scholarly journals Navigating change – managers’ experience of implementation processes in disability health care: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anette Granberg ◽  
Marie Matérne ◽  
Lars-Olov Lundqvist ◽  
Anna Duberg
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Contextual Factors ◽  
Implementation Process ◽  
Public And Private ◽  
Implementation Processes ◽  
Telephone Interviews ◽  
External Conditions ◽  
The Many ◽  
Dance Intervention

Abstract Background Effective implementation processes play a central role in health care organizations and affect the care of patients. Managers are pivotal in facilitating the use of new practices, but their experience and how it affects the implementation outcome are still largely unknown. In the field of disability health care in particular, managers experiences have scarcely been investigated. Therefore, the aim of this study is to explore managers’ experiences of the implementation process when transferring new practices into disability health care settings. Methods Semi-structured individual telephone interviews were conducted with managers at disability health care organizations in four administrative regions in central Sweden. A total of 23 managers with formal managerial responsibility from both public and private health care were strategically selected to be interviewed. The interviews were analysed using reflexive thematic analysis with an inductive approach. Results The analysis resulted in two themes about factors influencing the implementation process: firstly, Contextual factors set the agenda for what can be achieved, which highlighted aspects that hinder or enable the implementation process, such as internal and external conditions, the workplace culture, the employees and managers’ attitudes and openness to change: secondly, Leadership in the winds of change, which described the challenges of balancing managerial tasks with leading the change, and the importance of a leadership that involves the participation of the employees. Conclusions This study explored how and to what extent managers address and manage the implementation process and the many associated challenges. The findings highlight the importance of leadership support and organizational structure in order to transfer new practices into the work setting, and to encourage an organizational culture for leading change that promotes positive outcomes. We suggest that identifying strategies by focusing on contextual factors and on aspects of leadership will facilitate implementation processes. Trial registration The SWAN (Structured Water Dance Intervention) study was retrospectively registered on April 9, 2019 and is available online at ClinicalTrials.gov (ID: NCT03908801).

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

Ethical Integrity in Health Care Organizations

2015 ◽  
Vol 43 (3) ◽  
pp. 661-665
Author(s):  
Jessica Mantel
Keyword(s):  
Health Care ◽  
Clinical Judgment ◽  
Care Setting ◽  
Financial Integration ◽  
Health Care Organizations ◽  
Health Care Setting ◽  
Collaborative Partnerships ◽  
Public And Private ◽  
Physician Practices ◽  
Delivery Models

The rise of managed care initiated a steady decline in solo and small group physician practices and the emergence of new delivery models built around large health care organizations (HCOs). Health care reform has only accelerated this trend as public and private payors shift to new payment methodologies that reward clinical and financial integration among providers. As a result, patients increasingly receive care from physicians and other health professionals organized into collaborative partnerships with one another and institutional providers, such as hospitals. As described below, this new organizational dynamic profoundly influences the clinical judgment of physicians. No longer can society simply depend on the professionalism of individual physicians to ensure ethical integrity in the health care setting. Rather, ethical integrity in the health care setting also requires a strong foundation of organizational ethics.

scholarly journals Involvement of Patient and Family Representatives in Health-Care Job Interview Panels

2019 ◽  
Vol 7 (6) ◽  
pp. 1294-1302
Author(s):  
Thora Grothe Thomsen ◽  
Bibi Hølge-Hazelton
Keyword(s):  
Health Care ◽  
Formative Evaluation ◽  
Evaluation Research ◽  
Implementation Process ◽  
University Hospital ◽  
Recruitment Process ◽  
Job Interview ◽  
Telephone Interviews ◽  
Starting Point ◽  
Analysis Strategy

Objectives: The involvement of patient and family representatives in job interview panels is sparsely documented. This study was conducted at a newly established university hospital in Denmark. The aim was to identify different perspectives on attitudes and experiences associated with involving patient and family representatives in the recruitment process for senior staff. Furthermore, the aim was to highlight considerations and reservations related to the subsequent implementation process. Methods: Inspiration was drawn from formative evaluation research. Data Sources: Seventeen telephone interviews with applicants, 49 e-mail responses from staff, and unsolicited e-mails to the researcher. Analysis Strategy: Interpretive description. Results: Learnings from the study showed among other things that the participating staff experienced widespread skepticism before participation in the job interview panels, but their experience in the panels led them to consider the patients’ and families’ input to be beneficial to the entire recruitment process. The considerations and reservations raised were divided into 5 themes. Conclusions: The results provide a relevant starting point to negotiate and refine the aims of collective patient involvement related to a given situation—such as health-care recruitment processes.

scholarly journals 73. Lack of Prehospital Death Pronouncement by Air Medical Programs May Waste Health Care Resources

1996 ◽  
Vol 11 (S2) ◽  
pp. S47-S47
Author(s):  
Bartholomew J. Tortella ◽  
Robert Simon ◽  
Robert F. Lavery
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Organizations ◽  
Research Staff ◽  
Health Care Resources ◽  
Telephone Interviews ◽  
Physician Contact ◽  
Rotor Wing ◽  
Medical Programs ◽  
Ground Ambulances

Statement of Purpose: Prehospital death pronouncement policies are common among ground ambulances. No previous report has addressed such policies among Air Medical (AM) programs.Statement of Methods: Statement of Methods: Structured telephone interviews of 125 of 143 (87%) AM programs (14 fixed wing, 68 rotor wing, 43 both) were conducted by research staff from 6 to 8/95.Summary of Results: Summary of Results: Only fifty percent of AM crews are permitted to pronounce death in the field. Of those AM programs which permit pronouncement, direct medical command physician contact is required in 35% of pronouncements while 25% of programs utilize protocols. Of those AM programs which permit pronouncement, 77% of flight nurses can pronounce while only 33% of paramedics. Most programs (95%) conduct QA reviews of all deaths.Statement of Conclusions: Prehospital death pronouncement is permitted in only 50% of AM programs. Since prehospital death pronouncement may obviate the need for AM transport, AM programs may be transporting clinically dead but unpronounced patients wasting scarce medical resources. This differs greatly from ground EMS programs where death protocols are common. Particularly puzzling is the small percentage of flight paramedics who are allowed to pronounce when compared to flight nurses since ground EMS pronouncements are performed by paramedics. AM programs should review their prehospital pronouncement protocols since managed care initiatives will drive health care organizations to abandon the wasteful practice of transporting clinically dead, but unpronounced, patients.

Rorschach-CS Scores of Six Groups of Patients

2013 ◽  
Vol 34 (1) ◽  
pp. 24-55 ◽  
Author(s):  
Caspar C. Berghout ◽  
Jolien Zevalkink ◽  
Abraham N. J. Pieters ◽  
Gregory J. Meyer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Organizations ◽  
Total Sample ◽  
Psychoanalytic Psychotherapy ◽  
Cross Sectional ◽  
Treatment Groups ◽  
Treatment Type ◽  
Psychotherapy Groups ◽  
Cross Sectional Design

In this study we used a quasiexperimental, cross-sectional design with six cohorts differing in phase of treatment (pretreatment, posttreatment, 2-year posttreatment) and treatment type (psychoanalysis and psychoanalytic psychotherapy) and investigated scores on 39 Rorschach-CS variables. The total sample consisted of 176 participants from four mental health care organizations in The Netherlands. We first examined pretreatment differences between patients entering psychoanalysis and patients entering psychoanalytic psychotherapy. The two treatment groups did not seem to differ substantially before treatment, with the exception of the level of ideational problems. Next, we studied the outcome of psychoanalysis and psychoanalytic psychotherapy by comparing the Rorschach-CS scores of the six groups of patients. In general, we found significant differences between pretreatment and posttreatment on a relatively small number of Rorschach-CS variables. More pre/post differences were found between the psychoanalytic psychotherapy groups than between the psychoanalysis groups. More research is needed to examine whether analyzing clusters of variables might reveal other results.

INCREASING ADOPTION OFSOCIAL MEDIA IN HEALTHCARE ORGANIZATIONS : OPPORTUNITIES AND CONCERNS

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Sharafat Hussain ◽  
Prof. Mohd. Abdul Azeem
Keyword(s):  
Health Care ◽  
Social Media ◽  
Social Networking ◽  
Health Care Organizations ◽  
Healthcare Providers ◽  
Healthcare Organizations ◽  
Online Questionnaire ◽  
Potential Benefits ◽  
Social Media Presence ◽  
Use Of Social Media

Adoption of social media amongst health care organizations is thriving. Healthcare providers have begun to connect with patients via social media. While some healthcare organizations have taken the initiative, numerous others are attempting to comprehend this new medium of opportunity. These organizations are finding that social networking can be an effective way to monitor brand, connecting with patients, community, and patient education and acquiring new talent. This study is conducted to identify the purpose of using social media, concerns, policy and its implementation and the overall experience of healthcare organizations with social media. To collect first hand data, online questionnaire was sent via LinkedIn to 400 US healthcare organizations and representatives out of which 117 responded and were taken further for analsysis. The results of this study confirm the thriving adoption, increased opportunities and cautious use of social media by healthcare organizations. The potential benefits present outweigh the risk and concerns associated with it. Study concluded that social media presence will continue to grow into the future and the field of healthcare is no exception.

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