Sandra G Leggat

• MHSc, MBA, PhD
• La Trobe University

This Rapid Evidence Assessment (REA) aimed to investigate the impact of electronic medical record (EMR) implementation on the process and outcomes of nursing handover by synthesising the existing scientific literature. Clinical nursing handover involves transferring patient information, responsibility and accountability to ensure continuity of care...

Objective To evaluate how surgeons in Australia and Aotearoa New Zealand perceive the effectiveness of the Operating with Respect (OWR) face-to-face training program in reducing workplace bullying. Methods A cross-sectional survey examined the perceived effectiveness of the Royal College of Surgeons’ (RACS) face-to-face OWR training and complementa...

In 2022 the Australian Data Availability and Transparency Act (DATA) commenced, enabling accredited “data users” to access data from “accredited data service providers.” However, the DATA Scheme lacks guidance on “trustworthiness” of the data to be utilised for reuse purposes. Objectives: To determine: (i) Do researchers using government health dat...

In 2022 the Australian Data Availability and Transparency Act (DATA) commenced, enabling accredited “data users” to access data from “accredited data service providers.” However, the DATA Scheme lacks guidance on “trustworthiness” of the data to be utilised for reuse purposes. Objectives: To determine: (i) Do researchers using government health da...

Background Using government health datasets for secondary purposes is widespread; however, little is known on researchers’ knowledge and reuse practices within Australia. Objectives To explore researchers’ knowledge and experience of governance processes, and their data reuse practices, when using Victorian government health datasets for research...

Objective The objective of this research is to appraise current practice in hospitals against the ‘Framework to achieve value in healthcare’ (the Framework) and to identify additional contributory factors that support or hinder its application. Methods A multi-site case study was undertaken with five hospitals in Australia, the USA and UK using pur...

Background: A significant body of literature has examined the impact of verbal and non-verbal bullying in surgical settings, where a central focus has been on the experiences of trainee and junior members of the surgical team, women in surgery and other health professionals, such as nurses. Research on how surgeons' perceive or experience bullying...

Background Governments, funders and hospital managers around the world are looking for ways to address the continual growth in expenditure by reducing the level of waste in the healthcare delivery system and improving the value of care provided to patients. Process improvement methods are applied to increase high value care, reduce low value care a...

Title What is the evidence of how hospitals capture financial benefits of process improvement and does it impact hospital financial performance?: A systematic review Background Hospitals managers around the world are looking for ways to address the continual growth in expenditure by reducing the level of waste in the healthcare delivery system and...

Background: Community pharmacists are highly accessible for advice, as most pharmacies are open long hours and no appointment is needed. Community pharmacists, as essential community health workers, play a critical role in the fight against coronavirus disease 2019 (COVID-19). This study aimed to determine the general wellbeing and work impacts of...

Purpose To investigate the association between implementation of clinical governance and patient safety. Design/methodology/approach A pre-post study was conducted in an Australian health service following the implementation of clinical governance systems (CGS) in the inpatient wards in 2016. Health service audit data from 2017 on CGS implementati...

Background: Understanding the causes of patient safety incidents is essential for improving patient safety; therefore, reporting and analysis of these incidents is a key imperative. Despite its implemention more than 15 years ago, the institutionalization of incident reporting in Indonesian hospitals is far from satisfactory. The aim of this study...

Background: Governments have responsibility for ensuring the quality and fitness-for-purpose of personal health data provided to them. While these health information assets are used widely for research, this secondary usage has received minimal research attention. Objective: This study aimed to investigate the secondary uses, in research, of pop...

Purpose: The purpose of this study was to examine the concept of value in healthcare through a practical appraisal of the applicability of a conceptual framework, which is aimed at supporting the measurement and realisation of financial benefits from process improvement (PI) activities in a hospital setting. Design/methodology/approach: A single...

Purpose The authors explored clinical staff perceptions of their interactions with middle management and their experiences of the uncongeniality of their working environment. Design/methodology/approach Semi-structured interviews of clinical staff from an Australian public health service's Emergency, Surgery and Psychiatry departments. Volunteer i...

Objectives: Timely access to outpatient services is a major issue for public health systems. To address this issue, we aimed to establish the return on investment to the health system of the implementation of an alternative model for access and triage (Specific Timely Appointments for Triage: STAT) compared with a traditional waitlist model. Desi...

