DECIDE: A Decision-Making Model for More Effective Decision Making by Health Care Managers

How will the public health committees develop after COVID-19 pandemic in China? Exploration from mixed methods study in Pingshan District, Shenzhen

Introduction

The Public Health Committee has a long-standing presence in the Chinese Constitution. During the pandemic, it served as a grassroots self-governance organization and made significant contributions to China's community epidemic prevention and control system. Currently, 24 provinces in China have promoted the establishment of community public health committees.

Methods

To gather data, we conducted semi-structured interviews (n = 48) with the heads of superior departments of public health committees, the heads of public health committees, and the heads of community health centers, exploring aspects such as organizational structure, job responsibilities, and job security. In parallel, we administered a capacity-building survey to a sample of 23 community residents (n = 1,986) and performed regression analysis. Finally, we examined the impact of gender, age, and education level on the development of public health committees.

Results

Our study reveals that the development of public health committees displays features of administration across various dimensions, including personnel appointment, top-level design, medical professionalism, funding path dependence, and data path dependence. However, the decision-making function of the organization does not exhibit a significant impact.

Discussion

The construction of the Public Health Committee should demonstrate an "autonomization-administration" pendulum effect. Currently, due to the absence of decision-making functions within the Public Health Committee, autonomous organizations are exhibiting characteristics of administration. To prevent excessive autonomization or administrative nature in the development of committees, public health policies are continuously being refined based on the unique characteristics of public health committee construction. During exceptional circumstances or the initial stages of development, the establishment of public health committees should be primarily guided by administrative principles, utilizing political momentum to drive their progress. In contrast, during routine establishment phases or later stages of development, the establishment of public health committees should be primarily led by autonomization, restoring their capacity for self-decision making. It is essential to fully leverage the role of grassroots self-governance organizations, relying on the community to engage in self-management, self-education, and self-service within public health committees.

Emergency team competencies: scoping review for the development of a tool to support the briefing and debriefing activities of emergency healthcare providers

Globally, at least one adverse event occurs in 10% of patients using emergency, inpatient, outpatient, surgical and primary care services. Particularly in emergency health care, this problem is exacerbated by additional variables such as patient criticality, high-risk diagnostic and therapeutic interventions and varying levels of healthcare provider training. In relation to the last point, briefing and debriefing activities during an emergency reinforce staff training and support them in managing work resources, planning interventions and improving future performance. The aim of the scoping review is to explore the state of the art in human factors applied to emergency situations and to develop a new tool to support healthcare professionals in conducting evidence-based briefings and debriefings. This review was developed using a search strategy based on the Arksey and O'Malley's six-step framework for scoping reviews. The literature analysed and the data identified, which are heterogeneous due to different study methodologies, objectives and types of interventions, suggest that human factors applied to emergency situations are still under-researched. At the end of the data extraction, analysis process, authors' reviews, discussion rounds and comparison with the multidisciplinary team of healthcare providers, 42 behaviours, 33 elements and 8 domains were considered relevant and included in the Emergency Team Comptencies (ETC) briefing and debriefing tool, ranked in order of priority as follows: communication, decision-making, clinical skills, situational awareness, leadership, task management, collaboration and stress and fatigue management. Further research is needed to investigate human factors applied to emergency situations and to generate new evidence to improve clinical practice and reduce the risk of error. In the near future, further studies will be conducted by the authors to test the validity of the Emergency Team Competencies tool in objectively measuring the performance of professionals and multidisciplinary teams.

Nurse Managers' Involvement in Decision-Making and Associated Factors in Selected Government Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study

Introduction

In the healthcare system, nurse managers' participation in decision-making was invaluable in preserving cost-effective service and safe patient care. Despite the fact that nurse managers have the power to ensure optimal health care service, their involvement in decision-making has not been well studied.

Objectives

To assess nurse managers' decision-making involvement and associated factors working in selected governmental hospitals in Addis Ababa, Ethiopia 2021.

Methods

A cross-sectional study was conducted among 176 nurse managers from government hospitals in Addis Ababa, with a response rate of 168 (95.5%). The total sample size is assigned in proportion. The technique of systematic random sampling was used. A structured, self-administered questionnaire was used to collect data, which was then checked, cleaned, entered into EPI Info version 7.2, and exported to SPSS software version 25 for analysis. In a binary logistic regression model analysis, a p-value < .25 was used as the cut-off point to consider variables as candidates for multivariable analysis. A p-value of .05 was used to determine the predictor variables with a 95% confidence interval.

Result

The mean age and standard deviation of the 168 respondents were 34.9 ± 4.1 years. More than half, 97 (57.7%), were excluded from general decision-making. Nurse managers in matron positions were 10 times more likely to participate in decision-making than head nurses (AOR = 10.00, 95% CI: 1.14-87.72, p = .038). Nurse managers who received managerial support were five times more likely to participate in good decision-making than nurse managers who did not receive managerial support (AOR = 5.29, 95% CI: 1.208-23.158, p = .027). Nurse managers who received feedback on their decision-making involvement had 7.7 times more good decision-making involvement than those who did not (AOR = 7.70, 95% CI: 2.482-23.911, p = .000).

Conclusion

According to the findings of the study, the majority of nurse managers were not involved in decision-making.

The Norwegian Directorate of Health recommends malnutrition screening tool (MST) for all adults

BACKGROUND & AIMS

Malnutrition is underdiagnosed and undertreated in Norway. In a revision of a national guideline on malnutrition, the Norwegian Directorate of Health aimed for a harmonization and standardization of the malnutrition screening practice, including a recommendation of one malnutrition screening tool to be used among all adults in Norwegian health and care services.

METHODS

A working group was appointed by the Norwegian Directorate of Health. Evidence-based practice, a pragmatic decision-making process based on a literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE), and the DECIDE decision-making model was used as a guidance in order to convert evidence into recommendations.

RESULTS

The criteria and properties of the four most frequently validated malnutrition screening tools were identified and ranked by the working group. The tools were prioritized in the following order: 1: Malnutrition Screening Tool (MST), 2: Malnutrition Universal Screening Tool (MUST), 3: Nutritional Risk Screening 2002 (NRS-2002), and 4: Mini-Nutritional Assessment short form (MNA).

CONCLUSIONS

The Norwegian Directorate of Health recommends use of MST for screening for malnutrition among all adults (≥18 years), across all health care settings, and diagnoses or conditions in Norway.