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Ratter J, Wiertsema S, Ettahiri I, Mulder R, Grootjes A, Kee J, Donker M, Geleijn E, de Groot V, Ostelo RWJG, Bloemers FW, van Dongen JM. Barriers and facilitators associated with the upscaling of the Transmural Trauma Care Model: a qualitative study. BMC Health Serv Res 2024; 24:195. [PMID: 38350997 PMCID: PMC10865621 DOI: 10.1186/s12913-024-10643-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND To assess the barriers and facilitators associated with upscaling the Transmural Trauma Care Model (TTCM), a multidisciplinary and patient-centred transmural rehabilitation care model. METHODS Semi-structured interviews were conducted with eight trauma surgeons, eight hospital-based physiotherapists, eight trauma patients, and eight primary care physiotherapists who were part of a trauma rehabilitation network. Audio recordings of the interviews were made and transcribed verbatim. Data were analysed using a framework method based on the "constellation approach". Identified barriers and facilitators were grouped into categories related to structure, culture, and practice. RESULTS Various barriers and facilitators to upscaling were identified. Under structure, barriers and facilitators belonged to one of five themes: "financial structure", "communication structure", "physical structures and resources", "rules and regulations", and "organisation of the network". Under culture, the five themes were "commitment", "job satisfaction", "acting as a team", "quality and efficiency of care", and "patients' experience". Under practice, the two themes were "practical issues at the outpatient clinic" and "knowledge gained". CONCLUSION The success of upscaling the TTCM differed across hospitals and settings. The most important prerequisites for successfully upscaling the TTCM were adequate financial support and presence of "key actors" within an organisation who felt a sense of urgency for change and/or expected the intervention to increase their job satisfaction. TRIAL REGISTRATION NL8163 The Netherlands National Trial Register, date of registration 16-11-2019.
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Affiliation(s)
- Julia Ratter
- Amsterdam UMC, location AMC, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Suzanne Wiertsema
- Amsterdam UMC, location AMC, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Ilham Ettahiri
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Robin Mulder
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Anne Grootjes
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Julia Kee
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Marianne Donker
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Edwin Geleijn
- Amsterdam UMC, location VUmc, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Vincent de Groot
- Amsterdam UMC, location VUmc, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Amsterdam UMC, Department of Epidemiology and Data Science, location VUmc, Amsterdam Movement Sciences, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Frank W Bloemers
- Amsterdam UMC, location AMC, Department of Trauma Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Johanna M van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Ingram H, Rodriguez L, Meka J, Tumin D, Charles S. PhysioCamp: Cultivating Leaders Throughout Medical School. MEDICAL SCIENCE EDUCATOR 2022; 32:1309-1312. [PMID: 36415503 PMCID: PMC9672619 DOI: 10.1007/s40670-022-01686-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
To prepare medical students for leadership roles, medical student organizations should provide longitudinal leadership opportunities spanning the entire duration of the medical school curriculum. These long-term roles need to be adaptable to medical students' changing and busy schedules, provide a robust structure for communication, improve access to resources and mentors, and allow autonomy for individual decisions to facilitate effective engagement as a leader. We describe the design of a student-led organization, PhysioCamp, which facilitates opportunities for longitudinal medical student leadership through an internship program for high school graduates.
