scholarly journals Dysfunctional Effects of a Conflict in a Healthcare Organization / Дисфункциональный Аспект Конфликта В Организации Здравоохранения

Folia Medica ◽  
2015 ◽  
Vol 57 (2) ◽  
pp. 133-137 ◽  
Author(s):  
Ekaterina L. Raykova ◽  
Mariya A. Semerjieva ◽  
Georgi Y. Yordanov ◽  
Todor D. Cherkezov

AbstractConflicts in healthcare settings are quite common events because of the continuous changes and transformations today’s healthcare organizations are undergoing and the vigorous interaction between the medical professionals working in them. AIM: To survey the opinions of medical professionals about the possible destructive effects of conflicts on them in the workplace. MATERIALS AND METHODS: We conducted a direct individual survey of 279 medical employees at four general hospitals. We used a set of questions that reflect the negative effects and consequences of conflict on healthcare professionals as direct or indirect participants. All data were analysed using the descriptive statistics and non-parametric analysis at a significance level for the null hypothesis of p < 0.05. RESULTS: Workplace conflicts contribute a lot to the stress, psychological tension and emotional exhaustion medical professionals are exposed to. The confrontation the conflict brings the participants into acts as a catalyst of the conflict and enhances the manifestation of hostile actions. A conflict generates a situation which has an impact on the behaviour of all participants involved in it giving rise to emotional states such as anger, aggression and reproaches. The destructive consequences resulting from a conflict are seen in the reduced work satisfaction and demotivation to perform the work activity. The contradictions that arise as a result affect negatively the team cooperation and obstruct the collaborative efforts in solving the problems in the healthcare setting. CONCLUSION: A conflict in a healthcare setting exerts a considerable destructive effect on an employee, therefore it requires prompt identification and effective intervention to minimise its unfavourable outcomes.

2019 ◽  
Vol 34 (1) ◽  
pp. 99-105
Author(s):  
Ekaterina Raykova ◽  
Maria Semerdjieva

Conflict is a consistent and unavoidable issue in the healthcare organization. A hospital is the most complex healthcare setting in which conflict arises as a result of opposing interests, goals, and in other cases of confrontation. It creates a situation that reflects on the behavior and position of all parties involved. Conflict is a dynamic process and can have positive or negative effects on the hospital activity. Unresolved or inadequately managed conflict has numerous negative effects, including stress, ineffective decision making, a negative work environment, patient and medical dissatisfaction. However, effective conflict resolution has been shown to enhance team performance, increase patient safety, and improve patient outcomes. The conflict in healthcare organizations, as a result of intensification the contradictions, requires timely identification, prompt and effective intervention to minimize its adverse consequences. The implementation of effective methods for managing and reducing the number of destructive conflicts is emerging as a key criterion for the successful functioning of the hospital as an organization. Despite the existence of mechanisms embedded in their structure, the approaches to managing conflicts in healthcare organizations are different. This allows the conflict to be approached from different sides and provides a comprehensive overview of the process in the interests of actual practices practice of management. The specific nature of hospital work and its impact on the health of the population requires that conflicts in health care be accepted, discussed, and managed in a way that promotes good relationships, organizational development and productivity. The choice of adequate conflict management methods will help medical specialists and managers build an organizational culture that fosters collaboration and create the best work environment to engage in effective conflict management.


2018 ◽  
Vol 13 (3) ◽  
pp. i05 ◽  
Author(s):  
Elina Karalis ◽  
Gaery Barbery

Background: Implementing high reliability organization principles can enhance quality and safety in healthcare. Evidence-based instructions on how to effectively change the organizational culture in healthcare setting are required. Objectives:  A systematic review investigating methods, facilitators, and barriers to assist healthcare organizations in becoming a high reliability organization. Method: Literature searches were performed in PubMed, MEDLINE, CINAHL-Complete, EMBASE, and Scopus for articles published between January 2012 and October 2017. The included articles were case reports, case studies, and protocol development studies on implementing high reliability organization principles. The articles were appraised using a modified Critical Appraisal Skills Programme tool. Thematic synthesis was conducted using manual coding.  Results: Of the 14 eligible articles nine were case studies, four were case reports, and one was a framework development report. The study populations varied from whole healthcare systems to a single department of a hospital. The most common methods were supportive leadership, staff education, and analysing the safety events and sharing the knowledge. Cost was one of the barriers. Remuneration came in reduction of safety events and costs avoided. Conclusion Implementing high reliability organization principles in healthcare settings is slow and challenging, but doing so improves quality, resilience, and safety, thus increasing productivity.


