scholarly journals Intercultural opening: participant observation in two hospitals and two outpatient care services

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Peppler ◽  
P T Sonntag ◽  
L Schenk
Keyword(s):  
Outpatient Care ◽  
Participant Observation ◽  
Health Staff ◽  
Daily Routine ◽  
Daily Work ◽  
Care Services ◽  
Synergy Effects ◽  
Outpatient Sector ◽  
Framework Conditions ◽  
Routine Handling

Abstract Background The German healthcare system is facing intercultural diversity, since numerous migrant patients, nurses, and doctors are involved. This raises the question as to what extent everyday processes, working cultures and institutional framework conditions change because of this and how intercultural healthcare can be improved. Methods The participant observation took place on 22 days during summer 2018 in two outpatient care services and two hospitals, which show different degrees of intercultural opening (e.g. more or less migrant employees and patients). The aim was to reconstruct the daily work routine of health staff as well as the patients’ daily routine. The anonymized records include meetings, care tours, handovers and visits. The observation protocols were analyzed by documentary method and compared on two levels: degree of intercultural opening and sector affiliation. Results The results show that intercultural opening has a sector-specific impact on organization and daily work processes. The health staff of the hospital with high intercultural opening showed routine handling and relaxed reactions to communication difficulties due to the regular care of migrant patients, whereas that of the hospital with low intercultural opening showed stress-related defensive stance due to rare cases. The situation in the outpatient sector is different: The care of migrant patients was perceived to be more costly in the institution with high intercultural opening, because the migrant employees repeatedly perform additional socio-educational work that is not covered by insurance. Conclusions The migration-specific knowledge of employees has a positive effect on patient care in both inpatient and outpatient sector. However, this may be financially disadvantageous for nursing services under the conditions of outpatient care. Key messages Synergy effects arise from the involvement of migrant health workers and the care of migrant patients. Framework conditions must support these synergy effects in order to improve cultural sensitive healthcare.

scholarly journals Is There Time Enough? Temporal Resources and Service Performance in the Danish Home Care Sector

2013 ◽  
Vol 3 (2) ◽  
pp. 97 ◽  
Author(s):  
Pernille Tufte
Keyword(s):  
Home Care ◽  
Work Performance ◽  
Time Pressure ◽  
Participant Observation ◽  
Care Work ◽  
Daily Work ◽  
Care Services ◽  
Grounded Theory Method ◽  
Care Workers ◽  
And Performance

Reflecting on the temporal conditions of home care work, care workers are fairly critical, stressing that time frames are inflexible and time is limited and occasionally insufficient, altogether constituting a time pressure in work performance. Besides from the immediate consequences of time scarcity in the daily work performance, care workers relate the issue of time to a more fundamental discussion of what the performance of care does and should entail. The purpose of the article is to examine care workers’ perceptions of the temporal conditions of care work, investigating how time pressure constitutes a challenge to care workers’ own sense and valuation of their work. The article is informed by two theoretical perspectives: standardization of care services and performance of care work in private homes. Empirically, the article examines how care workers perceive the relations between the temporal framing and the possibilities to perform care work. Methodologically, the article is based on qualitative data, collected through focus group interviews and participant observation, and analyzed within the perspective of reflexive interpretation, using grounded theory method and hermeneutic approaches of analysis. A central focus of analysis is the concept of “additional care services.” The use of the concept reflects different understandings of care. Relying on the logic of standardization, managers articulate additional services as definite items, which could (and should) be left out of the performance of care work. Care workers do, however, not accept this notion. Relying on their experience of work, they perceive additional services as an ambiguous concept, which recognizes the multiple character of care work. Conclusions are that time scarcity constitutes a pressure on work performance as a whole, reducing care workers’ flexibility, challenging their authority, but still keeping them in a position of responsibility. Ultimately, the battle on time reflects the ambivalences in care work—ambivalences that are becoming increasingly difficult for care workers to handle in work performance.

scholarly journals Occupational Health and Safety Measures in German Outpatient Care Services during the COVID-19 Pandemic: A Qualitative Study

2021 ◽  
Vol 18 (6) ◽  
pp. 2987
Author(s):  
Mara Shirin Hetzmann ◽  
Natascha Mojtahedzadeh ◽  
Albert Nienhaus ◽  
Volker Harth ◽  
Stefanie Mache
Keyword(s):  
Occupational Health ◽  
Outpatient Care ◽  
Qualitative Content Analysis ◽  
Health And Safety ◽  
Occupational Health And Safety ◽  
Work Organisation ◽  
Safety Measures ◽  
Care Services ◽  
Health Threats ◽  
Company Doctor

Due to the coronavirus disease 2019 (COVID-19) pandemic, outpatient caregivers are exposed to new serious health threats at work. To protect their health, effective occupational health and safety measures (OHSM) are necessary. Outpatient caregivers (n = 15) participated in semi-structured telephone interviews in May/June 2020 (1) to examine the pandemic-related OHSM that have been implemented in their outpatient care services, as well as (2) to identify their corresponding unmet needs. Interviews were recorded, transcribed and analysed by using qualitative content analysis in accordance with Mayring. Available OHSM in outpatient care services described by outpatient caregivers mainly included personal protective equipment (PPE) and surface disinfection means after an initial shortage in the first peak of the pandemic. Further OHSM implied social distancing, increased hygiene regulations and the provision of pandemic-related information by the employer, as well as the possibility to consult a company doctor. Our study revealed that OHSM were largely adapted to the health threats posed by COVID-19, however an optimum has not yet been achieved. There is still a need for improvement in the qualitative and quantitative supply of PPE, as well as on the organisational level, e.g., with regard to the development of pandemic plans or in work organisation.

scholarly journals Electronic patient record and its effects on social aspects of interprofessional collaboration and clinical workflows in hospitals (eCoCo): a mixed methods study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marina Beckmann ◽  
Kerstin Dittmer ◽  
Julia Jaschke ◽  
Ute Karbach ◽  
Juliane Köberlein-Neu ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Services ◽  
Healthcare Professionals ◽  
Social Research ◽  
Interprofessional Collaboration ◽  
Participant Observation ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Daily Work ◽  
Network Analyses

Abstract Background The need for and usage of electronic patient records within hospitals has steadily increased over the last decade for economic reasons as well as the proceeding digitalization. While there are numerous benefits from this system, the potential risks of using electronic patient records for hospitals, patients and healthcare professionals must also be discussed. There is a lack in research, particularly regarding effects on healthcare professionals and their daily work in health services. The study eCoCo aims to gain insight into changes in interprofessional collaboration and clinical workflows resulting from introducing electronic patient records. Methods eCoCo is a multi-center case study integrating mixed methods from qualitative and quantitative social research. The case studies include three hospitals that undergo the process of introducing electronic patient records. Data are collected before and after the introduction of electronic patient records using participant observation, interviews, focus groups, time measurement, patient and employee questionnaires and a questionnaire to measure the level of digitalization. Furthermore, documents (patient records) as well as structural and administrative data are gathered. To analyze the interprofessional collaboration qualitative network analyses, reconstructive-hermeneutic analyses and document analyses are conducted. The workflow analyses, patient and employee assessment analyses and classification within the clinical adoption meta-model are conducted to provide insights into clinical workflows. Discussion This study will be the first to investigate the effects of introducing electronic patient records on interprofessional collaboration and clinical workflows from the perspective of healthcare professionals. Thereby, it will consider patients’ safety, legal and ethical concerns and quality of care. The results will help to understand the organization and thereby improve the performance of health services working with electronic patient records. Trial registration The study was registered at the German clinical trials register (DRKS00023343, Pre-Results) on November 17, 2020.

scholarly journals Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andreas Niedermaier ◽  
Anna Freiberg ◽  
Daniel Tiller ◽  
Andreas Wienke ◽  
Amand Führer
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Asylum Seekers ◽  
Health Care Services ◽  
Claims Data ◽  
Care Utilization ◽  
Care Services ◽  
Outpatient Sector ◽  
Analysis Of Claims Data ◽  
Care Costs

Abstract Background Asylum seekers are a vulnerable group with special needs in health care due to their migration history and pre-, peri- and postmigratory social determinants of health. However, in Germany access to health care is restricted for asylum seekers by law and administrative regulations. Methods Using claims data generated in the billing process of health care services provided to asylum seekers, we explore their utilization of health care services in the outpatient sector. We describe the utilization of outpatient specialties, prevalences of diagnoses, prescribed drugs and other health care services, as well as total costs of health care provision. Results The estimated prevalence for visiting an ambulatory physician at least once per year was 67.5% [95%-Confidence-Interval (CI): 65.1–69.9%], with a notably higher prevalence for women than men. The diagnoses with the highest one-year prevalence were “Acute upper respiratory infections” (16.1% [14.5–18.0%]), “Abdominal and pelvic pain” (15.6% [13.9–17.4%]) and “Dorsalgia” (13.8% [12.2–15.5%]). A total of 21% of all prescriptions were for common pain killers. Women received more diagnoses across most diagnosis groups and prescribed drugs from all types than men. Less than half (45.3%) of all health care costs were generated in the outpatient sector. Conclusion The analysis of claims data held in a municipal social services office is a novel approach to gain better insight into asylum seekers’ utilization of health services on an individual level. Compared to regularly insured patients, four characteristics in health care utilization by asylum seekers were identified: low utilization of ambulatory physicians; a gender gap in almost all services, with higher utilization by women; frequent prescription of pain killers; and a low proportion of overall health care costs generated in the outpatient sector. Further research is needed to describe structural and individual factors producing these anomalies.

