One year with the COVID-19 pandemic − Lessons learnt? Intersectoral collaboration measures established during the crisis could benefit capacity and patient flow management in daily clinical practice

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Maike Hiller ◽  
Hendrik Bracht ◽  
Stefan Schroeder
Keyword(s):  
Clinical Practice ◽  
Acute Care ◽  
Patient Flow ◽  
Intersectoral Collaboration ◽  
Open Communication ◽  
Clinical Routine ◽  
Content Type ◽  
Personnel Planning ◽  
Patient Pathways ◽  
The Way

PurposeThe COVID-19 pandemic has changed the way hospitals work. Strategies that were detached from the boundaries of departments and responsibilities in the COVID-19 pandemic have proven themselves under extreme conditions and show a beneficial influence on patient flow and resource management as well as on the communication culture. The continuation of closer interdisciplinary and cross-sectoral co-operation in a “new clinical routine” could have a positive impact on personnel concepts, communication strategies, and the management of acute care capacities and patient pathways.Design/methodology/approachThe aim of the paper is to critically discuss the knowledge gained in the context of the COVID-19 pandemic from the various approaches in patient flow and capacity management as well as interdisciplinary co-operation. More recent research has evaluated patient pathway management, personnel planning and communication measures with regard to their effect and practicability for continuation in everyday clinical practice.FindingsPatient flows and acute care capacities can be more efficiently managed by continuing a culture change towards closer interdisciplinary and intersectoral co-operation and technologies that support this with telemedicine functionalities and regional healthcare data interoperability. Together with a bi-directional, more frequent and open communication and feedback culture, it could form a “new clinical routine”.Originality/valueThis paper discusses a holistic approach on the way away from silo thinking towards cross-departmental collaboration.

scholarly journals One Year with the COVID-19 Pandemic - Lessons Learnt? Intersectoral Collaboration Measures Established during the Crisis Could Benefit Capacity and Patient Flow Management in Daily Clinical Practice

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Hiller M ◽  
◽  
Bracht H ◽  
Schroeder S ◽  
◽  
...  
Keyword(s):  
Clinical Practice ◽  
Positive Impact ◽  
Patient Flow ◽  
Resource Planning ◽  
Daily Clinical Practice ◽  
Intersectoral Collaboration ◽  
Patient Pathways ◽  
Patient Flow Management ◽  
One Year ◽  
Communication Culture

The COVID-19 pandemic has changed the way hospitals work. Some of the urgently established measures have proven to be so useful that they should be adopted in standard care. Recent research has assessed patient management, human resource planning and communication measures in terms of their impact and practicality for continuation in daily clinical practice. Strategies that were detached from the boundaries of departments and responsibilities in the COVID-19 pandemic and that have proven themselves under extreme conditions show a beneficial influence on patient flow and resource management as well as on the communication culture. The continuation of closer interdisciplinary and cross-sectoral cooperation in a “new clinical routine” could have a positive impact on personnel concepts, communication strategies, acute care capacities and the management of patient pathways.

scholarly journals Nurses’ voice: the role of hierarchy and leadership

2020 ◽  
Vol 33 (1) ◽  
pp. 12-26 ◽  
Author(s):  
Hanna Krenz ◽  
Michael Josef Burtscher ◽  
Bastian Grande ◽  
Michaela Kolbe
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Multilevel Regression ◽  
Open Communication ◽  
Content Type ◽  
Significant Relationships ◽  
Safety Research ◽  
Clinical Scenarios

