scholarly journals Building Indigenous health workforce capacity and capability through leadership – the Miwatj health leadership model

2021 ◽  
Vol 22 ◽  
Author(s):  
Stephen Harfield ◽  
Carol Davy ◽  
Anna Dawson ◽  
Eddie Mulholland ◽  
Annette Braunack-Mayer ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Indigenous Health ◽  
Cultural Safety ◽  
Structured Interviews ◽  
Indigenous Leadership ◽  
Health Care Organisation ◽  
Leadership Model ◽  
Care Services ◽  
Formal Leadership

Abstract Aim: In the crowded field of leadership research, Indigenous leadership remains under-researched. This article explores the Leadership Model of an Aboriginal Community Controlled Primary Health Care Organisation providing services to the Yolngu people of remote northern Australia: the Miwatj Health Aboriginal Corporation (Miwatj). Background: The limited research which does exist on Indigenous leadership points to unique challenges for Indigenous leaders. These challenges relate to fostering self-determination in their communities, managing significant community expectations, and navigating a path between culturally divergent approaches to management and leadership. Methods: Guided by Indigenous methodology and using a mixed methods approach, semi-structured interviews, self-reported health service data, organisational and publicly available documents, and literature were analysed using a framework method of thematic analysis to identify key themes of the Miwatj Leadership Model. Findings: The Miwatj Leadership Model is underpinned by three distinctive elements: it offers Yolngu people employment opportunities; it supports staff who want to move into leadership positions and provides capacity building through certificates and diplomas; and it provides for the physical, emotional, and cultural wellbeing of all Yolngu staff. Furthermore, the model respects traditional Yolngu forms of authority and empowers the community to develop, manage and sustain their own health. The Miwatj Leadership Model has been successful in providing formal pathways to support Indigenous staff to take on leadership roles, and has improved the accessibility and acceptability of health care services as a result of Yolngu employment and improved cultural safety. Conclusions: Translating the Miwatj Leadership Model into other health services will require considerable thought and commitment. The Miwatj Leadership Model can be adapted to meet the needs of other health care services in consideration of the unique context within which they operate. This study has demonstrated the importance of having a formal leadership model that promotes recruitment, retention, and career progression for Indigenous staff.

Reaction of New Soviet Immigrants to Primary Health Care Services in Israel

1998 ◽  
Vol 28 (3) ◽  
pp. 555-574 ◽  
Author(s):  
Larissa I. Remennick ◽  
Naomi Ottenstein-Eisen
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
The Elderly ◽  
Medical Services ◽  
Structured Interviews ◽  
Cultural Aspects ◽  
Care Services ◽  
Israeli Population ◽  
Primary Health Care Services ◽  
Diverse Cultures

The post-1989 immigration wave from the former U.S.S.R. has increased the Israeli population by over 12 percent, seriously affecting the host health care system. This study draws on semi-structured interviews with the immigrants visiting outpatient clinics in the Tel-Aviv area in order to explore organizational and cultural aspects of their encounter with the Israeli medical services. While instrumental aspects of care were seen as an improvement over the Soviet standards, communication between providers and clients was seriously flawed, reflecting both a language barrier and diverse cultures of illness and cure. Many interviewees complained of the impersonal, “technical” attitude of Israeli physicians toward patients and the lack of holism in care, which they allegedly enjoyed before emigration. Some immigrant patients feel deprived of the paternalism of the Soviet medical system, complaining that Israeli providers “forego responsibility” for patients' health. A consumerist approach to medical services is also a novelty, and immigrants have to learn to be informed and assertive clients. Most problems are experienced by the elderly patients; overall, women seem to adjust to the new system better than men.

The making and sustaining of leaders in health care

2019 ◽  
Vol 33 (2) ◽  
pp. 241-262 ◽  
Author(s):  
Terry J. Boyle ◽  
Kieran Mervyn
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Health Care Systems ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Triple Aim ◽  
Content Type ◽  
Care Services ◽  
Care Systems

Purpose Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools. Design/methodology/approach This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development. Findings This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages. Research limitations/implications The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community. Practical implications The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles. Originality/value This paper demonstrates how health care leadership can be developed and sustained.

scholarly journals Participative management in health care services

Curationis ◽  
1995 ◽  
Vol 18 (1) ◽  
Author(s):  
M. Muller
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Inductive Reasoning ◽  
Participative Management ◽  
Management Approach ◽  
Health Care Organisation ◽  
Care Services ◽  
Care Organisation ◽  
Interactive Decision Making

The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

scholarly journals Colonial Legacies and Collaborative Action: Improving Indigenous Peoples’ Health Care in Canada

