scholarly journals Barriers and Recommendations for Implementing the Baby-Friendly Hospital Initiative in Cairo University Hospitals: a Qualitative study

2020 ◽  
Vol 38 (2) ◽  
pp. 16-24
Keyword(s):  
Qualitative Study ◽  
Baby Friendly Hospital Initiative ◽  
University Hospitals

scholarly journals Environmental responsibility in hospital care: Findings from a qualitative study

2018 ◽  
Vol 7 (5) ◽  
pp. 56 ◽  
Author(s):  
Hanna Kallio ◽  
Anna-Maija Pietilä ◽  
Martin Johnson ◽  
Mari Kangasniemi
Keyword(s):  
Qualitative Study ◽  
Organizational Support ◽  
Hospital Care ◽  
Sustainable Use ◽  
Organizational Structures ◽  
Environmental Responsibility ◽  
University Hospitals ◽  
Structured Interviews ◽  
Hospital Organization ◽  
Environmental Support

Objective: To identify the key elements of environmental responsibility in hospital care and the stakeholders involved.Background: Hospital care causes a significant global environmental burden, which threatens human health and wellbeing. Environmental responsibility has been identified as an essential part of patient care with regard to health promotion and wellbeing of humans, but it has often been regarded as a secondary issue in hospitals. In addition, the lack of organizational structures and administrative as well as managerial support inhibit the promotion of environmental responsibility in hospitals.Methods: We used a qualitative study with semi-structured interviews and document analysis. Our data was drawn from the environmental managers of five Finnish university hospitals and documents on their environmental programs.Results: We found that the aim of environmental responsibility in hospital care was to avoid unnecessary emissions, and that it was guided by the authorities and by ethical values. It included targets for sustainable use of material, electricity, water and transport. Environmental responsibility required the involvement of several stakeholders, including administrators, environmental manager, immediate leaders, environmental support people, staff and patients. Implementation of environmental responsibility was promoted by collaboration, education, diverse initiatives to motivate staff, and continuously developing practices.Conclusions: Environmental responsibility extended throughout a hospital organization. Staff was in a key position to implement it, but they needed versatile organizational support, including education, clear procedures, defined roles, and a motivational culture and facilities.Implications for hospital management: This study yields new knowledge that will provide information for the development of organisational structures with respect to environmental responsibility in hospital care.

scholarly journals Interviews with experts in rare diseases for the development of clinical decision support system software - a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jannik Schaaf ◽  
Hans-Ulrich Prokosch ◽  
Martin Boeker ◽  
Johanna Schaefer ◽  
Jessica Vasseur ◽  
...  
Keyword(s):  
Decision Support ◽  
Qualitative Study ◽  
Medical Informatics ◽  
Clinical Decision Support ◽  
Rare Diseases ◽  
Qualitative Content Analysis ◽  
Medical Center ◽  
Clinical Decision ◽  
Diagnostic Process ◽  
University Hospitals

Abstract Background Patients with rare diseases (RDs) are often diagnosed too late or not at all. Clinical decision support systems (CDSSs) could support the diagnosis in RDs. The MIRACUM (Medical Informatics in Research and Medicine) consortium, which is one of four funded consortia in the German Medical Informatics Initiative, will develop a CDSS for RDs based on distributed clinical data from ten university hospitals. This qualitative study aims to investigate (1) the relevant organizational conditions for the operation of a CDSS for RDs when diagnose patients (e.g. the diagnosis workflow), (2) which data is necessary for decision support, and (3) the appropriate user group for such a CDSS. Methods Interviews were carried out with RDs experts. Participants were recruited from staff physicians at the Rare Disease Centers (RDCs) at the MIRACUM locations, which offer diagnosis and treatment of RDs. An interview guide was developed with a category-guided deductive approach. The interviews were recorded on an audio device and then transcribed into written form. We continued data collection until all interviews were completed. Afterwards, data analysis was performed using Mayring’s qualitative content analysis approach. Results A total of seven experts were included in the study. The results show that medical center guides and physicians from RDC B-centers (with a focus on different RDs) are involved in the diagnostic process. Furthermore, interdisciplinary case discussions between physicians are conducted. The experts explained that RDs exist which cannot be fully differentiated, but rather described only by their overall symptoms or findings: diagnosis is dependent on the disease or disease group. At the end of the diagnostic process, most centers prepare a summary of the patient case. Furthermore, the experts considered both physicians and experts from the B-centers to be potential users of a CDSS. The experts also have different experiences with CDSS for RDs. Conclusions This qualitative study is a first step towards establishing the requirements for the development of a CDSS for RDs. Further research is necessary to create solutions by also including the experts on RDs.