Purpose Voicing concerns and suggestions is crucial for preventing medical errors and improving patient safety. Research suggests that hierarchy in health-care teams impair open communication. Hierarchy, however, can vary with changing team composition, particularly during acute care situations where more senior persons join the team later on. The purpose of this study is to investigate how changes in hierarchy and leadership were associated with nurses’ voice frequency and nurses’ time to voice during simulated acute care situations. Design/methodology/approach This study’s sample consisted of 78 health-care providers (i.e. nurses, residents and consultants) who worked in 39 teams performing complex clinical scenarios in the context of interprofessional, simulation-based team training. Scenarios were videotaped and communication behaviour was coded using a systematic coding scheme. To test the hypotheses, multilevel regression analyses were conducted. Findings Hierarchy and leadership had no significant effect on nurses’ voice frequency. However, there were significant relationships between nurses’ time to voice and both hierarchy (γ = 30.00, p = 0.002; 95 per cent confidence interval [CI] = 12.43; 47.92) as well as leadership (γ = 0.30, p = 0.001; 95 per cent CI = 0.12; 0.47). These findings indicate that when more physicians are present and leadership is more centralised, more time passes until the first nurses’ voice occurred. Originality/value This study specifies previous findings on the relationships between hierarchy, leadership and nurses’ voice. Our findings suggest that stronger hierarchy and more centralised leadership delay nurses’ voice but do not affect the overall frequency of voice.

Klein with Lacan: A Study on the Reception of Lacanian Ideas in Uruguay and Its Effects on Clinical Practices (1955–82)

2020 ◽  
Vol 22 (3) ◽  
pp. 341-361
Author(s):  
Gonzalo Grau-Pérez ◽  
J. Guillermo Milán
Keyword(s):  
Clinical Practice ◽  
Clinical Material ◽  
Clinical Practices ◽  
Before And After ◽  
The Difference ◽  
The 1960S ◽  
The Relationship ◽  
Discursive Approach ◽  
The Way ◽  
Clinical Cases

In Uruguay, Lacanian ideas arrived in the 1960s, into a context of Kleinian hegemony. Adopting a discursive approach, this study researched the initial reception of these ideas and its effects on clinical practices. We gathered a corpus of discursive data from clinical cases and theoretical-doctrinal articles (from the 1960s, 1970s and 1980s). In order to examine the effects of Lacanian ideas, we analysed the difference in the way of interpreting the clinical material before and after Lacan's reception. The results of this research illuminate some epistemological problems of psychoanalysis, especially the relationship between theory and clinical practice.

A view on Practical Utility of Paradi Gunas

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Sachin Bagali ◽  
Umapati Baragi ◽  
M. R. Sajjanshetti
Keyword(s):  
Clinical Practice ◽  
Professional Practice ◽  
Continuous Process ◽  
Clinical Activity ◽  
Successful Management ◽  
Knowledge Domain ◽  
Practical Utility ◽  
The Subject ◽  
The Way

In the present day scenario prime need of Ayurveda is practical applicability of Ayurvedic fundamental principles and research should be more focused on all aspects where scientific inputs should confirm Ayurveda’s principles and philosophy. In Ayurveda, Gunas are described as the way of presentation of action without which no Karma (action) can be possible. Ayurveda has provided significance to every Guna so that they become useful in clinical practice. Clinical practice or research is a continuous process including a series of events which need to be performed in a sequential manner. Though there are many factors on which accomplishment of treatment depends, among these Charaka has given prime importance to Paradi Gunas. In clinical practice, Guna which are to be with Bhishak are mainly the Paradi Gunas which can also be called as miscellaneous Gunas. As rightly quoted by Acarya Charaka, for getting success in the treatment Paradi Gunas are the best. The Sutra quotes "Sidhyupaya Chikitsayam" which means that Chikitsa i.e. Dhatusamya will be done mainly with the help of Paradi Gunas. Knowledge of Paradi Gunas are required to be present in pharmacists, physicians and Researchers. Acharya Charaka says that Chikitsa Siddhi i.e. successful management of disease is not possible without the knowledge of Paradi Gunas. Paradi Gunas play an important role in selection, adaption and manifestation of drug as per condition of the disease and the patient in particular Desha and Kala. The ultimate goal of any clinical activity is to contribute in the knowledge domain and to improve professional practice. Thus this literary review of Paradi Gunas serves to explore the subject of the clinical practice.

