No one can whistle a symphony: how hospitals design for daily cross-boundary collaboration

2018 ◽  
Vol 32 (4) ◽  
pp. 618-634 ◽  
Author(s):  
Thim Prætorius ◽  
Peter Hasle ◽  
Anders Paarup Nielsen
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Organizational Design ◽  
Care Delivery ◽  
Organizational Structures ◽  
Content Type ◽  
Hospital Operations ◽  
Multiple Case ◽  
And Performance ◽  
Response Task

PurposeThe purpose of this paper is to investigate how and with which mechanisms health care professionals in practice design for collaboration to solve collective hospital tasks, which cross occupational and departmental boundaries.Design/methodology/approachAn in-depth multiple-case study of five departments across four hospitals facing fast to slow response task requirements was carried out using interviews and observations. The selected cases were revealing as the departments had designed and formalized their daily hospital operations differently to solve collaboration and performance issues.FindingsLocal collaboration across occupational and departmental boundaries requires bundles of behavioral formalization elements (e.g. standardized plans, resource allocation decisions, assigned formal roles, and handoff routines), and liaison devices (e.g. huddles, boards, and physical proximity), which are used in parallel or sequence. The authors label this “designed collaboration bundles.” These bundles supplement the central organizational structures, processes, and support systems less capable of ensuring fluent coordination at the front line.Practical implicationsHealth care professionals and hospital managers can consider designing bundles of organizational design features to proactively develop and ensure collaboration capable of solving collective tasks and bridging departmental and occupational silos to improve health care delivery.Originality/valueThis research paper addresses the fundamental organizational challenge of how to achieve efficient collaboration by studying how formal structures and processes are used in combination on the hospital floor, thereby going beyond previous research that studies these mechanisms individually.

Preparation for safeguarding in UK pre-registration graduate nurse education

2015 ◽  
Vol 17 (6) ◽  
pp. 371-379 ◽  
Author(s):  
Julie McGarry ◽  
Charley Baker ◽  
Claire Wilson ◽  
Anne Felton ◽  
Anirban Banerjee
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Student Evaluation ◽  
Care Delivery ◽  
Educational Support ◽  
Content Type ◽  
Graduate Nurse ◽  
Nursing Curricula ◽  
Adults And Children ◽  
The Uk

Purpose – It is now widely acknowledged that health care professionals on the front line of care delivery will often be among the first to whom patients or clients who have experienced abuse will present or disclose abuse in a clinical context. It is therefore of pivotal importance that all health care professionals, including nurses, are adequately prepared at the earliest opportunity to effectively respond to a disclosure of abuse or identify where abuse may be suspected. The paper aims to discuss these issues. Design/methodology/approach – In order to address this contemporary challenge within health care the authors present a model, developed in the UK, for the embedding of safeguarding knowledge, skills and attitudes within undergraduate pre-registration nursing curricula. This model is integrative and focuses on the acquisition of knowledge and skills in the field of safeguarding vulnerable adults and children. Findings – Student evaluation to date has been extremely positive with the majority of student responses indicating that individuals felt that they had received the requisite level of educational support and knowledge to enable them to recognise concerns. However, it was also clear that students felt that the knowledge gained within the classroom setting needed to be effectively supported and translated in the practice setting. Practical implications – Safeguarding clearly forms a central part of professional accountability and responsibility. It is therefore pivotal that professionals receive the requisite education, skills and knowledge at the earliest opportunity. Originality/value – To the authors’ knowledge this initiative is novel in approach and as such has the potential to inform similar education programmes.

scholarly journals Frontline meetings as support for cross-boundary coordination in hospitals

2019 ◽  
Vol 33 (7/8) ◽  
pp. 884-901 ◽  
Author(s):  
Thim Prætorius ◽  
Peter Hasle
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Collaborative Activity ◽  
Content Type ◽  
Hand Off ◽  
Local Engagement ◽  
Multiple Case ◽  
Practical Implications ◽  
Formal Meeting

