scholarly journals Benchmarking outcomes on multiple contextual levels in lean healthcare: a systematic review, development of a conceptual framework, and a research agenda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elina Reponen ◽  
Thomas G. Rundall ◽  
Stephen M. Shortell ◽  
Janet C. Blodgett ◽  
Angelica Juarez ◽  
...  
Keyword(s):  
Conceptual Framework ◽  
System Level ◽  
Future Research ◽  
Patient Centered ◽  
Performance Benchmarking ◽  
International Benchmarking ◽  
Lean Healthcare ◽  
Meta Analyses ◽  
Different Levels ◽  
Outcome Metrics

Abstract Background Reliable benchmarking in Lean healthcare requires widely relevant and applicable domains for outcome metrics and careful attention to contextual levels. These levels have been poorly defined and no framework to facilitate performance benchmarking exists. Methods We systematically searched the Pubmed, Scopus, and Web of Science databases to identify original articles reporting benchmarking on different contextual levels in Lean healthcare and critically appraised the articles. Scarcity and heterogeneity of articles prevented quantitative meta-analyses. We developed a new, widely applicable conceptual framework for benchmarking drawing on the principles of ten commonly used healthcare quality frameworks and four value statements, and suggest an agenda for future research on benchmarking in Lean healthcare. Results We identified 22 articles on benchmarking in Lean healthcare on 4 contextual levels: intra-organizational (6 articles), regional (4), national (10), and international (2). We further categorized the articles by the domains in the proposed conceptual framework: patients (6), employed and affiliated staff (2), costs (2), and service provision (16). After critical appraisal, only one fifth of the articles were categorized as high quality. Conclusions When making evidence-informed decisions based on current scarce literature on benchmarking in healthcare, leaders and managers should carefully consider the influence of context. The proposed conceptual framework may facilitate performance benchmarking and spreading best practices in Lean healthcare. Future research on benchmarking in Lean healthcare should include international benchmarking, defining essential factors influencing Lean initiatives on different levels of context; patient-centered benchmarking; and system-level benchmarking with a balanced set of outcomes and quality measures.

Understanding control in nonprofit organisations: moving governance research forward?

2015 ◽  
Vol 15 (1) ◽  
pp. 134-145 ◽  
Author(s):  
Terri Byers ◽  
Christos Anagnostopoulos ◽  
Georgina Brooke-Holmes
Keyword(s):  
Conceptual Framework ◽  
Design Methodology ◽  
Levels Of Analysis ◽  
Future Research ◽  
Holistic View ◽  
Content Type ◽  
Nonprofit Organisations ◽  
Critical Realist ◽  
Time Periods ◽  
Different Levels

Purpose – The purpose of this paper is to introduce the concept of organisational control and both its importance and utility for understanding nonprofit organisations. Design/methodology/approach – This paper uses a critical realist (CR) methodology to discuss the concept of control and its utility to research on governance of nonprofit organisations. Findings – The current study offers a conceptual framework that presents a holistic view of control, relevant for analysing nonprofit organisations, and a methodological lens (CR) through which this framework can be implemented. Research limitations/implications – This paper suggests that studies of governance should consider different levels of analysis, as suggested by examining the concept of control using a CR framework. This notion has yet to be tested empirically and a framework for examining governance from a CR perspective of control is suggested. Context is highly relevant to understanding control, and thus, this model requires testing in a wide diversity of nonprofit sectors, sizes of organisations and time periods. Originality/value – The literature on organisational control provides useful insights to advance our understanding of nonprofit organisations beyond the notion of governance, and this paper proposes both conceptual and methodological underpinnings to facilitate future research.

scholarly journals Theories of Health Care Decision Making at the End of Life: A Meta-Ethnography

2017 ◽  
Vol 40 (12) ◽  
pp. 1861-1884 ◽  
Author(s):  
Kyounghae Kim ◽  
Katherine Heinze ◽  
Jiayun Xu ◽  
Melissa Kurtz ◽  
Hyunjeong Park ◽  
...  
Keyword(s):  
Decision Making ◽  
Conceptual Framework ◽  
End Of Life ◽  
English Language ◽  
Future Research ◽  
Advanced Illness ◽  
Patient Centered ◽  
Change Models ◽  
End Of Life Decision ◽  
Life Decision

The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015. Forty-three articles were included. The most common theories included decision-making models ( n = 14) followed by family-centered ( n = 11) and behavioral change models ( n = 7). A conceptual framework was developed using themes including context of decision making, communication and negotiation of decision making, characteristics of decision makers, goals of decision making, options and alternatives, and outcomes. Future research should enhance and apply these theories to guide research to develop patient-centered decision-making programs that facilitate informed and shared decision making at the end of life among patients with advanced illness and their caregivers.