Background The study explored the role of emotional intelligence (EI) on employees’ perceived wellbeing and empowerment, as well as their performance, by measuring their quality of care. Methods The baseline data for the present project was collected from 78 staff of a Victorian aged care organization in Australia. Self-administered surveys were u...

Background: Understanding the causes of patient safety incidents is essential for improving patient safety; therefore, reporting and analysis of these incidents is a key imperative. Despite its implemention more than 15 years ago, the institutionalization of incident reporting in Indonesian hospitals is far from satisfactory. The aim of this study...

Purpose There is evidence that patient safety has not improved commensurate with the global attention and resources dedicated to achieving it. The authors explored the perspectives of hospital leaders on the challenges of leading safe care. Design/methodology/approach This paper reports the findings of a three-year longitudinal study of eight Aust...

Objective This study examined whether the management competency framework for health service managers developed in the Victorian healthcare context is applicable to managers in other Australian states. Methods An online questionnaire survey of senior and middle-level health service managers in both community health services and hospitals was conduc...

Planning and implementing surge capacity in healthcare services is challenging. The evolving nature of viral transmission makes it difficult to predict the potential impact on the health system and the readiness of healthcare managers and professional staff in responding to system transformation and consequential impacts. This is compounded by sudd...

Significant resources are spent on monitoring and improving the quality and safety of hospital care; however, evidence suggests that this investment is achieving disproportionately limited results. Accreditation and expectations of funders have focused hospital service quality management on compliance, with an over emphasis on the ‘control’ aspect...

This study assessed the link of patient care outcome to occupational differences in response to human resource management. A cross-sectional survey was conducted in three large regional hospitals in China. A total of 700 questionnaires were distributed to doctors, nurses, allied health workers, and managers and 499 (71%) were completed. Data were a...

(1) Background: The issue of burnout in healthcare staff is frequently discussed in relation to occupational health. In this paper, we report healthcare staff experiences of stress and burnout. (2) Methods: In total, 72 healthcare staff were interviewed from psychiatry, surgery, and emergency departments at an Australian public health service. The...

Purpose This study investigated the practical and cultural barriers of reporting patient safety incidents in three accredited public hospitals in East Java, Indonesia. Methods This study employed a mixed methods approach using a convergent parallel design. We surveyed 1121 health workers and interviewed 27 managerial staff members from the sampled...

Objective Ensuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual...

Objectives: Incident reporting is one of the tools used to improve patient safety that has been widely used in health facilities in many countries. Incident reporting systems provide functionality to collect, analyze, and disseminate lessons learned to the wider community, whether at the hospital or national level. The aim of this study was to com...

Background: Incident reporting is widely acknowledged as one of the ways of improving patient safety and has been implemented in Indonesia for more than ten years. However, there was no significant increase in the number of reported incidents nationally. The study described in this paper aimed at assessing the extent to which Indonesia's patient s...

Purpose The purpose of this paper is to explore the relationship between frequent turnover (churn) of the chief executive officer (CEO), quality manager and members of the governing board with the management of quality in eight Australian hospitals. Design/methodology/approach A mixed method three-year longitudinal study was conducted using valida...

Purpose: To determine if the addition of direct supervision to usual clinical supervision practice of physiotherapists can improve compliance with clinical practice guidelines and post-surgical outcomes for inpatients with hip fracture. Methods: A controlled before-and-after study was conducted on two acute orthopedic wards. Junior and mid-level ph...

Background Specific Timely Appointments for Triage (STAT) is an intervention designed to reduce waiting time in community outpatient health services, shown to be effective in a large stepped wedge cluster randomised controlled trial. STAT combines initial strategies to reduce existing wait lists with creation of a specific number of protected appoi...

(1) Background: A patient safety incident reporting system was introduced in Indonesian hospitals in 2006; however, under-reporting of patient safety incidents is evident. The government plays a vital role in the implementation of a national system. Therefore, this study focuses on how the Indonesian government has been undertaking its role in pati...

Purpose: Clinical supervision is widely accepted as an important element of practice for allied health professionals to ensure a high quality of patient care. However, it is unknown whether effective clinical supervision of allied health professionals improves patients’ outcomes. This study investigated whether effective clinical supervision of all...

There is evidence that meditation is a powerful organisational tool for enhancing employee effectiveness, wellbeing, and job satisfaction; however, experimental studies on the effects of meditation on other organisational factors such as presenteeism and emotional intelligence are limited. This study investigated the impact of meditation on mindful...

