scholarly journals Ethical dilemmas concerning decision-making within health care leadership: a systematic literature review

Medicina ◽  
2010 ◽  
Vol 46 (9) ◽  
pp. 595 ◽  
Author(s):  
◽  
Tarja Suominen ◽  
Päivi Åstedt-Kurki ◽  
Daiva Lepaitė
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Care Management ◽  
Ethical Dilemmas ◽  
Qualitative Content Analysis ◽  
Health Care Management ◽  
Structured Interview ◽  
Health Care Leadership

The objective was to describe the research methods and research focuses on ethical dilemmas concerning decision-making within health care leadership. Material and methods. The search was conducted on Medline and PubMed databases (1998–2008). The systematic review included 21 selected articles. Results. The ethical dilemmas concerning decision-making within health care leadership are related to three levels: institutional (particular organization), political and local interface (local governmental structure), and national (professional expertise and system). The terms that are used as adequate to the term of “ethical dilemma” are the following: “continuous balancing,” “result of resource allocation,” “gap between professional obligations and possibilities,” “ethically controversial situation,” “concern about interactions,” “ethical difficulty,” “outcome of medical choices,” “concern about society access to health care resources,” “ethically difficult/ challenging situation,” “(the consequence of) ethical concern/ethical issue.” In qualitative studies, a semi-structured interview and qualitative content analysis are the most commonly applied methods; in quantitative studies, questionnaire surveys are employed. In the research literature, there is a lack of specification according to professional qualification of health care professionals concerning ethical dilemmas by decision-making within health care management/administration. Conclusions. The research on ethical dilemmas in health care leadership, management, and administration should integrate data about levels at which ethical dilemmas occur and investigate ethical dilemmas as complex phenomena because those are attached to decision-making and specific nuances of health care management/administration. In this article, the presented scientific problem requires extensive scientific discussions and research on ethical dilemmas concerning decision-making within health care leadership at various levels.

scholarly journals Health and Clinical Management – Maximising Health Care Efficiency for Better Outcomes

2010 ◽  
Vol 19 (01) ◽  
pp. 09-12
Author(s):  
D. Kubias ◽  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Clinical Management ◽  
Care Management ◽  
Health Care Management ◽  
Population Surveillance ◽  
Clinical Syndrome ◽  
Information Support ◽  
Health Care Efficiency ◽  
Alerting Systems

Summary Objectives: To present some of last year’s best papers in the field of health and clinical management. Method: Synopsis of the best articles selected for the IMIA Yearbook 2010. Results: All five selected articles present promising results, each in a different subtopic of health care management. From automated clinical syndrome detection to global population surveillance, through improving alerting systems’ impact, the selected articles should give an idea of how IT, not only can, but how it does help in health care management. Conclusions: While some people fear that computers might, one day, replace humans in health care, this is very far from being the case. What literature shows is that IT merely provides health care professionals with valuable tools that let them spend more time with their patients, prevent them from missing critical information, support them in their decision making and thus help improve their efficiency.

scholarly journals Weighing up the costs of seeking health care for dengue symptoms: a grounded theory study of backpackers’ decision-making processes

2015 ◽  
Vol 21 (2) ◽  
pp. 245 ◽  
Author(s):  
Bálint Vajta ◽  
Mette Holberg ◽  
Jane Mills ◽  
William J. H. McBride
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Grounded Theory ◽  
Dengue Fever ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Australian Health ◽  
Core Category

Dengue fever, a mosquito-borne virus, is an ongoing public health issue in North Queensland. Importation of dengue fever by travellers visiting or returning to Australia can lead to epidemics. The mosquito can acquire the virus in the symptomatic viraemic phase, so timely recognition of cases is important to prevent epidemics. There is a gap in the literature about backpackers’ knowledge of dengue fever and the decision-making process they use when considering utilising the Australian health-care system. This study uses grounded theory methods to construct a theory that explains the process backpackers use when seeking health care. Fifty semi-structured interviews with backpackers, hostel receptionists, travel agents and pharmacists were analysed, resulting in identification of a core category: ‘weighing up the costs of seeking health care’. This core category has three subcategories: ‘self-assessment of health status’, ‘wait-and-see’ and ‘seek direction’. Findings from this study identified key areas where health promotion material and increased access to health-care professionals could reduce the risk of backpackers spreading dengue fever.

Head nurses’ decision-making when managing ethical dilemmas

2015 ◽  
Vol 10 (2) ◽  
pp. 166-187 ◽  
Author(s):  
Vilma Zydziunaite ◽  
Daiva Lepaite ◽  
Päivi Åstedt-Kurki ◽  
Tarja Suominen
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Resistance To Change ◽  
Ethical Dilemmas ◽  
Qualitative Content Analysis ◽  
Nursing Management ◽  
Structured Interviews ◽  
Content Type ◽  
Written Form ◽  
Societal Expectations

Purpose – The purpose of this paper is to characterize issues related to head nurses’ decision making when managing ethical dilemmas. Design/methodology/approach – The study is qualitative descriptive, in which researchers stay close to the data. The data were collected in the format of unstructured written reflections. Inductive conventional latent qualitative content analysis was applied to the data. Findings – The issues of head nurses’ management of decision making in ethical dilemmas relate to the following aspects: taking risks in deviating from the formalities, balancing power and humaneness, maintaining the professional hierarchy, managing resistance to change, managing with limited options, and experiencing the decline of nurse’s professional and/or human dignity. Research limitations/implications – Reflections in written form were preferred to semi-structured interviews and the researchers were unable to contact the participants directly and to ask additional questions. All the reflections were produced in a language other than English. Practical implications – The issues of head nurses’ management of decision making in ethical dilemmas reveal the gap between societal expectations and the opportunities to improve nursing leadership in health care organizations. Social implications – The issues of head nurses’ decision making when managing ethical dilemmas are related to contexts that reflect the attitudes of society and health care system toward nursing management. Originality/value – The study adds to the understanding of issues of the management of decision making in ethical dilemmas. It is an ongoing systematic process that encourages head nurses to learn from practice and manage the quality of care by empowering themselves and nurses to take responsibility for leadership.

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