The Experiences of Treatment Burden in People with Parkinson’s Disease and Their Caregivers: A Systematic Review of Qualitative Studies

2021 ◽  
pp. 1-21
Author(s):  
Qian Yue Tan ◽  
Natalie J. Cox ◽  
Stephen E.R. Lim ◽  
Laura Coutts ◽  
Simon D.S. Fraser ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Care Coordination ◽  
Grey Literature ◽  
System Level ◽  
Future Research ◽  
Treatment Burden ◽  
Patient Centered ◽  
Modifiable Factors

Background High treatment burden is associated with poor adherence, wasted resources, poor quality of life and poor health outcomes. Identifying factors that impact treatment burden in Parkinson’s disease can offer insights into strategies to mitigate them. Objective To explore the experiences of treatment burden among people with Parkinson’s disease (PwP) and their caregivers. Methods A systematic review of studies published from year 2006 was conducted. Qualitative and mixed-method studies with a qualitative component that relate to usual care in Parkinson’s disease were included. Quantitative studies and grey literature were excluded. Data synthesis was conducted using framework synthesis. Results 1757 articles were screened, and 39 articles included. Understanding treatment burden in PwP and caregivers was not the primary aim in any of the included studies. The main issues of treatment burden in Parkinson’s disease are: 1) work and challenges of taking medication; 2) healthcare provider obstacles including lack of patient-centered care, poor patient-provider relationships, lack of care coordination, inflexible organizational structures, lack of access to services and issues in care home or hospital settings; and 3) learning about health and challenges with information provision. The treatment burden led to physical and mental exhaustion of self-care and limitations on the role and social activities of PwP and caregivers. Conclusion: There are potential strategies to improve the treatment burden in Parkinson’s disease at an individual level such as patient-centered approach to care, and at system level by improving access and care coordination between services. Future research is needed to determine the modifiable factors of treatment burden in Parkinson’s disease.

scholarly journals Pain and Associated Neuropsychiatric Symptoms in Patients Suffering from Dementia: Challenges at Different Levels and Proposal of a Conceptual Framework

2021 ◽  
pp. 1-7
Author(s):  
Liane Kaufmann ◽  
Korbinian Moeller ◽  
Josef Marksteiner
Keyword(s):  
Chronic Pain ◽  
High Risk ◽  
Conceptual Framework ◽  
Language Comprehension ◽  
Pain Perception ◽  
Neuropsychiatric Symptoms ◽  
Future Research ◽  
Advanced Dementia ◽  
Clinical Process ◽  
Different Levels

Old age is critically associated with multi-morbidity, chronic pain, and high risk for dementia. Recognizing and treating pain is very much dependent on language comprehension and production. Both may be impaired in dementia. Moreover, neuropsychiatric symptoms may interact with pain perception. The main aims of the present article were 1) to identify key areas for future research to elucidate the relation between pain and associated neuropsychiatric symptoms in dementia, and 2) to provide a conceptual framework for ameliorating the clinical process of recognizing, assessing, and managing pain in non-communicating patients with advanced dementia.

Physical and Psychological Benefits of Written Emotional Expression

2015 ◽  
Vol 20 (4) ◽  
pp. 242-251 ◽  
Author(s):  
Éva Kállay
Keyword(s):  
Mental Health ◽  
Expressive Writing ◽  
Mental Health Problems ◽  
Cost Effective ◽  
Health Problems ◽  
Future Research ◽  
Psychological Benefits ◽  
Cost Effective Treatment ◽  
Meta Analyses

Abstract. The last several decades have witnessed a substantial increase in the number of individuals suffering from both diagnosable and subsyndromal mental health problems. Consequently, the development of cost-effective treatment methods, accessible to large populations suffering from different forms of mental health problems, became imperative. A very promising intervention is the method of expressive writing (EW), which may be used in both clinically diagnosable cases and subthreshold symptomatology. This method, in which people express their feelings and thoughts related to stressful situations in writing, has been found to improve participants’ long-term psychological, physiological, behavioral, and social functioning. Based on a thorough analysis and synthesis of the published literature (also including most recent meta-analyses), the present paper presents the expressive writing method, its short- and long-term, intra-and interpersonal effects, different situations and conditions in which it has been proven to be effective, the most important mechanisms implied in the process of recovery, advantages, disadvantages, and possible pitfalls of the method, as well as variants of the original technique and future research directions.

The Emergence and Maintenance of Ethical Leadership in Organizations

2012 ◽  
Vol 11 (1) ◽  
pp. 7-19 ◽  
Author(s):  
Silke Astrid Eisenbeiß ◽  
Steffen R. Giessner
Keyword(s):  
Cultural Values ◽  
Ethical Leadership ◽  
Leadership Behavior ◽  
Peer Group ◽  
Organizational Characteristics ◽  
Future Research ◽  
Environmental Complexity ◽  
Group Influence ◽  
Analysis Society ◽  
Different Levels

The present paper gives a review of empirical research on ethical leadership and shows that still little is known known about the contextual antecedents of ethical leadership. To address this important issue, a conceptual framework is developed that analyzes the embeddedness of organizational ethical leadership. This framework identifies manifest and latent contextual factors on three different levels of analysis – society, industry, and organization – which can affect the development and maintenance of ethical leadership. In particular, propositions are offered about how (1) societal characteristics, notably the implementation and the spirit of human rights in a society and societal cultural values of responsibility, justice, humanity, and transparency; (2) industry characteristics such as environmental complexity, the content of the organizational mandate, and the interests of stakeholder networks; and (3) intra-organizational characteristics, including the organizational ethical infrastructure and the ethical leadership behavior of a leader’s peer group, influence the development and maintenance of ethical leadership in organizations. This list of factors is not exhaustive, but illustrates how the three levels may impact ethical leadership. Implications for managerial practice and future research are discussed.

Sport-Related and Psychosocial Factors Associated With Motives and Consequences Of Alcohol and Cannabis Use Among NCAA Athletes: A Systematic Review

2021 ◽  
Author(s):  
Callon M Williams ◽  
Michael T Shaw ◽  
Nadine R Mastroleo ◽  
Emily L Zale
Keyword(s):  
Sensation Seeking ◽  
Positive Reinforcement ◽  
National Collegiate Athletic Association ◽  
Cannabis Use ◽  
Drinking Motives ◽  
Future Research ◽  
Reference List ◽  
Psychosocial Correlates ◽  
Ncaa Athletes ◽  
Meta Analyses

Abstract Aims To review differences in alcohol- and cannabis-related motives and consequences among National Collegiate Athletic Association (NCAA) athletes as a function of athlete characteristics (e.g. gender and competition season status). Methods Procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, PsycINFO and manual reference list review were used to identify studies that reported alcohol- or cannabis-related motives and consequences among NCAA athletes as a function of gender, race, season status, division level or sport-type through December 2019. Relevant findings and any reported psychosocial correlates were extracted by two independent reviewers. Results The majority of studies (K = 15) focused on alcohol-related motives or consequences, with one examining cannabis-related motives, and no studies examined cannabis-related consequences. Social drinking motives were strongest among men and White NCAA athletes, and athlete-specific motives were most salient for men and in-season athletes. Cannabis use motives for positive reinforcement (e.g. enhancement) and coping were also strongest during the in-season. Negative alcohol-related consequences were greatest among men, athletes of color and out-of-season athletes, although women and in-season athletes experienced more consequences in athletic performance. Our exploratory aim revealed two studies that examined psychosocial correlates, and the results indicate that sensation-seeking, stress and negative affect were associated with more alcohol-related consequences. Conclusion NCAA athletes are a heterogenous population, and their motives and consequences of use appear to vary across multiple athlete factors (e.g., gender). This review highlights the gaps in the literature and suggests future research directions to identify the risk and protective factors for substance use among NCAA athletes.

scholarly journals Aircraft Requirements for Sustainable Regional Aviation

Aerospace ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 61
Author(s):  
Dominik Eisenhut ◽  
Nicolas Moebs ◽  
Evert Windels ◽  
Dominique Bergmann ◽  
Ingmar Geiß ◽  
...  
Keyword(s):  
Systems Engineering ◽  
System Level ◽  
Policy Initiative ◽  
The European Union ◽  
Calculation Methods ◽  
Figures Of Merit ◽  
Performance Requirements ◽  
High Level ◽  
Different Levels ◽  
The Eu

Recently, the new Green Deal policy initiative was presented by the European Union. The EU aims to achieve a sustainable future and be the first climate-neutral continent by 2050. It targets all of the continent’s industries, meaning aviation must contribute to these changes as well. By employing a systems engineering approach, this high-level task can be split into different levels to get from the vision to the relevant system or product itself. Part of this iterative process involves the aircraft requirements, which make the goals more achievable on the system level and allow validation of whether the designed systems fulfill these requirements. Within this work, the top-level aircraft requirements (TLARs) for a hybrid-electric regional aircraft for up to 50 passengers are presented. Apart from performance requirements, other requirements, like environmental ones, are also included. To check whether these requirements are fulfilled, different reference missions were defined which challenge various extremes within the requirements. Furthermore, figures of merit are established, providing a way of validating and comparing different aircraft designs. The modular structure of these aircraft designs ensures the possibility of evaluating different architectures and adapting these figures if necessary. Moreover, different criteria can be accounted for, or their calculation methods or weighting can be changed.

scholarly journals Hypnotherapy for Procedural Pain and Distress in Children: A scoping Review Protocol

Pain Medicine ◽  
2021 ◽  
Author(s):  
Daly Geagea ◽  
Zephanie Tyack ◽  
Roy Kimble ◽  
Lars Eriksson ◽  
Vince Polito ◽  
...  
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Cochrane Library ◽  
Procedural Pain ◽  
Future Research ◽  
Theoretical Frameworks ◽  
Eligibility Criteria ◽  
Pharmacological Agents ◽  
Review Protocol ◽  
Meta Analyses

Abstract Objective Inadequately treated pain and distress elicited by medical procedures can put children at higher risks of acute and chronic biopsychosocial sequelae. Children can benefit from hypnotherapy, a psychological tailored intervention, as an adjunct to pharmacological agents to address the multiple components of pain and distress. Despite providing evidence on the effectiveness and potential superiority of hypnotherapy to other psychological interventions, research on hypnotherapy for paediatric procedural pain and distress has been predominantly limited to oncology and needle procedures. Plus, there is a lack of reporting of intervention manuals, factors influencing hypnotic responding, pain unpleasantness outcomes, theoretical frameworks, adverse events, as well as barriers and facilitators to the feasibility of delivering the intervention and study procedures. The proposed review aims to map the range and nature of the evidence on hypnotherapy for procedural pain and distress in children to identify gaps in literature and areas requiring further investigation. Methods This review will follow the Arksey and O'Malley (2005) methodology and incorporate additional scoping review recommendations by The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses. Relevant studies will be identified through searching published literature databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus and Web of Science) and grey literature in addition to hand-searching of reference lists and key journals. Two authors will independently screen titles and abstracts of search results followed by full-texts review against eligibility criteria. Conclusion Findings are anticipated to guide future research and inform the development of tailored hypnotic interventions in children.

scholarly journals Mapping Digital Religion: Exploring the Need for New Typologies

Religions ◽  
2021 ◽  
Vol 12 (6) ◽  
pp. 373
Author(s):  
Piotr Siuda
Keyword(s):  
Conceptual Framework ◽  
Religious Movements ◽  
New Religious Movements ◽  
Future Research ◽  
The Internet ◽  
Traditional Religion ◽  
Dynamic Nature ◽  
Visual Frame

Today, it is challenging to separate online and offline spaces and activities, and this is also true of digital religion as online and offline religious spaces become blended or blurred. With this background, the article explores the need for new typologies of what is religious on the Internet and proposes a conceptual framework for mapping digital religion. Four types of that which is religious on the Internet are presented based on influential classification by Helland. He introduced (1) religion online (sites that provide information without interactivity) and (2) online religion (interactivity and participation). Helland’s concept is developed by, among others, adding two types: (3) innovative religion (new religious movements, cults, etc.) and (4) traditional religion (e.g., Christianity or Islam). Each type is illustrated by selected examples and these are a result of a larger project. The examples are grouped into three areas: (1) religious influencers, (2) online rituals and (3) cyber-religions (parody religions). Additionally, the visual frame for mapping digital religion is presented including the examples mentioned. The presented framework attempts to improve Helland’s classification by considering a more dynamic nature of digital religion. The model is just one possible way for mapping digital religion and thus should be developed further. These and other future research threads are characterized.

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