Background Competent managers are essential to the productivity of organisations and the sustainability of health systems. Effective workforce development strategies sensitive to the current competency development needs of health service managers (HSMs) are required. Purpose To conduct a 360° assessment of the competence of Australian HSMs to iden...

This paper investigates the role of medical professionals in the success and longevity of the implementation of workplace innovation and organizational change in the Accident and Emergency (A&E) Departments of two large public hospitals, in Australia and Canada, during the introduction of process improvement using Lean Management (LM) methodologies...

Background Long waiting times are associated with public community outpatient health services. This trial aimed to determine if a new model of care based on evidence-based strategies that improved patient flow in two small pilot trials could be used to reduce waiting time across a variety of services. The key principle of the Specific Timely Appoin...

Purpose: The purpose of this paper is to review the implementation of seven components of quality systems (QSs) linked with quality improvement in a sample of Australian hospitals. Design/methodology/approach: The authors completed a systematic review to identify QS components associated with measureable quality improvement. Using mixed methods,...

Purpose: To explore participants’ personal perspectives: on psychosocial aspects of living with multiple sclerosis (MS) following inpatient rehabilitation; and on experiences of the rehabilitation hospital stay and discharge to home. Methods: One-on-one, semi-structured in-depth interviews, were conducted with 15 people with various forms of MS, po...

This paper outlines a successful partnership program between La Trobe University in Melbourne Australia, and Harbin Medical University in Harbin, China. These two universities have been collaborating for more than 15 years to provide a comprehensive Master of Health Administration program that adapts the Australian curriculum to meet the rapidly in...

To redress the scholarly preoccupation with problems, there is a need to focus on practices that exceed expectation. This study is the first to explicate healthcare professionals’ perceptions of brilliance within their health service. Via online discussions, 78 postgraduate health management students from an Australian university shared their exper...

Background: Emotional intelligence (EI) training is popular among human resource practitioners, but there is limited evidence of the impact of such training on health care workers. Purpose: In the current article, we examine the effects of EI training on quality of resident care and worker well-being and psychological empowerment in an Australia...

Objective The aim of the present study was to investigate whether the content of annual Victorian quality of care reports had an increased consumer participation focus following the introduction of the National Safety and Quality Health Service (NSQHS) Partnering with Consumers standard.MethodsA mixed-methods approach comprising a comparative descr...

Purpose The purpose of this paper is to report on the validation of a management competency assessment tool for health services managers (HSM), which resulted from the development and validation of the framework, addressed by a previous paper. Design/methodology/approach The management competency assessment tool (MCAP Tool) was validated using ass...

Purpose The importance of managerial competencies in monitoring and improving the performance of organisational leaders and managers is well accepted. Different processes have been used to identify and develop competency frameworks or models for healthcare managers around the world to meet different contextual needs. The purpose of the paper is to...

How are hospital staff involved in process improvement initiatives such as Lean? What can we learn from Lean implementation experiences about the sustainability of such initiatives? The authors considered such questions in a study of workplace change in Australia and Canada. They found that Lean is more likely to be sustained when leaders adopted t...

Background To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of h...

Background Hospital staff are interested in information on patient satisfaction and patient experience that can help them improve quality of care. Staff perceptions of quality of care have been identified as useful proxies when patient data are not available. This study explores the organizational factors and staff attitudes that influence staff pe...

Objective To explore the impact of the organisational quality systems on quality of care in Victorian health services.Methods During 2015 a total of 55 focus groups were conducted with more than 350 managers, clinical staff and board members in eight Victorian health services to explore the effectiveness of health service quality systems. A review...

Public hospitals are required to have quality systems in place to meet accreditation standards, achieve government performance expectations and continually improve care. However, previous study suggests that there has been limited success in the implementation of effective quality systems. Using document review, self-evaluation and qualitative data...

Objective The aim of the present study was to investigate the effects of work organisation on the emotional labour withdrawal behaviour of Australian community nurses.Methods Using a paper-based survey, a sample of 312 Australian community nurses reported on their emotional dissonance, withdrawal behaviours (i.e. job neglect, job dissatisfaction, s...

Purpose Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. T...

Objective The aim of the present study was to develop a positive organisational scholarship in health care approach to health management, informed by health managers and health professionals' experiences of brilliance in health care delivery.Methods A sample of postgraduate students with professional and/or management experience within a health ser...

