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Saragih ID, Hsiao CT, Fann WC, Hsu CM, Saragih IS, Lee BO. Impacts of interprofessional education on collaborative practice of healthcare professionals: A systematic review and meta-analysis. NURSE EDUCATION TODAY 2024; 136:106136. [PMID: 38422794 DOI: 10.1016/j.nedt.2024.106136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/01/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To investigate and statistically synthesise data on the effects of interprofessional education on healthcare professionals' collaborative practice among healthcare professionals. DESIGN A systematic review and meta-analysis. DATA SOURCES Seven databases and the grey literature were searched to collect relevant studies from database inception to 15 May 2023. REVIEW METHODS A random-effects model was used to assess the pooled effect size. Each pooled analysis was tested for publication bias using Egger's regression test. RESULTS Eleven studies were included in the final analysis. The evaluation of pooled results showed that interprofessional education significantly enhanced attitudes towards or mutual respect among healthcare professionals (pooled standardized mean difference: 0.14; 95 % Confidence Interval: 0.01-0.28; p = 0.04) and interprofessional knowledge (pooled standardized mean difference: 0.43; 95 % Confidence Interval: 0.22-0.65; p < 0.001). CONCLUSIONS Interprofessional education is a feasible approach to enhance attitudes towards or mutual respect among healthcare professionals as well as their interprofessional knowledge. Future research is needed to consider the inclusion of a module designed to develop mutual interests and communication to enhance students' perspectives on the importance of the interprofessional education approach.
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Affiliation(s)
| | - Cheng-Ting Hsiao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Wen-Chih Fann
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Chih-Mimng Hsu
- Medical education Department, Chang Gung Memorial Hospital, Chiayi, Taiwan; National Chung Cheng University, Minhsiung, Chiayi, Taiwan.
| | | | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Taiwan.
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Soller B, Myers O, Sood A. Transfer of Knowledge on Pneumoconiosis Care Among Rural-Based Members of a Digital Community of Practice: Cross-Sectional Study. JMIR Form Res 2024; 8:e52414. [PMID: 38265861 PMCID: PMC10851115 DOI: 10.2196/52414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Given the re-emergence of coal workers' pneumoconiosis in Appalachia and Mountain West United States, there is a tremendous need to train rural professionals in its multidisciplinary management. Since 2016, the Miners' Wellness TeleECHO (Extension for Community Health Outcomes) Program held by the University of New Mexico, Albuquerque, and Miners' Colfax Medical Center, Raton, New Mexico, provides structured longitudinal multidisciplinary telementoring to diverse professionals taking care of miners by creating a digital community of practice. Program sessions emphasize active learning through discussion, rather than didactic training. Professional stakeholder groups include respiratory therapists, home health professionals, benefits counselors, lawyers or attorneys, clinicians, and others. Rural-urban differences in knowledge transfer in such a community of practice, however, remain unknown. OBJECTIVE We aim to evaluate the role of the rurality of the patient or client base in the transfer of knowledge to professionals caring for miners using the digital community of practice approach. METHODS This is a cross-sectional study of 70 professionals participating in the Miners' Wellness TeleECHO Program between 2018 and 2019. Drawing insights from social network analysis, we examined the association between the rurality of participants' patient or client base and their self-reported receipt of knowledge. Our focal independent variable was the respondent's self-reported percentage of patients or clients who reside in rural areas. We measured knowledge transfer sources by asking participants if they received knowledge regarding the care of miners during and outside of TeleECHO sessions from each of the other participants. Our dependent variables included the number of knowledge sources, number of cross-stakeholder knowledge sources, number of same stakeholder knowledge sources, and range and heterogeneity of knowledge sources. RESULTS Respondents, on average, identified 4.46 (SD 3.16) unique knowledge sources within the community, with a greater number of cross-stakeholder knowledge sources (2.80) than same stakeholder knowledge sources (1.72). The mean knowledge source range was 2.50 (SD 1.29), indicating that, on average, respondents received knowledge sources from roughly half of the 5 stakeholder groups. Finally, the mean heterogeneity of knowledge sources, which can range between 0 and 0.80, was near the midpoint of the scale at 0.44 (SD 0.30). Multivariable analyses revealed that as the rurality of patient or client bases increased, participants reported more knowledge sources overall, more knowledge sources from outside of their stakeholder groups, a higher knowledge source range, and greater heterogeneity of knowledge sources (P<.05 for all comparisons). CONCLUSIONS Our findings suggest that participants who serve rural areas especially benefit from knowledge transfer within the TeleECHO community of practice. Additionally, the knowledge they receive comes from diverse information sources, emphasizing its multidisciplinary nature. Our results underscore the capacity of the TeleECHO model to leverage technology to promote rural health equity for miners.
