Coherence Ideal Work Element: Safety

Psychological Safety ◽

Clinical Work ◽

Work Environments ◽

Leadership And Organization ◽

The Ideal

Physical and psychological safety are important elements of the ideal work environment for health care professionals. Health care organizations should regularly assess both types of safety in their clinical work environments and mitigate factors that erode these qualities. Improving physical and psychological safety is central to creating Coherence and must be embedded into the leadership and organization infrastructure.

Coherence Ideal Work Element: Fairness and Equity

Mayo Clinic Strategies To Reduce Burnout ◽

10.1093/med/9780190848965.003.0021 ◽

2020 ◽

pp. 159-162

Author(s):

Stephen J. Swensen ◽

Tait D. Shanafelt

Keyword(s):

Health Care ◽

Work Environment ◽

Work Schedules ◽

The Ideal ◽

The Way

Fairness and equity are important elements of the ideal work environment. Health care professionals need transparency in all matters that make sense including the way pay, privileges, and work schedules are determined. This Ideal Work Element also requires fair and just accountability to provide support when clinicians experience a traumatic patient adverse care event.

Bedside Nurse Acceptance of Intensive Care Unit Telemedicine Presence

Critical Care Nurse ◽

10.4037/ccn2018926 ◽

2018 ◽

Vol 38 (6) ◽

pp. e1-e4 ◽

Cited By ~ 5

Author(s):

Christina Canfield ◽

Sandra Galvin

Keyword(s):

Health Care ◽

Intensive Care Unit ◽

Intensive Care ◽

Nurse Practitioners ◽

Care Delivery ◽

Health Care Delivery System ◽

Perception Of Support ◽

Evidence Based Care

Since 2010, health care organizations have rapidly adopted telemedicine as part of their health care delivery system to inpatients and outpatients. The application of telemedicine in the intensive care unit is often referred to as tele-ICU. In telemedicine, nurses, nurse practitioners, physicians, and other health care professionals provide patient monitoring and intervention from a remote location. Tele-ICU presence has demonstrated positive outcomes such as increased adherence to evidence-based care and improved perception of support at the bedside. Despite the successes, acceptance of tele-ICU varies. Known barriers to acceptance include perceptions of intrusiveness and invasion of privacy.

Klinkende meerstemmige verhalen, deel II

KWALON ◽

10.5117/2014.019.001.047 ◽

2014 ◽

Vol 19 (1) ◽

Author(s):

Monique Bussmann ◽

Chris Kuiper ◽

Alexander Maas

Keyword(s):

Health Care ◽

Labor Market ◽

Data Collection ◽

Elderly Care ◽

Music Listening ◽

Musical Work ◽

Narrative Methodology ◽

The Government

Sounding polyphonic stories, part II. The phase of listening in data collection Sounding polyphonic stories, part II. The phase of listening in data collection In the Netherlands, future staffing of elderly care will demand a big effort and a lot of creativity of health care organizations and the government. In this study an unconventional qualitative, narrative methodology is applied to throw a new light on the significance having a job and working in elderly care has for health care professionals and to use this as a source of inspiration for labor market policymakers. The methodology is rather unconventional because it doesn’t only focuses on the lingual content of the stories, but also includes other significant aspects of storytelling (e.g., voice and sound). Therefore musical work forms (e.g., music listening and singing) are used additionally.In the first phase of data collection stories of care professionals about the intertwining of their lifeline and career have been collected. In the second, listening phase HR-professionals listened to the stories told by the care professionals and used them as a source of inspiration for HR policy innovation.In a former article the methodology of the storytelling phase has been described. This article treats the methodology of the listening phase in the data collection. Later on the analysis methods will be described.

Lessons from Nuremberg: ethical and social responsibilities for health care professionals, health care organizations, and medical journals

JAMA ◽

10.1001/jama.277.9.711b ◽

1997 ◽

Vol 277 (9) ◽

pp. 711b-711

Author(s):

K. K. Vuylsteke

Keyword(s):

Health Care ◽

Medical Journals ◽

Social Responsibilities

Paradoxes of Practice Guidelines, Professional Expertise, and Patient Centeredness: The Medical Care Triangle

Medical Care Research and Review ◽

10.1177/1077558718774905 ◽

2018 ◽

Vol 76 (4) ◽

pp. 359-385 ◽

Cited By ~ 2

Author(s):

L. Michele Issel

Keyword(s):

