scholarly journals Different roles with different goals: Designing to support shared situational awareness between patients and clinicians in the hospital

2020 ◽  
Author(s):  
Ari H Pollack ◽  
Sonali R Mishra ◽  
Calvin Apodaca ◽  
Maher Khelifi ◽  
Shefali Haldar ◽  
...  
Keyword(s):  
Situational Awareness ◽  
Quality Care ◽  
Hospital Environment ◽  
Healthcare Team ◽  
Card Sorting ◽  
Structured Interviews ◽  
Team Members ◽  
Mixed Methods Approach ◽  
Critical Knowledge ◽  
Adult Hospital

Abstract Objective Team situational awareness helps to ensure high-quality care and prevent errors in the complex hospital environment. Although extensive work has examined factors that contribute to breakdowns in situational awareness among clinicians, patients’ and caregivers’ roles have been neglected. To address this gap, we studied team-based situational awareness from the perspective of patients and their caregivers. Materials and Methods We utilized a mixed-methods approach, including card sorting and semi-structured interviews with hospitalized patients and their caregivers at a pediatric hospital and an adult hospital. We analyzed the results utilizing the situational awareness (SA) theoretical framework, which identifies 3 distinct stages: (1) perception of a signal, (2) comprehension of what the signal means, and (3) projection of what will happen as a result of the signal. Results A total of 28 patients and 19 caregivers across the 2 sites participated in the study. Our analysis uncovered how team SA helps patients and caregivers ensure that their values are heard, their autonomy is supported, and their clinical outcomes are the best possible. In addition, our participants described both barriers—such as challenges with communication—and enablers to facilitating shared SA in the hospital. Discussion Patients and caregivers possess critical knowledge, expertise, and values required to ensure successful and accurate team SA. Therefore, hospitals need to incorporate tools that facilitate patients and caregivers as key team members for effective SA. Conclusions Elevating patients and caregivers from passive recipients to equal contributors and members of the healthcare team will improve SA and ensure the best possible outcomes.

scholarly journals A Qualitative Description of Millennial Nurse Administrators’ Perspectives on Leadership and Their Practice Environment

2019 ◽  
Vol 3 (2) ◽  
pp. 153 ◽  
Author(s):  
John Ian Lamasan ◽  
Ryan Michael F Oducado
Keyword(s):  
Qualitative Content Analysis ◽  
Quality Care ◽  
Qualitative Description ◽  
Healthcare Team ◽  
Practice Environment ◽  
Professional Relationship ◽  
Structured Interviews ◽  
Nurse Administrators ◽  
Team Members ◽  
Tertiary Hospitals

Introduction: Millennial nurses are beginning to accept leadership roles and will soon take over governance in the nursing profession and healthcare industry. This study aimed to describe the perspectives on leadership and their practice environment of millennial nurse administrators working in tertiary hospitals in Iloilo City, Philippines. Methods: Eight (8) millennial nurse administrators were purposively chosen. Through a qualitative descriptive inquiry by Sandelowski (2000), data were gathered using semi-structured interviews and analyzed employing qualitative content analysis. Results: Twelve (12) meaningful categories were derived directly from the interview transcripts. Millennial nurse administrators perceive leadership by way of (1) directing, (2) guiding, (3) empowering and (4) modeling to staff. They viewed their practice environment as (5) having a harmonious relationship while (6) maintaining professional relationship among the healthcare team members, (7) upholding standards and (8) ensuring client satisfaction as a measure of quality care. Millennial nurse administrators shared feelings of being (9) overwhelmed at the start yet (10) fulfilling in the end. Lastly, they had challenges in (11) dealing with older staff and in (12) assuming the full responsibility and accountability of their unit. Conclusions: Considering the complexities in the healthcare profession, millennial nurse administrators cope with the responsibilities brought by their position as major key players to ensure that unit operations abide with practice standards. Millennial nurse administrators must be provided with understanding, support, and mentoring, to enhance their leadership competencies as they progress into higher leadership positions.

scholarly journals We Learnt a Lot: Challenges and Learning Experiences in a Southern African—North European Municipal Partnership on Education for Sustainable Development

2020 ◽  
Vol 12 (20) ◽  
pp. 8607
Author(s):  
Kerstin Sonesson ◽  
Birgitta Nordén
Keyword(s):  
Sustainable Development ◽  
Transformational Learning ◽  
Education For Sustainable Development ◽  
Three Dimensions ◽  
Global Learning ◽  
Structured Interviews ◽  
Team Members ◽  
Critical Knowledge ◽  
Knowledge Formation ◽  
Development Goals

This study investigates a reciprocal partnership between two cities in Namibia and Sweden to deepen the understanding of challenges and learning outcomes in a project on education for sustainable development. Since 2008, two municipalities have developed a strong partnership via The Municipal Partnership Programme at the Swedish International Centre for Local Democracy. Municipal partnerships are results-oriented collaborations in joint projects on sustainability. The purpose is to describe how eight team members in the mutual South-North project, by addressing similar problems in different contexts, experienced challenges in the implementation of the project plan, solutions and learning processes. Semi-structured interviews were conducted at the end of the second project year. Transcripts and field notes were analysed using a phenomenographic approach and contextual analysis. Five main categories of description based on collective statements and three dimensions of learning were recognised in the research data. The analysis identifies strategies for critical knowledge formation and capability building to support mutual learning in South-North Municipal Partnerships. The concluding discussion spots the learning dimensions—how sharing experiences by justifying non-formal and transformational learning promotes organisations’ readiness for knowledge formation by conducting mutual global learning towards sustainable development goals.

scholarly journals The application of AHP in the development of a taxonomy of merchant marine deck officers’ non-technical skills (NTS)

2019 ◽  
Vol 10 (1) ◽  
pp. 55-70 ◽  
Author(s):  
Farhan Saeed ◽  
Alan Bury ◽  
Stephen Bonsall ◽  
Ramin Riahi
Keyword(s):  
Cognitive Skills ◽  
Human Error ◽  
Situational Awareness ◽  
Language Skills ◽  
Relevant Literature ◽  
Structured Interviews ◽  
Merchant Marine ◽  
Team Members ◽  
Managerial Skills ◽  
Hierarchy Process

Abstract The importance of NTS has been realised in many safety critical industries. Recently the maritime domain has also embraced the idea and implemented an NTS training course for both merchant marine deck and engineering officers. NTS encompass both interpersonal and cognitive skills such as situational awareness, teamwork, decision making, leadership, managerial skills, communication and language skills. Well-developed NTS training allow ship’s officers to recognise quickly when a problem is developing and manage the situation safely and efficiently with the available team members. As a result, the evaluation and grading of deck officers’ NTS is necessary to assure safety at sea, reduce the effects of human error on-board ships, and allow ship board operations to be performed safely. This paper identifies the skills necessary for deck officers to effectively perform their duties on the bridge of a ship. To achieve this, initially, a taxonomy of deck officers’ NTS is developed through a review of relevant literature and the conducting of semi-structured interviews with experienced seafarers. Subsequently, NTS weighting data is collected from experienced seafarers to allow the weight of each element of the taxonomy to be established by the use of the Analytical Hierarchy Process (AHP).

scholarly journals Building trust and facilitating goals of care conversations: A qualitative study in people with heart failure receiving home hospice care

2020 ◽  
Vol 34 (7) ◽  
pp. 925-933
Author(s):  
Dawon Baik ◽  
David Russell ◽  
Lizeyka Jordan ◽  
Daniel D Matlock ◽  
Frances Dooley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Family Support ◽  
Family Caregivers ◽  
Hospice Care ◽  
Qualitative Interviews ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Goals Of Care ◽  
Team Members ◽  
Interprofessional Healthcare

