scholarly journals The roles, activities and impacts of middle managers who function as knowledge brokers to improve care delivery and outcomes in healthcare organizations: a critical interpretive synthesis

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Faith Boutcher ◽  
Whitney Berta ◽  
Robin Urquhart ◽  
Anna R. Gagliardi
Keyword(s):  
Health Care ◽  
Middle Managers ◽  
Care Delivery ◽  
Empirical Studies ◽  
Practice Change ◽  
Cochrane Library ◽  
Healthcare Organizations ◽  
Eligibility Criteria ◽  
Critical Interpretive Synthesis ◽  
Knowledge Brokers

Abstract Background Middle Managers (MMs) are thought to play a pivotal role as knowledge brokers (KBs) in healthcare organizations. However, the role of MMs who function as KBs (MM KBs) in health care is under-studied. Research is needed that contributes to our understanding of how MMs broker knowledge in health care and what factors influence their KB efforts. Methods We used a critical interpretive synthesis (CIS) approach to review both qualitative and quantitative studies to develop an organizing framework of how MMs enact the KB role in health care. We used compass questions to create a search strategy and electronic searches were conducted in MEDLINE, CINAHL, Social Sciences Abstracts, ABI/INFORM, EMBASE, PubMed, PsycINFO, ERIC and the Cochrane Library. Searching, sampling, and data analysis was an iterative process, using constant comparison, to synthesize the results. Results We included 41 articles (38 empirical studies and 3 conceptual papers) that met the eligibility criteria. No existing review was found on this topic. A synthesis of the studies revealed 12 MM KB roles and 63 associated activities beyond existing roles hypothesized by extant theory, and we elaborate on two MM KB roles: 1) convincing others of the need for, and benefit of an innovation or evidence-based practice; and 2) functioning as a strategic influencer. We identified organizational and individual factors that may influence the efforts of MM KBs in healthcare organizations. Additionally, we found that the MM KB role was associated with enhanced provider knowledge, and skills, as well as improved organizational outcomes. Conclusion Our findings suggest that MMs do enact KB roles in healthcare settings to implement innovations and practice change. Our organizing framework offers a novel conceptualization of MM KBs that advances understanding of the emerging KB role that MMs play in healthcare organizations. In addition to roles, this study contributes to the extant literature by revealing factors that may influence the efforts and impacts of MM KBs in healthcare organizations. Future studies are required to refine and strengthen this framework. Trial registration A protocol for this review was not registered.

A Scoping Review of Telehealth-Assisted Case Management for Chronic Illnesses

2021 ◽  
pp. 019394592110089
Author(s):  
Jee Young Joo ◽  
Megan F. Liu
Keyword(s):  
Health Care ◽  
Case Management ◽  
Scoping Review ◽  
Access To Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Management Practice ◽  
Empirical Studies ◽  
Chronic Illnesses ◽  
Future Research

This scoping review aimed to examine telehealth-assisted case management for chronic illnesses and assess its overall impact on health care delivery. Guided by the PRISMA statement, this review included 36 empirical studies published between 2011 and 2020. This study identified three weaknesses and four strengths of telehealth-assisted case management. While the weaknesses were negative feelings about telehealth, challenges faced by patients in learning and using telehealth devices, and increased workload for case managers, the strengths included efficient and timely care, increased access to health care services, support for patients’ satisfaction, and cost savings. Future research can be designed and conducted for overcoming the weaknesses of telehealth-assisted case management. Additionally, the strengths identified by this review need to be translated from research into case management practice for chronic illness care. This review not only describes the value of such care strategy, but also provides implications for future nursing practice and research.

scholarly journals Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Routine Care ◽  
Future Research ◽  
Healthcare Organizations ◽  
Care Services ◽  
Global Pandemic ◽  
Facilitators And Barriers

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.

scholarly journals Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery

2018 ◽  
Vol 36 (20) ◽  
pp. 2088-2100 ◽  
Author(s):  
Paul B. Jacobsen ◽  
Antonio P. DeRosa ◽  
Tara O. Henderson ◽  
Deborah K. Mayer ◽  
Chaya S. Moskowitz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Outcomes ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Cochrane Library ◽  
Survivorship Care Plan ◽  
Satisfaction With Care ◽  
Survivorship Care ◽  
Care Plans

Purpose Numerous organizations recommend that patients with cancer receive a survivorship care plan (SCP) comprising a treatment summary and follow-up care plans. Among current barriers to implementation are providers’ concerns about the strength of evidence that SCPs improve outcomes. This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors. Methods Randomized and nonrandomized studies evaluating patient-reported outcomes, health care use, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Data extracted by independent raters were summarized on the basis of qualitative synthesis. Results Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer types, SCP delivery timing and method, SCP recipients and content, SCP-related counseling, and outcomes assessed. Nonrandomized study findings yielded descriptive information on satisfaction with care and reactions to SCPs. Randomized study findings were generally negative for the most commonly assessed outcomes (ie, physical, functional, and psychological well-being); findings were positive in single studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care. Conclusion Existing research provides little evidence that SCPs improve health outcomes and health care delivery. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal outcomes. Findings are limited but more positive for proximal outcomes (eg, information received) and for care delivery, particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care.

scholarly journals SUPPORTIVE SUPERVISION AS A TECHNOLOGY OF IMPROVING THE QUALITY OF HOSPITAL CARE DELIVERY

2017 ◽  
Vol 14 (3) ◽  
pp. 192-197 ◽  
Author(s):  
Svetlana A. Mukhortova ◽  
Tatiana V. Kulichenko ◽  
Leyla S. Namazova-Baranova ◽  
Svetlana G. Piskunova ◽  
Elena A. Besedina ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Hospital Care ◽  
Care Delivery ◽  
Health Care Facilities ◽  
Cochrane Library ◽  
Supportive Supervision ◽  
Technology Application ◽  
Quality Of Medical Care

Improving the quality of medical care is a priority in countries with developed and developing health care system. There are various approaches to improve the quality and safety of patient’s care, as well as various strategies to encourage hospitals to achieve this goal. The purpose of the presented literature review was to analyze existing experience of the implementation of technology of supportive supervision in health care facilities to improve the quality of hospital care delivery. The data sources for publication were obtained from the following medical databases: PubMed, Cochrane Library, Medscape, e-library, and books on the topic of the review written by experts. The article discusses the results of the research studies demonstrating the successes and failures of supportive supervision technology application. Implementation of supportive supervision in medical facilities based on generalized experience of different countries is a promising direction in improving the quality of medical care delivery. This technology opens up opportunities to improve skills and work quality of the staff at pediatric hospitals in the Russian Federation.

Pricing and cost accounting: challenges for healthcare organizations in a market economy

2021 ◽  
pp. 16-23
Author(s):  
L.M. Korchagina
Keyword(s):  
Health Care ◽  
Market Economy ◽  
Care Delivery ◽  
Cost Accounting ◽  
Healthcare Organizations ◽  
Pricing Models ◽  
Healthcare Executives ◽  
Reducing Costs ◽  
Access And Quality ◽  
Improve Access

The development of health care aims to improve access and quality while reducing costs. An important part of this is improving pricing models to more accurately reflect the costs of health care delivery. Transparent, cost-reflective pricing is needed to communicate information to consumers and manufacturers. This information is central to a consumer-driven marketplace. Healthcare organizations today must focus as much on financial performance and profitability as they do on patient care. This means that healthcare executives must be well versed in cost accounting and budgeting. This article explores pricing issues and the problems associated with cost accounting in healthcare organizations. The author considers application of a method of the account of the expenses based on identification of processes within the firm and allocation of expenses in proportion to their use (method ABC).

scholarly journals Improving Female Preventive Health Care Delivery Through Practice Change: An Every Woman Matters Study

2005 ◽  
Vol 18 (5) ◽  
pp. 401-408 ◽  
Author(s):  
E. L. Backer ◽  
J. A. Geske ◽  
H. E. McIlvain ◽  
D. M. Dodendorf ◽  
W. C. Minier
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Practice Change

Organizational commitment among physicians: A systematic literature review

2020 ◽  
pp. 095148482095230
Author(s):  
Timothy Hoff ◽  
Do Rim Lee ◽  
Kathryn Prout
Keyword(s):  
Health Care ◽  
Organizational Commitment ◽  
Health Systems ◽  
Longitudinal Research ◽  
Care Delivery ◽  
Personal Characteristics ◽  
Empirical Literature ◽  
Healthcare Organizations ◽  
Supportive Culture ◽  
Health Care Delivery Systems

Purpose Physicians work increasingly in larger organizations across different health care delivery systems. This systematic review examines the published empirical literature on organizational commitment among physicians within an international context. Design A systematic, PRISMA-guided review examining studies of organizational commitment among physicians published over time. Four article databases and a combination of appropriate search terms aided in identifying relevant articles. Findings Key findings include: (a) physicians, regardless of country, personal characteristics, type of job, or place of employment generally have lower levels of organizational commitment than other health care workers; (b) work- and job-related variables, particular age and job satisfaction, shape physicians’ organizational commitment; and (c) organizational commitment and the factors that shape it are similar across physicians working in different health systems. Review implications: Organizational commitment should remain central for researchers to study in most health systems internationally. Larger samples, longitudinal research, and greater use of theory are design improvements that will strengthen the extant research. The findings imply that if healthcare organizations create workplaces that make physicians feel in control, do not overwhelm them with work, provide a supportive culture, enhance their ability to give input, and keep them job satisfied, they may gain enhanced organizational commitment. Originality and value: To our knowledge, this is the first review of research examining organizational commitment among physicians. It is a resource for researchers and managers interested in learning more about aligning physician thinking and behavior with health care organizations.

Organizational readiness for artificial intelligence in health care: insights for decision-making and practice

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hassane Alami ◽  
Pascale Lehoux ◽  
Jean-Louis Denis ◽  
Aude Motulsky ◽  
Cecile Petitgand ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Organizational Readiness ◽  
Decision Makers ◽  
Value Assessment ◽  
Healthcare Organizations ◽  
Content Type ◽  
Health Technologies

PurposeArtificial intelligence (AI) raises many expectations regarding its ability to profoundly transform health care delivery. There is an abundant literature on the technical performance of AI applications in many clinical fields (e.g. radiology, ophthalmology). This article aims to bring forward the importance of studying organizational readiness to integrate AI into health care delivery.Design/methodology/approachThe reflection is based on our experience in digital health technologies, diffusion of innovations and healthcare organizations and systems. It provides insights into why and how organizational readiness should be carefully considered.FindingsAs an important step to ensure successful integration of AI and avoid unnecessary investments and costly failures, better consideration should be given to: (1) Needs and added-value assessment; (2) Workplace readiness: stakeholder acceptance and engagement; (3) Technology-organization alignment assessment and (4) Business plan: financing and investments. In summary, decision-makers and technology promoters should better address the complexity of AI and understand the systemic challenges raised by its implementation in healthcare organizations and systems.Originality/valueFew studies have focused on the organizational issues raised by the integration of AI into clinical routine. The current context is marked by a perplexing gap between the willingness of decision-makers and technology promoters to capitalize on AI applications to improve health care delivery and the reality on the ground, where it is difficult to initiate the changes needed to realize their full benefits while avoiding their negative impacts.

Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis

2018 ◽  
Vol 46 (6) ◽  
pp. 665-676 ◽  
Author(s):  
Stientje Esther Rai ◽  
Amneet Kaur Sidhu ◽  
Rohin Jayaram Krishnan
Keyword(s):  
Systematic Review ◽  
Necrotizing Enterocolitis ◽  
Meta Analysis ◽  
Subsequent Development ◽  
Practice Change ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Eligibility Criteria ◽  
Meta Analyses ◽  
The Cochrane Library

Abstract Context: Significant controversy exists surrounding the possible association between recent packed red blood cell (PRBC) transfusion and the subsequent development of necrotizing enterocolitis (NEC) in infants. Previous studies and meta-analyses reporting a statistically significant association led to a practice change to withhold enteral feeds in the peri-transfusion period in many centers in an effort to prevent NEC; however, results from more recent studies do not support the existence of an association and, thus, question the validity of this practice change. Objective: This study aimed to perform a systematic review and meta-analysis to determine whether exposure to recent PRBC transfusion (defined as within 48 h) is associated with the subsequent development of NEC stage ≥II (Bell’s criteria) in infants. Methods: Medline, Embase, CINAHL, and the Cochrane Library were searched from inception to October 7, 2015. A gray literature search was also performed. Studies comparing the risk of NEC in infants exposed and unexposed to recent PRBC transfusion were included. Thirteen studies met eligibility criteria, and 10 (n=15,675 infants) were included in the meta-analysis. Three authors independently extracted data, and meta-analysis was performed using a random effects model. Results: We found a statistically significant 45% reduction in the unadjusted odds of NEC in infants exposed to a recent PRBC transfusion (odds ratio=0.55, 95% confidence interval=0.31–0.98). Conclusion: Our results show a protective effect of recent PRBC transfusion on the subsequent development of NEC. The practice of withholding enteral feeds during the peri-transfusion period should be re-evaluated in light of these results.

Translational Research: A Concept Analysis

2013 ◽  
Vol 27 (3) ◽  
pp. 214-232 ◽  
Author(s):  
M. Cecilia Wendler ◽  
Geri Kirkbride ◽  
Kristen Wade ◽  
Lynne Ferrell
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Translational Research ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Concept Analysis ◽  
Practice Change ◽  
Design Data ◽  
Antecedents And Consequences ◽  
Definition Of

Background/conceptual framework: Little is known about which approaches facilitate adoption and sustainment of evidence-based practice change in the highly complex care environments that constitute clinical practice today. The purpose of this article was to complete a concept analysis of translational research using a modified Walker and Avant approach. Design/data collection: Using a rigorous and thorough review of the recent health care literature generated by a deep electronic search from 2004–2011, 85 appropriate documents were retrieved. Close reading of the articles by three coresearchers yielded an analysis of the emerging concept of translational research. Data analysis: Using the iterative process described by Walker and Avant, a tentative definition of the concept of translational research, along with antecedents and consequences were identified. Implications for health care professionals in education, practice, and research are offered. Further research is needed to determine the adequacy of the definition, to identify empirical referents, and to guide theory development. Results: The study resulted in a theoretical definition of the concept of translational research, along with identification of antecedents and consequences and a description of an ideal or model case to illustrate the definition. Implications/conclusions: Implications for practice and education include the importance of focusing on translational research approaches that may reduce the research-practice gap in health care, thereby improving patient care delivery. Research is needed to determine the usefulness of the definition in health care clinical practice.

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