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Affiliation(s)
- Brian Soller
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, Baltimore, MD, United States
| | - Orrin Myers
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Akshay Sood
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
- Miners Colfax Medical Center, Raton, NM, United States
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van Staalduinen DJ, van den Bekerom PEA, Groeneveld SM, Franx A, Stiggelbout AM, van den Akker-van Marle ME. Differing Professional Perspectives on the Interprofessional Collaboration in IPUs: A Mixed-methods Study. Int J Integr Care 2023; 23:5. [PMID: 37577143 PMCID: PMC10418149 DOI: 10.5334/ijic.7516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/31/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction An important aspect of Value-Based Healthcare (VBHC) is providing the full cycle of care for a specific medical condition through interprofessional collaboration. This requires employees from diverse professional backgrounds to interact, but there is limited knowledge on how professionals perceive such interprofessional collaboration. We aimed to provide insight into how different professionals perceive Integrated Practice Unit (IPU) composition and what factors influence the quality of interprofessional collaboration within IPUs. Methods A survey was administered to employees from different professional backgrounds (medical specialists, nurses, allied health professionals, administrative employees) working in IPUs to assess their perception of the composition of their IPU and the quality of the interactions. Subsequently, semi-structured interviews were conducted to gain a deeper understanding of the findings of the survey. Results Medical specialists and nurses were most frequently considered to be part of an IPU and indicated that they have high quality interactions. Allied health professionals were less often considered part of the team by all other professional groups and all report low quality interaction with this group. The extent to which a professional group is perceived as a team member depends on their visibility, involvement in the treatment of the patient, and shared interest. Differences in the quality of interprofessional collaboration are influenced by organizational structures, knowledge of each other's expertise, and by ways of communication. Conclusions In VBHC, there seems to be a lack of common perception of an IPU's composition and a failure to always achieve high quality interprofessional collaboration. Given the importance of interprofessional collaboration in VBHC, effort should be invested in achieving a shared understanding and improved collaboration.
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Affiliation(s)
- Dorine J. van Staalduinen
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | | | - Sandra M. Groeneveld
- Institute of Public Administration, Leiden University, Turfmarkt 99, 2511 DP, Den Haag, The Netherlands
| | - Arie Franx
- Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Anne M. Stiggelbout
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
- Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - M. Elske van den Akker-van Marle
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
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Saatchi AG, Pallotti F, Sullivan P. Network approaches and interventions in healthcare settings: A systematic scoping review. PLoS One 2023; 18:e0282050. [PMID: 36821554 PMCID: PMC9949682 DOI: 10.1371/journal.pone.0282050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
INTRODUCTION The growing interest in networks of interactions is sustained by the conviction that they can be leveraged to improve the quality and efficiency of healthcare delivery systems. Evidence in support of this conviction, however, is mostly based on descriptive studies. Systematic evaluation of the outcomes of network interventions in healthcare settings is still wanting. Despite the proliferation of studies based on Social Network Analysis (SNA) tools and techniques, we still know little about how intervention programs aimed at altering existing patterns of social interaction among healthcare providers affect the quality of service delivery. We update and extend prior reviews by providing a comprehensive assessment of available evidence. METHODS AND FINDINGS We searched eight databases to identify papers using SNA in healthcare settings published between 1st January 2010 and 1st May 2022. We followed Chambers et al.'s (2012) approach, using a Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. We distinguished between studies relying on SNA as part of an intervention program, and studies using SNA for descriptive purposes only. We further distinguished studies recommending a possible SNA-based intervention. We restricted our focus on SNA performed on networks among healthcare professionals (e.g., doctors, nurses, etc.) in any healthcare setting (e.g., hospitals, primary care, etc.). Our final review included 102 papers. The majority of the papers used SNA for descriptive purposes only. Only four studies adopted SNA as an intervention tool, and measured outcome variables. CONCLUSIONS We found little evidence for SNA-based intervention programs in healthcare settings. We discuss the reasons and challenges, and identify the main component elements of a network intervention plan. Future research should seek to evaluate the long-term role of SNA in changing practices, policies and behaviors, and provide evidence of how these changes affect patients and the quality of service delivery.
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Affiliation(s)
| | - Francesca Pallotti
- Department of Business, Operations and Strategy, University of Greenwich, London, United Kingdom
| | - Paul Sullivan
- NIHR ARC Northwest London, Imperial College London, London, United Kingdom
- University Sussex Hospitals NHS Foundation Trust, Sussex, United Kingdom
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Blacklock C, Darwin A, English M, McKnight J, Hinton L, Harriss E, Wong G. The social networks of hospital staff: A realist synthesis. J Health Serv Res Policy 2022; 27:242-252. [PMID: 35513308 PMCID: PMC9277319 DOI: 10.1177/13558196221076699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The social ties people have with one another are known to influence behaviour, and how information is accessed and interpreted. It is unclear, however, how the social networks that exist in multi-professional health care workplaces might be used to improve quality in hospitals. This paper develops explanatory theory using realist synthesis to illuminate the details and significance of the social ties between health care workers. Specifically we ask: How, why, for whom, to what extent and in what context, do the social ties of staff within a hospital influence quality of service delivery, including quality improvement? METHODS From a total of 75 included documents identified through an extensive systematic literature search, data were extracted and analysed to identify emergent explanatory statements. RESULTS The synthesis found that within the hospital workforce, an individual's place in the social whole can be understood across four identified domains: (1) social group, (2) hierarchy, (3) bridging distance and (4) discourse. Thirty-five context-mechanism-outcome configurations were developed across these domains. CONCLUSIONS The relative position of individual health care workers within the overall social network in hospitals is associated with influence and agency. As such, power to bring about change is inequitably and socially situated, and subject to specific contexts. The findings of this realist synthesis offer a lens through which to understand social ties in hospitals. The findings can help identify possible strategies for intervention to improve communication and distribution of power, for individual, team and wider multi-professional behavioural change in hospitals.