scholarly journals Routine healthcare for families in transition after a natural disaster

2013 ◽  
Vol 21 (4) ◽  
pp. 982-989 ◽  
Author(s):  
Gisele Cristina Manfrini Fernandes ◽  
Astrid Eggert Boehs
Keyword(s):  
Natural Disasters ◽  
Natural Disaster ◽  
Narrative Analysis ◽  
Participant Observation ◽  
Rural Families ◽  
Healthcare Services ◽  
Routine Care ◽  
Daily Routine ◽  
Family Routines ◽  
Professional Assistance

OBJECTIVE: to present the healthcare routines of families in transition after natural disasters based on the Family Routines and Rituals theoretical framework. METHOD: this qualitative study of multiple cases was developed based on six rural families in southern Brazil, 2 years after a natural disaster. The data were collected through participant observation, interviews, narratives, genograms, ecomaps, and routine calendars, and a narrative analysis was conducted. RESULTS: families showed notable episodes of illness that required professional assistance during post-disaster care, daily routine care, and other routines associated with healthcare services. CONCLUSION: these results reinforce the need for nurses to attend to family experiences during transitions after natural disasters and to prepare for the changes and needs with regard to healthcare and its promotion.

scholarly journals Decision-making of the nursing team after the revitalization of a decentralized management model

2014 ◽  
Vol 23 (2) ◽  
pp. 286-293 ◽  
Author(s):  
Karen Yukari Hayashida ◽  
Andrea Bernardes ◽  
Vanessa Gomes Maziero ◽  
Carmen Silvia Gabriel
Keyword(s):  
Decision Making ◽  
Public Hospital ◽  
Participant Observation ◽  
Management Model ◽  
Participatory Management ◽  
Structured Interviews ◽  
Daily Work ◽  
Decentralized Management ◽  
Qualified Work

This study's objective was to identify changes in decision-making arising from the revitalization of the participatory management model and how these changes impacted the daily work of the nursing staff, as well as to identify potential difficulties. This qualitative case study was conducted in a public hospital in the State of São Paulo, Brazil. Participant observation and semi-structured interviews were conducted with 23 nursing workers and the Health Technical Assistant. We used thematic content analysis for data analysis. The revitalization of the management model was not comprehensive because many professionals were oblivious to the process. Shared actions did not occur and adherence to the model was hampered because the workers were not fully informed of the assumptions concerning this management model. For the implementation of this model to be effective, teamwork and the inclusion of all the stakeholders should be reviewed in order to achieve more cooperative and qualified work.

scholarly journals Preparing for long-term non-face-to-face outpatient care services during the COVID-19 pandemic

2020 ◽  
Author(s):  
Youn Jeong Kim ◽  
Yeon Jeong Jeong ◽  
Si Hyun Kim ◽  
Ah Reum Oh ◽  
Ji Hye Park ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Face To Face ◽  
Care Services

scholarly journals Care management for the hospitalized child with chronic cancer pain: intervening conditions

2019 ◽  
Vol 72 (suppl 1) ◽  
pp. 181-188 ◽  
Author(s):  
Thiago Privado da Silva ◽  
Laura Johanson da Silva ◽  
Benedita Maria Rêgo Deusdará Rodrigues ◽  
Ítalo Rodolfo Silva ◽  
Marialda Moreira Chistoffel ◽  
...  
Keyword(s):  
Human Resources ◽  
Cancer Pain ◽  
Care Management ◽  
Participant Observation ◽  
Structured Interview ◽  
Health Staff ◽  
Theoretical Frameworks ◽  
Professional Qualification ◽  
Chronic Cancer Pain ◽  
Caring Relationship

ABSTRACT Objective: To understand the intervening conditions of care management for the hospitalized child with chronic cancer pain. Method: Qualitative research, anchored in the methodological and theoretical frameworks, respectively, Grounded Theory and Complex Thinking. The semi-structured interview and non-participant observation were used to collect the data. Twenty-one health professionals, organized in three sample groups: nurses; nursing technicians; and professionals of the multiprofessional health staff. Results: They emerged as intervening conditions of care management: human resources and materials, teamwork, absenteeism, professional relocation, professional qualification, family, playful, dialogue, empathy and caring relationship. Conclusion: It was understood as limiting conditions for care management: deficits of human resources and materials, absenteeism, ineffective teamwork, professional relocation, and insufficient professional qualification. On the other hand, they were presented as facilitating conditions: adequate professional knowledge, effective teamwork, dialogue, empathy, playful and affective relationship with the child.

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