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Lloy Wylie ◽  
Stephanie McConkey ◽  
Ann Marie Corrado
Keyword(s):  
Health Care ◽  
Health Services ◽  
Indigenous People ◽  
Health Care System ◽  
Health Care Services ◽  
Indigenous Health ◽  
Care Practice ◽  
Attitudes And Practices ◽  
Care Services ◽  
Care System

Indigenous people experience significant health disparities compared to non-Indigenous people, which are exacerbated by less accessible and poorer quality health care services. This research aimed to understand the specific barriers to health care that Indigenous patients and their families face, as well as to explore promising practices and strategies for improving the responsiveness of health services to the needs of Indigenous people. Through qualitative interviews with Indigenous and non-Indigenous health care and social services providers, we identified a range of challenges and successful approaches, and developed recommendations for improving policy and practice to address the gaps in culturally safe health care services. Our study shows that many of the barriers Indigenous people face when accessing health care are rooted in the broader social determinants of health, such as poverty, racism, housing, and education. These are complex problems that are outside of the traditional scope of health care practice. However, this study has also demonstrated that many barriers to equitable care actually stem from within the health care system itself. We found that health care gaps were often attributable to poorly funded on-reserve health care services and culturally unsafe off-reserve services.  Attitudes and practices among those working in health care and gaps in coordination between mainstream and Indigenous services are challenges related to the way the health care system operates. Solutions are needed that address these issues. Given the multifaceted nature of access barriers, strategies to improve health services for Indigenous people and communities require a comprehensive and systemic approach.  

scholarly journals Implementation of Sustainable Complex Interventions in Health Care Services: The Triple C Model

2020 ◽  
Author(s):  
Hanan Khalil ◽  
Kate Kynoch
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Current Knowledge ◽  
Complex Interventions ◽  
Practice Change ◽  
Health Care Organisation ◽  
Implementation Project ◽  
Implementation Model ◽  
Care Services ◽  
Three Stages

Abstract Background The changing and evolving healthcare means organisations are under increasing pressure to deliver value-based, high quality care to patients through enabling access, reducing costs and improving outcomes. These factors result in an increased pressure to deliver efficient and beneficial interventions to improve patient care and ensure sustainability beyond the scope of the implementation of such interventions. This paper discusses the development of a triple C model for implementation that ensures sustainability of complex interventions in health care services. Methods In order to develop the proposed implementation model, we adapted the formal tradition of theory building that is described in sociology. Firstly, through a review of the literature on complex interventions and the available implementation models used to embed these interventions. Secondly, devising a framework that encompassed these findings into a simple and workable model that can be easily embedded into everyday practice. This proposed model uses clear, systemic explanation, adds to the current knowledge in this area and is fit for purpose, providing healthcare workers with a simple easy-to-follow framework to embed practice change. Results A three-stage implementation model was devised based on the findings of the literature and named the Triple C model (Consultation, Collaboration and Consolidation). The three stages are interconnected and overlap to ensure sustainability is considered at all levels of the project ensuring its greater success. This model considers the sustainability within any implementation project. Sustainability of interventions are a key consideration for continuous and successful change in any health care organisation. A set of criteria were developed for each of the three stages to ensure adaptability and sustainment of interventions are maintained throughout the life of the intervention.Conclusion Ensuring sustainability of interventions requires continuing effort and embedding the need for sustainability throughout all stages of an implementation project. The Triple C model offers a new approach for healthcare clinicians to ensure sustainability of organizational change.

Culturally safe health care practice for Indigenous Peoples in Australia: A systematic meta-ethnographic review

2021 ◽  
pp. 135581962110418
Author(s):  
Stephanie De Zilva ◽  
Troy Walker ◽  
Claire Palermo ◽  
Julie Brimblecombe
Keyword(s):  
Health Care ◽  
Indigenous Peoples ◽  
Health Care Services ◽  
Torres Strait Islander ◽  
Indigenous Health ◽  
Cultural Knowledge ◽  
Cultural Safety ◽  
Care Practice ◽  
Health Care Practice ◽  
Torres Strait

Objectives Culturally safe health care services contribute to improved health outcomes for Aboriginal and Torres Strait Islander Peoples in Australia. Yet there has been no comprehensive systematic review of the literature on what constitutes culturally safe health care practice. This gap in knowledge contributes to ongoing challenges providing culturally safe health services and policy. This review explores culturally safe health care practice from the perspective of Indigenous Peoples as recipients of health care in Western high-income countries, with a specific focus on Australian Aboriginal and Torres Strait Islander Peoples. Methods A systematic meta-ethnographic review of peer-reviewed literature was undertaken across five databases: Ovid MEDLINE, Scopus, PsychINFO, CINAHL Plus and Informit. Eligible studies included Aboriginal and Torres Strait Islander Peoples receiving health care in Australia, had a focus on exploring health care experiences, and a qualitative component to study design. Two authors independently determined study eligibility (5554 articles screened). Study characteristics and results were extracted and quality appraisal was conducted. Data synthesis was conducted using meta-ethnography methodology, contextualised by health care setting. Results Thirty-four eligible studies were identified. Elements of culturally safe health care identified were inter-related and included personable two-way communication, a well-resourced Indigenous health workforce, trusting relationships and supportive health care systems that are responsive to Indigenous Peoples’ cultural knowledge, beliefs and values. Conclusions These elements can form the basis of interventions and strategies to promote culturally safe health care practice and systems in Australia. Future cultural safety interventions need to be rigorously evaluated to explore their impact on Indigenous Peoples’ satisfaction with health care and improvements in health care outcomes.

scholarly journals “A prison with extra flavours”: experiences of immigrants in Swedish immigration detention centres

2015 ◽  
Vol 11 (2) ◽  
pp. 73-85 ◽  
Author(s):  
Soorej Jose Puthoopparambil ◽  
Beth Maina Ahlberg ◽  
Magdalena Bjerneld
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Well Being ◽  
Structured Interviews ◽  
Immigration Detention ◽  
Content Type ◽  
Care Services ◽  
Lack Of Control ◽  
Health And Well Being

Purpose – The immigration detention environment largely influences the health and well-being of detainees by either aggravating medical conditions or contributing to new illness. There is limited research on how detainees experience and try to cope with this environment. The purpose of this paper is to describe experiences of detainees in Swedish immigration detention centres. Design/methodology/approach – Semi-structured interviews were conducted in three detention centres with a total of 21 detainees who had been detained for at least two weeks. Interview transcripts were analysed using thematic analysis. Findings – The detainees likened immigration detention to imprisonment. They experienced lack of control over their life situation mainly through arbitrary restrictions and lack of proper response from authorities making it appear futile to seek help. This perceived lack of control forced them into passivity. Differences in amenities provided in the centres were observed and some of these were reported to assist in making detention more bearable. Research limitations/implications – This study provides only one stakeholder perspective. The perspectives of other stakeholders, such as detention staff, health care professionals and volunteers must be explored to improve understanding and mitigate the effects of detention. Originality/value – Irrespective of the better standards of detention in Sweden, the detainees considered detention as imprisonment affecting their health and well-being. If states deem detention to be necessary, improved staff-detainee interaction should be ensured through proper staff training, arbitrary restrictions within detention should be avoided and health care services should be improved.

Psychological autopsy studies – a review

2001 ◽  
Vol 16 (7) ◽  
pp. 379-385 ◽  
Author(s):  
E.T. Isometsä
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Mental Disorders ◽  
Health Care Services ◽  
Multiple Informants ◽  
Psychological Autopsy ◽  
Structured Interviews ◽  
Care Services ◽  
Major Interest ◽  
Available Information

SummaryPsychological autopsy is one of the most valuable tools of research on completed suicide. The method involves collecting all available information on the deceased via structured interviews of family members, relatives or friends as well as attending health care personnel. In addition, information is collected from available health care and psychiatric records, other documents, and forensic examination. Thus a psychological autopsy synthesizes the information from multiple informants and records. The early generation of psychological autopsies established that more than 90% of completed suicides have suffered from usually co-morbid mental disorders, most of them mood disorders and/or substance use disorders. Furthermore, they revealed the remarkable undertreatment of these mental disorders, often despite contact with psychiatric or other health care services. More recent psychological autopsy studies have mostly used case-control designs, thus having been better able to estimate the role of various risk factors for suicide. The future psychological autopsy studies may be more focused on interactions between risk factors or risk factor domains, focused on some specific suicide populations of major interest for suicide prevention, or combined psychological autopsy methodology with biological measurements.

scholarly journals Providers' Perceptions of Challenges in Obstetrical Care for Somali Women

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Jalana N. Lazar ◽  
Crista E. Johnson-Agbakwu ◽  
Olga I. Davis ◽  
Michele P.-L. Shipp
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Delivery ◽  
Clinical Encounter ◽  
Female Genital Cutting ◽  
Care Providers ◽  
Structured Interviews ◽  
Care Services ◽  
Somali Refugee

Background. This pilot study explored health care providers’ perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers’ experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC).Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio.Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families.Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement.

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