Health Care ◽

Medical Care ◽

Practice Guidelines ◽

Professional Expertise ◽

Work Processes ◽

Patient Centeredness ◽

Medical Practitioners ◽

Delivery Of Medical Care

The coexistence of institutionalized evidence-based practice guidelines, professional expertise of medical practitioners, and the patient centeredness approach form a triangle. Each component of this Medical Care Triangle has characteristics that create paradoxes for health care professionals and their patients. The value of a paradox lies in uncovering and utilizing the contradiction to better understand the underlying organizational phenomenon. Method: Following Poole and van de Ven’s (1989) suggested approaches to resolving paradoxes, each paradox of the Medical Care Triangle is defined and analyzed. Results: A total of 10 paradoxes related to practice guidelines, professional expertise, and patient centeredness are revealed. The resolution of each paradox yields insights specific to structuring health care organizations in ways that support the delivery of medical care. Implications: The results renew an emphasis on the centrality of practitioners’ work processes to health care organizations; this has potential benefits for organizations, clinicians/employees, and patients.

Cultural dynamics and tensions when applying design thinking for improving health-care quality

International Journal of Quality and Service Sciences ◽

10.1108/ijqss-04-2019-0055 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Jonas Boström ◽

Helene Hillborg ◽

Johan Lilja

Keyword(s):

Health Care ◽

Health Care Quality ◽

Design Thinking ◽

User Involvement ◽

Clinical Work ◽

Care Quality ◽

Content Type ◽

Improving Health Care ◽

Practical Implications

Purpose The purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking (DT) for improving quality in a health-care setting. Design/methodology/approach This paper is based on a case study following a quality improvement (QI) project in a medium-sized Swedish county council in the field of somatic care. The project involved eight health-care professionals, one designer, four patients and two relatives. A multiple data collection method over a period of ten months was used. It included individual interviews, e-mail correspondence and observations of workshops that covered the QI project. Findings The result shows tensions between QI work and the daily clinical work of the participants. These tensions primarily concern the conflict between fast and slow processes, the problem of moving between different fields of knowledge, being a resource for the individual clinic and the system and the participants’ expectations and assumptions about roles and responsibilities in a QI project. Furthermore, these findings could be interpreted as signs of a development culture in the health-care context. Practical implications There are several practical implications. Among others, the insights can inspire how to approach and contextualize the current concepts, roles and methods of DT and user involvement so that they can be more easily understood and integrated into the existing culture and way of working in the health-care sector. Originality/value This study provides a unique insight into a case, trying to uncover what actually is going on and perhaps, why certain things are not happening at all, when user involvement and design practices are applied for improving health-care quality.

Tobacco Control and Nicotine Addiction in Canada: Current trends, Management and Challenges

Canadian Respiratory Journal ◽

10.1155/2009/485953 ◽

2009 ◽

Vol 16 (1) ◽

pp. 21-26 ◽

Cited By ~ 5

Author(s):

Andrew McIvor

Keyword(s):

Health Care ◽

Smoking Cessation ◽

Tobacco Control ◽

Nicotine Addiction ◽

Current Trends ◽

Canadian Health ◽

Canadian Health Care

Despite a significant decrease in tobacco use over the past four decades, cigarette smoking remains the leading preventable cause of death and disease in Canada. Nicotine addiction, unequal access to available support programs and gaps in continuity of health care are recognized as the main barriers to smoking cessation. To overcome these obstacles and to reach the Federal Tobacco Control Strategy goal of reducing smoking prevalence in Canada from 19% to 12% by 2011, several Canadian health care organizations developed extensive sets of recommendations. Improved access to affordable pharmacotherapies and behavioural counselling, better training of health care professionals and the addition of systemic cessation measures appear to be the key components in all of the proposed recommendations.The present article provides an overview of the current approaches to smoking cessation in Canada, describes the remaining challenges, and outlines recent recommendations that are geared toward not only tobacco control but also overall improvement in long-term health outcomes.

The Experience of Providing Physical Therapy in a Changing Health Care Environment

Physical Therapy ◽

10.1093/ptj/82.7.648 ◽

2002 ◽

Vol 82 (7) ◽

pp. 648-657 ◽

Cited By ~ 21

Author(s):

Rosemary Blau ◽

Sarah Bolus ◽

Terrence Carolan ◽

Daniel Kramer ◽

Elizabeth Mahoney ◽

...