Co-workers’ perceptions of and reactions to employee’s involuntary demotion

2019 ◽  
Vol 41 (4) ◽  
pp. 740-757 ◽  
Author(s):  
Sophie Hennekam ◽  
Subramaniam Ananthram ◽  
Steve McKenna
Keyword(s):  
Design Methodology ◽  
Emotional Responses ◽  
Emotional Reaction ◽  
Content Type ◽  
Informational Justice ◽  
Behavioural Responses ◽  
Behavioural Reaction ◽  
Three Stages ◽  
Depth Interviews ◽  
The Way

Purpose The purpose of this paper is to investigate how individuals perceive and react to the involuntary demotion of a co-worker in their organisation. Design/methodology/approach The authors draw on 46 semi-structured in-depth interviews (23 dyads) with co-workers of demoted individuals. Findings The findings suggest that an individual’s observation of the demotion of a co-worker has three stages: their perception of fairness, their emotional reaction and their behavioural reaction. The perception of fairness concerned issues of distributive, procedural, interpersonal and informational justice. The emotional responses identified were feelings of disappointment/disillusion, uncertainty, vulnerability and anger. Finally, the behavioural reactions triggered by their emotional responses included expressions of voice, loyalty, exit and adaptation. Originality/value Perceptions of (in)justice perpetrated on others stimulate emotional and behavioural responses, which impacts organisational functioning. Managers should therefore pay attention to the way a demotion is perceived, not only by those directly concerned, but also by co-workers as observers.

scholarly journals Healthcare pathways and resource use: mapping consequences of ambulance assessment for direct care with alternative healthcare providers

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sofi Varg ◽  
Veronica Vicente ◽  
Maaret Castren ◽  
Peter Lindgren ◽  
Clas Rehnberg
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Resource Use ◽  
Healthcare Providers ◽  
Healthcare Utilisation ◽  
Direct Care ◽  
Care Centre ◽  
Decision System ◽  
Geriatric Ward ◽  
Patient Pathways

Abstract Background A decision system in the ambulance allowing alternative pathways to alternate healthcare providers has been developed for older patients in Stockholm, Sweden. However, subsequent healthcare resource use resulting from these pathways has not yet been addressed. The aim of this study was therefore to describe patient pathways, healthcare utilisation and costs following ambulance transportation to alternative healthcare providers. Methods The design of this study was descriptive and observational. Data from a previous RCT, where a decision system in the ambulance enabled alternative healthcare pathways to alternate healthcare providers were linked to register data. The receiving providers were: primary acute care centre or secondary geriatric ward, both located at the same community hospital, or the conventional pathway to the emergency department at an acute hospital. Resource use over 10 days, subsequent to assessment with the decision system, was mapped in terms of healthcare pathways, utilisation and costs for the 98 included cases. Results Almost 90% were transported to the acute care centre or geriatric ward. The vast majority arriving to the geriatric ward stayed there until the end of follow-up or until discharged, whereas patients conveyed to the acute care centre to a large extent were admitted to hospital. The median patient had 6 hospital days, 2 outpatient visits and costed roughly 4000 euros over the 10-day period. Arrival destination geriatric ward indicated the longest hospital stay and the emergency department the shortest. However, the cost for the 10-day period was lower for cases arriving to the geriatric ward than for those arriving to the emergency department. Conclusions The findings support the appropriateness of admittance directly to secondary geriatric care for older adults. However, patients conveyed to the acute care centre ought to be studied in more detail with regards to appropriate level of care.