Background: Despite a majority of persons receiving hospice care in their homes, there are gaps in understanding how to facilitate goals of care conversations between persons with heart failure and healthcare providers. Aim: To identify barriers and facilitators which shape goals of care conversations for persons with heart failure in the context of home hospice. Design: A qualitative descriptive study design was used with semi-structured interviews. Setting/participants: We conducted qualitative interviews with persons with heart failure, family caregivers, and interprofessional healthcare team members at a large not-for-profit hospice agency in New York City between March 2018 and February 2019. Results: A total of 39 qualitative interviews were conducted, including with healthcare team members (e.g. nurses, physicians, social workers, spiritual counselors), persons with heart failure, and family caregivers. Three themes emerged from the qualitative interviews regarding facilitators and barriers in goals of care conversations for better decision-making: (1) trust is key to building and maintaining goals of care conversations; (2) lack of understanding and acceptance of hospice inhibits goals of care conversations; and (3) family support and engagement promote goals of care conversations. Conclusion: Findings from this study suggest that interventions designed to improve goals of care conversations in the home hospice setting should focus on promoting understanding and acceptance of hospice, family support and engagement, and building trusting relationships with interprofessional healthcare teams.

Oncology pharmacist opportunities: Closing the gap in quality care.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 174-174
Author(s):  
Shannon Hough ◽  
Vera Vulaj ◽  
Karen B Farris ◽  
Emily R. Mackler
Keyword(s):  
Quality Care ◽  
Quality Metrics ◽  
Quality Data ◽  
Healthcare Team ◽  
Patient Counseling ◽  
Team Members ◽  
Medication Therapy ◽  
Data Registry ◽  
American Society ◽  
Oncology Practice

174 Background: The quality of care provided to oncology patients is beginning to be linked to hospital and practice payment models. Oncology pharmacy specialists are well trained to deliver high-quality oncology care, with a focus on the appropriate utilization and monitoring of medication therapy, patient education and collaboration with other healthcare team members. The extent to which the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) metrics identify specific areas in which pharmacists may enhance care is not known. These findings are important because Centers for Medicare and Medicaid Services designate QOPI as a Qualified Clinical Data Registry (QCDR) and over 1000 US-based oncology practices submit quality data to it. Methods: We reviewed all QOPI measures for potential oncology pharmacist involvement. We utilized a summary of services provided by board-certified oncology pharmacists to identify which services would best fit the care described by the selected QOPI measures. Three individuals identified the areas where pharmacists could contribute and consensus was reached. Metrics were only scored positively for pharmacist impact if they could be obtained via the pharmacist as the primary team member responsible for meeting the measure. Results: Two hundred QOPI quality measures from Fall 2016 were reviewed and 177 were analyzed. Potential areas of pharmacist impact were identified in 67 (38%) of the included metrics. These measures fell within 11 of the 13 possible categories of the service summary. A total of 147 services were identified for the 67 actionable metrics. Patient counseling and education (28%), symptom management and supportive care (23%), chemotherapy adjustment (10%), and participation in protocol-based care (10%) comprised services that most commonly contributed to the ASCO QOPI measure performance. Conclusions: Multiple opportunities exist for pharmacists to directly impact the quality metrics that are measured by the service summary. Focusing new services and patient care activities to address validated quality metrics is a natural next step in the care that oncology clinical pharmacists provide to patients.

scholarly journals Peer support workers as a bridge: a qualitative study exploring the role of peer support workers in the care of people who use drugs during and after hospitalization

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Robin Lennox ◽  
Larkin Lamarche ◽  
Tim O’Shea
Keyword(s):  
Qualitative Study ◽  
Peer Support ◽  
Healthcare Providers ◽  
People Who Use Drugs ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Support Worker ◽  
Team Members ◽  
Key Stakeholders