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Affiliation(s)
| | | | - Mike English
- Nuffield Department of Medicine, University of Oxford, UK
| | - Jacob McKnight
- Nuffield Department of Medicine, University of Oxford, UK
| | - Lisa Hinton
- The Healthcare Improvement Studies
Institute, University of Cambridge, UK
| | - Elinor Harriss
- Bodleian Health Care Libraries, University of Oxford, UK
| | - Geoff Wong
- Nuffield Department of Primary Care
Health Sciences, University of Oxford, UK
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King O, Shaw N. ' … breaks down silos': allied health clinicians' perceptions of informal interprofessional interactions in the healthcare workplace. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:47-63. [PMID: 33661074 DOI: 10.1080/14461242.2021.1886865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
Informal interprofessional interactions have gained interest in recent interprofessional care, education, health services and social sciences research literature. Some of the established benefits associated with these interactions include enhanced communication, teamwork, research translation and the provision of safer care. Limited evidence about how informal interprofessional interactions are perceived by the allied health workforce, exists. The survey conducted at a large Australian health service explored allied health clinicians' perceptions of the benefits, challenges and enablers of informal interprofessional interactions and their recommendations to improve opportunities for these workplace interactions. Sixty-four responses were analysed descriptively (for close-ended questions) and using a framework analysis approach, informed by Bourdieu's social space theory (for open-ended questions). Perceived benefits were aligned with three themes: teams and organisations, individual clinicians and service-users. Challenges to, and enablers of, informal interprofessional interactions were identified according to five themes: socio-cultural practices, physical environment, timing-related factors, individual and organisational factors. Participant recommendations to increase opportunities for informal interprofessional workplace interactions for allied health reflected three of the aforementioned themes: socio-cultural practices, physical environment and organisational factors. This theoretically-informed analysis may aid in the development of strategies to support these types of workplace interactions and realise the benefits identified.
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Affiliation(s)
- Olivia King
- Allied Health, University Hospital Geelong, Geelong, Australia
- Allied Health, South West Healthcare, Warrnambool, Australia
- Monash Centre for Scholarship in Health Education, Monash University, Clayton, Australia
| | - Nicole Shaw
- Clinical Education and Training, University Hospital Geelong, Geelong, Australia
- School of Psychology, Deakin University, Geelong, Australia
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7
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Integrating network theory into the study of integrated healthcare. Soc Sci Med 2021; 296:114664. [PMID: 35121369 DOI: 10.1016/j.socscimed.2021.114664] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022]
Abstract
Healthcare policy in the United States (U.S.) has focused on promoting integrated healthcare to combat fragmentation (e.g., 1993 Health Security Act, 2010 Affordable Care Act). Researchers have responded by studying coordination and developing typologies of integration. Yet, after three decades, research evidence for the benefits of coordination and integration are lacking. We argue that research efforts need to refocus in three ways: (1) use social networks to study relational coordination and integrated healthcare, (2) analyze integrated healthcare at three levels of analysis (micro, meso, macro), and (3) focus on clinical integration as the most proximate impact on patient outcomes. We use examples to illustrate the utility of such refocusing and present avenues for future research.
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Ferrer-Serrano M, Fuentelsaz L, Latorre-Martinez MP. Examining knowledge transfer and networks: an overview of the last twenty years. JOURNAL OF KNOWLEDGE MANAGEMENT 2021. [DOI: 10.1108/jkm-04-2021-0265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Purpose
Knowledge transfer (KT) has been attracting significant attention from the scientific community. The need to establish collaborative network relationships to achieve effective KT has led to a large volume of studies that attempt to identify how collaborative networks influence KT processes. However, papers, which link KT and networks have not been systematised. This study aims to provide an overview of this academic field and sets an agenda for future research.
Design/methodology/approach
The authors followed the preferred reporting items for systematic reviews and meta-analyses method to conduct a systematic review of the literature published in 2000–2020. The authors sourced the sample from the Web of Science and Scopus databases. The authors screened the references under the management and business categories that were published in the first two quartiles of the Journal Citation Report. This search returned 190 impactful papers across the 53 journals that were analysed.
Findings
The authors present the main results in two sections. First, this paper elaborates a conceptual model of the field; second, the authors review KT between firms and other agents, which allows us to identify KT flows within and between companies, universities and public institutions.
Originality/value
This paper provides the first systematic review of collaborative networks and KT. Five areas of action are identified for future research and are specified in several research questions. The authors also provide several practical implications. In a world in which more and more dynamic agents coexist, it is important to be aware of the needs of organisations that create and disseminate specific knowledge.
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Giorgio L, Mascia D, Cicchetti A. Hospital reorganization and its effects on physicians' network churn: The role of past ties. Soc Sci Med 2021; 286:113885. [PMID: 34272101 DOI: 10.1016/j.socscimed.2021.113885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/22/2021] [Accepted: 03/25/2021] [Indexed: 11/28/2022]
Abstract
Hospital reorganizations are difficult and often fail to produce their intended benefits. Prior research has investigated how and under which contingencies changes in organizational structure affect the modification of clinician behaviors, yet we know little about how organizational redesign interventions affect physicians' collaborative networks. This paper explores how hospital reorganizations affect physicians' network churn. We developed hypotheses on the relationship between structural characteristics of networks before reorganization and the formation of cross-unit network ties after reorganization. We tested our hypotheses on a sample of 175 physicians in a large teaching hospital. The hospital had recently adopted a new organizational model aimed at enhancing a process-based approach to care delivery. Our findings revealed that the physicians' propensity to form cross-unit ties after the change was related to the structure of their collaborative networks before the change. In particular, the formation of cross-unit relations was negatively related to the size of advice networks before the reorganization. Furthermore, we found that the diversity of network ties along with the presence of structural holes in the physicians' networks before the change moderated this relationship. We discussed the theoretical and practical implications of our findings. In particular, our results may inform organizational redesign interventions within hospitals.
