全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

How to Implement Change in Asthma Management in a Developing Country

DOI: 10.4236/ojrd.2019.91003, PP. 26-35

Keywords: Bronchial Asthma, Health Service, Developing Country, Kotter’s Model, Leadership

Full-Text   Cite this paper   Add to My Lib

Abstract:

The goal of asthma management is to control symptoms, reduce the need for short acting beta agonist, and maintain optimal pulmonary function, and normal physical activities. Uncontrolled asthma can lead to obesity, suboptimal pulmonary function, poor quality of life and mortality. Children with bronchial asthma in River State University Teaching Hospital were just receiving acute care in the emergency room with no concrete plan for a follow up care for their chronic asthma; as a result most of the patients had uncontrolled asthma. In the hospital, the situation led to increased emergency hospitalization, resulting in decreased bed availability, increased burden on manpower and health resource utilization thereby putting more pressure on the limited health resources. Using the Kotter’s model for change management, transformational and situational leadership style, the change in the desired quality and scope of health service rendered to asthmatic patients was successfully implemented; as a result there was a decrease in emergency room visit for acute asthma by 57.5% and an increase in the uptake of scheduled clinic visits for asthma control services. The effect of these changes was an improvement in the control of asthma and quality of life of our patient cohort. Implementation of change in health service delivery is a delicate process that needs a stepwise approach in order to successfully implement and sustain the desired change.

References

[1]  Girish, D.S. (2017) Paediatric Asthma Treatment and Management.
https://emedicine.medscape.com/article/1000997-treatme
[2]  Pavord, I.D., Mathieson, N., Scowcroft, A., Pedersini, R., Isherwood, G. and Price, D. (2017) The Impact of Poor Asthma Control among Asthma Patients Treated with Inhaled Corticosteroids plus Long-Acting β2-Agonists in the United Kingdom: A Cross-Sectional Analysis. NPJ Primary Care Respiratory Medicine, 27, 17.
[3]  Zhong, N., Lin, J., Zheng, J., Lai, K., Xie, C., Tang, K., et al. (2016) Uncontrolled Asthma and Its Risk Factors in Adult Chinese Asthma Patients. Therapeutic Advances in Respiratory Disease, 10, 507-517.
[4]  Berwick, D. (2013) A Promise to Learn—A Commitment to Act.
https://www.gov.uk/government/uploads/system/uploads
/attachment_data/file/226703/Berwick_Report.pdf
[5]  NICE (2018) How to Change Practice. Barriers to Change.
https://www.nice.org.uk/media/default/about/what-we-do/into-practice/support-for-
service-improvement-and-audit/how-to-change-practice-barriers-to-change.pdf
[6]  Sherring, S. (2012) Nursing Leadership within the NHS: An Evolutionary Perspective. British Journal of Nursing, 21, 491-494.
https://doi.org/10.12968/bjon.2012.21.8.491
[7]  Lewin, K. (1951) Field Theory in Social Science: Selected Theoretical Papers. American Journal of Sociology, 57, 86-87.
[8]  Hussain, S.T., Lei, S., Akram, T., Haider, M.J., Hussain, S.H. and Ali, M. (2016) Kurt Lewin’s Change Model: A Critical Review of the Role of Leadership and Employee Involvement in Organizational Change. Journal of Innovation & Knowledge, 3, 123-127.
[9]  Robert, T. (2018) Kotter’s Eight Step Leading Change Model.
https://managementisajourney.com/summary-of-kotters-eight-step-leading-change-model
[10]  Kotter, J.P. and Rathgeber, H. (2006) Our Iceberg Is Melting: Changing and Succeeding under Any Conditions. Macmillan, London.
[11]  GINA (2016) Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma.
http://ginasthma.org/wp-content/uploads/2016/04/GINA-2016-main-report_tracked.pdf
[12]  Northouse, P.G. (2016) Transformational Leadership. In: Stanley, M., Ed., Leadership: Theory and Practice, 7th Edition, Sage, Thousand Oaks, CA, 161-191.
[13]  Avolio, B.J. (1999) Full Leadership Development: Building the Vital Forces in Organizations. Sage, Thousand Oaks, CA.
[14]  Shamir, B., House, R.J. and Arthur, M.B. (1993) The Motivational Effects of Charismatic Leadership: A Self-Concept Based Theory. Organization Science, 4, 577-594.
[15]  Bass, B.M. and Riggio, R.E. (2014) Transformational Leadership. 2nd Edition, Routledge, New York.
[16]  Burns, J.M. (1978) Leadership. Harper & Row, New York.
[17]  Howell, J.M. and Avolio, B.J. (1992) The Ethics of Charismatic Leadership: Submission or Liberation? AMP, 6, 43-54.
[18]  House, R.J. (1976) Theory of Charismatic Leadership. Working Paper Series 76-06.
https://files.eric.ed.gov/fulltext/ED133827.pdf
[19]  NHS and AMRC (2009) Shared Leadership: Underpinning of the MLCF.
https://www.fmlm.ac.uk/resources/shared-leadership-underpinning-of-the-mlcf
[20]  Bryman, A. (1992) Charisma and Leadership in Organization. Sage Publications, London.
[21]  Northouse, P.G. (2013) Situational Leadership. Leadership: Theory and Practice. 6th Edition, Sage Publications Ltd., New York, 99-136.
[22]  Blanchard, K., Zigarmi, P. and Zigarmi, D. (1999) Leadership and the One Minute Manager: Increasing Effectiveness through Situational Leadership. 2nd Edition, William Morrow Company, Chicago.
[23]  Graeff, C.L. (1983) The Situational Leadership Theory: A Critical View. AMR, 8, 285-291.
[24]  Lynch, B.M., McCormack, B. and McCance, T. (2011) Development of a Model of Situational Leadership in Residential Care for Older People. Journal of Nursing Management, 19, 1058-1069.
[25]  Giltinane, C.L. (2013) Leadership Styles and Theories. Nursing Standard, 27, 35-39.
https://doi.org/10.7748/ns2013.06.27.41.35.e7565
[26]  Grimm, J.W. (2010) Effective Leadership: Making the Difference. Journal of Emergency Nursing, 36, 74-77. https://doi.org/10.1016/j.jen.2008.07.012
[27]  Yukl, G.A. (2013) Leadership in Organizations. 8th Edition, Prentice Hall, Upper Saddle River.
[28]  Carew, D.K., Parisi-Carew, E. and Blanchard, K.H. (1990) Group Development and Situational Leadership: A Model for Managing Groups. Training & Development Journal, 40, 46-50.

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133