Purpose The purpose of this paper is to examine the role of transformational leadership (TL) in developing social identity and its subsequent impact on team climate, intention to leave, burnout and quality of patient care among nurses. Design/methodology/approach Data for this cross-sectional study were collected from a sample of 201 registered...

Background: Waiting lists for treatment are common in outpatient and community services, Existing methods for managing access and triage to these services can lead to inequities in service delivery, inefficiencies and divert resources from frontline care. Evidence from two controlled studies indicates that an alternative to the traditional "waitli...

Purpose To determine whether clinical supervision (CS) of health professionals improves patient safety. Data sources Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Study selection Two reviewers independently...

Management competence links positively to organisational success and efficient and safe healthcare service delivery. A newly developed 360° management competency assessment tool was used to assess 68 middle level managers working in the community health services in Victoria, Australia. Based on the assessment results, this study confirmed the benef...

Purpose – Medical Colleges rely on the volunteer labour of their Fellows to undertake their key functions. In the Australasian context, there is anecdotal evidence to suggest that Fellow participation is declining. The purpose of this paper is to examine the main factors that influence Fellows’ participation in the activities of a Medical College....

Objective: To develop clinical leadership among health professionals working in public sector organisations to improve their skills in ensuring high quality and safe health services. Methods: A longitudinal pre-post-intervention mixed methods study that included 60 health professionals working in one state in Australia. Results: The program wa...

Objectives. The aim of the present study was to explore the perspectives of allied health professionals on appropriate content for effective clinical supervision of staff. Methods. A set of statements regarding clinical supervision was identified from the literature and confirmed through a Q-sort process. The final set was administered as an online...

Objectives The present study was designed to determine what staff consider when asked to respond to the Friends and Family Test question.Methods Over 300 health service staff responded to an online questionnaire exploring whether they would recommend treatment at their organisation to friends and family (Friends and Family Test).Results Staff ident...

To navigate the complexity of the industry and national and international factors it is not enough to just be a good manager or a good leader. Being successful, as a manager, leader or a health professional, requires a combination of both management and leadership skills and aptitudes. ‘Leading and Managing Health Services: An Australasian Perspect...

A systematic literature review identified 41 studies, including four reviews, reporting on process redesign interventions in hospitals. Success factors for the changes included mechanisms to facilitate participation throughout the process, clearly documented protocols and expectations for the health professionals which were supported by education,...

To determine whether a formal mentoring programme assists nurse practitioner candidates to develop competence in the clinical leadership competencies required in their advanced practice roles. Nurse practitioner candidates are required to show evidence of defined clinical leadership competencies when they apply for endorsement within the Australian...

Objective: This paper analyses an organisational development project that aimed to change the organisational culture and improve people management systems and processes. The questions addressed were: was the change process a success; how was success defined; and what were the barriers to its progress? Methods: We examined the process of change o...

This study examined whether and how participation by doctors in management decision-making was associated with patient care. A questionnaire survey was conducted in three hospitals operating in China. Staff members of the selected hospitals were invited to participate in the survey, measuring perceived quality of patient care, employee participatio...

Emotional intelligence has long been associated with lower levels of stress and enhanced well-being. This paper contributes empirically by examining the direct and moderating effects of emotional intelligence on the presenteeism and well-being relationship. A sample of 312 registered nurses who provide home-based care in an Australian community nur...

This paper examines the mediating effects of social identification on the relationship between high performance work systems (HPWS) and psychological empowerment and the direct relationship between psychological empowerment and clinician perceptions of quality of patient care. We use structural equation modelling on a sample of 254 health professio...

Using a multi-level analysis of a sample of 193 employees matched to 58 managers in a regional Australian hospital, this paper examines the effects of management and employee perceptions of high-performance work systems (HPWS) on HR outcomes. These relationships are examined across four distinct occupational groups. The findings suggest that only w...

This article examines the relationships among emotional labour, team climate, burnout, perceived quality of care and turnover intention among nurses in Australia, with the aim of addressing nurse retention and burnout. Emotional labour refers to the regulation of emotion during interpersonal transactions. It may involve faking unfelt emotions, hidi...

While there has been substantial discussion about the potential for clinical leadership in improving quality and safety in healthcare, there has been little robust study. The purpose of this paper is to present the results of a qualitative study with clinicians and clinician managers to gather opinions on the appropriate content of an educational i...