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Affiliation(s)
- Luca Giorgio
- University of Bologna, Department of Management, Via Capo di Lucca, 34, 40126, Bologna, Italy.
| | - Daniele Mascia
- Luiss University, Department of Business and Management, Viale Romania, 32, 00198, Rome, Italy.
| | - Americo Cicchetti
- Università Cattolica del Sacro Cuore, Faculty of Economics, Largo F. Vito, 1, 00168, Rome, Italy.
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Matsuo M, Aihara M. Effect of a community of practice on knowledge sharing across boundaries: the mediating role of learning goals. JOURNAL OF KNOWLEDGE MANAGEMENT 2021. [DOI: 10.1108/jkm-08-2020-0604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
A community of practice (CoP) is believed to be a driver for knowledge creation but it can hinder knowledge sharing across boundaries. Drawing on social cognitive theory, this study aims to investigate how a CoP within a single unit promotes knowledge sharing with other units by examining the mediating effect of the members’ learning goals (LG).
Design/methodology/approach
Structural equation modeling was conducted using a two-wave survey data on nurses from eight Japanese hospitals (n = 263).
Findings
The results indicated that LG fully and positively mediated the effect of a CoP on the knowledge-sharing intention of one unit toward other units and that LG fully and negatively mediated the effect of a CoP on knowledge withholding (KW) from other units.
Practical implications
Knowledge managers need to note that intellectual benefits from experienced CoP can play a key role in reducing the perceived risks associated with members’ knowledge sharing and in creating effective knowledge sharing with other units.
Originality/value
The main contribution is to identify the process by which CoP promotes knowledge sharing and prevents KW across boundaries mediated through LG. This study is the first to quantitatively show how LG cross inter-professional barriers caused by CoPs.
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Implementing a new clinical pathway in a non-receptive context: Mixed methods evaluation of a new fracture pathway for older people in a hospital Trust in the West Midlands, UK. PLoS One 2021; 16:e0247455. [PMID: 33617583 PMCID: PMC7899317 DOI: 10.1371/journal.pone.0247455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 02/07/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This paper reports a mixed methods evaluation of a new pathway to improve clinical outcomes for older people with fractures treated at a hospital Trust in the West Midlands, UK. The paper focuses specifically on the context surrounding the translation of the new pathway into practice and the way that external and internal factors influenced its adaptation and implementation. METHODS Quantitative analysis used a controlled Interrupted Time Series (ITS) to estimate the effect of the new pathway on patient complication rate, median length of hospital stay and 30-day mortality by comparing the pre- and post-intervention periods. ITS data were extracted from the UK Trauma Audit and Research Network (TARN) database and a patient-level control group identified using propensity score matching. Parallel qualitative analysis aimed to examine the context surrounding the new pathway and how external and internal factors might influence its adaption and implementation into clinical practice. Data were collected via semi-structured interviews (n = 16) undertaken with staff and clinical stakeholders within the Trust and were analysed using the COM-B (Capability, Opportunity, Motivation) model of behaviour. RESULTS No statistically significant effects were found for any of the patient outcomes studied in the controlled ITS analysis. Qualitative data suggest that the lack of effectiveness of the new initiative can be explained with reference to the capability, opportunity and motivation of internal Trust stakeholders to engage with the pathway, which created a non-receptive environment within the Trust. CONCLUSIONS Successfully implementing new care pathways in environments that may be non-receptive to change requires efforts to be put into winning 'hearts and minds' within the organisation to ensure engagement from key stakeholders during intervention development. Evidence must be provided internally of the way that a given intervention will alleviate the problematic issues being experienced within the organisation, and external dissemination of results should be avoided until there is evidence of a positive effect within the organisation where the new care pathway is first implemented.
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Mæhle PM, Small Hanto IK, Smeland S. Practicing Integrated Care Pathways in Norwegian Hospitals: Coordination through Industrialized Standardization, Value Chains, and Quality Management or an Organizational Equivalent to Improvised Jazz Standards. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9199. [PMID: 33317088 PMCID: PMC7764546 DOI: 10.3390/ijerph17249199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/20/2020] [Accepted: 12/04/2020] [Indexed: 11/26/2022]
Abstract
The goal of coordinating pathways for cancer patients through their diagnostic and treatment journey is often approached by borrowing strategies from traditional industries, including standardization, process redesign, and variation reduction. However, the usefulness of these strategies is sometimes limited in the face of the complexity and uncertainty that characterize these processes over time and the situation at both patient and institutional levels. We found this to be the case when we did an in-depth qualitative study of coordination processes in patient pathways for three diagnoses in four Norwegian hospitals. What allows these hospitals to accomplish coordination is supplementing standardization with improvisation. This improvisation is embedded in four types of emerging semi-formal structures: collegial communities, networks, boundary spanners, and physical proximity. The hierarchical higher administrative levels appear to have a limited ability to manage and support coordination of these emerging structures when needed. We claim that this can be explained by viewing line management as representative of an economic-administrative institutional logic while these emerging structures represent a medical-professional logic that privileges proximity to the variation and complexity in the situations. The challenge is then to find a way for emergent and formal structures to coexist.