Purpose The purpose of this paper is to investigate frontline meetings in hospitals and how they are used for coordination of daily operations across organizational and occupational boundaries. Design/methodology/approach An in-depth multiple-case study of four purposefully selected departments from four different hospitals is conducted. The selected cases had actively developed and embedded scheduled meetings as structural means to achieve coordination of daily operations. Findings Health care professionals and managers, next to their traditional mono-professional meetings (e.g. doctors or nurses), develop additional operational, daily meetings such as work-shift meetings, huddles and hand-off meetings to solve concrete care tasks. These new types of meetings are typically short, task focussed, led by a chair and often inter-disciplinary. The meetings secure a personal proximity which the increased dependency on hospital-wide IT solutions cannot. During meetings, objects and representations (e.g. monitors, whiteboards or paper cards) create a needed gathering point to span across boundaries. As regards embedding meetings, local engagement helps contextualizing meetings and solving concrete care tasks, thereby making health care professionals more likely to value these daily meeting spaces. Practical implications Health care professionals and managers can use formal meeting spaces aided by objects and representations to support solving daily and interdependent health care tasks in ways that IT solutions in hospitals do not offer today. Implementation requires local engagement and contextualization. Originality/value This research paper shows the importance of daily, operational hospital meetings for frontline coordination. Organizational meetings are a prevalent collaborative activity, yet scarcely researched organizational phenomenon.

Future thinking: the role of marketing in healthcare

2019 ◽  
Vol 53 (8) ◽  
pp. 1521-1545 ◽  
Author(s):  
Sidney Anderson ◽  
Steven W. Rayburn ◽  
Jeremy J. Sierra
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Technology Use ◽  
Care Delivery ◽  
Care Service ◽  
Health Care Service ◽  
Futures Studies ◽  
Content Type ◽  
Use Of Technology ◽  
Future Challenges

PurposeThe purpose of this paper is to discuss how, using a futures studies perspective, marketing is uniquely positioned to address future challenges facing health-care service systems.Design/methodology/approachThe futures studies perspective involves predicting probable, preferable and possible futures. Using digital and face-to-face data collection methods, health-care professionals, academics and patients were asked about their perspectives and expectations of health care’s future. Using grounded theory, responses were analyzed to a point of thematic saturation to expose the immediate probable future and a preferred future of health care.FindingsPatients expressed a desire to participate in health-care delivery, impacting caregivers’ roles. Thus, co-creation of value in this context is contingent on the relationship among stakeholders: patients, patients’ families, caregivers and health-care organizations. Concordance, a type of value co-creation, is an effective way for physicians and patients to ameliorate health outcomes.Research limitations/implicationsAlthough a more diverse sample would be ideal, insight from health-care professionals, academics and patients across global regions was obtained.Practical implicationsTo achieve a preferred future in health care, practitioners should implement a three-pronged approach, which includes health promotion and prevention, appropriate use of technology in health care and concordance.Originality/valueUsing patients, health-care professionals and academics, this research broadens the concept of value co-creation in health care. Additionally, paths (i.e. promotion and prevention, technology use and concordance) to a preferred health-care future are uncovered.

Are Communities Willing to Transition Into Learning Health Care Communities? A Community-Based Participatory Evaluation of Stakeholders’ Receptivity

2021 ◽  
pp. 104973232199864
Author(s):  
Nabil Natafgi ◽  
Olayinka Ladeji ◽  
Yoon Duk Hong ◽  
Jacqueline Caldwell ◽  
C. Daniel Mullins
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Lessons Learned ◽  
Community Members ◽  
Community Based ◽  
Care Community ◽  
Care Experience ◽  
National Initiative

This article aims to determine receptivity for advancing the Learning Healthcare System (LHS) model to a novel evidence-based health care delivery framework—Learning Health Care Community (LHCC)—in Baltimore, as a model for a national initiative. Using community-based participatory, qualitative approach, we conducted 16 in-depth interviews and 15 focus groups with 94 participants. Two independent coders thematically analyzed the transcripts. Participants included community members (38%), health care professionals (29%), patients (26%), and other stakeholders (7%). The majority considered LHCC to be a viable model for improving the health care experience, outlining certain parameters for success such as the inclusion of home visits, presentation of research evidence, and incorporation of social determinants and patients’ input. Lessons learned and challenges discussed by participants can help health systems and communities explore the LHCC aspiration to align health care delivery with an engaged, empowered, and informed community.

