Organisational Model
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2021 ◽  
pp. 095001702110215
Lander Vermeerbergen ◽  
Valeria Pulignano ◽  
Markieta Domecka ◽  
Marieke Jansens

In 2020, Covid-19 was spreading quickly in nursing homes, leading to numerous challenges for care workers. We tell the story of Marieke, a devoted female care assistant working in a Belgian nursing home that is customer-centred in their organisational model. Her narrative provides poignant insights into the ‘work and life’ struggles and conflicts of a female care assistant facing the challenges of this model during the Covid-19 pandemic, which has left the largely female care workforce widely exposed to the risk of work intensification and over-involvement with residents, especially in a context of liberalisation and privatisation of care. In the early stages of the Covid-19 pandemic, this model led to Marieke facing the unprecedented fear of endangering her own life and the lives of those she loves. In this article, she reflects on her work and family life under the strain of ensuring physical distancing in a nursing home.

2021 ◽  
pp. 00152-2021
R. Trisolini ◽  
D. Magnini ◽  
V. Livi ◽  
F. Leoncini ◽  
L. M. Porro ◽  

2021 ◽  
Vol 15 (2) ◽  
pp. 191-198
Andreja Rudančić ◽  
Petar Mišević ◽  
Dušan Tomašević

Today, knowledge management is used as part of a business strategy by which an organisation adapts to rapid changes in society and the business world, by which it not only becomes more competitive but also achieves goals and remains successful. Organisations have become aware of the importance of the lifelong learning concept. It should be noted that knowledge management is in close synergy with human resource management in the organisation. To achieve the scientific value of the paper, the authors have conducted empirical research by using a survey questionnaire in which the elements of a learning organisation were investigated, along with the implementation of knowledge on the selected organisational model. The synthesis of the results and conclusions of this research will be used to formulate specific critical recommendations and valuable guidelines indicating possible areas of improving the level of learning organisation and motivation to learn, which indicates potential ways and approaches to knowledge management.

2021 ◽  
Vol 36 (Supplement_1) ◽  
Lucrezia Carlassara ◽  
Giordano Pastori ◽  
Umberto Savi ◽  
Marco Pasqualetto ◽  
Morena Giozzet ◽  

Abstract Background and Aims Belluno is a mountainous province of 3610 Km2, with a low population density (56 people/Km2), and an high ISTAT old age index of 228. Four HemoDialysis (HD) Centers assist 112 patients, who spend up to 8 hours/week by ambulance to arrive at the HD Center, with a CO2 estimated emission (EE) up to 6.6 ton/year patient. The cost of in-Center HD may reach up to 61.000 €/year patient. Giving these premisis, we consider as first choice either Peritoneal Dialysis or Home HD (HDD), otherwise than in-Center HD. HHD can be Not assited HHD (NHHD), performed by the patient himself, or Assisted HHD (AHHD), the new HHD service which involves a nurse assistance at home. Both HHDs enables patients to stay at home, may improve patient’s quality of life, reduce the HD costs (32.000-34000 €/year patient), and may reduce the environmental burden of the healthcare procedures (CO2 EE of 0-2.3 ton/year patient). Method One patient have undertaken NHHD and other two the AHHD. Patient 1, on NHHD, is a 50 year old (y.o.) male, on HD since 9/2013. His Past Medical History (PMH) encompasses End Stage Renal Disease (ESRD) due to IgA Nephropathy, a previous kidney transplant, and hypertensive cardiopathy. Patient 2, on AHHD, is a 88y.o. woman, on HD since 01/2020. Her PMH includes ESRD due to multiple myeloma, and hypertension. Patient 3, on AHHD, is a 95y.o. male on HD since 09/2009. His PMH includes ESRD due to hypertensive nephropathy, atrioventricular block with pacemaker, hepatopathy. HHD is performed utilising: the NxStage System (Fresenius®) for NHHD, and the Dialog iQ® System (B.BRAUN®) for AHHD. The HD prescription plans 2 hours treatment for 6 times/week for NHHD, and 4 hours treatment for 3 times/week for AHHD. The total amount of the economical resoureces employed for HD comprise: HD equipment, healthcare-worker, and ambulance transportation (Figure). The EE of CO2 have been determined using a calculator ( The EE of CO2 for in-Centre HD comprise both those caused by patients and nurses (Figure). We assumed the same fuel consumption of a diesel Van for the ambulances one. We assumed that nurses use a diesel compact car to commute. Results All patients reported a significantly improved quality of life because they were able to avoid many hours of travel to reach the HD Center. Moreover, the patient on NHHD, appreciated an increased subjective wellness, a greater independence in setting the daily work and personal appointments, and a wider freedom in the eating and drinking habits. The economical resources that may be riallocated by the Healthcare System are up to 30.000 €/year patient. Finally, the environmental burden of the HD procedures may be significantly reduced, with a CO2 EE saved up to 6.6 ton/year patient (equal to 3 round-trip flights Venice-NY). Conclusion Home HD enable patients and their families to substantially improve their quality of life, provide a safe and effective dialysis treatment for the patients, contribute to operational efficiency of the healthcare system, and reduce both the economical impact and the environmental burden of hemodialysis. In conclusion, we believe both HHDs are exellent solution, in particular NHHD for active young patients, and AHHD for fragile patients without a caregiver, resulting in a better management and outcome.

2021 ◽  
Vol 44 (1) ◽  
pp. 103-126
Marzena Świstak

Free-of-charge legal assistance remains one of the key areas of state activity. However, the system created is not optimal and its formal, organisational and financial framework needs to be modified. This concerns not only an increase in the amounts of funding, but also the quality of services provided. Not only is the choice of the legal and organisational model of providing legal assistance doubtful, but also the subjective and objective scope of the statutory regulations (including in the context of interpretation of tax regulations) raise some objections. As a postulate for the law as it should stand de lege ferenda), it is proposed to make appropriate legislative changes, aimed not only at clarifying the content of the provisions, or removing the legislative inconsistencies found, but also at thoroughly considering a remodelling of the legal assistance system in Poland. The above conclusions were formulated against the backdrop of the organisational and financial legal solutions adopted in other countries.  To this end, the author used the formal-dogmatic and comparative legal methods, and also resorted to the historical method as an auxiliary method, in order to show the evolution of the institution under analysis.

2021 ◽  
Katarzyna Pejda ◽  
Cezary Ciemniewski

The reconstruction of the organisational model of Chinese society, with particular reference to the models of forming social relations. The books explores the most important notions of Confucian ethics, the rules of social exchange as well as other terms which influence behavioural norms, perception of the world and basic communication strategies. A Chinese face lian 臉 (moral face) and mian 面 (social face) is described on this cultural matrix. It is a central notion from the perspective of internalised social control, the most important symbolic protected value, built by people in the space of social roles and bonds.

2020 ◽  
Vol 29 (12) ◽  
pp. 764-775
Héctor González-de la Torre ◽  
José Verdú-Soriano ◽  
María L Quintana-Lorenzo ◽  
Miriam Berenguer-Pérez ◽  
Raquel Sarabia Lavín ◽  

Objective: To determine the number of specialised wound care units/clinics (SWCUs) in Spain, at present, and to describe their most important characteristics. Method: This was an observational study with a descriptive-analytical, cross-sectional, multicentre approach, where the studied population consisted of SWCUs in Spain. A specific data-collection questionnaire was designed using a modified Delphi method, consisting of four rounds, with the collaboration of 10 wound experts. The final questionnaire included 49 items distributed across four dimensions/areas with a content validity index (CVI-Total for pertinence=0.96 and CVI-Total for relevance=0.94. Results: A total of 42 SWCUs were included in the study. Most SWCUs were based in hospitals (n=15, 35.7%) or healthcare centres, covering a specific healthcare area (n=17, 40.5%). SWCU coordinators were primarily nurses (n=33, 78.6%). Staff members' professions in SWCUs included registered nurses (n=38 units, 92.7%), nursing assistants (n=8 units, 19.5%), podiatrists (n=8 units, 19.5%), vascular surgeons (n=7 units, 17%), osteopaths (n=2 units, 4.8%) and medical doctors from different specialties (n=3 units, 7.2%). For wound aetiology, the most prevalent wounds managed were diabetic foot ulcers (n=38 units, 90.5%), followed by venous leg ulcers (n=36 units, 85.7%) and arterial ischaemic ulcers (n=36 units, 85.7%). A statistically significant association was found between the number of staff members in a SWCU and the existence of resistance/opposition barriers when developing a SWCU (Chi-square test, p=0.049; Cramér's V=0.34; 34%), as well as between resistance/opposition barriers when developing a SWCU and a nurse as coordinator of a SWCU (MacNemar test, p=0.007, Cramér's V=0.35; 35%). Conclusion: The typical SWCU implemented in Spain is located in a hospital or integrated in a healthcare structure that offers coverage to a whole health area and providing services for people with hard-to-heal wounds (wound management and prevention) and health professionals (advice, consultancy and training/education). Despite the growing number of SWCUs in Spain, the future of this new organisational model is uncertain, as there can be barriers to creating them and some deficiencies, such as low staff numbers, which need to be addressed.

2020 ◽  
Vol 15 (1) ◽  
Talarico Rosaria ◽  
Cannizzo Sara ◽  
Lorenzoni Valentina ◽  
Marinello Diana ◽  
Palla Ilaria ◽  

Abstract Background In 2017, the European Commission has launched the European Reference Networks (ERNs), virtual networks involving healthcare providers across Europe. The aim of the ERNs is to tackle complex and rare diseases and conditions that require highly specialized treatment and a concentration of knowledge and resources. The ERN on rare and complex connective tissue and musculoskeletal diseases (ERN ReCONNET) is one of the 24 ERNs approved that aims to improve the management of Rare and Complex Connective Tissue and Musculoskeletal Diseases. Objective The RarERN Path methodology aims to create a single reference organisational model for patients’ care pathways which, if applied in different contexts, helps to ensure an improved, cost-effective and patient-centred equal care to rare and complex diseases. Methods Starting from existing standard methods for the creation and elaboration of patients’ care pathways, a specific methodology was created in order to take advantage of the distinctive and peculiar characteristics of the ERNs. Specifically, the development of the RarERN Path methodology involved different stakeholders: health economists, clinicians and researchers expert in rare and complex diseases, communication experts, experts in patients’ involvement and narrative medicine and policy-makers. Results The RarERN Path methodology foresees six consecutive phases, each with different and specific aims. Specifically, the six phases are represented by: Phase 1—mapping of existing patients’ care pathways and patients’ stories; Phase 2—design of an optimised common patients’ care pathway; Phase 3—consensus on an optimised common patients’ care pathway; Phase 4—key performance indicators definition; Phase 5—refinement; Phase 6—pilot phase (optional). Conclusion The application of RarERN Path to the different disease-specific and geographical contexts would help to ensure an improved, cost-effective and patient-centred equal care to rare and complex diseases across Europe as well as a possible tangible action towards the integration of ERNs into the different European healthcare systems.

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