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Affiliation(s)
- Per Magnus Mæhle
- Institute of Health and Society, Faculty of Medicine, University of Oslo, 0314 Oslo, Norway
- Comprehensive Cancer Centre, Division of Cancer Medicine, Oslo University Hospital, 0450 Oslo, Norway; (I.K.S.H.); (S.S.)
| | - Ingrid Kristine Small Hanto
- Comprehensive Cancer Centre, Division of Cancer Medicine, Oslo University Hospital, 0450 Oslo, Norway; (I.K.S.H.); (S.S.)
| | - Sigbjørn Smeland
- Comprehensive Cancer Centre, Division of Cancer Medicine, Oslo University Hospital, 0450 Oslo, Norway; (I.K.S.H.); (S.S.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
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Luz S, Drach-Zahavy A, Shadmi E. A personal network approach to the study of nurse champions of innovation and their innovation projects' spread. J Adv Nurs 2020; 77:775-786. [PMID: 33150626 DOI: 10.1111/jan.14620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 09/01/2020] [Accepted: 10/09/2020] [Indexed: 11/30/2022]
Abstract
AIMS To develop and test the relationship between nurse champions' personal social networks and innovation success in terms of spread. DESIGN A cross sectional. METHOD(S) Data were collected on 94 nurse champions at three medium-large tertiary medical centres from 2015-2016. Data from champions on their personal network were assessed via a standardized and acceptable three-step network survey. Success in terms of innovation spread was assessed via perceived extent of spread. Network structural and relational characteristics were depicted by level of spread. Multivariate linear regression was used to assess the relationship between network characteristics and innovation spread. FINDINGS Above and beyond various project and network control variables, network density was significantly and positively related to project spread, tie-strength diversity was significantly and negatively related to project spread and difference in ethnic origin between champions and alters was significantly and positively related to project spread. Maximum age of network members was marginally significantly related to project spread. CONCLUSION(S) Our findings show that high-density personal social networks; networks where tie strength among network members is similar, thus, creating liking and trust among members; having at least one older network member who might have close access to professional and organizational resources acquired throughout their career; and having ties with network members from different ethnic groups to prevent knowledge stickiness, all promote innovation spread. Champions should be carefully nominated based on their ability to engage network members and to build ties with various network members inside and outside the nursing unit; once selected, champions should be aware of their social networks. IMPACT The current study explored champions' personal-network structure, composition and variance measures and their implications for innovation project spread. The findings demonstrated that nursing champions' personal social networks matter for innovation spread. This finding has implications for the nominating and the coaching of champions.
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Affiliation(s)
- Shirly Luz
- Department of Nursing, The University of Haifa, Rehovot, Israel
| | | | - Efrat Shadmi
- Department of Nursing, The University of Haifa, Rehovot, Israel
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The impact of time pressure on knowledge transfer effectiveness in teams: trust as a critical but fragile mediator. JOURNAL OF KNOWLEDGE MANAGEMENT 2020. [DOI: 10.1108/jkm-05-2020-0379] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
With faster innovation and shorter product cycles, time pressure is a highly relevant factor affecting contemporary business processes. This study aims to extend prior research on the effects of velocity at the firm level by considering the effect of time pressure on knowledge transfer effectiveness (KTE) on the team level and the role of trust as a mediator of this effect.
Design/methodology/approach
We empirically assess the impact of time pressure on knowledge transfer effectiveness in teams. Further, we test the mediating effect of trust on this relationship. We study a sample of 285 project teams applying partial least squares structural equation modeling (PLS-SEM).
Findings
The authors find that time pressure is negatively associated with KTE. Moreover, trust among team members has a complementary mediating effect on this relationship. Thus, while trust is urgently needed for enhancing KTE under time pressure, time pressure reduces trust-building too.
Research limitations/implications
This study establishes empirically the importance of time pressure and trust as drivers of KTE in teams. The contribution connects the field of knowledge management to important streams in the wider business literature: organization studies, management, strategic management, project management, innovation etc. Whereas the model is parsimonious, it has high explanatory power and high generalizability to other contexts.
Practical implications
Team managers should take care to allow enough time for knowledge transfer within the team. This is particularly important when knowledge sharing is central, e.g. in innovation, development and change processes. If this is not possible, measures should be taken to maintain trust among team members.
Social implications
Effective knowledge management enhances the performance of business entities and public-sector organizations alike. Today, both the private and public sectors are under considerable pressure to increase both efficiency and effectiveness. Effective knowledge transfer within teams is a core capability to achieve this goal. More effective organizations result in more competitive private firms, more employment opportunities and improved public services to citizens.
Originality/value
Time pressure is an increasingly relevant factor in contemporary business but so far little explored in research. This study extends current knowledge by considering the effect of time pressure on KTE.