scholarly journals Innovation Pathways in the NHS: An Introductory Review

2021 ◽  
Author(s):  
Anmol Arora ◽  
Andrew Wright ◽  
Mark Cheng ◽  
Zahra Khwaja ◽  
Matthew Seah
Keyword(s):  
Health Care ◽  
National Health ◽  
Health Care Professionals ◽  
New Technologies ◽  
Care Delivery ◽  
Cost Effective ◽  
Care Models ◽  
Set Up ◽  
The Uk ◽  
Introductory Review

AbstractHealthcare as an industry is recognised as one of the most innovative. Despite heavy regulation, there is substantial scope for new technologies and care models to not only boost patient outcomes but to do so at reduced cost to healthcare systems and consumers. Promoting innovation within national health systems such as the National Health Service (NHS) in the United Kingdom (UK) has been set as a key target for health care professionals and policy makers. However, while the UK has a world-class biomedical research industry, several reports in the last twenty years have highlighted the difficulties faced by the NHS in encouraging and adopting innovations, with the journey from idea to implementation of health technology often taking years and being very expensive, with a high failure rate. This has led to the establishment of several innovation pathways within and around the NHS, to encourage the invention, development and implementation of cost-effective technologies that improve health care delivery. These pathways span local, regional and national health infrastructure. They operate at different stages of the innovation pipeline, with their scope and work defined by location, technology area or industry sector, based on the specific problem identified when they were set up. In this introductory review, we outline each of the major innovation pathways operating at local, regional and national levels across the NHS, including their history, governance, operating procedures and areas of expertise. The extent to which innovation pathways address current challenges faced by innovators is discussed, as well as areas for improvement and future study.

Voice activity detection using optimal window overlapping especially over health-care infrastructure

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Shilpa Sharma ◽  
Punam Rattan ◽  
Anurag Sharma ◽  
Mohammad Shabaz
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Research Work ◽  
Voice Activity Detection ◽  
Support Vector ◽  
Activity Detection ◽  
Content Type ◽  
Health Care Infrastructure ◽  
Voice Activity ◽  
Optimal Window

Purpose This paper aims to introduce recently an unregulated unsupervised algorithm focused on voice activity detection by data clustering maximum margin, i.e. support vector machine. The algorithm for clustering K-mean used to solve speech behaviour detection issues was later applied, the application, therefore, did not permit the identification of voice detection. This is critical in demands for speech recognition. Design/methodology/approach Here, the authors find a voice activity detection detector based on a report provided by a K-mean algorithm that permits sliding window detection of voice and noise. However, first, it needs an initial detection pause. The machine initialized by the algorithm will work on health-care infrastructure and provides a platform for health-care professionals to detect the clear voice of patients. Findings Timely usage discussion on many histories of NOISEX-92 var reveals the average non-speech and the average signal-to-noise ratios hit concentrations which are higher than modern voice activity detection. Originality/value Research work is original.

scholarly journals Incorporating digital self-services into integrated mental health care: a physician’s perspective

2018 ◽  
Vol 52 (11) ◽  
pp. 2234-2250 ◽  
Author(s):  
Heini Sisko Maarit Taiminen ◽  
Saila Saraniemi ◽  
Joy Parkinson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Delivery ◽  
Value Creation ◽  
Care Delivery ◽  
Service Marketing ◽  
Content Type ◽  
Integrated Mental Health ◽  
Physician’S Perspective

