scholarly journals Conditions for successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses

2019 ◽  
Author(s):  
Per Nilsen ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Sarah A. Birken ◽  
Kristina Schildmeijer
Keyword(s):  
Health Care ◽  
Organizational Change ◽  
Registered Nurses ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Organizational Changes ◽  
Structured Interviews ◽  
Disease Patterns ◽  
Swedish Health Care ◽  
Assistant Nurses

Abstract Background: Health care organizations are constantly changing as a result of technological advancements, ageing populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and policy initiatives. Changes can be challenging because they contradict humans’ basic need for a stable environment. The present study poses the question: what characterizes successful organizational changes in health care? The aim was to investigate the characteristics of changes of relevance for the work of health care professionals that they deemed successful. Methods: The study was based on semi-structured interviews with 30 health care professionals: 11 physicians, 12 registered nurses and seven assistant nurses employed in the Swedish health care system. An inductive approach was applied using questions based on the existing literature on organizational change and change responses. The questions concerned the interviewees’ experiences and perceptions of any changes that they considered to have affected their work, regardless of whether these changes were “objectively” large or small changes. The interviewees’ responses were analysed using directed content analysis. Results: The analysis yielded three categories concerning conditions for successful changes: having the opportunity to influence the change; being prepared for the change; valuing the change. The interviewees emphasized the importance of having the opportunity to influence the organizational changes that are implemented. Changes that were initiated by the professionals themselves were considered the easiest and were rarely resisted. Changes that were clearly communicated to allow for preparation increased the chances for success. The interviewees did not support organizational changes that were perceived to be implemented unexpectedly and/or without prior communication. They conveyed that it was important for them to understand the need for and benefits of organizational changes. They particularly valued and perceived as successful organizational changes with a patient focus, with clear benefits to patients.Conclusions: Organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients. Keywords: Organizational change, Implementation, Influence, Preparedness, Patient benefit

scholarly journals Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses

2020 ◽  
Author(s):  
Per Nilsen ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Sarah A. Birken ◽  
Kristina Schildmeijer
Keyword(s):  
Health Care ◽  
Registered Nurses ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Organizational Changes ◽  
Structured Interviews ◽  
Disease Patterns ◽  
Swedish Health Care ◽  
Assistant Nurses ◽  
Ageing Populations

Abstract Background: Health care organizations are constantly changing as a result of technological advancements, ageing populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and policy initiatives. Changes can be challenging because they contradict humans’ basic need for a stable environment. The present study poses the question: what characterizes successful organizational changes in health care? The aim was to investigate the characteristics of changes of relevance for the work of health care professionals that they deemed successful.Methods: The study was based on semi-structured interviews with 30 health care professionals: 11 physicians, 12 registered nurses and seven assistant nurses employed in the Swedish health care system. An inductive approach was applied using questions based on the existing literature on organizational change and change responses. The questions concerned the interviewees’ experiences and perceptions of any changes that they considered to have affected their work, regardless of whether these changes were “objectively” large or small changes. The interviewees’ responses were analysed using directed content analysis.Results: The analysis yielded three categories concerning characteristics of successful changes: having the opportunity to influence the change; being prepared for the change; valuing the change. The interviewees emphasized the importance of having the opportunity to influence the organizational changes that are implemented. Changes that were initiated by the professionals themselves were considered the easiest and were rarely resisted. Changes that were clearly communicated to allow for preparation increased the chances for success. The interviewees did not support organizational changes that were perceived to be implemented unexpectedly and/or without prior communication. They conveyed that it was important for them to understand the need for and benefits of organizational changes. They particularly valued and perceived as successful organizational changes with a patient focus, with clear benefits to patients.Conclusions: Organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients.

scholarly journals Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Per Nilsen ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Sarah A. Birken ◽  
Kristina Schildmeijer
Keyword(s):  
Health Care ◽  
Registered Nurses ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Organizational Changes ◽  
Structured Interviews ◽  
Disease Patterns ◽  
Swedish Health Care ◽  
Assistant Nurses ◽  
Ageing Populations