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Affiliation(s)
- Holly Ingram
- Brody School of Medicine, East Carolina University, Greenville, NC USA
- Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Lauren Rodriguez
- Thomas D. Arthur Graduate School of Business, East Carolina University, Greenville, NC USA
- College of Sciences and Mathematics, Auburn University, Auburn, AL USA
| | - Jahnavi Meka
- Drexel University College of Medicine, Philadelphia, PA USA
| | - Dmitry Tumin
- Brody School of Medicine, East Carolina University, Greenville, NC USA
| | - Stephen Charles
- Baylor College of Medicine, School of Medicine Temple Campus, Temple, TX USA
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3
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Myers CG, Sutcliffe KM. High reliability organising in healthcare: still a long way left to go. BMJ Qual Saf 2022; 31:845-848. [DOI: 10.1136/bmjqs-2021-014141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 12/23/2022]
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Rauwerdink A, Kasteleyn MJ, Chavannes NH, Schijven MP. Successes of and Lessons From the First Joint eHealth Program of the Dutch University Hospitals: Evaluation Study. J Med Internet Res 2021. [PMID: 34842536 DOI: 10.1016/j.ceh.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A total of 8 Dutch university hospitals are at the forefront of contributing meaningfully to a future-proof health care system. To stimulate nationwide collaboration and knowledge-sharing on the topic of evidence-based eHealth, the Dutch university hospitals joined forces from 2016 to 2019 with the first Citrien Fund (CF) program eHealth; 29 eHealth projects with various subjects and themes were selected, supported, and evaluated. To determine the accomplishment of the 10 deliverables for the CF program eHealth and to contribute to the theory and practice of formative evaluation of eHealth in general, a comprehensive evaluation was deemed essential. OBJECTIVE The first aim of this study is to evaluate whether the 10 deliverables of the CF program eHealth were accomplished. The second aim is to evaluate the progress of the 29 eHealth projects to determine the barriers to and facilitators of the development of the CF program eHealth projects. METHODS To achieve the first aim of this study, an evaluation study was carried out using an adapted version of the Commonwealth Scientific and Industrial Research Organization framework. A mixed methods study, consisting of a 2-part questionnaire and semistructured interviews, was conducted to analyze the second aim of the study. RESULTS The 10 deliverables of the CF program eHealth were successfully achieved. The program yielded 22 tangible eHealth solutions, and significant knowledge on the development and use of eHealth solutions. We have learned that the patient is enthusiastic about accessing and downloading their own medical data but the physicians are more cautious. It was not always possible to implement the Dutch set of standards for interoperability, owing to a lack of information technology (IT) capacities. In addition, more attention needed to be paid to patients with low eHealth skills, and education in such cases is important. The eHealth projects' progress aspects such as planning, IT services, and legal played an important role in the success of the 29 projects. The in-depth interviews illustrated that a novel eHealth solution should fulfill a need, that partners already having the knowledge and means to accelerate development should be involved, that clear communication with IT developers and other stakeholders is crucial, and that having a dedicated project leader with sufficient time is of utmost importance for the success of a project. CONCLUSIONS The 8 Dutch university hospitals were able to collaborate successfully and stimulate through a bottom-up approach, nationwide eHealth development and knowledge-sharing. In total, 22 tangible eHealth solutions were developed, and significant eHealth knowledge about their development and use was shared. The eHealth projects' progress aspects such as planning, IT services, and legal played an important role in the successful progress of the projects and should therefore be closely monitored when developing novel eHealth solutions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.ceh.2020.12.002.
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Affiliation(s)
- Anneloek Rauwerdink
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Marise J Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
- Citrien Fund program eHealth, Amsterdam, Netherlands
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5