AimsTo investigate the extent to which emotional labour and emotional intelligence are associated with well-being and job-stress among a group of Australian community nurses. The moderating role of emotional intelligence was evaluated as a key factor in the rescue of healthcare workers from job-stress, thus increasing job retention. Background Alth...

Background: A trial of a new model of triage (Specific and Timely Appointments for Triage: STAT) at a community rehabilitation program (CRP) reduced the mean time to first appointment from 17.5 to 10.0 days. However, quantitative findings reveal little about the impact of the system on those who used it. We aimed to explore the experiences of pati...

Objective: The purpose of this paper is to confirm the core competencies required for middle to senior level managers in Victorian public hospitals in both metropolitan and regional/rural areas. Methods: This exploratory mixed-methods study used a three-step approach which included position description content analysis, focus group discussions a...

Purpose The purpose of this paper is to evaluate the current evidence regarding the content of clinical supervision for nursing and allied health professionals. Design/methodology/approach The authors searched CINAHL, Medline, PsychINFO and Cochrane Database. Studies were included if the participants involved were nursing, medical or allied health...

Objective: To explore the effectiveness of the current clinical supervision (CS) processes for allied health professionals (AHPs) at a regional health service from the perspective of the supervisor. Method: A mixed method study with two phases, involving AHPs across nine disciplines, employed at a regional health service and providing CS. In the...

Objective: Recent health system enquiries and commissions, including the National Health and Hospital Reform Commission, have promoted clinical engagement as necessary for improving the Australian healthcare system. In fact, the Rudd Government identified clinician engagement as important for the success of the planned health system reform. Yet th...

Objective: To investigate whether a simple alternative (specific timely appointments for triage [STAT]) to the more common approach of managing demand using a waitlist with a triage system could reduce waiting time for a community rehabilitation program (CRP) without adverse impacts on patient care. Design: A prospective, controlled before-and-a...

The objective of this paper is to present and provide justification for a framework to improve evidence-informed management decision-making among health service managers. Three research questions informed the study: How have different perspectives influenced how evidence has been defined? What are the barriers to the practice of evidence-informed d...

The Australian health system has been subjected to rapid changes in the last 20 years to meet increasingly unmet health needs. Improvement of the efficiency and comprehensiveness of community-based services is one of the solutions to reducing the increasing demand for hospital care. Competent managers are one of the key contributors to effective an...

This study uses Leader–Member Exchange (LMX) theory to test the associations between the supervisor–subordinate relationship, psychological empowerment and affective commitment amongst 1283 nurses working in Australian public and private hospitals. Both qualitative and quantitative data were collected, analysed and presented. The findings show that...

The purpose of this article was to explore the relationships between perceived high performance work systems, emotional labour, burnout and intention to leave among nurses in Australia. Previous studies show that emotional labour and burnout are associated with an increase in intention to leave of nurses. There is evidence that high performance wor...

To investigate how the allocation of referrals for a community rehabilitation service to triage categories affects waiting time from referral to first appointment, and whether other factors also contribute to variance in waiting time. A prospective cohort study. A multidisciplinary outpatient community rehabilitation program within a large metropol...

Clinical supervision (CS) for health professionals supports quality clinical practice. This study explored current CS effectiveness for allied health professionals (AHPs) at a regional health service from a supervisee perspective and identified improvements. The Manchester Clinical Supervision Scale (MCSS) was completed by 30 supervisees to determi...

This paper reports on a training programme using action learning sets designed to enhance the management abilities of health-care managers. Numerous independent reports in Australia, and around the world, have related the lack of management systems and processes to substandard health-care delivery. This has suggested a need for better approaches to...

Triage processes are often used by Emergency Departments to sort patients according to urgency or type of service required. Triage may also be used in a broad spectrum of other health services and not just emergency departments. Triage systems may be used to ensure the most urgent patients get timely service, but do they have an effect on patient f...

Objective: To evaluate the effect of formal training on agreement between clinicians making decisions on client priority. Setting: A centralized intake service receiving referrals for a community rehabilitation programme. Design: Agreement was measured between the priority categories allocated to consecutive referrals by one of five clinicians in t...

Studies of high-performing organisations have consistently reported a positive relationship between high performance work systems (HPWS) and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved care delivery and patient outcomes hav...