Are the Organisational Management Characteristics of Healthcare Organisations Distinguishable from Other Professional Organisations?

Group Conflict ◽

Management Innovation ◽

Healthcare Administration ◽

Physician Autonomy ◽

Legal Structure ◽

Healthcare Settings ◽

Professional Fields ◽

Structured Literature Review

Organisational management characteristics occur with varying rates across industries and organisations within industries. While professional organisations tend to have fewer undesirable management characteristics than non-professional organisations, little work has been done to assess whether healthcare, with its unique legal structure that can put hospital administration at odds with physician autonomy, is an exception among professional organisations. In this study, rates of positive as well as undesirable management practices were estimated from publicly available ethnography data and compared to data from non-healthcare professional settings. A structured literature review was conducted to validate the ethnography data and further explore possible mechanisms. The main finding is that healthcare professionals do have greater group conflict with administration than other professionals and that healthcare settings exhibit greater instances of unwritten rules than other professional organisations. Overall, our results suggest that common management practices in other professional settings may not fully apply to healthcare. The potential for group conflict between physicians and administration is higher than other autonomous professional fields. Healthcare administration may benefit from examining practices in non-professional settings for beneficial ideas in management innovation.

Patients perspectives on drug shortages in six European hospital settings – a cross sectional study

10.1186/s12913-021-06721-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Darija Kuruc Poje ◽

Domagoj Kifer ◽

Isabelle Huys ◽

Joao Miranda ◽

Helena Jenzer ◽

...

Keyword(s):

Management Practices ◽

Demographic Data ◽

General Information ◽

Basic Knowledge ◽

Drug Shortage ◽

Cross Sectional ◽

Drug Shortages ◽

Good Communication ◽

Information Preferences

Abstract Background It is known that drug shortages represent a major challenge for all stakeholders involved in the process, but there is little evidence regarding insights into patients′ awareness and perspectives. This study aimed to investigate the patients-perceived drug shortages experience and their view on outcomes in different European hospital settings. Furthermore, we wanted to explore information preferences on drug shortages. Methods A retrospective, cross sectional, a mixed method study was conducted in six European hospital settings. One hospital (H) from each of this country agreed to participate: Bosnia and Herzegovina (H-BiH), Croatia (H-CR), Germany (H-GE), Greece (H-GR), Serbia (H-SE) and Poland (H-PO). Recruitment and data collection was conducted over 27 months from November 2017 until January 2020. Overall, we surveyed 607 patients which completed paper-based questionnaire. Questions related to: general information (demographic data), basic knowledge on drug shortages, drug shortages experienced during hospitalization and information preferences on drug shortage. Differences between hospital settings were analyzed using Chi-squared test or Fisher’s exact test. For more complex contingency tables, Monte Carlo simulations (N = 2000) were applied for Fisher’s test. Post-hoc hospital-wise analyses were performed using Fisher’s exact tests. False discovery rate was controlled using the Bonferroni method. Analyses were performed using R: a language and environment for statistical computing (v 3.6.3). Results 6 % of patients reported experiences with drug shortages while hospitalized which led to a deterioration of their health. The majority of affected patients were hospitalized at hematology and/or oncology wards in H-BiH, H-PO and H-GE. H-BiH had the highest number of affected patients (18.1 %, N = 19/105, p < 0.001) while the fewest patients were in H-SE (1 %, N = 1/100, p = 0.001). In addition, 82.5 %, (N = 501/607) of respondents wanted to be informed of alternative treatment options if there was a drug shortage without a generic substitute available. Majority of these patients (66.4 %, N = 386/501) prefer to be informed by a healthcare professional. Conclusions Although drug shortages led to serious medical consequences, our findings show that most of the patients did not perceive shortages as a problem. One possible interpretation is that good hospital management practices by healthcare professionals helped to mitigate the perceived impact of shortages. Our study highlights the importance of a good communication especially between patients and healthcare professionals in whom our patients have the greatest trust.

Healthcare professionals’ experiences with highly qualified nurses working in acute care teams in primary healthcare settings

Scandinavian Journal of Primary Health Care ◽

10.1080/02813432.2021.1913903 ◽

2021 ◽

pp. 1-10

Author(s):

Stine Emilie Junker Udesen ◽

Annmarie Touborg Lassen ◽

Nina Andersen ◽

Christina Østervang ◽

Dorthe Suanne Nielsen

Keyword(s):

Acute Care ◽

Primary Healthcare ◽

Highly Qualified ◽

Healthcare Settings

What are the risk factors for avoidable transitions in the last year of life? A qualitative exploration of professionals’ perspectives for improving care in Germany

10.1186/s12913-021-06138-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Alina Kasdorf ◽

◽

Gloria Dust ◽

Vera Vennedey ◽

Christian Rietz ◽

...

Keyword(s):

Healthcare Professional ◽

Qualitative Content Analysis ◽

Individual Interviews ◽

Information Power ◽

Care Services ◽

Healthcare Settings ◽

Nursing Services ◽

Value Based Care ◽

Qualitative Exploration

Abstract Background Little is known about the nature of patients’ transitions between healthcare settings in the last year of life (LYOL) in Germany. Patients often experience transitions between different healthcare settings, such as hospitals and long-term facilities including nursing homes and hospices. The perspective of healthcare professionals can therefore provide information on transitions in the LYOL that are avoidable from a medical perspective. This study aims to explore factors influencing avoidable transitions across healthcare settings in the LYOL and to disclose how these could be prevented. Methods Two focus groups (n = 11) and five individual interviews were conducted with healthcare professionals working in hospitals, hospices and nursing services from Cologne, Germany. They were asked to share their observations about avoidable transitions in the LYOL. The data collection continued until the point of information power was reached and were audio recorded and analysed using qualitative content analysis. Results Four factors for potentially avoidable transitions between care settings in the LYOL were identified: healthcare system, organization, healthcare professional, patient and relatives. According to the participants, the most relevant aspects that can aid in reducing unnecessary transitions include timely identification and communication of the LYOL; consideration of palliative care options; availability and accessibility of care services; and having a healthcare professional taking main responsibility for care planning. Conclusions Preventing avoidable transitions by considering the multicomponent factors related to them not only immediately before death but also in the LYOL could help to provide more value-based care for patients and improving their quality of life.

In the Moment: Fostering Mindfulness and Reducing Stressors in the Healthcare Workplace

HERD Health Environments Research & Design Journal ◽

10.1177/1937586720988243 ◽

2021 ◽

pp. 193758672098824

Author(s):

Shabboo Valipoor ◽

Sheila J. Bosch

Keyword(s):

Design Research ◽

Well Being ◽

Job Dissatisfaction ◽

Future Research ◽

Design Strategies ◽

Environmental Interventions ◽

Work Related ◽

Healthcare Settings ◽

The Moment

While healthcare design research has primarily focused on patient outcomes, there is a growing recognition that environmental interventions could do more by promoting the overall quality of care, and this requires expanding the focus to the health and well-being of those who deliver care to patients. Healthcare professionals are under high levels of stress, leading to burnout, job dissatisfaction, and poor patient care. Among other tools, mindfulness is recommended as a way of decreasing stress and helping workers function at higher levels. This article aims to identify potential environmental strategies for reducing work-related stressors and facilitating mindfulness in healthcare settings. By examining existing evidence on workplace mindfulness and stress-reducing design strategies, we highlight the power of the physical environment in not only alleviating stressful conditions but intentionally encouraging a mindful perspective. Strategies like minimizing distractions or avoiding overstimulation in the healthcare environment can be more effective if implemented along with the provision of designated spaces for mindfulness-based programs. Future research may explore optimal methods and hospital workers’ preferences for environments that support mindfulness and stress management. The long-term goal of all these efforts is to enhance healthcare professionals’ well-being, reignite their professional enthusiasm, and help them be resilient in times of stress.

Ethical and culturally competent care of transgender patients: A scoping review

Nursing Ethics ◽

10.1177/0969733020988307 ◽

2021 ◽

pp. 096973302098830

Author(s):

Amara Sundus ◽

Sharoon Shahzad ◽

Ahtisham Younas

Keyword(s):

Scoping Review ◽

Culturally Sensitive ◽

Culturally Competent ◽

Culturally Competent Care ◽

Individual Level ◽

Culturally Sensitive Care ◽

Healthcare Settings ◽

Ethical Approval ◽

Sensitive Issues

Background: Transgender individuals experience discrimination, stigmatization, and unethical and insensitive attitudes in healthcare settings. Therefore, healthcare professionals must be knowledgeable about the ways to deliver ethical and culturally competent care. Ethical considerations: No formal ethical approval was required. Aim: To synthesize the literature and identify gaps about approaches to the provision of ethical and culturally competent care to transgender populations. Design: A Scoping Review Literature Search: Literature was searched within CINAHL, Science Direct, PubMed, Google Scholar, EMBASE, and Scopus databases using indexed keywords such as “transgender,” “gender non-conforming,” “ethically sensitive care,” and “culturally sensitive care.” In total, 30 articles, which included transgender patients and their families and nurses, doctors, and health professionals who provided care to transgender patients, were selected for review. Data were extracted and synthesized using tabular and narrative summaries and thematic synthesis. Findings: Of 30 articles, 23 were discussion papers, 5 research articles, and 1 each case study and an integrative review. This indicates an apparent dearth of literature about ethical and culturally sensitive care of transgender individuals. The review identified that healthcare professionals should educate themselves about sensitive issues, become more self-aware, put transgender individual in charge during care interactions, and adhere to the principles of advocacy, confidentiality, autonomy, respect, and disclosure. Conclusions: The review identified broad approaches for the provision of ethical and culturally competent care. The identified approaches could be used as the baseline, and further research is warranted to develop and assess organizational and individual-level approaches.

Involving clinicians in management: assessing views of doctors and nurses on hybrid professionalism in clinical directorates

10.1186/s12913-021-06352-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anna Prenestini ◽

Marco Sartirana ◽

Federico Lega

Keyword(s):

Management Practices ◽

Clinical Work ◽

Local Health Authority ◽

Local Health ◽

Policy Makers ◽

Polarity Index ◽

Validated Questionnaire ◽

Clinical Directorates ◽

Doctors And Nurses

Abstract Background Hybrid professionalism is one of the most effective ways to involve clinicians in management practices and responsibilities. With this study we investigated the perceptions of doctors and nurses on hybridization in clinical directorates (CDs) in hospitals. Methods We investigated the attitudes of healthcare professionals (doctors and nurses) towards eight hospital CDs in the Local Health Authority (LHA) of Bologna (Emilia Romagna, Italy) 6 years after their implementation. We used a validated questionnaire by Braithwaite and Westbrook (2004). Drawing on Palmer et al. (2007), we added a section about the characteristics of department heads. In all, 123 healthcare professionals in managerial roles completed and returned the questionnaire. The return rate was 47.4% for doctors and 31.6% for nurses. Results Doctors reported an increase in clinical governance, interdisciplinarity collaboration, and standardization of clinical work. Hybridization of practices was noted to have taken place. While doctors did not see these changes as a threat to professional values, they felt that hospital managers had taken greater control. There was a large overlap of attitudes between doctors and nurses: inter-professional integration in CDs fostered alignment of values and aims. The polarity index was higher for responses from the doctors than from the nurses. Conclusion The study findings have implications for policy makers and managers: mission and strategic mandate of CDs; governance of CDs, leadership issues; opportunities for engaging healthcare professionals; changes in managerial involvement during the COVID-19 pandemic. We also discuss the limitations of the present study and future areas for research into hybrid structures.

Women’s Experiences of Medical Miss-Diagnosis: How does gender matter in healthcare settings?

10.26686/wgtn.14198627.v1 ◽

2021 ◽

Author(s):

Jessica Thompson ◽

Denise Blake

Keyword(s):

Narrative Analysis ◽

Gender Stereotypes ◽

Well Being ◽

Self Advocacy ◽

Healthcare Settings ◽

Aotearoa New Zealand ◽

Unexplained Symptoms ◽

Female Bodies ◽

Mental Well Being

Medical misdiagnosis for women continues to be a significant problem, leading to disparate health outcomes. To understand how women make sense of experiences of medical misdiagnosis, eight women from Aotearoa/ New Zealand were interviewed about misdiagnosis of conditions that equally affect female and male bodies. This work was guided by feminist principles and used narrative analysis to develop the following three themes: (1) Contradictory dialogues: doctor as expert or not? (2) Self-advocacy in the misdiagnosis experience; and (3) Not taken seriously in healthcare settings: it’s all in your head. Supported by previous work, our findings assert that women are treated poorly in healthcare settings with detrimental outcomes for them and their wider community. Reasons for this include female bodies being excluded from medical research, so that little is known about how illnesses present in female bodies, or how they affect women. Problematically, knowledge founded on male bodies is used to diagnose conditions in women. These biases perpetuate gender stereotypes and preconceived beliefs about women. Unexplained symptoms are considered ‘made up’ or are blamed on women’s mental well- being. Women are therefore not always considered credible symptom reporters and may be dismissed and ignored by healthcare professionals.

Implementation of a proactive referral tool for child healthcare professionals to encourage and facilitate parental smoking cessation in the Netherlands: a mixed-methods study

10.1186/s12913-021-06969-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tessa Scheffers-van Schayck ◽

Bethany Hipple Walters ◽

Roy Otten ◽

Marloes Kleinjan

Keyword(s):

Smoking Cessation ◽

The Netherlands ◽

Counseling Program ◽

Smoking Cessation Counseling ◽

Healthcare Settings ◽

Quit Smoking ◽

Child Healthcare ◽

Referral Tool ◽

The Impact

Abstract Background Recently, the parent-tailored telephone based smoking cessation counseling program ‘Smoke-free Parents’ was shown to be effective in helping parents to quit smoking. To implement this program in child healthcare settings in the Netherlands, the research team developed a proactive referral tool to refer parents to Smoke-free Parents. The aim of the present implementation study was to explore the facilitators, barriers, and suggestions for improvement in the implementation of this referral tool. Methods Child healthcare professionals (N = 68) were recruited via multiple strategies (e.g., social media, mailings, and word of mouth among healthcare professionals) and invited to complete two online (quantitative and qualitative) questionnaires and to participate in a telephone semi-structured qualitative interview between April 2017 and February 2019. In total, 65 child healthcare professionals were included in the analyses. After inductive coding, thematic analyses were performed on the qualitative data. Descriptive analyses were performed on the quantitative data. Results The data from both questionnaires and the telephone interview revealed that the majority of the child healthcare professionals (92.3 % female; average years of working as a healthcare professional: 23.0) found the Smoke-free Parents referral tool accessible and convenient to use. Yet there were several barriers that limited their use of the tool. The data revealed that one of the main barriers that healthcare professionals experienced was parental resistance to smoking cessation assistance. In addition, healthcare professionals noted that they experienced tension when motivating parents to quit smoking, as they were not the parent’s, but the child’s healthcare provider. Additionally, healthcare professionals reported being concerned about the lack of information about the costs of Smoke-free Parents, which limited professionals referring parents to the service. Conclusions Although healthcare professionals reported rather positive experiences with the Smoke-free Parents referral tool, the use of the tool was limited due to barriers. To increase the impact of the Smoke-free Parents telephone-based smoking cessation counseling program via child healthcare settings, it is important to overcome these barriers. Suggestions for improvement in the implementation of the referral tool in child healthcare settings are discussed.

Health and Wellness Coaching in Serving the Needs of Today’s Patients: A Primer for Healthcare Professionals

Global Advances in Health and Medicine ◽

10.1177/2164956120959274 ◽

2020 ◽

Vol 9 ◽

pp. 216495612095927

Author(s):

Adam I Perlman ◽

Abd Moain Abu Dabrh

Keyword(s):

Quality Of Life ◽

Clinical Outcomes ◽

Potential Role ◽

Well Being ◽

Health And Wellness ◽

Healthcare Settings ◽

Wellness Coaching ◽

Medical Advances

The past six decades have been marked by leaps and bounds in medical advances, while concurrently clinical outcomes and the quality of life continued to lag or decline. There is a need for more comprehensive approaches to delivering healthcare to patients that address illness and wellness within and outside healthcare settings. Mounting evidence shows that making sustainable changes in healthcare requires approaching patients’/individuals’ care as a continuum—within and outside healthcare settings—while addressing their capacity (ie ability) and workload (ie demands) and incorporating their values and preferences. Health and Wellness Coaching (HWC) has been proposed as a solution to create partnerships to empower individuals to take ownership, leadership, and accountability of their well-being, using nondirective, empathic, and mindful conversations that employ motivational-interviewing and evidence-based approaches. Insufficient clarity exists among healthcare professionals in understanding the definition, roles, and types of HWC. This primer summarizes HWC concepts and history and compares HWC types and its potential role in promoting, supporting, and improving the well-being, clinical outcomes, and quality of life of the pertinent stakeholders. This primer also highlights current and potential areas of application of HWC within different subpopulations and healthcare-related settings.

Overview of the uptake and implementation of non-medical prescribing in Wales: a national survey

BMJ Open ◽

10.1136/bmjopen-2016-015313 ◽

2017 ◽

Vol 7 (9) ◽

pp. e015313 ◽

Cited By ~ 12

Author(s):

Molly Courtenay ◽

Riyad Khanfer ◽

Gail Harries-Huntly ◽

Rhain Deslandes ◽

David Gillespie ◽

...

Keyword(s):

Median Number ◽

Master's Level ◽

Healthcare Settings ◽

Independent Prescribing ◽

Governance Systems ◽

Job Title ◽

Specialist Nurses ◽

Medical Healthcare

ObjectivesTo identify (1) the non-medical healthcare professionals in Wales qualified to prescribe medicines (including job title, employer, where the prescribing qualification is used, care setting and service provided); (2) the mode of prescribing used by these healthcare professionals, the frequency with which medicines are prescribed and the different ways in which the prescribing qualification is used; and (3) the safety and clinical governance systems within which these healthcare professionals practise.DesignNational questionnaire survey.SettingAll three National Health Service (NHS) Trusts and seven Health Boards (HB) in Wales.ParticipantsNon-medical prescribers.Results379 (63%) participants responded to the survey. Most of these prescribers (41.1%) were specialist nurses who work in a variety of healthcare settings (primarily in secondary care) within each HB/NHS Trust, and regularly use independent prescribing to prescribe for a broad range of conditions. Nearly a quarter of the sample (22%) reported that prior to undertaking the prescribing programme, they had completed master’s level specialist training and 65.5% had 5 years qualified experience. Over half (55.8%) reported that there were plans to increase non-medical prescriber numbers within the team in which they worked. Only 7.1% reported they did not prescribe and the median number of items prescribed per week was between 21 and 30. Nearly all (87.8%) of the sample reported that they perceived prescribing to have ensured better use of their skills and 91.5% indicated that they believed it had improved the quality of care they were able to provide.ConclusionNon-medical prescribing has been implemented across the whole of Wales; however, its uptake within HBs and NHS Trusts has been inconsistent, and it has not been considered across all services, particularly those in primary care. Opportunities therefore exist to share learning across organisations.