An action-oriented method for interprofessional organization development at a hospital operating unit

2016 ◽  
Vol 15 (2) ◽  
pp. 177-197 ◽  
Author(s):  
Christofer Rydenfält ◽  
Per-Anders Larsson ◽  
Per Odenrick

The complexity of modern interdisciplinary health care practices, where different specialties work together to solve complex problems, challenges traditional approaches to organizational development and quality improvement. An example of this is surgery. This article describes and evaluates an action-oriented method to facilitate organizational development and innovation at an operating unit, centered on interprofessional aspects of health care, a method that shares some features with action learning. At its core the method had a group with members from all specialties in an operating team, who participated in regular meetings facilitated by a process leader, according to experiential learning principles. The group was evaluated using mixed methods (including interaction process analysis (IPA)), of which video recorded group meetings and interviews constituted the main sources of data. Results showed that the group achieved a successful organizational change. Indications of the success of the group process were the low level of conflicts and the high level of task focus. Interprofessional boundaries appeared to be bridged as all members participated in formulation of both problems and solutions while not being afraid to voice different opinions. Problems could be attributed to lack of awareness of the group at the operating unit at which the intervention took place.

1992 ◽  
Vol 31 (03) ◽  
pp. 204-209 ◽  
Author(s):  
T. Timpka ◽  
J. M. Nyce

Abstract:For the development of computer-supported cooperative health care work this study investigated, based upon activity theory, daily dilemmas encountered by the members of interprofessional primary health care work groups. The entire staff at four Swedish primary health care centers were surveyed, 199 personal interviews being conducted by the Critical Incident Technique. Medical dilemmas were mainly reported by general practitioners and nurses, organizational dilemmas by laboratory staff, nurses’ aides, and secretaries, and dilemmas in the patient-provider relation by nurses, nurses’ aides, and secretaries. Organizational and communication dilemmas reported by nurses, nurses’ aides, and secretaries often had their cause outside the control of the individual professional. These dilemmas were often “caused” by other group members (general practitioners or nurses), e.g., by not keeping appointment times or by not sharing information with patients. The implication for computer-supported cooperative health care work is that computer support should be planned on two levels. Collective work activity as a whole should benefit from individual clinical decision support for general practitioners and nurses. However, since most patient communication and organizational problems occurred at group level, group process support is required in these areas.


2009 ◽  
Vol 5 (2) ◽  
pp. 133-144 ◽  
Author(s):  
Patricia Geist-Martin ◽  
Catherine Becker ◽  
Summer Carnett ◽  
Katherine Slauta

The big island of Hawaii has been named the healing island – a place with varied interpretations of healing, health, and a wide range of holistic health care practices. This research explores the perspectives of holistic providers about the communicative practices they believe are central to their interactions with patients. Intensive ethnographic interviews with 20 individuals revealed that they perceive their communication with clients as centered on four practices, specifically: (a) reciprocity – a mutual action or exchange in which both the practitioner and patient are equal partners in the healing process; (b) responsibility – the idea that, ultimately, people must heal themselves; (c) forgiveness – the notion that healing cannot progress if a person holds the burden of anger and pain; and (d) balance – the idea that it is possible to bring like and unlike things together in unity and harmony. The narratives revealed providers’ ontological assumptions about mind-body systems and the rationalities they seek to resist in their conversations with patients.


Author(s):  
Ekaterina Peredelskaya ◽  
Tatyana Safyanova ◽  
Mikhail Druchanov

Chickenpox is an urgent problem, as it is widely spread with a high level of morbidity and an increasing share in the structure of the General infectious pathology with significant economic damage. The aim of the study is to study the epidemiological and clinical features of chickenpox in adults hospitalized in Krai government-owned publicy funded health care institution «City clinical hospital No. 5, Barnaul» for the period 2008‑2018. Content analysis included statistical reporting forms No. 2 of Federal state statistical supervision «Data on infectious and parasitic diseases» in the city of Barnaul during the period 2008‑2018 of medical archival documents adult infectious Department Krai government-owned publicy funded health care institution «City clinical hospital №5, Barnaul» for the same period. Data processing was performed using calculation of intensive and extensive indicators, calculation of the arithmetic mean (X) and standard error of the average (m). Calculations were made using the STATISTICA-10 program. Consistently high rates were recorded, with an average of 64.32 ± 3.46 per 100,000 population. The percentage of hospitalized adults averaged 18.5% during the study period. Adults aged 18‑30 were more likely to be admitted to the hospital (90.3%); 41.6% were students. Adults with moderate severity were hospitalized more often (70.6%); 7 patients (1.3%) had complications: aphthous stomatitis (3 cases), pustulosis (2 cases), and pneumonia (2 cases). Patients with severe severity of the disease accounted for 2.4%, the premorbid background was burdened in 48% (HIV infection, tuberculosis). In 35% of patients with severe severity, the final diagnosis of Herpes zoster was made, all patients older than 40 years, stayed in the hospital for 20‑25 days.


Author(s):  
Gregory A. Aarons ◽  
Joanna C. Moullin ◽  
Mark G. Ehrhart

Both organizational characteristics and specific organizational strategies are important for the effective dissemination and implementation of evidence-based practices (EBPs) in health and allied health care settings, as well as mental health, alcohol/drug treatment, and social service settings. One of the primary goals of this chapter is to support implementers and leaders within organizations in attending to and shaping the context in which implementation takes place in order to increase the likelihood of implementation success and long-term sustainment. The chapter summarizes some of the most critical organizational factors and strategies likely to impact successful evidence-based practice implementation. There are myriad approaches to supporting organizational development and change—this chapter focuses on issues supported by relevant scientific literatures, particularly those germane to EBP implementation in health care and related settings.


Author(s):  
Ewan Ferlie ◽  
Sue Dopson ◽  
Chris Bennett ◽  
Michael D. Fischer ◽  
Jean Ledger ◽  
...  

The chapter discusses management consultants and consulting knowledge in health care, highlighting significant expenditure on consultancy and how consultants have shaped thinking in public services, which some critics suggest has served consultants’ own (financial) interests. The chapter then discusses the way consultants mobilize management knowledge and frame clients’ problems and solutions. It discusses an empirical case study of a consultancy project to redesign NHS organizations to make substantial ‘efficiency savings’. Here, consultants framed the NHS’s problem and solution, and then imposed an organizational redesign. Local NHS managers and clinicians framed the NHS’s problem differently, doubting the consultants’ framing and proposing redesign, but feeling unable to engage in dialogue about these concerns. Consequently, they engaged with the project in a calculated and defensive way, superficially accepting the redesign while waiting for its implementation to fail. Thus, the chapter demonstrates framing politics surrounding management consulting knowledge.


2021 ◽  
pp. 2455328X2199571
Author(s):  
Manisha Thapa ◽  
Pinak Tarafdar

In all cultures and regions, the concept of health varies, based on the type of environment and prevalent sociocultural traditions. The present study is conducted among the Lepchas of the village of Lingthem divided into two sectors—Upper and Lower Lingthem, Upper Dzongu, North Sikkim. This population comprising Buddhist Lepchas residing away from the mainstream through poor infrastructural facilities still maintain ethnomedical health care practices without influence of major Indian healing systems. Living in the area of Dzongu exclusively inhabited by Lepchas revival of ancient cultural practices is evident among Lepchas of Lingthem. The structure of religious beliefs prevalent among the Lepchas, including traditional animistic as well as Buddhist practices, greatly influence forms of treatment sought for specific ailments. Even today, the use and maintenance of traditional health care with syncretized Buddhist religious belief among residents of Lingthem act as a vital source for understanding the influence of religion on traditional health care practices. Despite the presence of a few modern health care agencies, the traditional treatment of Bongthing (Lepcha shaman) and Buddhist monks remain widely popular as primary means of health care.


2020 ◽  
Vol 4 (1) ◽  
pp. 13-27 ◽  
Author(s):  
Lynn Rochester ◽  
Claudia Mazzà ◽  
Arne Mueller ◽  
Brian Caulfield ◽  
Marie McCarthy ◽  
...  

Health care has had to adapt rapidly to COVID-19, and this in turn has highlighted a pressing need for tools to facilitate remote visits and monitoring. Digital health technology, including body-worn devices, offers a solution using digital outcomes to measure and monitor disease status and provide outcomes meaningful to both patients and health care professionals. Remote monitoring of physical mobility is a prime example, because mobility is among the most advanced modalities that can be assessed digitally and remotely. Loss of mobility is also an important feature of many health conditions, providing a read-out of health as well as a target for intervention. Real-world, continuous digital measures of mobility (digital mobility outcomes or DMOs) provide an opportunity for novel insights into health care conditions complementing existing mobility measures. Accepted and approved DMOs are not yet widely available. The need for large collaborative efforts to tackle the critical steps to adoption is widely recognised. Mobilise-D is an example. It is a multidisciplinary consortium of 34 institutions from academia and industry funded through the European Innovative Medicines Initiative 2 Joint Undertaking. Members of Mobilise-D are collaborating to address the critical steps for DMOs to be adopted in clinical trials and ultimately health care. To achieve this, the consortium has developed a roadmap to inform the development, validation and approval of DMOs in Parkinson’s disease, multiple sclerosis, chronic obstructive pulmonary disease and recovery from proximal femoral fracture. Here we aim to describe the proposed approach and provide a high-level view of the ongoing and planned work of the Mobilise-D consortium. Ultimately, Mobilise-D aims to stimulate widespread adoption of DMOs through the provision of device agnostic software, standards and robust validation in order to bring digital outcomes from concept to use in clinical trials and health care.


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