Keyword(s):

Health Care ◽

Work Environment ◽

Phenomenological Study ◽

Physical Therapists ◽

Medical Center ◽

Systemic Change ◽

Academic Medical Center ◽

Health Care Environment ◽

Care Environment

Abstract Background and Purpose. The changes in the health care environment during the last decade have had an impact on the roles and responsibilities of all health care professionals. The purpose of this phenomenological study was to describe the experience of staff physical therapists during a time of systemic change within a large urban academic medical center. Subjects and Methods. Participants were 5 physical therapists working in various clinical settings within the medical center. The participants were interviewed and asked the question “Over the past 4 years, there have been major changes in your work environment. What has it been like for you working as a clinician during this time of change?” Interviews were recorded, transcribed, and analyzed to find thematic patterns of responses. Results. Four common themes emerged in which participants described experiencing loss of control, stress, discontent, and disheartenment. A fifth theme showed that despite these negative feelings, participants were able to “find the silver lining” in their daily work lives (ie, they were able to find positive aspects of their professional lives despite the perceived unpleasant changes with which they had to cope). Discussion and Conclusion. This study provides insight into the experiences of a group of staff physical therapists during a time of systemic change in their work environment. Although the themes reflect largely unsettling and negative experiences, there seems to be an underlying ability to find affirmative aspects of work.

Involuntary automaticity: a work-system induced risk to safe health care

Health Services Management Research ◽

10.1258/095148405774518615 ◽

2005 ◽

Vol 18 (4) ◽

pp. 211-216 ◽

Cited By ~ 49

Author(s):

Brian Toft ◽

Hugo Mascie-Taylor

Keyword(s):

Health Care ◽

Patient Safety ◽

Negative Effects ◽

Care Community ◽

Work System ◽

Skilled Action ◽

Conscious Attention

Automaticity is the term given by psychologists to the skilled action that people develop through repeatedly practising the same activity, for example driving a car. Usually, automaticity is discussed in terms of the benefits it brings to people, such as the reduction in the degree of conscious attention a person needs to pay to such skilled activities. However, there is evidence to suggest that substantial costs may also be associated with such learned behaviour. Managing patient safety is a difficult task and one of the ways in which health-care professionals seek to accomplish it is through the use of verbal challenge-response protocols. However, it is argued in this paper that it is possible for the negative effects of automaticity to involuntarily capture those using such verbal checklist techniques and cause them to erroneously believe that the treatment that they are about to administer to a patient is safe when it is not. This phenomenon does not, however, seem to have been recognized by the health-care community nationally or internationally. We conclude that patient safety could be significantly improved worldwide if the organizational arrangements which appear to induce involuntary automaticity were to be robustly addressed by the management of all health-care organizations.

Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses

10.21203/rs.2.17863/v2 ◽

2020 ◽

Author(s):

Per Nilsen ◽

Ida Seing ◽

Carin Ericsson ◽

Sarah A. Birken ◽

Kristina Schildmeijer

Keyword(s):

Health Care ◽

Registered Nurses ◽

Organizational Changes ◽

Structured Interviews ◽

Disease Patterns ◽

Swedish Health Care ◽

Assistant Nurses ◽

Ageing Populations

Abstract Background: Health care organizations are constantly changing as a result of technological advancements, ageing populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and policy initiatives. Changes can be challenging because they contradict humans’ basic need for a stable environment. The present study poses the question: what characterizes successful organizational changes in health care? The aim was to investigate the characteristics of changes of relevance for the work of health care professionals that they deemed successful.Methods: The study was based on semi-structured interviews with 30 health care professionals: 11 physicians, 12 registered nurses and seven assistant nurses employed in the Swedish health care system. An inductive approach was applied using questions based on the existing literature on organizational change and change responses. The questions concerned the interviewees’ experiences and perceptions of any changes that they considered to have affected their work, regardless of whether these changes were “objectively” large or small changes. The interviewees’ responses were analysed using directed content analysis.Results: The analysis yielded three categories concerning characteristics of successful changes: having the opportunity to influence the change; being prepared for the change; valuing the change. The interviewees emphasized the importance of having the opportunity to influence the organizational changes that are implemented. Changes that were initiated by the professionals themselves were considered the easiest and were rarely resisted. Changes that were clearly communicated to allow for preparation increased the chances for success. The interviewees did not support organizational changes that were perceived to be implemented unexpectedly and/or without prior communication. They conveyed that it was important for them to understand the need for and benefits of organizational changes. They particularly valued and perceived as successful organizational changes with a patient focus, with clear benefits to patients.Conclusions: Organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients.