Encouraging teamwork and innovative practices by creating proximity: A qualitative study of continuous improvements in the Quebec Cancer Network.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13509-e13509
Author(s):  
Dominique Tremblay ◽  
Nassera Touati ◽  
Susan Usher ◽  
Johanne Cournoyer
Keyword(s):  
Qualitative Study ◽  
Communities Of Practice ◽  
Medical Care ◽  
Knowledge Sharing ◽  
Care Coordination ◽  
Cancer Care ◽  
Local Level ◽  
National Level ◽  
Cancer Network ◽  
Proximity Dimensions

e13509 Background: Quality cancer care relies on each profession keeping up with advances and best practices and spreading these across a complex multi-team system1. It requires enabling multiple providers and people living with cancer to bridge the distance between them and complement each other's contributions. The proximity framework2 provides a valuable way to understand conditions that increase the likelihood of knowledge sharing, innovation and collaboration. Methods: A qualitative study design of the Quebec Cancer Network was undertaken, with data collected from interviews with policymakers, managers, providers and users (N=22), observation of national and local level meetings (N=28) and document review. Interpretive Description using content analysis sought to identify actions that created proximity dimensions and the perceived influence these had on the development and spread of new approaches. Results: Deliberate actions taken within the network created different dimensions of proximity that impacted teamwork. Prescriptions from network leadership – including consistent promotion of the National cancer plan, patient participation in governance structures, shared quality indicators, and establishment of multidisciplinary committees at local level, created cognitive proximity: a shared mental model emphasizing patient-centred care and organizational proximity: shared standards across the network. Support for professional communities of practice created relational and institutional proximity, increasing trust and knowledge sharing. Local committees enhanced relational and cognitive proximity as providers came to appreciate and optimize each other's contribution to care. Conclusions: The combination of proximity dimensions created through communities of practice and prescriptions from the national level help develop and spread improvements that are tailored to - and take advantage of - networked team-based cancer care delivery. This reflects a balanced proximity where communities of practice pursue new knowledge and innovative practices that can be introduced in local committees to see how it fits with other contributions to solving a problem, thereby promoting recognition of interdependency within and between teams. Synergy between actions is essential to enhancing proximity. The proximity framework offers a complementary perspective to better understand opportunities for improving models of care. References: 1Weaver, S. J., et al. (2018). Unpacking care coordination through a multiteam system lens. Medical care, 56(3), 247-259. et al. Unpacking Care Coordination Through a Multiteam System Lens. Medical Care. 2018;56(3):247-59. 2Knoben, J., & Oerlemans, L. A. (2006). Proximity and inter‐organizational collaboration: A literature review. I nternational Journal of management reviews, 8(2), 71-89.

scholarly journals What are the current barriers to effective cancer care coordination? A qualitative study

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Jennifer Walsh ◽  
James D Harrison ◽  
Jane M Young ◽  
Phyllis N Butow ◽  
Michael J Solomon ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Care Coordination ◽  
Cancer Care

scholarly journals Joint Action on cancer iPAAC - building on experience and streamlining recommendations for the future

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Jelenc ◽  
T Albreht
Keyword(s):  
Cancer Care ◽  
National Level ◽  
Cancer Control ◽  
Professional Community ◽  
The Other ◽  
Consensus Building ◽  
Good Practices ◽  
Policy Initiatives ◽  
European Code ◽  
And Control

Abstract Background Policy initiatives, proposals and projects often end up proposing solutions and/or measures that are eventually either not or only partially implemented or they are lacking a system, which would consistently evaluate their implementation and/or impact. Good solutions are often not visible enough to the broader professional community and it is important to identify certain outstanding challenges in cancer control and policy. Driven by the need to better use the outputs from projects on cancer policy, European Commission was trying to address two challenges - one was in solving the problems with the implementation and use of the solutions that have already been proposed and the other one in identifying the outstanding challenges in cancer policy. Results We have decided to follow the structure to develop a series of recommendations and examples of good practices at the national level by selected areas. These would be streamlined into a roadmap to support policymakers at the national and EU level in formulating their cancer policies. Three pairs of targeted recommendations have been identified: Cancer prevention, including health promotion, implementation of the European Code Against Cancer and the reshaping and extension of cancer registriesGenomics and immunotherapy in cancerChallenges in cancer care and governance of cancer control Conclusions Multinational collaboration can bring about important consensual solutions, which build on the existing good practices in the countries. This can be combined well with the existing work on specific areas, carried out both internationally and nationally. Consensus building on jointly defined challenges represents a task that appears to be resolved rather pragmatically. Key message It is important that advance in cancer care and control are quickly analysed and that policymakers receive up-to-date recommendations to improve their policies on cancer control.

scholarly journals Local-Level Democratic Backsliding? The Consolidation of Aspiring Dominant-Party Regimes in Hungary and Poland

2021 ◽  
pp. 1-24
Author(s):  
Conor O'Dwyer ◽  
Matthew Stenberg
Keyword(s):  
Local Politics ◽  
Electoral Systems ◽  
Local Level ◽  
National Level ◽  
Dominant Party ◽  
Mayoral Elections ◽  
Political Reforms ◽  
Strategic Coordination ◽  
The Future ◽  
Two Factors

Abstract Aspiring dominant-party regimes often institute major institutional and political reforms at the national level to ensure they retain control. However, subnational politics is an important, under-studied, component of regime consolidation. This study uses mayoral races in Hungary and Poland from 2006 to 2018 to examine two factors that may inhibit dominant-party regime consolidation in local politics: the use of two-round, i.e. runoff, electoral systems and strategic coordination among opposition parties. While we find little evidence that strategic coordination can lead to widespread opposition success in single-round systems, we do find that increasing the number of candidates decreases the likelihood of the nationally dominant party winning in the first round while not affecting the second round. As such, two-round mayoral elections may be an important buffer to dominant-party regime consolidation and may provide a training ground for the future opposition.

Reducing the Impact of Unemployment through Work-Sharing: Some Industrial Relations Considerations

1983 ◽  
Vol 25 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Noah M. Meltz ◽  
Frank Reid
Keyword(s):  
Local Level ◽  
Industrial Relations ◽  
National Level ◽  
Economic Benefits ◽  
Firm Level ◽  
Labour Relations ◽  
Work Sharing ◽  
Long Run ◽  
Short Run ◽  
The Impact

The Canadian Government has introduced a work-sharing program in which lay offs are avoided by reducing the work week and using unemployment insurance funds to pay workers short-time compensation. Compared to the lay-off alternative, there appear to be economic benefits to work-sharing for both management and employees. Reaction to the scheme has been generally positive at the union local level and the firm level, but it has been negative at the national level of both labour and management. These divergent views can be explained mainly as a result of short-run versus long-run perspectives. Managers at the firm level see the immediate benefit of improved labour relations and the avoidance of the costs of hiring and training replacements for laid-off workers who do not respond when recalled. The national business leaders are more concerned with work incentive and efficiency aspects of work-sharing.

scholarly journals Underneath Kyoto: Emerging Subnational Government Initiatives and Incipient Issue-Bundling Opportunities in China and the United States

2008 ◽  
Vol 8 (1) ◽  
pp. 53-77 ◽  
Author(s):  
Peter H. Koehn
Keyword(s):  
United States ◽  
Stress Reduction ◽  
Traffic Congestion ◽  
Local Level ◽  
National Level ◽  
Ghg Emissions ◽  
The United States ◽  
Healthy Human ◽  
Republic Of China ◽  
Stabilization Policies

At present, progress in mitigating global GHG emissions is impeded by political stalemate at the national level in the United States and the People's Republic of China. Through the conceptual lenses of multilevel governance and framing politics, the article analyzes emerging policy initiatives among subnational governments in both countries. Effective subnational emission-mitigating action requires framing climatic-stabilization policies in terms of local co-benefits associated with environmental protection, health promotion, and economic advantage. In an impressive group of US states and cities, and increasingly at the local level in China, public concerns about air pollution, consumption and waste management, traffic congestion, health threats, the ability to attract tourists, and/or diminishing resources are legitimizing policy developments that carry the co-benefit of controlling GHG emissions. A co-benefits framing strategy that links individual and community concerns for morbidity, mortality, stress reduction, and healthy human development for all with GHG-emission limitation/reduction is especially likely to resonate powerfully at the subnational level throughout China and the United States.

Portugal: 19 July 1987

1987 ◽  
Vol 22 (4) ◽  
pp. 444-451 ◽  
Author(s):  
Marcelo Rebelo de Sousa
Keyword(s):  
Party System ◽  
Local Level ◽  
National Level ◽  
Political Regime ◽  
Public Companies ◽  
Parliamentary Elections ◽  
Universal Suffrage ◽  
The Republic ◽  
The Government ◽  
Economic Regime

THE PORTUGUESE PARLIAMENTARY ELECTIONS OF 19 JULY 1987 initiated a profound change in the Portuguese party system and in the system of government. From 1974 onwards, Portugal had moved peacefully towards a democratic political system, enshrined in the 1976 Constitution. This evolution lasted about eight years and culminated in the revision of the Constitution in 1982. From 1982 onwards the present political regime has been a democratic one, coexisting with a capitalist economic regime attenuated by state monopoly in key sectors and by public companies which were nationalized between 1974 and 1976. It is also since 1982 that the system of government has been semi-presidential. There is pure representativeness as referendums do not exist at national level and have never been regulated at local level. But the government is semi-presidential in the sense that, owing to French influence, it attempts to balance Parliament with the election of the President of the Republic by direct and universal suffrage.

Abstract 2552: Adapting a novel cancer care delivery model: identifying barriers unique to care coordination for LGBTQ cancer survivors

2021 ◽  
Author(s):  
Nicolas Francone ◽  
Jonathan Alhalel ◽  
Will Dunne ◽  
Sankirtana Danner ◽  
Nihmotallahi Adebayo ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Care Coordination ◽  
Cancer Care ◽  
Care Delivery ◽  
Delivery Model ◽  
Care Delivery Model

Integrating Slum Upgrading and Vulnerability Reduction in Mozambique

2006 ◽  
Vol 31 (1) ◽  
pp. 106-115
Author(s):  
Mathias Spaliviero
Keyword(s):  
Local Level ◽  
National Level ◽  
Intervention Strategy ◽  
Sustainable Urban Development ◽  
Practical Implementation ◽  
Peace Agreement ◽  
Local Authorities ◽  
Vulnerability Reduction ◽  
Extreme Flood ◽  
Slum Upgrading

Due to its location, Mozambique suffers from cyclical flooding associated with heavy rains and cyclones. In recent years, extreme flood events affected millions of people, disrupting the economic recovery process that followed the peace agreement in 1992. Despite this natural threat, most of the population continues to live in flood prone areas both in rural environment, due to the dependency on agricultural activities, and in urban environment, since unsafe zones are often the only affordable option for new settlers. This paper presents a brief analytical review on different issues related with urban informal settlements, or slums, based on different project activities developed by the United Nations Human Settlements Programme (UN-HABITAT) in Mozambique. The aim is to identify applicable strategies to reduce vulnerability in urban slums, where approximately 70 percent of the urban population live. The implemented project activities target different organisational levels in an integrated manner, seeking for active involvement of the Government, local authorities and communities at each implementation stage, from decision-making to practical implementation. They consist of three main components: 1) supporting policy-making in order to ensure sustainable urban development, 2) delivering a comprehensive training and capacity building based on the mainstreaming concept of “Learning How to Live with Floods” as valid alternative to resettlement, and 3) facilitating participatory land use planning coupled with physical upgrading interventions at the local level. In the long-term, the intention of UN-HABITAT is to progressively focus on community-based slum upgrading and vulnerability reduction activities, coordinated by local authorities and actively monitored by central institutions, in improving and managing basic services and infrastructures (i.e. water supply, drainage, sanitation, waste management, road network, etc). This type of bottom-up experiences should then represent a basis for setting up a slum upgrading intervention strategy to be applied at the national level.

Concerns and difficulties associated with the COVID-19 pandemic among older adults with cancer in Mexico.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12042-12042
Author(s):  
Sofia Sánchez-Román ◽  
Yanin Chavarri Guerra ◽  
Andrea Morales Morales Alfaro ◽  
Daniela Ramirez Maza ◽  
Andrea de la O Murillo ◽  
...  
Keyword(s):  
Older Adults ◽  
Developing Countries ◽  
Medical Care ◽  
Cancer Care ◽  
Significant Proportion ◽  
Stage Iv ◽  
Well Being ◽  
Public Hospitals ◽  
The Individual

12042 Background: The COVID-19 pandemic has impacted the well-being of people not only due to the disease but also because of stay-at-home orders, social distancing, unemployment, and different kinds of loses. Older adults have particularly suffered during the pandemic, with increased health-related concerns and anxiety leading to increased vulnerability. However, little is known about the effects of the pandemic on older adults with cancer living in developing countries. They are facing issues related to their diagnosis and treatment, as well as the effects of the pandemic on their care and on the well-being of their families. To improve care for this vulnerable population, we studied the concerns and difficulties associated with COVID-19 among older Mexican adults with cancer. Methods: We included patients age ≥65 with the 10 most common tumors in Mexico according to GLOBOCAN and within 3-24 months of cancer diagnosis at two public hospitals in Mexico City. Patients were contacted telephonically and asked to complete a survey reporting the difficulties encountered during the COVID-19 pandemic and to rate their concerns associated with cancer care management using a 0-10 Likert-type scale, with higher ratings meaning increased concerns. Focused interviews were used to describe the individual experience of selected patients and their relatives related to COVID-19 and cancer care. Results: Between April 20, 2020 and December 1, 2021, 67 patients (mean age 71.9, min 65, max 90; 35.8% female; 62.7% living with a partner) were included. The most common tumors were prostate (43%), colon (16%), and lung (12%). 46% had Stage IV disease, and 61% had a life expectancy of more than a year. Twenty-five percent of patients reported encountering at least one difficulty in obtaining cancer care due to the COVID-19 pandemic. 43% of the patients reported difficulties with accessing follow-up cancer care; 39% reported issues with obtaining medications, including chemotherapy; and 34% reported problems obtaining medical care in general, including oncology visits. Regarding concerns, 33% of the patients reported being “very worried” or “extremely worried” about the COVID-19 pandemic. The most relevant concerns were related to getting infected with COVID-19 (or having a family member who became infected) (mean rating 7.9, SD 2.9); not being able to pay for cancer treatments or medical care (mean rating 6.9, SD 3.5); and worsening of cancer due to delayed care during the pandemic (mean rating 6.6, SD 3.7). Conclusions: A significant proportion of older adults with cancer in Mexico faced difficulties obtaining cancer treatment and follow-up care during the COVID-19 pandemic. Their most relevant concerns included getting infected, financial losses, and progression of disease. Creating systems to provide continued cancer care for vulnerable populations in developing countries is essential to face the COVID-19 pandemic.

Sign in / Sign up

Export Citation Format

Share Document