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Rauwerdink A, Kasteleyn MJ, Chavannes NH, Schijven MP. Successes of and Lessons From the First Joint eHealth Program of the Dutch University Hospitals: Evaluation Study. J Med Internet Res 2021; 23:e25170. [PMID: 34842536 PMCID: PMC8663485 DOI: 10.2196/25170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/23/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A total of 8 Dutch university hospitals are at the forefront of contributing meaningfully to a future-proof health care system. To stimulate nationwide collaboration and knowledge-sharing on the topic of evidence-based eHealth, the Dutch university hospitals joined forces from 2016 to 2019 with the first Citrien Fund (CF) program eHealth; 29 eHealth projects with various subjects and themes were selected, supported, and evaluated. To determine the accomplishment of the 10 deliverables for the CF program eHealth and to contribute to the theory and practice of formative evaluation of eHealth in general, a comprehensive evaluation was deemed essential. OBJECTIVE The first aim of this study is to evaluate whether the 10 deliverables of the CF program eHealth were accomplished. The second aim is to evaluate the progress of the 29 eHealth projects to determine the barriers to and facilitators of the development of the CF program eHealth projects. METHODS To achieve the first aim of this study, an evaluation study was carried out using an adapted version of the Commonwealth Scientific and Industrial Research Organization framework. A mixed methods study, consisting of a 2-part questionnaire and semistructured interviews, was conducted to analyze the second aim of the study. RESULTS The 10 deliverables of the CF program eHealth were successfully achieved. The program yielded 22 tangible eHealth solutions, and significant knowledge on the development and use of eHealth solutions. We have learned that the patient is enthusiastic about accessing and downloading their own medical data but the physicians are more cautious. It was not always possible to implement the Dutch set of standards for interoperability, owing to a lack of information technology (IT) capacities. In addition, more attention needed to be paid to patients with low eHealth skills, and education in such cases is important. The eHealth projects' progress aspects such as planning, IT services, and legal played an important role in the success of the 29 projects. The in-depth interviews illustrated that a novel eHealth solution should fulfill a need, that partners already having the knowledge and means to accelerate development should be involved, that clear communication with IT developers and other stakeholders is crucial, and that having a dedicated project leader with sufficient time is of utmost importance for the success of a project. CONCLUSIONS The 8 Dutch university hospitals were able to collaborate successfully and stimulate through a bottom-up approach, nationwide eHealth development and knowledge-sharing. In total, 22 tangible eHealth solutions were developed, and significant eHealth knowledge about their development and use was shared. The eHealth projects' progress aspects such as planning, IT services, and legal played an important role in the successful progress of the projects and should therefore be closely monitored when developing novel eHealth solutions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.ceh.2020.12.002.
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Affiliation(s)
- Anneloek Rauwerdink
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Marise J Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, Amsterdam, Netherlands
- Citrien Fund program eHealth, Amsterdam, Netherlands
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Chan MK, Dickson G, Keegan DA, Busari JO, Matlow A, Van Aerde J. A tale of two frameworks: charting a path to lifelong learning for physician leaders through CanMEDS and LEADS. Leadersh Health Serv (Bradf Engl) 2021; ahead-of-print. [PMID: 34738770 DOI: 10.1108/lhs-04-2021-0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper was to determine the complementarity between the Canadian Medical Education Directions for Specialists (CanMEDS) physician competency and LEADS leadership capability frameworks from three perspectives: epistemological, philosophical and pragmatic. Based on those findings, the authors propose how the frameworks collectively layout pathways of lifelong learning for physician leadership. DESIGN/METHODOLOGY/APPROACH Using a qualitative approach combining critical discourse analysis with a modified Delphi, the authors examined "How complementary the CanMEDS and LEADS frameworks are in guiding physician leadership development and practice" with the following sub-questions: What are the similarities and differences between CanMEDS and LEADS from: An epistemological and philosophical perspective? The perspective of guiding physician leadership training and practice? How can CanMEDS and LEADS guide physician leadership development from medical school to retirement? FINDINGS Similarities and differences exist between the two frameworks from philosophical and epistemological perspectives with significant complementarity. Both frameworks are founded on a caring ethos and value physician leadership - CanMEDS (for physicians) and LEADS (physicians as one of many professions) define leadership similarly. The frameworks share beliefs in the function of leadership, embrace a belief in distributed leadership, and although having some philosophical differences, have a shared purpose (preparing for changing health systems). Practically, the frameworks are mutually supportive, addressing leadership action in different contexts and where there is overlap, complement one another in intent and purpose. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first paper to map the CanMEDS (physician competency) and LEADS (leadership capabilities) frameworks. By determining the complementarity between the two, synergies can be used to influence physician leadership capacity needed for today and the future.
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Affiliation(s)
- Ming-Ka Chan
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Graham Dickson
- School of Leadership Studies, Royal Roads University, Victoria, Canada and Canadian Society of Physician Leaders, Ottawa, Canada
| | - David A Keegan
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jamiu O Busari
- Department of Educational Development and Research, Maastricht University, Maastricht, The Netherlands and Department of Pediatrics, Horacio Oduber Hospital, Oranjestad, Aruba
| | - Anne Matlow
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Myers CG, Mayo AT, Kachalia A, Polsky D, Sutcliffe KM. Covid-19 has made clear why all physicians need to know about the business of healthcare. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2021. [DOI: 10.1177/2516043521990255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Amid longstanding recognition that healthcare challenges are often managerial, not just clinical, many have called for greater attention to developing physicians’ business management abilities. However, the Covid-19 pandemic has amplified the urgency of building physicians’ business knowledge and skills—from understanding health economics and finances to managing dynamics of collaborative leadership and change—in order to respond to pandemic-induced business challenges that threaten healthcare organizations. Unfortunately, existing efforts to develop these critical skills among physicians remain limited, focusing primarily on early-career physicians-in-training or later-career physicians in formal leadership positions. These efforts leave a wide swath of frontline physician leaders “in the middle” without systematic resources for developing their business management abilities. We advocate for several key changes to professional practices and policies to help bring business of health knowledge and skills to the foreground for all physicians, both in the pandemic and beyond.
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Affiliation(s)
- Christopher G Myers
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
- Hopkins Business of Health Initiative, Johns Hopkins University, Baltimore, MD, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Armstrong Institute for Patient Safety & Quality, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Anna T Mayo
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
- Hopkins Business of Health Initiative, Johns Hopkins University, Baltimore, MD, USA
| | - Allen Kachalia
- Hopkins Business of Health Initiative, Johns Hopkins University, Baltimore, MD, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Armstrong Institute for Patient Safety & Quality, Johns Hopkins Medicine, Baltimore, MD, USA
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Daniel Polsky
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
- Hopkins Business of Health Initiative, Johns Hopkins University, Baltimore, MD, USA
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kathleen M Sutcliffe
- Carey Business School, Johns Hopkins University, Baltimore, MD, USA
- Hopkins Business of Health Initiative, Johns Hopkins University, Baltimore, MD, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Armstrong Institute for Patient Safety & Quality, Johns Hopkins Medicine, Baltimore, MD, USA
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Standish MP, Alba JL, Ayman R. Bridging leadership science and medical leadership using servant leadership theory. BMJ LEADER 2020. [DOI: 10.1136/leader-2019-000175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Psychologists' Leadership Roles and Leadership Training Needs in Academic Health Centers. J Clin Psychol Med Settings 2020; 28:252-261. [PMID: 32107722 DOI: 10.1007/s10880-020-09707-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Psychologists are increasingly called upon to become more involved in academic health centers (AHCs) as leaders across a range of leadership roles in areas such as the clinical, teaching, and research missions, and in the administration thereof. Similarly, expansion of psychologists' service in national associations, boards, and other forums is increasing. This paper attempts to delineate the nature and extent of psychologists' involvement in leadership roles and their needs for professional leadership development to assist them in securing and succeeding in these positions. Members of the Association of Psychologists in Academic Health Centers (APAHC) were invited to complete a survey to identify current leadership roles and training needed to enhance leadership capabilities. Most (75%) of the respondents (total n = 105; 42% of APAHC full members; 70% female) were currently serving in leadership roles (range 1 to ≥ 10 positions). Years since degree conferred was positively associated with the number of leadership positions. Diversity of roles was delineated across AHC missions including psychology training (49.5%), clinical service (33.3%), and research (26.7%). An important subgroup (11.5%) served in upper-level administrative leadership positions. Leadership roles external to AHCs were common, particularly service ion committees (30.5%) and boards (27.6%) in state and national professional organizations. Half (51.4%) of survey respondents endorsed at least one leadership development need, with approximately 10% endorsing leadership development needs in all areas. The most common leadership development need was financial management skills, endorsed by nearly two-thirds of the sample. Early career respondents recognized more needs than advanced career respondents. AHC psychologists are expanding their leadership roles and distinguishing themselves as important contributors in AHCs. Despite this, many identified needs for further leadership training.
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