scholarly journals A midwife’s exploration into how power & hierarchy influence both staff and patient safety

2021 ◽  
pp. 251604352110270
Author(s):  
Helen Elliott-Mainwaring

My experiences as a legitimate informal whistle-blower have afforded me an understanding of the dichotomy that is Trust allegiance and misplaced brand loyalty over and above both patient and staff safety, such that when poor care is spoken of as a potential or experienced from either angle, the general rule within healthcare management is not to acknowledge, reflect, mitigate and learn in order to improve, but instead to gaslight, deny and subordinate such that from a staff safety perspective they are caught between a rock and a hard place. This paper explores some of the opportunities which healthcare organizations could embrace to positively influence the effects of power and hierarchy on staff safety. Aims This paper discusses the bigger picture of maternity services safety. Methods This is a discussion piece. Findings For some healthcare staff it is preferable to remain quiet, not rock the proverbial boat, and maintain deeply loyal allegiances to their employers over and above public protection. For others, the journey of honesty, integrity and tenacity carries a high price in terms of personal energy, health and financial compromise. Conclusion This exploration into how power & hierarchy influence both staff and patient safety has identified and briefly explored some of the tensions created by misplaced brand loyalty inherent within healthcare institutions, and the legacy of harms resulting.

2020 ◽  
Author(s):  
Niki O'Brien ◽  
Guy Martin ◽  
Emilia Grass ◽  
Mike Durkin ◽  
Ara Darzi ◽  
...  

BACKGROUND Health systems around the world are increasingly reliant on digital technology. Such reliance requires that healthcare organizations consider effective cybersecurity and digital resilience as a fundamental component of patient safety, with recent cyberattacks highlighting the risks to patients and targeted organizations. OBJECTIVE The purpose of this study was to explore the current global cybersecurity landscape and maturity in healthcare. METHODS We developed and administered a survey to examine the current cybersecurity landscape and preparedness level across global healthcare organizations. RESULTS Cyber threats were a common concern for the 17 healthcare organizations who participated. The principal concerns highlighted were data security, including the manipulation or loss of electronic health records; loss of trust in the organization; and risks of service disruption. Cybersecurity maturity scoring showed that despite the majority of organizations having established cybersecurity practices, levels of awareness and education were universally poor. CONCLUSIONS Policymakers should consider raising awareness and improving education/training on cybersecurity as a fundamental tenet of patient safety.


BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shahram Zaheer ◽  
Liane Ginsburg ◽  
Hannah J. Wong ◽  
Kelly Thomson ◽  
Lorna Bain ◽  
...  

Abstract Background This study contributes to a small but growing body of literature on how context influences perceptions of patient safety in healthcare settings. We examine the impact of senior leadership support for safety, supervisory leadership support for safety, teamwork, and turnover intention on overall patient safety grade. Interaction effects of predictors on perceptions of patient safety are also examined. Methods In this mixed methods study, cross-sectional survey data (N = 185) were collected from nurses and non-physician healthcare professionals. Semi-structured interview data (N = 15) were collected from nurses. The study participants worked in intensive care, general medicine, mental health, or the emergency department of a large community hospital in Southern Ontario. Results Hierarchical regression analyses showed that staff perceptions of senior leadership (p < 0.001), teamwork (p < 0.01), and turnover intention (p < 0.01) were significantly associated with overall patient safety grade. The interactive effect of teamwork and turnover intention on overall patient safety grade was also found to be significant (p < 0.05). The qualitative findings corroborated the survey results but also helped expand the characteristics of the study’s key concepts (e.g., teamwork within and across professional boundaries) and why certain statistical relationships were found to be non-significant (e.g., nurse interviewees perceived the safety specific responsibilities of frontline supervisors much more broadly compared to the narrower conceptualization of the construct in the survey). Conclusions The results of the current study suggest that senior leadership, teamwork, and turnover intention significantly impact nursing staff perceptions of patient safety. Leadership is a modifiable contextual factor and resources should be dedicated to strengthen relational competencies of healthcare leaders. Healthcare organizations must also proactively foster inter and intra-professional collaboration by providing teamwork educational workshops or other on-site learning opportunities (e.g., simulation training). Healthcare organizations would benefit by considering the interactive effect of contextual factors as another lever for patient safety improvement, e.g., lowering staff turnover intentions would maximize the positive impact of teamwork improvement initiatives on patient safety.


2019 ◽  
Vol 40 (1) ◽  
pp. 34-67 ◽  
Author(s):  
Iacopo Rubbio ◽  
Manfredi Bruccoleri ◽  
Astrid Pietrosi ◽  
Barbara Ragonese

PurposeIn the healthcare management domain, there is a lack of knowledge concerning the role of resilience practices in improving patient safety. The purpose of this paper is to understand the capabilities that enable healthcare resilience and how digital technologies can support these capabilities.Design/methodology/approachWithin- and cross-case research methodology was used to study resilience mechanisms and capabilities in healthcare and to understand how digital health technologies impact healthcare resilience. The authors analyze data from two Italian hospitals through the lens of the operational failure literature and anchor the findings to the theory of dynamic capabilities.FindingsFive different dynamic capabilities emerged as crucial for managing operational failure. Furthermore, in relation to these capabilities, medical, organizational and patient-related knowledge surfaced as major enablers. Finally, the findings allowed the authors to better explain the role of knowledge in healthcare resilience and how digital technologies boost this role.Practical implicationsWhen trying to promote a culture of patient safety, the research suggests healthcare managers should focus on promoting and enhancing resilience capabilities. Furthermore, when evaluating the role of digital technologies, healthcare managers should consider their importance in enabling these dynamic capabilities.Originality/valueAlthough operations management (OM) research points to resilience as a crucial behavior in the supply chain, this is the first research that investigates the concept of resilience in healthcare systems from an OM perspective, with only a few authors having studied similar concepts, such as “workaround” practices.


2021 ◽  
Vol 10 (2) ◽  
pp. 158-176
Author(s):  
Yumna Nur Millati Hanifa ◽  
Inge Dhamanti

The implementation of safe and quality care with attention to patient safety, requires organization’s effort to create and cultivating patient safety culture. The purpose of this article was to map the instruments used in measuring patient safety culture in healthcare organizations. The method used integrated literature review from various sources of research articles published from 2015 to 2020. The article included if it was available in full text and open access as well as articles described the instruments of patient safety culture or measurement of patient safety culture using one of the instruments of measurement of patient safety culture. The results of the literature review unravel the findings of three instruments such as HSOPSC (Hospital Survey on Patient Safety Culture), MaPSaF (Manchester Patient Safety Assessment Framework) and SAQ (Safety Attitudes Questionnaire). We concluded all three instruments contained four dimensions of patient safety culture, namely open culture, just culture, reporting culture and learning culture and were widely used to measure patient safety culture in hospitals, primary health facilities and other health facilities.


2021 ◽  
Vol 8 (1) ◽  
pp. 45-58
Author(s):  
Ursulla Aho-Glele ◽  
Marie-Pascale Pomey ◽  
Maiana Regina Gomes de Sousa ◽  
Khayreddine Bouabida

2021 ◽  
pp. JDNP-D-19-00067
Author(s):  
Brittany Debeltz

BackgroundBupropion is being abused due to effects that are comparable with methamphetamine and cocaine. Current research indicates several interventions that can prevent prescription medication abuse.ObjectivesA research study was performed at two healthcare organizations to evaluate whether education on prevention-based interventions increased self-efficacy of healthcare staff in addressing potential and ongoing bupropion abuse and whether the education reduced the rate of bupropion prescribing.MethodsThe study sample consisted of 43 staff members who completed a paper-based preeducation survey, attended a 1-hour educational session, and completed a paper-based posteducation survey.ResultsThere was a 42% increase in total staff self-efficacy scores along with significant differences between pre-/postsurvey scores (p ≤ .001). After education prescribers answered they plan to change prescribing practices and the number of bupropion prescriptions filled decreased.Implications for NursingFuture practice recommendations should include education on bupropion abuse and implementation of prevention interventions to reduce the occurrence of the abuse of bupropion.ConclusionsThe research findings suggested that education on interventions for bupropion abuse prevention improved healthcare staff self-efficacy in the management of potential and ongoing bupropion abuse, influenced prescribing practices of prescribers, and decreased the number of bupropion prescriptions. This research can be used to continue providing education to help prevent further cases of bupropion abuse.


2015 ◽  
Vol 10 (2) ◽  
pp. 175
Author(s):  
Rintar Agus Simatupang ◽  
Marlis Ida

The objectives of this research were to test difference of decision making on brand loyal group andnon brand loyal group, association between demographical factor and brand loyal group and nonbrand loyal group, and difference in postpurchase satisfaction on brand loyal group with high priceand non brand loyal group with low price. Data analysis technique used were discriminant analysis,Chi-Square, and t-test. Result of the research indicated that there is no difference in shoppingorientation and buying criteria on brand loyal group and non brand loyal group for Jeans and shirtsproducts. Age and income variables had no association with brand loyal group and non brand loyalgroup for Jeans and shirt products. In addition, there was no difference in post-purchase satisfactionbrand loyal group with high price and non brand loyal group with low price for Jeans product, butthere was association for shirt product.Keywords: Brand Loyalty, Shopping Orientation, Buying Criteria, Age, Income, andPost-Purchase Satisfaction


2015 ◽  
pp. 1-22
Author(s):  
Patrick Albert Palmieri ◽  
Lori T. Peterson ◽  
Miguel Noe Ramirez Noeding

Healthcare organizations are increasingly willing to develop more efficient and higher quality processes to combat the competition and enhance financial viability by adopting contemporary solutions such as Health Information Technology (HIT). However, technological failures occur and represent a contemporary organizational development priority resulting from incongruent organization-technology interfaces. Technologically induced system failure has been defined as technological iatrogenesis. The chapter offers the Healthcare Iatrogenesis Model as an organizational development strategy to guide the responsible implementation of HIT projects. By recognizing the etiology of incongruent organizational interfaces and anticipating patient safety concerns, leaders can proactively respond to system limitations and identify hidden process instabilities prior to costly and consequential catastrophic events.


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