Quality improvement in hospitals: barriers and facilitators

2017 ◽  
Vol 30 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Dick E. Zoutman ◽  
B. Douglas Ford
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Patient Care ◽  
Acute Care ◽  
Medical Staff ◽  
Acute Care Hospitals ◽  
Content Type ◽  
Active Involvement ◽  
Staff Engagement ◽  
Positive Impacts

Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives. Findings The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals. QI initiatives had positive impacts on patient safety and care. Staff in all hospitals reported conducting past or present hand-hygiene QI projects and C. difficile and surgical site infection were the next most frequent foci. Hospital staff not having time and problems with staff prioritizing QI with other duties were identified as important QI barriers. All respondents reported hospital leadership support, data utilization and internal champions as important QI facilitators. Multiple regression models identified nurses’ active involvement and medical staff engagement in QI with improved patient care and physicians’ active involvement and medical staff engagement with greater patient safety. Practical implications There is the need to study how best to support and encourage physicians and nurses to become more engaged in QI. Originality/value QI initiatives were shown to have positive impacts on patient safety and patient care and barriers and facilitating factors were identified. The results indicated patient care and safety would benefit from increased physician and nurse engagement in QI initiatives.

How to turn managers into data-driven decision makers

2019 ◽  
Vol 25 (3) ◽  
pp. 553-578 ◽  
Author(s):  
Kevin Daniel André Carillo ◽  
Nadine Galy ◽  
Cameron Guthrie ◽  
Anne Vanhems
Keyword(s):  
Measurement Instrument ◽  
Data Driven ◽  
Business Analytics ◽  
Business World ◽  
Content Type ◽  
Multi Stage ◽  
Attitudes Toward Statistics ◽  
Attitude Toward Business ◽  
Professional Contexts ◽  
The Way

Purpose The purpose of this paper is to emphasize the need to engender a positive attitude toward business analytics in order for firms to more effectively transform into data-driven businesses, and for business schools to better prepare future managers. Design/methodology/approach This paper develops and validates a measurement instrument that captures the attitude toward business statistics, the foundation of business analytics. A multi-stage approach is implemented and the validation is conducted with a sample of 311 students from a business school. Findings The instrument has strong psychometric properties. It is designed so that it can be easily extrapolated to professional contexts and extended to the entire domain of business analytics. Research limitations/implications As the advent of a data-driven business world will impact the way organizations function and the way individuals think, work, communicate and interact, it is crucial to engage a transdisciplinary dialogue among domains that have the expertise to help train and transform current and future professionals. Practical implications The contribution provides educators and organizations with a means to measure and monitor attitudes toward statistics, the most anxiogenic component of business analytics. This is a first step in monitoring and developing an analytics mindset in both managers and students. Originality/value By demonstrating how the advent of the data-driven business era is transforming the DNA and functioning of organizations, this paper highlights the key importance of changing managers’ and all employees’ (to a lesser extent) mindset and way of thinking.

Blockchain as supply chain technology: considering transparency and security

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Pei Xu ◽  
Joonghee Lee ◽  
James R. Barth ◽  
Robert Glenn Richey
Keyword(s):  
Supply Chain ◽  
Text Mining ◽  
Information Security ◽  
Design Methodology ◽  
Use Cases ◽  
Future Research ◽  
Content Type ◽  
Blockchain Technology ◽  
Twitter Data ◽  
The Way

PurposeThis paper discusses how the features of blockchain technology impact supply chain transparency through the lens of the information security triad (confidentiality, integrity and availability). Ultimately, propositions are developed to encourage future research in supply chain applications of blockchain technology.Design/methodology/approachPropositions are developed based on a synthesis of the information security and supply chain transparency literature. Findings from text mining of Twitter data and a discussion of three major blockchain use cases support the development of the propositions.FindingsThe authors note that confidentiality limits supply chain transparency, which causes tension between transparency and security. Integrity and availability promote supply chain transparency. Blockchain features can preserve security and increase transparency at the same time, despite the tension between confidentiality and transparency.Research limitations/implicationsThe research was conducted at a time when most blockchain applications were still in pilot stages. The propositions developed should therefore be revisited as blockchain applications become more widely adopted and mature.Originality/valueThis study is among the first to examine the way blockchain technology eases the tension between supply chain transparency and security. Unlike other studies that have suggested only positive impacts of blockchain technology on transparency, this study demonstrates that blockchain features can influence transparency both positively and negatively.

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