Materials ◽  
2021 ◽  
Vol 14 (3) ◽  
pp. 697
Author(s):  
Anna Wiejak ◽  
Barbara Francke

Durability tests against fungi action for wood-plastic composites are carried out in accordance with European standard ENV 12038, but the authors of the manuscript try to prove that the assessment of the results done according to these methods is imprecise and suffers from a significant error. Fungi exposure is always accompanied by high humidity, so the result of tests made by such method is always burdened with the influence of moisture, which can lead to a wrong assessment of the negative effects of action fungus itself. The manuscript has shown a modification of such a method that separates the destructive effect of fungi from moisture accompanying the test’s destructive effect. The functional properties selected to prove the proposed modification are changes in the mass and bending strength after subsequent environmental exposure. It was found that intensive action of moisture measured in the culture chamber of about (70 ± 5)%, i.e., for 16 weeks, at (22 ± 2) °C, which was the fungi culture, which was accompanying period, led to changes in the mass of the wood-plastic composites, amounting to 50% of the final result of the fungi resistance test, and changes in the bending strength amounting to 30–46% of the final test result. As a result of the research, the correction for assessing the durability of wood-polymer composites to biological corrosion has been proposed. The laboratory tests were compared with the products’ test results following three years of exposure to the natural environment.


2020 ◽  
Vol 41 (S1) ◽  
pp. s439-s439
Author(s):  
Valerie Beck

Background: It is well known that contaminated surfaces contribute to the transmission of pathogens in healthcare settings, necessitating the need for antimicrobial strategies beyond routine cleaning with momentary disinfectants. A recent publication demonstrated that application of a novel, continuously active antimicrobial surface coating in ICUs resulted in the reduction of healthcare-associated infections. Objective: We determined the general microbial bioburden and incidence of relevant pathogens present in patient rooms at 2 metropolitan hospitals before and after application of a continuously active antimicrobial surface coating. Methods: A continuously active antimicrobial surface coating was applied to patient rooms in intensive care units (ICUs) twice over an 18-month period and in non-ICUs twice over a 6-month study period. The environmental bioburden was assessed 8–16 weeks after each treatment. A 100-cm2 area was swabbed from frequently touched areas in patient rooms: patient chair arm rest, bed rail, TV remote, and backsplash behind the sink. The total aerobic bacteria count was determined for each location by enumeration on tryptic soy agar (TSA); the geometric mean was used to compare bioburden before and after treatment. Each sample was also plated on selective agar for carbapenem-resistant Enterobacteriaceae (CRE), vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridioides difficile to determine whether pathogens were present. Pathogen incidence was calculated as the percentage of total sites positive for at least 1 of the 4 target organisms. Results: Before application of the antimicrobial coating, total aerobic bacteria counts in ICUs were >1,500 CFU/100 cm2, and at least 30% of the sites were positive for a target pathogen (ie, CRE, VRE, MRSA or C. difficile). In non-ICUs, the bioburden before treatment was at least 500 CFU/100 cm2, with >50% of sites being contaminated with a pathogen. After successive applications of the surface coating, total aerobic bacteria were reduced by >80% in the ICUs and >40% in the non-ICUs. Similarly, the incidence of pathogen-positive sites was reduced by at least 50% in both ICUs and non-ICUs. Conclusions: The use of a continuously active antimicrobial surface coating provides a significant (P < .01) and sustained reduction in aerobic bacteria while also reducing the occurrence of epidemiologically important pathogens on frequently touched surfaces in patient rooms. These findings support the use of novel antimicrobial technologies as an additional layer of protection against the transmission of potentially harmful bacteria from contaminated surfaces to patients.Funding: Allied BioScience provided Funding: for this study.Disclosures: Valerie Beck reports salary from Allied BioScience.


2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Fateme Omidvari ◽  
Mehdi Jahangiri ◽  
Reza Mehryar ◽  
Moslem Alimohammadlou ◽  
Mojtaba Kamalinia

Fire is one of the most dangerous phenomena causing major casualties and financial losses in hospitals and healthcare settings. In order to prevent and control the fire sources, first risk assessment should be conducted. Failure Mode and Effect Analysis (FMEA) is one of the techniques widely used for risk assessment. However, Risk Priority Number (RPN) in this technique does not take into account the weight of the risk parameters. In addition, indirect relationships between risk parameters and expert opinions are not considered in decision making in this method. The aim is to conduct fire risk assessment of healthcare setting using the application of FMEA combined with Multi‐Criteria Decision Making (MCDM) methods. First, a review of previous studies on fire risk assessment was conducted and existing rules were identified. Then, the factors influencing fire risk were classified according to FMEA criteria. In the next step, weights of fire risk criteria and subcriteria were determined using Intuitionistic Fuzzy Multiplicative Best-Worst Method (IFMBWM) and different wards of the hospital were ranked using Interval-Valued Intuitionistic Fuzzy Combinative Distance-based Assessment (IVIFCODAS) method. Finally, a case study was performed in one of the hospitals of Shiraz University of Medical Sciences. In this study, fire alarm system (0.4995), electrical equipment and installations (0.277), and flammable materials (0.1065) had the highest weight, respectively. The hospital powerhouse also had the highest fire risk, due to the lack of fire extinguishers, alarms and fire detection, facilities located in the basement floor, boilers and explosive sensitivity, insufficient access, and housekeeping. The use of MCDM methods in combination with the FMEA method assesses the risk of fire in hospitals and health centers with great accuracy.


2021 ◽  
Vol 17 (2) ◽  
pp. 115-124
Author(s):  
Kathryn W. Zavaleta, MHSA ◽  
Lindsey M. Philpot, PhD, MPH ◽  
Julie L. Cunningham, PharmD, RPh ◽  
Halena M. Gazelka, MD ◽  
Holly L. Geyer, MD ◽  
...  

Introduction: Opioid prescribing occurs within almost every healthcare setting. Implementation of safe, effective opioid stewardship programs represents a critical but daunting challenge for medical leaders. This study sought to understand the barriers and aids to the routine use of clinical guidelines for opioid prescribing among healthcare professionals and to identify areas in need of additional education for prescribing providers, pharmacists, and nurses.Methods: Data collection and analysis in 2018-2019 employed a team of two trained facilitators who conducted 20 focus groups using a structured facilitation guide to explore operational, interpersonal, and patient care-related barriers to best practice adherence. Each professional group was interviewed separately, with similar care settings assigned together. Invitation to participate was based on a sampling methodology representing emergency, medical specialty, primary care, and surgical practice settings.Results: Key concerns among all groups reflected the inadequacy of available tools for staff to appropriately assess and treat patients’ pain. Tools and technology to support safe opioid prescribing were also cited as a barrier by all three professional groups. All groups noted that prescribers tend to rely upon default settings within the electronic medical record when issuing prescriptions. Both pharmacists and prescribers cited time and scheduling as a barrier to adherence.Conclusions: In spite of significant regulatory and public policy efforts to address the opioid crisis, healthcare organizations face significant challenges to improve adherence to best practice prescribing guidelines. These findings highlight several facilitators for change which could boost opioid stewardship initiatives to focus on critical systems’ factors for improvement.


2018 ◽  
Vol 72 (8) ◽  
pp. 1341-1368 ◽  
Author(s):  
Mike Bresnen ◽  
Damian Hodgson ◽  
Simon Bailey ◽  
John Hassard ◽  
Paula Hyde

While hybrid managers are increasingly important in contemporary organizations (especially in the public sector), we know little about why or how they become hybrid managers, or how this is shaped by the interplay of professional experience and organizational circumstances. In pursuit of a more variegated, contextualized and dynamic understanding of hybrid management, this article focuses on how individuals transition into managerial hybrids, emphasizing the dynamic and emergent nature of hybrid management identity. Studying managers in English healthcare, we employ the concept of identity work as expressed through career narratives to examine the influence of career trajectories and organizational experiences on emerging hybrid manager identity. The study identifies three broad managerial career narratives – aspirational, ambivalent and agnostic – and relates them to experiences of doctor and nurse hybrid managers in three healthcare settings. An interpretive analysis of these narratives reveals a more variegated, situated and dynamic interpretation of hybrid managerial identities than previously considered and underscores the importance of personal and organizational experiences in shaping emergent hybrid professional/managerial identity.


2015 ◽  
Vol 10 (1) ◽  
pp. 95
Author(s):  
Elizabeth Margaret Stovold

A Review of: Perrier, L., Farrell, A., Ayala, A. P., Lightfoot, D., Kenny, T., Aaronson, E., . . . Weiss, A. ( 2014). Effects of librarian-provided services in healthcare settings: A systematic review. Journal of the American Medical Informatics Association, 21(6), 1118-1124. http://dx.doi.org/10.1136/amiajnl-2014-002825 Abstract Objective – To assess the effects of librarian-provided services, in any healthcare setting, on outcomes important to patients, healthcare providers, and researchers. Design – Systematic review and narrative synthesis. Setting – MEDLINE, CINAHL, ERIC, LISA, and CENTRAL databases; library-related websites, conference proceedings, and reference lists of included studies. Subjects – Twenty-five studies identified through a systematic literature search. Methods – In consultation with the review team, a librarian designed a search to be run in MEDLINE that was peer-reviewed against a published checklist. The team then conducted searches in the five identified databases, adapting the search as appropriate for each database. Authors also checked the websites of library and evidence based healthcare organisations, along with abstracts of relevant conference proceedings, to supplement the electronic search. Two authors screened the literature search results for eligible studies, and reached agreement by consensus. Studies of any librarian-delivered service in a healthcare setting, directed at either patients, clinicians of any type, researchers, or students, along with studies reporting outcomes relevant to clinicians, patients, or researchers, were eligible for inclusion. The authors assessed results initially on the titles and abstracts, and then on the full-text of potentially relevant reports. The data from included studies were then extracted into a piloted data extraction form, and each study was assessed for quality using the Cochrane EPOC risk of bias tool or the Newcastle-Ottawa scale. The results were synthesised narratively. Main Results – The searches retrieved a total of 25 studies that met the inclusion criteria, comprised of 22 primary papers and 3 companion reports. Authors identified 12 randomised trials, 4 controlled before-and-after studies, 3 cohorts, 2 non-randomised trials, and 1 case-control study. They identified three main categories of intervention: librarians teaching search skills; providing literature searching as a service; and a combination of the teaching and provision of search services. The interventions were delivered to a mix of trainees, clinicians, and students. None of the studies examined services delivered directly to patients or to researchers. The quality assessment found most of the studies had a mid- to high-risk of bias due to factors such as lack of random sequence generation, a lack of validated tools for data collection, or a lack of statistical analysis included in the study. Two studies measured patient relevant outcomes and reported that searches provided by librarians to clinicians had a positive impact on the patient’s length of stay in hospital. Five studies examined the effect of librarian provided services on outcomes important to clinicians, such as whether a literature search influenced a clinical decision. There was a trend towards a positive effect, although two studies found no significant difference. The majority of studies investigated the impact of training delivered to trainees and students on their literature search skills. Twelve of these studies found a positive effect of training on the recipients’ search skills, while three found no difference. The secondary outcomes considered by this review were satisfaction with the service (8 studies), relevance of the answers provided by librarians (2), and cost (3). The majority reported good satisfaction, and relevance. A cost benefit was found in 2 of 3 studies that reported this outcome. Conclusion – Authors report a positive effect of training on the literature search skills of trainees and students, and identified a benefit in the small number of studies that examined librarian services to clinicians. Future studies should use validated data collection tools, and further research should be conducted in the area of services provided to clinicians. Research is needed on the effect of librarian-provided services to patients and researchers as no studies meeting the inclusion criteria examining these two groups were identified by the literature search.


2017 ◽  
Vol 9 (10) ◽  
pp. 155
Author(s):  
Osinachi Akanwa Ekeagwu

Due to weight stigma, obese and overweight individuals are stereotyped, rejected and victimised by the public. The pervasion of this discrimination in healthcare settings is concerning given that the healthcare setting plays a crucial role in influencing health and shaping perception of health conditions. Without adequate support and little public attention, obese individuals are primarily left on their own to deal with ongoing prejudice unless addressed through vigorous research and strategic interventions at individual, interpersonal, organisational and community levels, and through policy implementation.


Author(s):  
Swarna Priya B. ◽  
Kalepu Srinath ◽  
Anagha Jammalamadaka ◽  
Anurita Hindodi

Telemedicine is the mixed structure of tele-communication technologies and quality health care making it feasible for general populace to obtain superlative healthcare. Starting from video chat for medical services in 2000 to e-Sanjeevani OPD 2020, Indian healthcare reform has come a long way in achieving sustainable healthcare in which, the setting up of the National Telemedicine Taskforce by the Health Ministry of India, in 2005, played a huge role for various projects like the ICMR-AROGYASREE, NeHA and VRCs. Despite the lack of awareness among common public on Tele-medicine, it has a lot of benefits on existing health care settings which makes it to thrive and progress within a decade. Health systems and polices have a critical role in determining the manner in which health services are delivered, utilized and affect health outcomes. This article in brief discusses on the changes and advancement of traditional healthcare system, realizing the pace of timeline in bringing Tele-medicine into practice. As, international telemedicine initiatives are attaining quality healthcare, this article also describes the challenges of telemedicine in Indian healthcare settings.


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