Abstract Background To describe the key qualities and unique roles of peer support workers in the care of people who inject drugs during and after hospitalization. Methods We conducted a qualitative study. Key stakeholders were recruited including: people who use drugs who had been hospitalized, healthcare team members, peer support workers, and employers of peer support workers. Data were collected from 2019 to 2020 using semi-structured interviews that were audio-recorded, transcribed, and analyzed thematically. Results Fourteen participants were interviewed: 6 people who use drugs who had been hospitalized, 5 healthcare team members, 2 peer support workers, and 1 employer of peer support workers. At the core of the data was the notion of peer workers acting as a bridge. We found four themes that related to functions of this bridge: overcoming system barriers, advocacy, navigating transitions within the healthcare system, and restoring trust between HCPs and PWUD. We found two themes for building a strong bridge and making the role of a peer support worker function effectively (training and mentorship, and establishing boundaries). We found three themes involving characteristics of an effective peer worker (intrinsic qualities, contributions of shared experiences, and personal stability). Conclusion Peer support workers are highly valued by both people who use drugs and members of the healthcare team. Peer support workers act as a bridge between patients and healthcare providers and are critical in establishing trust, easing transitions in care, and providing unique supports to people who use drugs during and after hospitalization.

scholarly journals Peer Support Workers as a Bridge: A Qualitative Study Exploring the Role of Peer Support Workers in the Care of People Who Use Drugs During and After Hospitalization 

2020 ◽  
Author(s):  
Robin Lennox ◽  
Larkin Lamarche ◽  
Tim O'Shea
Keyword(s):  
Qualitative Study ◽  
Peer Support ◽  
Healthcare Providers ◽  
People Who Use Drugs ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Support Worker ◽  
Team Members ◽  
Key Stakeholders

Abstract Background: To describe the key qualities and unique roles of peer support workers in the care of people who inject drugs during and after hospitalization.Methods: We conducted a qualitative study. Key stakeholders were recruited including: people who use drugs who had been hospitalized, healthcare team members, peer support workers, and employers of peer support workers. Data was collected from 2019-2020 using semi-structured interviews that were audio-recorded, transcribed, and analyzed thematically.Results: Fourteen participants were interviewed: 6 people who use drugs who had been hospitalized, 5 healthcare team members, 2 peer support workers, and 1 employer of peer support workers. At the core of the data was the notion of peer workers acting as a bridge to overcome systemic barriers. We found two themes that related to functions of this bridge: advocacy and navigating transitions within the healthcare system. We found two themes for building a strong bridge and making the role of a peer support worker function effectively (training and mentorship, and establishing boundaries). We found three themes involving characteristics of an effective peer worker (intrinsic qualities, contributions of shared experiences, and personal stability). When the bridge works well it ultimately serves to rebuild trust between healthcare providers and people who use drugs.Conclusions: Peer support workers are highly valued by both people who use drugs and members of the healthcare team. Peer support workers act as a bridge between patients and healthcare providers, and are critical in establishing trust, easing transitions in care, and providing unique supports to people who use drugs during and after hospitalization.

Understanding the Abortion Experiences of Young People to Inform Quality Care in Argentina, Bangladesh, Ethiopia, and Nigeria

2021 ◽  
pp. 0044118X2110110
Author(s):  
Laura E. Jacobson ◽  
Ana Maria Ramirez ◽  
Chiara Bercu ◽  
Anna Katz ◽  
Caitlin Gerdts ◽  
...  
Keyword(s):  
Young People ◽  
Quality Care ◽  
First Trimester ◽  
Structural Barriers ◽  
Structured Interviews ◽  
Safe Abortion ◽  
Medication Abortion ◽  
Abortion Care ◽  
The Mean ◽  
Reproductive Healthcare

Young people face social and structural barriers when accessing abortions. High-quality, sexual and reproductive healthcare is needed; however, literature on youth-informed abortion services is limited. This study assesses accounts of youth who obtained an abortion in Argentina, Bangladesh, Ethiopia, and Nigeria and provides recommendations to improve person-centered aspects of abortion quality. We analyzed 48 semi-structured interviews with clients recruited from clinics, safe abortion hotlines, and patent and proprietary medicine vendors. We coded transcripts and conducted a thematic analysis. The mean age was 21 years (range 16–24), and the majority had a first trimester, medication abortion. Prominent themes included access to information; privacy; stigma associated with age or marital status; the decision-making process; and comfort and rapport with providers. Youth-centered abortion care should anticipate the distinct needs of younger clients. Supportive providers have an important role in offering a non-judgmental service that makes young clients feel comfortable and prepared.

scholarly journals An evaluation of the implementation of quality improvement (QI) in primary care dentistry: a multi-method approach

2021 ◽  
Vol 10 (2) ◽  
pp. e000839
Author(s):  
Heather Cassie ◽  
Vinay Mistry ◽  
Laura Beaton ◽  
Irene Black ◽  
Janet E Clarkson ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Case Studies ◽  
Quality Care ◽  
Theoretical Domains Framework ◽  
Team Members ◽  
Knowledge And Skills ◽  
Scottish Government ◽  
The Impact

ObjectivesEnsuring that healthcare is patient-centred, safe and harm free is the cornerstone of the NHS. The Scottish Patient Safety Programme (SPSP) is a national initiative to support the provision of safe, high-quality care. SPSP promotes a coordinated approach to quality improvement (QI) in primary care by providing evidence-based methods, such as the Institute for Healthcare Improvement’s Breakthrough Series Collaborative methodology. These methods are relatively untested within dentistry. The aim of this study was to evaluate the impact to inform the development and implementation of improvement collaboratives as a means for QI in primary care dentistry.DesignA multimethod study underpinned by the Theoretical Domains Framework and the Kirkpatrick model. Quantitative data were collected using baseline and follow-up questionnaires, designed to explore beliefs and behaviours towards improving quality in practice. Qualitative data were gathered using interviews with dental team members and practice-based case studies.ResultsOne hundred and eleven dental team members completed the baseline questionnaire. Follow-up questionnaires were returned by 79 team members. Twelve practices, including two case studies, participated in evaluation interviews. Findings identified positive beliefs and increased knowledge and skills towards QI, as well as increased confidence about using QI methodologies in practice. Barriers included time, poor patient and team engagement, communication and leadership. Facilitators included team working, clear roles, strong leadership, training, peer support and visible benefits. Participants’ knowledge and skills were identified as an area for improvement.ConclusionsFindings demonstrate increased knowledge, skills and confidence in relation to QI methodology and highlight areas for improvement. This is an example of partnership working between the Scottish Government and NHSScotland towards a shared ambition to provide safe care to every patient. More work is required to evaluate the sustainability and transferability of improvement collaboratives as a means for QI in dentistry and wider primary care.

scholarly journals Implementation of Person-Centered Care: A Feasibility Study Using the WE-CARE Roadmap

2021 ◽  
Vol 18 (5) ◽  
pp. 2205
Author(s):  
Roman A. Lewandowski ◽  
Jędrzej B. Lewandowski ◽  
Inger Ekman ◽  
Karl Swedberg ◽  
Jan Törnell ◽  
...  
Keyword(s):  
Pilot Study ◽  
Feasibility Study ◽  
Health Care Professionals ◽  
Quality Care ◽  
Structured Interviews ◽  
Rehabilitation Hospital ◽  
Person Centered Care ◽  
Centered Care ◽  
Multi Disciplinary Team

Background: Person-Centered Care (PCC) is a promising approach towards improved quality of care and cost containment within health systems. It has been evaluated in Sweden and England. This feasibility study examines initial PCC implementation in a rehabilitation hospital for children in Poland. Methods: The WE-CARE Roadmap of enablers was used to guide implementation of PCC for patients with moderate scoliosis. A multi-disciplinary team of professionals were trained in the PCC approach and the hospital Information Technology (IT) system was modified to enhance PCC data capture. Semi-structured interviews were conducted with the nine health care professionals involved in the pilot study and three patients/parents receiving care. Transcribed data were analyzed via content analysis. Results: 51 patients and their families were treated via a PCC approach. High proportions of new PCC data fields were completed by the professionals. The professionals were able to implement the three core PCC routines and perceived benefits using the PCC approach. Patients and their families also perceived improved quality care. The WE-CARE framework enablers facilitated PCC implementation in this setting. Conclusions: This feasibility pilot study indicates that the Gothenburg PCC approach can be successfully transferred to a rehabilitation hospital in Poland with favorable perceptions of implementation by both professionals and patients/their families.

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