Purpose This paper aims to enhance the current understanding of digital self-services (computerized cognitive behavioral therapy [cCBT]) and how they could be better incorporated into integrated mental health care from the physician’s perspective. Service marketing and information systems literature are combined in the context of mental health-care delivery. Design/methodology/approach An online survey of 412 Finnish physicians was undertaken to understand physicians’ acceptance of cCBT. The study applies thematic analysis and structural equation modeling to answer its research questions. Findings Adopting a service marketing perspective helps understand how digital self-services can be incorporated in health-care delivery. The findings suggest that value creation within this context should be seen as an intertwined process where value co-creation and self-creation should occur seamlessly at different stages. Furthermore, the usefulness of having a value self-creation supervisor was identified. These value creation logic changes should be understood and enabled to incorporate digital self-services into integrated mental health-care delivery. Research limitations/implications Because health-care systems vary across countries, strengthening understanding through exploring different contexts is crucial. Practical implications Assistance should be provided to physicians to enable better understanding of the application and suitability of digital self-service as a treatment option (such as cCBT) within their profession. Additionally, supportive facilitating conditions should be created to incorporate them as part of integrated care chain. Social implications Digital self-services have the potential to serve goals beyond routine activities in a health-care setting. Originality/value This study demonstrates the relevance of service theories within the health-care context and improves understanding of value creation in digital self-services. It also offers a profound depiction of the barriers to acceptance.

scholarly journals Bedside Nurse Acceptance of Intensive Care Unit Telemedicine Presence

2018 ◽  
Vol 38 (6) ◽  
pp. e1-e4 ◽  
Author(s):  
Christina Canfield ◽  
Sandra Galvin
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Nurse Practitioners ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
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.

Dealing with organizational silos with communities of practice and human resource management

2017 ◽  
Vol 29 (6) ◽  
pp. 473-489 ◽  
Author(s):  
Riitta Forsten-Astikainen ◽  
Pia Hurmelinna-Laukkanen ◽  
Tuija Lämsä ◽  
Pia Heilmann ◽  
Elina Hyrkäs
Keyword(s):  
Communities Of Practice ◽  
Organizational Structures ◽  
Energy Sector ◽  
Negative Effects ◽  
Organizational Boundaries ◽  
Content Type ◽  
Competence Management ◽  
And Performance ◽  
Hr Managers ◽  
Hr Function

Purpose Organizational silos that build on the existing organizational structures are often considered to have negative effects in the form of focus on private narrow objectives and organizational fragmentation. To avoid such harmful outcomes, competence management is called for, and in this, the human resources (HR) function takes a key role. Among other things, it can provide basis for emergence and utilization of communities of practice (CoPs) that build on common interests and effectively cross organizational boundaries. These features of CoPs allow them to carry competences and ease knowledge transfer and to break down the harmful isolation. Quite paradoxically, the challenge is that CoPs can also form within silos, thereby strengthening isolation, and HR as a utility department can itself be particularly prone to the silo effects. Examination of boundaries and silos through an original study conducted in a Finnish energy sector company suggests that HR managers need competences outside their own expertise area and courage to augment their CoPs across the functional boundaries to break out of the HR silo and to assist other functions to do the same. Design/methodology/approach The study is based on qualitative research data gathered in four focus group interviews with HR personnel from an energy sector company in November 2012. Totally, 19 professionals were interviewed (five HR partners, five talent development and performance managers, five vice presidents of HR and four HR managers) in the four focus groups. The company’s HR personnel represented units from Finland, Sweden, Poland and Estonia. Findings Examination of boundaries and silos in the Finnish energy sector suggests that HR managers need competences outside their own field (e.g. knowledge of the business and offerings of the firm) and courage to augment their CoPs across the functional boundaries to break out of the HR silo and to assist other functions to do the same. Originality/value Research provided that CoPs can have different effects on silos. As they are capable of crossing organizational and functional boundaries, they may effectively mitigate adverse silo effects; however, if CoPs are formed within silos, they may strengthen isolation and fragmentation. In addition, utility departments and supporting functions are particularly prone to the risk of CoPs forming within silos. The HR function is one manifestation of this. Paradoxically, it also has the potential to enhance the other type of effects that CoPs can exert, as competence management can be used to foster intentional and self-organizing CoPs that counter silo effects.

Sign in / Sign up

Export Citation Format

Share Document