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Tasselli S, Zappa P, Lomi A. Bridging Cultural Holes in Organizations: The Dynamic Structure of Social Networks and Organizational Vocabularies Within and Across Subunits. ORGANIZATION SCIENCE 2020. [DOI: 10.1287/orsc.2019.1352] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The mechanisms by which social networks and organizational vocabularies combine jointly to affect communication patterns across organizational boundaries remain largely unexplored. In this paper, we examine the mutually constitutive relation between the network ties through which organizational members communicate with each other and the vocabularies that they use to describe their organization. We suggest that the dynamic structure of social networks and organizational vocabularies is contingent on the formal design of organizational subunits. Within subunit boundaries, members who interact with each other are more likely to develop similar vocabularies over time. Interestingly, between subunits, the more two members share similar organizational vocabularies, the more likely they are to form a tie over time. We find empirical evidence for these arguments in a longitudinal study conducted among the managers of a multiunit organization. Organizational vocabularies, we suggest, may sustain communication patterns across organizational boundaries, thus bridging cultural holes within organizations.
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Affiliation(s)
- Stefano Tasselli
- Rotterdam School of Management, Erasmus University, 3062 PA Rotterdam, Netherlands
| | - Paola Zappa
- School of Business, Maynooth University, W23 WK26 Maynooth, Ireland
| | - Alessandro Lomi
- Faculty of Economics, Università della Svizzera italiana, 6900 Lugano, Switzerland
- University of Exeter Business School, Exeter EX4 4ST, United Kingdom
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Siedlok F, Hibbert P, Whitehurst F. Social network influences on employee responses to organizational withdrawals. ORGANIZATION MANAGEMENT JOURNAL 2020. [DOI: 10.1108/omj-01-2018-0498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to develop a more detailed understanding of how embedding in different social networks relates to different types of action that individuals choose in the context of organizational closures, downsizing or relocations. To develop such insights, this paper focuses on three particular types of social networks, namely, intra-organizational; external professional and local community networks. These three types of networks have been frequently related to different types of action in the context of closures and relocations.
Design/methodology/approach
This is a conceptual paper. The authors develop the argument by integrating relevant recent literature on the salience related to embedding in different types of social networks, with a particular focus on responses to organizational closure or relocation.
Findings
The authors argue that at times of industrial decline and closure: embeddedness in intra-organizational networks can favor collective direct action; embeddedness in professional networks is likely to favor individual direct action and embeddedness in community networks can lead to individual indirect action. The authors then add nuance to the argument by considering a range of complicating factors that can constrain or enable the course (s) of action favored by particular combinations of network influences.
Originality/value
On a theoretical level, this paper adds to understandings of the role of network embeddedness in influencing individual and collective responses to such disruptive events; and direct or indirect forms of response. On a practical level, the authors contribute to understandings about how the employment landscape may evolve in regions affected by organizational demise, and how policymakers may study with or through network influences to develop more responsible downsizing approaches.
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Kelly Costa D, Liu H, Boltey EM, Yakusheva O. The Structure of Critical Care Nursing Teams and Patient Outcomes: A Network Analysis. Am J Respir Crit Care Med 2020; 201:483-485. [PMID: 31626555 PMCID: PMC7049918 DOI: 10.1164/rccm.201903-0543le] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Deena Kelly Costa
- University of Michigan School of NursingAnn Arbor, Michigan
- University of Michigan Institute for Healthcare Policy and InnovationAnn Arbor, Michiganand
| | - Haiyin Liu
- University of Michigan School of NursingAnn Arbor, Michigan
| | | | - Olga Yakusheva
- University of Michigan School of NursingAnn Arbor, Michigan
- University of Michigan Institute for Healthcare Policy and InnovationAnn Arbor, Michiganand
- University of Michigan School of Public HealthAnn Arbor, Michigan
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Abstract
Purpose
The purpose of this paper is to investigate frontline meetings in hospitals and how they are used for coordination of daily operations across organizational and occupational boundaries.
Design/methodology/approach
An in-depth multiple-case study of four purposefully selected departments from four different hospitals is conducted. The selected cases had actively developed and embedded scheduled meetings as structural means to achieve coordination of daily operations.
Findings
Health care professionals and managers, next to their traditional mono-professional meetings (e.g. doctors or nurses), develop additional operational, daily meetings such as work-shift meetings, huddles and hand-off meetings to solve concrete care tasks. These new types of meetings are typically short, task focussed, led by a chair and often inter-disciplinary. The meetings secure a personal proximity which the increased dependency on hospital-wide IT solutions cannot. During meetings, objects and representations (e.g. monitors, whiteboards or paper cards) create a needed gathering point to span across boundaries. As regards embedding meetings, local engagement helps contextualizing meetings and solving concrete care tasks, thereby making health care professionals more likely to value these daily meeting spaces.
Practical implications
Health care professionals and managers can use formal meeting spaces aided by objects and representations to support solving daily and interdependent health care tasks in ways that IT solutions in hospitals do not offer today. Implementation requires local engagement and contextualization.
Originality/value
This research paper shows the importance of daily, operational hospital meetings for frontline coordination. Organizational meetings are a prevalent collaborative activity, yet scarcely researched organizational phenomenon.