scholarly journals Evaluation of a Clinical Decision Support System for Rare Diseases - A Qualitative Study

2020 ◽  
Author(s):  
Jannik Schaaf ◽  
Martin Sedlmayr ◽  
Brita Sedlmayr ◽  
Hans-Ulrich Prokosch ◽  
Holger Storf
Keyword(s):  
Decision Support ◽  
Qualitative Study ◽  
Clinical Decision Support ◽  
Rare Diseases ◽  
Qualitative Content Analysis ◽  
Clinical Decision ◽  
Similarity Analysis ◽  
University Hospitals ◽  
Difficult Patient ◽  
System Usability Scale

Abstract BackgroundRare Diseases (RDs) are difficult to diagnose. Clinical Decision Support Systems (CDSS) could support the diagnosis for RDs. The MIRACUM (Medical Informatics in Research and Medicine) consortium developed a CDSS for RDs based on distributed clinical data from ten German university hospitals. To support the diagnosis for difficult patient cases, the CDSS uses data from the different hospitals to perform a patient similarity analysis in order to obtain an indication of a diagnosis. To optimize our CDSS, we conducted this qualitative study to investigate the usability of the CDSS with its functionality and information included. Methods A Thinking Aloud Test (TA-Test) was performed with RDs experts recruited from Rare Diseases Centres (RDCs) at the MIRACUM locations which were specialized in the diagnosis and treatment of RDs.An instruction sheet with tasks was prepared that the participants should perform with the CDSS during the study. Participants were asked to share any thoughts about the CDSS. The TA-Test was recorded on audio and video. A questionnaire was handed out at the end of the study including the System Usability Scale (SUS). Afterwards, the data was analysed with the qualitative content analysis according to Mayring, which includes a category-guided deductive approach.ResultsA total of eight experts were included in the study since eight MIRACUM locations have established an RDC.The results show that more detailed information about the patients, such as descriptive attributes or findings, are needed. The given functionality of the CDSS was rated positively, such as the function for the overview of similar patients and medical history. However, there is a lack of transparency regarding the results of the CDSS patient similarity analysis. The participants stated that the system should present exactly which symptoms, diagnosis etc. have matched. Regarding usability, the CDSS received a score of 73.21 points according to the SUS, which is ranked as a good usability.ConclusionsThis qualitative study investigated the usability of a CDSS of RDs. Despite the promising results, the CDSS still needs some revisions before use in clinical practice, e.g. by improving the transparency of the patient similarity analysis.

scholarly journals What do people with lung cancer and stroke expect from patient navigation? A qualitative study in Germany

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050601
Author(s):  
Hella Fügemann ◽  
Ute Goerling ◽  
Kathrin Gödde ◽  
Anke Kristin Desch ◽  
Jacqueline Müller-Nordhorn ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Qualitative Study ◽  
Emotional Support ◽  
Patient Navigation ◽  
Qualitative Interview ◽  
University Hospitals ◽  
Patient Navigators ◽  
Self Help ◽  
Qualitative Interview Study ◽  
Depth Interviews

ObjectiveThis qualitative study investigated patients’ needs and wishes in relation to patient navigation.DesignA qualitative interview study was conducted. Participants were invited to take part in three in-depth interviews over a period of 6–12 months. Thematic analysis was used.SettingInterviewees were sought in the Berlin metropolitan area of Germany in academic university hospitals, in rehabilitation clinics and through self-help organisations.ParticipantsThe sample consisted of individuals diagnosed with lung cancer (n=20) or stroke (n=20).ResultsFrom the perspective of interviewees, patient navigators should function as consistent contact persons, present during the whole care trajectory. Their role would be to guide patients through an often confusing healthcare landscape, offering practical, advisory and emotional assistance corresponding to patients’ needs. The study shows that—independent of the disease—participants had similar expectations and needs regarding support from navigators.ConclusionFor chronic and complex diseases—as is the case with lung cancer and stroke—it appears less important for navigators to fulfil disease-specific tasks. Rather, they should ensure that patients’ more general needs, in relation to social, practical and emotional support, are met in a way that suits their individual wishes. Following these results, patient navigation programmes might be designed to include generic elements, which should then be adapted to the infrastructure in a particular healthcare region and to the particularities of a specific healthcare system.

scholarly journals The bumpy road to implementing the Baby-Friendly Hospital Initiative in Austria: a qualitative study

2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Christina C Wieczorek ◽  
Hermann Schmied ◽  
Thomas E Dorner ◽  
Wolfgang Dür
Keyword(s):  
Qualitative Study ◽  
Baby Friendly Hospital Initiative

scholarly journals The Limbo Atmosphere in operating room settings Caused by Disruptive Behaviors: A Qualitative Study

2020 ◽  
Author(s):  
Sahar Mirzaei ◽  
Marzieh Pazokian ◽  
Foroozan Atashzadeh-Shoorideh ◽  
Seyed Amir Hosein Pishgooie
Keyword(s):  
Qualitative Study ◽  
Operating Room ◽  
Disruptive Behaviors ◽  
University Hospitals ◽  
Structured Interviews ◽  
Negative Effects ◽  
Team Working ◽  
Operating Room Nurses ◽  
Great Pressure ◽  
And Performance

Abstract Background Operating room nurses are one of the groups frequently expose to Disruptive Behaviors in different situations in the operating rooms that have different impacts on them and their performance. Recognition of DBs and their effects can help to offer strategies for better management of these behaviors. This study aimed to explore the experiences of Iranian operating room nurses regarding Disruptive Behaviors in operating room settings.Methods This is a descriptive qualitative study conducted in university hospitals in Tehran. The data were collected by deep semi-structured interviews with a total number of 17 operating room nurses selected purposefully. Finally, the data were analyzed with the conventional content analysis approach.Results Five categories were extracted from the study, including "activity in a poisonous atmosphere", "role subtraction", "escape to a safe margin", "adaptation to stay calm", and "Indirect confrontation". Finally, a theme was "struggle in a limbo Atmosphere caused by Disruptive Behaviors".Conclusion Under great pressure of surgeon’s Disruptive Behaviors, operating room nurses were struggling to maintain their balance and performance at possible. Considering the effect of Disruptive Behavior, it seems necessary to take training measures for improving team-working in operation room settings. Besides, monitoring and follow-up such behaviors according to negative effects is necessary.

scholarly journals Interviews with experts in Rare Diseases for the development of Clinical Decision Support System software - a qualitative study

2020 ◽  
Author(s):  
Jannik Schaaf ◽  
Hans-Ulrich Prokosch ◽  
Martin Boeker ◽  
Johanna Schaefer ◽  
Jessica Vasseur ◽  
...  
Keyword(s):  
Decision Support ◽  
Qualitative Study ◽  
Medical Informatics ◽  
Clinical Decision Support ◽  
Rare Diseases ◽  
Qualitative Content Analysis ◽  
Medical Center ◽  
Clinical Decision ◽  
Diagnostic Process ◽  
University Hospitals

Abstract Background Patients with rare diseases (RDs) are often diagnosed too late or not at all. Clinical decision support systems (CDSSs) could support the diagnosis in RDs. The MIRACUM (Medical Informatics in Research and Medicine) consortium, which is one of four funded consortia in the German Medical Informatics Initiative, will develop a CDSS for RDs based on distributed clinical data from ten university hospitals. This qualitative study aims to investigate (1) the relevant organizational conditions for the operation of a CDSS for RDs when diagnose patients (e.g. the diagnosis workflow), (2) which data is necessary for decision support, and (3) the appropriate user group for such a CDSS.Methods Interviews were carried out with RDs experts. Participants were recruited from staff physicians at the Rare Disease Centers (RDCs) at the MIRACUM locations, which offer diagnosis and treatment of RDs.An interview guide was developed with a category-guided deductive approach. The interviews were recorded on an audio device and then transcribed into written form. We continued data collection until all interviews were completed. Afterwards, data analysis was performed using Mayring’s qualitative content analysis approach.Results A total of seven experts were included in the study. The results show that medical center guides and physicians from RDC B-centers (with a focus on different RDs) are involved in the diagnostic process. Furthermore, interdisciplinary case discussions between physicians are conducted. The experts explained that RDs exist which cannot be fully differentiated, but rather described only by their overall symptoms or findings: diagnosis is dependent on the disease or disease group. At the end of the diagnostic process, most centers prepare a summary of the patient case. Furthermore, the experts considered both physicians and experts from the B-centers to be potential users of a CDSS. The experts also have different experiences with CDSS for RDs.Conclusions This qualitative study is a first step towards establishing the requirements for the development of a CDSS for RDs. Further research is necessary to create solutions by also including the experts on RDs.

scholarly journals Factors related to educational adaptations and social life at school experienced by young people with CFS/ME: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051094
Author(s):  
Wenche Ann Similä ◽  
Torunn Hatlen Nøst ◽  
Ingrid B Helland ◽  
Torstein Baade Rø
Keyword(s):  
Young People ◽  
Qualitative Study ◽  
Social Life ◽  
Online Teaching ◽  
School Personnel ◽  
Chronic Fatigue ◽  
Theory Approach ◽  
University Hospitals ◽  
Fatigue Syndrome ◽  
Lack Of Knowledge

ObjectivesTo explore factors perceived as positive or negative among young people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in relation to school and everyday life.DesignA qualitative study with semistructured individual interviews performed at the local hospital or at the informants’ homes between September 2017 and January 2018, with an additional telephone interview to collect data on experiences from the COVID-19 pandemic, conducted in September 2020. Data were analysed using a grounded theory approach.SettingThe informants were recruited from two university hospitals that offer interdisciplinary assessments of young people with CFS/ME from various parts of Norway.ParticipantsFive males and 13 females aged 13–21 years with CFS/ME diagnosed 3–56 months prior to the interviews participated.ResultsThe informants were concerned about a lack of educational adaptations and missed social life at school. Educational and social adaptations could improve schooling and health among young people with CFS/ME. Negative experiences were related to a lack of knowledge about CFS/ME among school personnel and young people’s difficulties to limit activities. Online teaching as experienced during the COVID-19 pandemic was described as positive both for education and social life.ConclusionsYoung people with CFS/ME can benefit from better educational adaptations and increased social interaction with peers. From the participants’ view, factors that limit learning and socialisation include a lack of knowledge about CFS/ME among teachers and school personnel, expectations from teachers of doing more than they could manage at school, feeling alone coping with the disease and not recognising their own limitations regarding what they are able to do. Suggested factors perceived to enhance learning and socialisation were a better understanding of the disease among school personnel and peers, suitable educational adaptations and being able to socialise with peers.

scholarly journals Strategies used by emergency care professionals to handle interpersonal difficulties with patients: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042362
Author(s):  
Philippe Charrier ◽  
Pauline Occelli ◽  
Karine Buchet-Poyau ◽  
Marion Douplat ◽  
Marine Delaroche-Gaudin ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Emergency Care ◽  
Interpersonal Violence ◽  
Toxic Substance ◽  
Nursing Assistants ◽  
University Hospitals ◽  
Staff Members ◽  
Interpersonal Difficulties ◽  
Registration Number ◽  
The Face

ObjectivesIdentify the strategies implemented by emergency care professionals when facing tension and interpersonal violence from patients and their friends and family.DesignDescriptive qualitative study based on 38 semidirective interviews.ParticipantsDoctors, nurses, nursing assistants and administrative staff.SettingFour emergency departments (EDs) from three French university hospitals.ResultsAccording to the medical professionals interviewed, the difficulties that they encounter with patients or their accompanying family members can be explained by a lack of understanding of the functioning of EDs, by a general increase in individualistic behaviours leading to a lack of civility or by deviant behaviours (related to toxic substance abuse or mental illness). While managing deviant behaviours may sometimes require a collective intervention, ED staff also implement what are essentially individual communication strategies (with the use of rational explanation, seduction and empathy), confrontation or flight to deal with interpersonal difficulties.ConclusionsStrategies used by staff members tend to be individualised for the most part, and some, such as confrontational or escape strategies, may not be adapted to all situations. In the face of difficulties between staff and patients, mediators, specialised in resolving conflict, could entrust some cases to professionals.Trial registration numberClinicalTrials.gov Registry (NCT03139110).

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