Abstract Background Health care organizations are constantly changing as a result of technological advancements, ageing populations, changing disease patterns, new discoveries for the treatment of diseases and political reforms and policy initiatives. Changes can be challenging because they contradict humans’ basic need for a stable environment. The present study poses the question: what characterizes successful organizational changes in health care? The aim was to investigate the characteristics of changes of relevance for the work of health care professionals that they deemed successful. Methods The study was based on semi-structured interviews with 30 health care professionals: 11 physicians, 12 registered nurses and seven assistant nurses employed in the Swedish health care system. An inductive approach was applied using questions based on the existing literature on organizational change and change responses. The questions concerned the interviewees’ experiences and perceptions of any changes that they considered to have affected their work, regardless of whether these changes were “objectively” large or small changes. The interviewees’ responses were analysed using directed content analysis. Results The analysis yielded three categories concerning characteristics of successful changes: having the opportunity to influence the change; being prepared for the change; valuing the change. The interviewees emphasized the importance of having the opportunity to influence the organizational changes that are implemented. Changes that were initiated by the professionals themselves were considered the easiest and were rarely resisted. Changes that were clearly communicated to allow for preparation increased the chances for success. The interviewees did not support organizational changes that were perceived to be implemented unexpectedly and/or without prior communication. They conveyed that it was important for them to understand the need for and benefits of organizational changes. They particularly valued and perceived as successful organizational changes with a patient focus, with clear benefits to patients. Conclusions Organizational changes in health care are more likely to succeed when health care professionals have the opportunity to influence the change, feel prepared for the change and recognize the value of the change, including perceiving the benefit of the change for patients.

scholarly journals Women, Exercise, and Eating Disorder Recovery: The Normal and the Pathological

2021 ◽  
pp. 104973232199204
Author(s):  
Hester Hockin-Boyers ◽  
Megan Warin
Keyword(s):  
Health Care ◽  
Eating Disorder ◽  
Affect Regulation ◽  
Health Care Professionals ◽  
Value Systems ◽  
Structured Interviews ◽  
Data Set ◽  
The United Kingdom ◽  
Theoretical Frame ◽  
Intensity Of Exercise

The appropriate form, regularity, and intensity of exercise for individuals recovering from eating disorders is not agreed upon among health care professionals or researchers. When exercise is permitted, it is that which is mindful, embodied, and non-competitive that is considered normative. Using Canguilhem’s concepts of “the normal and the pathological” as a theoretical frame, we examine the gendered assumptions that shape medical understandings of “healthy” and “dysfunctional” exercise in the context of recovery. The data set for this article comes from longitudinal semi-structured interviews with 19 women in the United Kingdom who engaged in weightlifting during their eating disorder recovery. We argue that women in recovery navigate multiple and conflicting value systems regarding exercise. Faced with aspects of exercise that are pathologized within the eating disorder literature (such as structure/routine, body transformations, and affect regulation), women re-inscribe positive value to these experiences, thus establishing exercise practices that serve them.

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.

scholarly journals Bedside Nurse Acceptance of Intensive Care Unit Telemedicine Presence

2018 ◽  
Vol 38 (6) ◽  
pp. e1-e4 ◽  
Author(s):  
Christina Canfield ◽  
Sandra Galvin
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Nurse Practitioners ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Perception Of Support ◽  
Evidence Based Care

Since 2010, health care organizations have rapidly adopted telemedicine as part of their health care delivery system to inpatients and outpatients. The application of telemedicine in the intensive care unit is often referred to as tele-ICU. In telemedicine, nurses, nurse practitioners, physicians, and other health care professionals provide patient monitoring and intervention from a remote location. Tele-ICU presence has demonstrated positive outcomes such as increased adherence to evidence-based care and improved perception of support at the bedside. Despite the successes, acceptance of tele-ICU varies. Known barriers to acceptance include perceptions of intrusiveness and invasion of privacy.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals ‘By the way….how’s your sex life?’ – A descriptive study reporting primary health care registered nurses engagement with youth about sexual health

2017 ◽  
Vol 9 (1) ◽  
pp. 22 ◽  
Author(s):  
Rhiannon Martel ◽  
Ruth Crawford ◽  
Helen Riden
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Sexual Health ◽  
Registered Nurses ◽  
Online Survey ◽  
Ethical Issues ◽  
Descriptive Study ◽  
Health Providers ◽  
Cultural Issues ◽  
Structured Interviews