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Glegg SMN, Jenkins E, Kothari A. How the study of networks informs knowledge translation and implementation: a scoping review. Implement Sci 2019; 14:34. [PMID: 30917844 PMCID: PMC6437864 DOI: 10.1186/s13012-019-0879-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/11/2019] [Indexed: 11/17/2022] Open
Abstract
Background To date, implementation science has focused largely on identifying the individual and organizational barriers, processes, and outcomes of knowledge translation (KT) (including implementation efforts). Social network analysis (SNA) has the potential to augment our understanding of KT success by applying a network lens that examines the influence of relationships and social structures on research use and intervention acceptability by health professionals. The purpose of this review was to comprehensively map the ways in which SNA methodologies have been applied to the study of KT with respect to health professional networks. Methods Systematic scoping review methodology involved searching five academic databases for primary research on KT that employed quantitative SNA methods, and inclusion screening using predetermined criteria. Data extraction included information on study aim, population, variables, network properties, theory use, and data collection methods. Descriptive statistics and chronology charting preceded theoretical analysis of findings. Results Twenty-seven retained articles describing 19 cross-sectional and 2 longitudinal studies reported on 28 structural properties, with degree centrality, tie characteristics (e.g., homophily, reciprocity), and whole network density being most frequent. Eleven studies examined physician-only networks, 9 focused on interprofessional networks, and 1 reported on a nurse practitioner network. Diffusion of innovation, social contagion, and social influence theories were most commonly applied. Conclusions Emerging interest in SNA for KT- and implementation-related research is evident. The included articles focused on individual level evidence-based decision-making: we recommend also applying SNA to meso- or macro-level KT activities. SNA research that expands the range of professions under study, examines network dynamics over time, extends the depth of analysis of the role of network structure on KT processes and outcomes, and employs mixed methods to triangulate findings, is needed to advance the field. SNA is a valuable approach for evaluating key network characteristics, structures and positions of relevance to KT, implementation, and evidence informed practice. Examining how network structure influences connections and the implications of those holding prominent network positions can provide insights to improve network-based KT processes.
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Affiliation(s)
- Stephanie M N Glegg
- Rehabilitation Sciences, The University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. .,Therapy Department, Sunny Hill Health Centre for Children, 3644 Slocan Street, Vancouver, BC, V5M 3E8, Canada. .,BC Children's Hospital Research Institute, 938 West 28th Ave, Vancouver, BC, V5Z 4H4, Canada.
| | - Emily Jenkins
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Anita Kothari
- School of Health Studies, Western University, Arthur and Sonia Labatt Health Sciences Building, Room 222, London, ON, V6A 5B9, Canada
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20
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Racko G, Oborn E, Barrett M. Developing collaborative professionalism: an investigation of status differentiation in academic organizations in knowledge transfer partnerships. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2019. [DOI: 10.1080/09585192.2017.1281830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Girts Racko
- Warwick Business School, University of Warwick, Coventry, UK
| | - Eivor Oborn
- Warwick Business School, University of Warwick, Coventry, UK
| | - Michael Barrett
- Judge Business School, University of Cambridge, Cambridge, UK
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21
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Abstract
Purpose The purpose of this paper is to examine how knowledge exchange between academics and clinicians in Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) is influenced by their social position based on their symbolic and social capitals, that is, their personal professional status and connections to high-status professional peers, knowledge brokers, and unfamiliar professional peers. Design/methodology/approach Using an online survey, the author triangulates the cross-sectional measurement of the effects of academic and clinicians' social position in the initial and later phases of CLAHRCs with the longitudinal measurement of these effects over a two-year period. Findings First, academics and clinicians with a higher personal professional status are more likely to develop joint networks and decision making both in the early and later phases of a CLAHRC. Second, academics and clinicians who are more connected to higher status occupational peers are more likely to develop joint networks in the early phase of a knowledge exchange partnership but are less likely to become engaged in joint networks over time. Third, involvement of knowledge brokers in the networks of academics and clinicians is likely to facilitate their inter-professional networking only in the later partnership phase. Practical implications Academics and clinicians' capitals have a distinctive influence on knowledge exchange in the early and later phases of CLAHRCs and on a change in knowledge exchange over a two-year period. Originality/value Prior research on CLAHRCs has examined how knowledge exchange between academics and clinicians can be encouraged by the creation of shared governance mechanisms. The author advances this research by highlighting the role of their social position in facilitating knowledge exchange.
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Affiliation(s)
- Girts Racko
- Warwick Business School, University of Warwick , Coventry, UK
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22
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Makanjee CR, Bergh A, Hoffmann WA. Distributed decision making in action: diagnostic imaging investigations within the bigger picture. J Med Radiat Sci 2018; 65:5-12. [PMID: 29130645 PMCID: PMC5846027 DOI: 10.1002/jmrs.250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 09/20/2017] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Decision making in the health care system - specifically with regard to diagnostic imaging investigations - occurs at multiple levels. Professional role players from various backgrounds are involved in making these decisions, from the point of referral to the outcomes of the imaging investigation. The aim of this study was to map the decision-making processes and pathways involved when patients are referred for diagnostic imaging investigations and to explore distributed decision-making events at the points of contact with patients within a health care system. METHOD A two-phased qualitative study was conducted in an academic public health complex with the district hospital as entry point. The first phase included case studies of 24 conveniently selected patients, and the second phase involved 12 focus group interviews with health care providers. Data analysis was based on Rapley's interpretation of decision making as being distributed across time, situations and actions, and including different role players and technologies. RESULTS Clinical decisions incorporating imaging investigations are distributed across the three vital points of contact or decision-making events, namely the initial patient consultation, the diagnostic imaging investigation and the post-investigation consultation. Each of these decision-making events is made up of a sequence of discrete decision-making moments based on the transfer of retrospective, current and prospective information and its transformation into knowledge. CONCLUSION This paper contributes to the understanding of the microstructural processes (the 'when' and 'where') involved in the distribution of decisions related to imaging investigations. It also highlights the interdependency in decision-making events of medical and non-medical providers within a single medical encounter.
