van verpleegkundige
zorg

13. Context
Convenant patiëntveiligheid

15. Context
Visitatie/Accreditatie
The international essentials of health care quality and patient safety
1. Leadership proces and accountabilty
2. Competent and capable workforce
3. Safe environment for staff and patients
4. Clinical care of patients
5. Improving quality and safety

16. Accreditatie
Section I: Patient-Centered Standards
International Patient Safety Goals (IPSG)
Access to Care and Continuity of Care (ACC)
Patient and Family Rights (PFR)
Assessment of Patients (AOP)
Care of Patients (COP)
Anesthesia and Surgical Care (ASC)
Medication Management and Use (MMU)
Patient and Family Education (PFE)
Section II: Health Care Organization Management Standards
Quality Improvement and Patient Safety (QPS)
Prevention and Control of Infections (PCI)
Governance, Leadership, and Direction (GLD)
Facility Management and Safety (FMS)
Staff Qualifications and Education (SQE)
Management of Communication and Information (MCI)

17. Standard of QPS. 1
Those responsible for governing and managing the organization participate in planning and measuring a quality
improvement and patient safety program.
• Intent of QPS.1
If an organization is to initiate and to maintain improvement and to reduce risks to patients and staff, leadership
and planning are essential. This leadership and planning come from the governing body of the organization
along with those who manage the clinical and managerial activities of the organization on a daily basis.
Collectively they represent the leadership of the organization. The leadership is responsible for establishing the
organization’s commitment, approach to improvement and safety, and program management and oversight.
The leadership develops the quality and patient safety plan and, through its vision and support, shapes the
quality culture of the organization.
The governing body holds ultimate accountability for quality and patient safety in the organization, and,
thus, it approves the quality and patient safety plan (also see GLD.1.6); on a regular basis, it receives and acts
on reports related to the organization’s program to improve quality and patient safety (also see GLD.1.6).
• Measurable Elements of QPS.1
❏ 1. The organization’s leadership participates in developing the plan for the quality improvement and
patient safety program.
❏ 2. The organization’s leadership participates in measuring the quality improvement and patient safety
program.
❏ 3. The organization’s leadership establishes the oversight process or mechanism for the organization’s
quality improvement and patient safety program.
❏ 4. The organization’s leadership reports on the quality and patient safety program to governance.
JOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR HOSPITALS, 4TH EDITION

18. Standard QPS.10
Improvement and safety activities are undertaken for the priority areas identified by the organization’s leaders.
• Intent of QPS.10
The organization uses appropriate resources and involves those individuals, disciplines, and departments closest
to the processes or activities to be improved. Responsibility for planning and carrying an improvement is
assigned to individuals or a team, any needed training is provided, and information management or other
resources are made available.
Once planned, data are collected during a test period to demonstrate that the planned change was actually an
improvement. To ensure that the improvement is sustained, measurement data are then collected for ongoing
analysis. Effective changes are incorporated into standard operating procedure, and any necessary staff education
is carried out. The organization documents those improvements achieved and sustained as part of its
quality management and improvement program.
• Measurable Elements of QPS.10
❏ 1. The priority areas identified by the organization’s leaders are included in improvement activities. (Also
see QPS.3, ME 1)
❏ 2. Human and other resources needed to carry out an improvement are assigned or allocated.
❏ 3. Changes are planned and tested.
❏ 4. Changes that resulted in improvements are implemented.
❏ 5. Data are available to demonstrate that improvements are effective and sustained.
❏ 6. Policy changes necessary to plan, to carry out, and to sustain the improvement are made.
❏ 7. Successful improvements are documented.
JOINT COMMISSION INTERNATIONAL ACCREDITATION STANDARDS FOR HOSPITALS, 4TH EDITION

20. Context
RN4CAST
Working environment
- Adequacy of nursing staff
- Collaboration between nurses
- Working climate
- Participation in hospital affairs
- The administrative support
- Patient documentation is continuously updated
Quality and saftety
- quality of patient care
- quality improvement last year
- patient safety on the ward
- psycho-social attention
- patient ability to manage care after discharge
Statisfaction and emotional exhaustion

22. Context
Economische toestand
Crisis:
1. Nationaal
2. Europees
3. Wereldwijd
 Kostenbeheersing
 Efficiëntie
 Lean management
 Kwaliteit= Meerwaarde / cost

23. Context
Opvolging
en Leiderschap Definities
monitoring
literatuur

25. Definities
• Leadership: the process of influencing
people to accomplish goals
• Strong leadership: the empowering of
individuals and instilling the belief and
confidence in their ability to achieve and
succeed
D,L,Huber; Leadership and nursing care management; 2006 third edition

26. Definities
• Management: the process of influencing
employees work towards the goals of the
organization by integrating resources through
planning, organizing, coordinating, directing
and controlling
D,L,Huber; Leadership and nursing care management; 2006 third edition

27. Definities
5 aspects of leadership
1. The leader
2. The follower
3. The situation
4. The communication process
5. The goals
D,L,Huber; Leadership and nursing care management; 2006 third edition

28. Definities
• Transformational leadership: activate
followers to perform to their full potential and
provide a sense of direction
C.A.Wong, H.K.Laschinger, G.G.Cummings; athentic leadership ansd nurses voice, behaviour and perceptions
of care; journal of nursing management;2010

29. Definities
• Authentic leadership: building trust,
sound work environments by special attention
to honesty, integrety and ethical standards in
the relationship of leader-follower
D,L,Huber; Leadership and nursing care management; 2006 third edition

30. Context
Opvolging
en Leiderschap Definities
monitoring
literatuur

32. Systematic review:
2 doelstellingen
1.Welke factoren worden door de verpleegkundige gepercipieerd als
beïnvloedend op hun motivatie om goed te presteren?
– Autonomie
– Working relationship
– Access to resources
– Individual nurse characteristics
– Leadership practices
2.Welke leiderschapsgedragingen correleren met verpleegkundige
performantie?
P.B.Germain, G.G.Cummings; The influence of nursing leadership on nurse performance: a systematic review; Journal
of Nursing Management; 2010; 425-439

33. Systematic review:
2 conclusies:
1.Negatieve relatie tussen taakgeörienteerd
leiderschap en optimale verpleegkundige outcomes
2.Transformationeel leiderschap en relationeel
leiderschap beïnvloedt verpleegkundige job
satisfactie, recruitment, retentie en gezonde
werkomgeving
G.G. Cummings, T. McGregor, M. Davey,H.Lee, C.A. Wong, E. Lo, M. Muise, E. Stafford; Leadership styles and outcome
patterns for the nursing workforce and work environment; A systematic review; 2010; International Journal of Nursing
Studies 47; 363-385

34. Systematic review:
Conclusie:
Positieve relatie tussen transformationeel leiderschap,
ondersteunende werkomgeving en intentie van
verpleegkundige staf om te blijven werken in huidige
werkomgeving
T. Cowden, G.G. Cummings, J.P.Mc-Grath; Leadership practices and staff nurses intent tot stay: a systematic review;
Journal of Nursing Management; 2011; 19; 461-477

35. Context
Opvolging
en Leiderschap Definities
monitoring
literatuur

36. Ondersteunende instrumenten voor
ontwikkeling van leiderschap
T
• Primaire ontwikkeling van klinisch
A leiderschap in basisopleiding
L • Specifieke focus in master-
opleiding
E
• In house detectie van talent
N
• Loopbaanontwikkeling
T • Training/ verdieping

37. Ondersteunende instrumenten voor
ontwikkeling van leiderschap
I
N
• Duidelijke visie van het ziekenhuis
V • Betrokken bij operationele invulling
O
L • Communicatie
V
E • Duidelijke doelstellingen (SMART)
M
E
N
T

38. Ondersteunende instrumenten voor
ontwikkeling van leiderschap
S
• Mentorship
U
• Coaching & feedback
P
P
• Loopbaangeleiding
O • 360° FB
R • POP
T • FG

39. Ondersteunende instrumenten voor
ontwikkeling van leiderschap
T
• Balanced score card
O
– Activiteiten
O – Middelen (personeel/
verbruiksgoederen)
L
– Investeringen
S – Q-indicatoren
• Structuur/proces/outcome