ABSTRACT INTRODUCTION Youth rates of sexually transmitted infections in New Zealand are among the highest in the Organisation for Economic Cooperation and Development. Registered nurses employed in primary healthcare settings (PHC RNs) may lack confidence engaging with youth about their sexual health. AIM To identify what facilitates PHC RNs to discuss sexual health with youth. METHODS This descriptive study was undertaken in two phases. In phase one, 23 PHC RNs completed an online survey. Phase two followed up the survey with semi-structured interviews with seven PHC RNs. RESULTS Most PHC RNs are female, aged between 40 and 60 years old and identify with New Zealand or other European ethnicity. Participants identified specific educational needs relating to youth sexual health that are not being met: legal and ethical issues (65%); cultural issues (65%); youth sexual (44%) and psychological (52%) development; and working with gay, lesbian, bisexual or transsexual youth (48%). Lack of time was cited as a barrier to engaging with youth about sexual health by 30% of the participants. Ongoing support practices such as regular debriefing, reflections of practice and case reviews with colleagues (74%); support from other sexual health providers (87%); and access to educational materials about youth sexual health aimed at health professionals (100%) were perceived to be useful to increase confidence in discussing sexual health with youth. DISCUSSION The PHC RNs lacked knowledge and confidence engaging with youth about sexual health. PHC RNs need resourcing to provide culturally safe, effective sexual health care to youth.

Klinkende meerstemmige verhalen, deel II

KWALON ◽  
2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Monique Bussmann ◽  
Chris Kuiper ◽  
Alexander Maas
Keyword(s):  
Health Care ◽  
Labor Market ◽  
Data Collection ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Elderly Care ◽  
Music Listening ◽  
Musical Work ◽  
Narrative Methodology ◽  
The Government

Sounding polyphonic stories, part II. The phase of listening in data collection Sounding polyphonic stories, part II. The phase of listening in data collection In the Netherlands, future staffing of elderly care will demand a big effort and a lot of creativity of health care organizations and the government. In this study an unconventional qualitative, narrative methodology is applied to throw a new light on the significance having a job and working in elderly care has for health care professionals and to use this as a source of inspiration for labor market policymakers. The methodology is rather unconventional because it doesn’t only focuses on the lingual content of the stories, but also includes other significant aspects of storytelling (e.g., voice and sound). Therefore musical work forms (e.g., music listening and singing) are used additionally.In the first phase of data collection stories of care professionals about the intertwining of their lifeline and career have been collected. In the second, listening phase HR-professionals listened to the stories told by the care professionals and used them as a source of inspiration for HR policy innovation.In a former article the methodology of the storytelling phase has been described. This article treats the methodology of the listening phase in the data collection. Later on the analysis methods will be described.

scholarly journals Where else would I look for it? A five-country qualitative study on purposes, strategies, and consequences of online health information seeking

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Nicola Diviani ◽  
Eva Haukeland Fredriksen ◽  
Corine S. Meppelink ◽  
Judy Mullan ◽  
Warren Rich ◽  
...  
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Information ◽  
Health Care Professionals ◽  
Information Seeking ◽  
The Body ◽  
Online Health Information ◽  
Structured Interviews ◽  
Ehealth Literacy ◽  
Digital Divides

Background. Online health information (OHI) is widely available and consulted by many people in Western countries to gain health advice. The main goal of the present study is to provide a detailed account of the experiences among people from various demographic backgrounds living in high-income countries, who have used OHI. Design and methods. Thematic analysis of 165 qualitative semi-structured interviews conducted among OHI users residing in Australia, Israel, the Netherlands, Norway, and Switzerland was performed. Results. The lived experience of people using OHI seem not to differ across countries. The interviews show that searches for OHI are motivated from curiosity, sharing of experiences, or affirmation for actions already taken. Most people find it difficult to appraise the information, leading them to cross-check sources or discuss OHI with others. OHI seems to impact mostly some specific types of health behaviors, such as changes in diet or physical activity, while it only plays a complementary role for more serious health concerns. Participants often check OHI before seeing their GP, but are reluctant to discuss online content with health care personnel due to expected negative reception. Conclusions. This study adds to the body of knowledge on eHealth literacy by demonstrating how OHI affects overall health behavior, strengthens patients’ ability to understand, live with, and prepare themselves for diverse health challenges. The increasing digitalization of health communication and health care calls for further research on digital divides and patient-professional relations. Health care professionals should acknowledge OHI seeking and engage in discussions with patients to enable them to appreciate OHI, and to support shared decision making in health care. The professionals can utilize patient’s desire to learn as a resource for health prevention, promotion or treatment, and empowerment.

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