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Affiliation(s)
| | - Anne‐Marie Bergh
- South African Medical Research Council Unit for Maternal and Infant Health Care StrategiesUniversity of PretoriaPretoriaSouth Africa
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23
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Tasselli S. Love and Organization Studies: Moving beyond the Perspective of Avoidance. ORGANIZATION STUDIES 2018. [DOI: 10.1177/0170840617747924] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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24
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Kang M, Kim B. Motivation, opportunity, and ability in knowledge transfer: a social network approach. KNOWLEDGE MANAGEMENT RESEARCH & PRACTICE 2017. [DOI: 10.1057/s41275-016-0045-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Minhyung Kang
- Department of Advanced Industry FusionKonkuk University 120 Neungdong-ro, Gwangjin-gu 05029 Seoul South Korea
| | - Byoungsoo Kim
- School of BusinessYeungnam University 280 Daehak-ro 712-749 Gyeongsan Gyeongbuk South Korea
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25
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Carroll N, Richardson I. Mapping a Careflow Network to assess the connectedness of Connected Health. Health Informatics J 2017; 25:106-125. [PMID: 28438102 DOI: 10.1177/1460458217702943] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Connected Health is an emerging and rapidly developing field which has the potential to transform healthcare service systems by increasing its safety, quality and overall efficiency. From a healthcare perspective, process improvement models have mainly focused on the static workflow viewpoint. The objective of this article is to study and model the dynamic nature of healthcare delivery, allowing us to identify where potential issues exist within the service system and to examine how Connected Health technological solutions may support service efficiencies. We explore the application of social network analysis (SNA) as a modelling technique which captures the dynamic nature of a healthcare service. We demonstrate how it can be used to map the 'Careflow Network' and guide Connected Health innovators to examine specific opportunities within the healthcare service. Our results indicate that healthcare technology must be correctly identified and implemented within the Careflow Network to enjoy improvements in service delivery. Oftentimes, prior to making the transformation to Connected Health, researchers use various modelling techniques that fail to identify where Connected Health innovation is best placed in a healthcare service network. Using SNA allows us to develop an understanding of the current operation of healthcare system within which they can effect change. It is important to identify and model the resource exchanges to ensure that the quality and safety of care are enhanced, efficiencies are increased and the overall healthcare service system is improved. We have shown that dynamic models allow us to study the exchange of resources. These are often intertwined within a socio-technical context in an informal manner and not accounted for in static models, yet capture a truer insight on the operations of a Careflow Network.
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26
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Chan B, Reeve E, Matthews S, Carroll PR, Long JC, Held F, Latt M, Naganathan V, Caplan GA, Hilmer SN. Medicine information exchange networks among healthcare professionals and prescribing in geriatric medicine wards. Br J Clin Pharmacol 2017; 83:1185-1196. [PMID: 28009444 DOI: 10.1111/bcp.13222] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/01/2016] [Accepted: 12/05/2016] [Indexed: 12/12/2022] Open
Abstract
AIMS Effective transfer of information is vital for rational drug therapy. This is particularly important for older patients, who have a high prevalence of polypharmacy and are managed by multidisciplinary teams. We aimed to assess medicine information exchange (MIE) networks in geriatric medicine wards and whether they are associated with prescribing patterns. METHODS We conducted network analysis in acute geriatric medicine wards from four hospitals to characterize MIE networks among multidisciplinary team members. Corresponding patient data were collected to analyze high-risk prescribing in conjunction with network characteristics. RESULTS We found that junior doctors, senior nurses and pharmacists were central to MIE across all four hospitals. Doctors were more likely than other professions to receive medicines information in three hospitals. Reciprocity and the tendency to communicate within one's own profession also influenced network formation. No difference was observed in prescribing practice between hospitals. CONCLUSIONS Understanding MIE networks can identify gaps in multidisciplinary communication that can be addressed. Networks may identify targets for dissemination of interventions to improve prescribing.
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Affiliation(s)
- Bosco Chan
- Kolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Emily Reeve
- Kolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Cognitive Decline Centre, University of Sydney, Sydney, Australia
| | - Slade Matthews
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Peter R Carroll
- Kolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Janet C Long
- Cognitive Decline Centre, University of Sydney, Sydney, Australia
| | - Fabian Held
- Faculty of Science, School of Mathematics and Statistics, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Mark Latt
- Sydney Medical School, University of Sydney, Sydney, Australia.,Department of General, Geriatric and Rehabilitation Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Vasi Naganathan
- Sydney Medical School, University of Sydney, Sydney, Australia.,Centre for Education and Research on Ageing, University of Sydney and Ageing and Alzheimers Institute, Concord Hospital, Australia
| | - Gideon A Caplan
- Department of Geriatric Medicine, Prince of Wales Hospital, Sydney, Australia.,University of New South Wales, Sydney, Australia
| | - Sarah N Hilmer
- Kolling Institute of Medical Research, Royal North Shore Hospital and University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Cognitive Decline Centre, University of Sydney, