What Do We Know About Teamwork in Chinese Hospitals? A Systematic Review

Background and Objective: Improving quality of care is one of the primary goals in current Chinese hospital reforms. Teamwork can play an essential role. Characteristics of teamwork and interventions for improving teamwork in hospitals have been widely studied. However, most of these studies are from a Western context; evidence from China is scarce. Because of the contextual differences between China and Western countries, empirical evidence on teamwork from Western hospitals may have limited validity in China. This systematic review aims to advance the evidence base and understanding of teamwork in Chinese hospitals.Methods: Both English (i.e., Embase, Medline, and Web of Science) and Chinese databases (i.e., CNKI, CQVIP, and Wanfang) were searched for relevant articles until February 6, 2020. We included the studies that empirically researched teamwork in Chinese hospitals. Studies were excluded if they (1) were not conducted in hospitals in Mainland China, (2) did not research teamwork on team interventions, (3) were not empirical, (4) were not written in English or Chinese, (5) were not published in peer-reviewed journals, and (6) were not conducted in teams that provide direct patient care. Both deductive and inductive approaches were used to analyze data. The Mixed Methods Appraisal Tool (MMAT) was used to assess their methodological quality.Results: A total of 70 articles (i.e., 39 English articles and 31 Chinese articles) were included. The results are presented in two main categories: Teamwork components and Team interventions. The evidence regarding the relationships among inputs, processes, and outcomes is scarce and mostly inconclusive. The only conclusive evidence shows that females perceive better team processes than males. Similar types of training and tools were introduced as can be found in Western literature, all showing positive effects. In line with the Chinese health reforms, many of the intervention studies regard the introduction of multidisciplinary teams (MDTs). The evidence on the implementation of MDTs reveals that they have led to lower complication rates, shorter hospital stays, higher diagnosis accuracy, efficiency improvement, and a variety of better disease-specific clinical outcomes. Evidence on the effect on patient survival is inconclusive.Conclusion: The Chinese studies on teamwork components mainly focus on the input-process relationship. The evidence provided on this relationship is, however, mostly inconclusive. The intervention studies in Chinese hospitals predominantly focus on patient outcomes rather than organizational and employee outcomes. The introduction of training, tools, and MDTs generally shows promising results. The evidence from primary hospitals and rural areas, which are prioritized in the health reforms, is especially scarce. Advancing the evidence base on teamwork, especially in primary hospitals and rural areas, is needed and can inform policy and management to promote the health reform implementation.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020175069, identifier CRD42020175069.

The Human Cost of 'Caring' Care for Registered Nurses in Clinical Practice

<p>This research utilised a focus group methodology to discover what nurses in clinical practice considered 'caring' care meant for them. Six registered nurses volunteered to participate in the project. They practised over a variety of clinical settings within a public hospital, which provided both acute and elective surgical and medical services to the community, including an extensive elderly population. Taking these important 'caring' care statements, I then explored with the group what factors in their work environment hindered or enhanced their identified 'caring' care. New Zealand nurses identified similar themes and concepts important to their 'caring' in clinical practice as did their overseas counterparts. This study also highlighted the impact the health reforms had on individual clinical practice at this hospital. The effects of the institutional changes in response to the health reforms were far reaching at both a personal and professional level. Caring is an important concept found in nursing practice. It has been widely documented by nurse scholars, researchers and nurse authors that care is at the core of nursing practice. Some have even referred to care as being the heart of nursing. The findings from the present research indicates the importance nurses place on caring in their day to day encounters with patients. It also demonstrates how nurses express their care and their perceptions of the importance care has in their clinical practice.</p>

The Human Cost of 'Caring' Care for Registered Nurses in Clinical Practice

<p>This research utilised a focus group methodology to discover what nurses in clinical practice considered 'caring' care meant for them. Six registered nurses volunteered to participate in the project. They practised over a variety of clinical settings within a public hospital, which provided both acute and elective surgical and medical services to the community, including an extensive elderly population. Taking these important 'caring' care statements, I then explored with the group what factors in their work environment hindered or enhanced their identified 'caring' care. New Zealand nurses identified similar themes and concepts important to their 'caring' in clinical practice as did their overseas counterparts. This study also highlighted the impact the health reforms had on individual clinical practice at this hospital. The effects of the institutional changes in response to the health reforms were far reaching at both a personal and professional level. Caring is an important concept found in nursing practice. It has been widely documented by nurse scholars, researchers and nurse authors that care is at the core of nursing practice. Some have even referred to care as being the heart of nursing. The findings from the present research indicates the importance nurses place on caring in their day to day encounters with patients. It also demonstrates how nurses express their care and their perceptions of the importance care has in their clinical practice.</p>

Intersections between education and health reforms in Brazil: when the "target population" is an active builder of the public policy

This article presents fragments of history about the intersections between Health and Education in Brazil and its connections to discussions concerning democracy ideals. The background argument is how an ethical posture in public policy consistent with the one proposed by Paulo Freire allows for population participation in a way that strengthens the commitment to democracy in public policy. Such ethical posture 1) considers social determinants of the phenomena that happens to an individual, and 2) requires constant effort to not fall for the tempting silencing of one's existence and full citizenship.

National Health Reforms in Georgia during 1994-2021 and their Success

The Health Reform of the country is a very difficult burden for two reasons: firstly, we need an appropriate economy level in the country, that can bear the new health model, established through reform, and secondly, the country needs a health system that is appropriate either for its economic system or for its tradition and history. Health reformers need to match all the points of the health reform concept, its implementation, and the systems of the country. Due to its Soviet past, Georgia struggled in the last twenty years to find an effective and cost efficient health model for its citizens. Starting from the 90s, Georgia instituted three health reforms and finally found some sustainable measures. The present article explores the three waves of the Georgian Health Care reforms, and analyses the factors of their success and the reasons for their failures. The importance of studying the Health Care systems is derived from Sustainable Development Goals targeting Health issues including health-related topics to improve the population’s health and wellbeing as well as achieve universal coverage of health services. The research contributes to the knowledge regarding the Health Care Reforms, and their practical implications on a country.

Health Politics in Europe

Health Politics in Europe: A Handbook is a work of reference that provides historical background and up-to-date information and analysis on health politics and health systems throughout Europe. In particular, it captures developments that have taken place since the end of the Cold War, a turning point for many European health systems, with most post-communist transition countries privatizing their state-run health systems, and many Western European health systems experimenting with new public management and other market-oriented health reforms. Following three introductory, stage-setting chapters, the handbook offers country cases divided into seven regional sections, each of which begins with a short regional outlook chapter that highlights the region’s common characteristics and divergent paths taken by the separate countries, including comparative data on health system financing, healthcare access, and the political salience of health. Each regional section contains at least one detailed main case, followed by shorter treatments of the other countries in the region. Country chapters comprise an historical overview focusing on the country’s progression through a series of political regimes and the consequences of this history for the health system; an overview of the institutions and functioning of the contemporary health system; and a political narrative tracing the politics of health policy since 1989. This political narrative, the core of each country case, examines key health reforms in order to understand the political motivations and dynamics behind them and their impact on public opinion and political legitimacy. The handbook’s systematic structure makes it useful for country-specific, cross-national, and topical research and analysis.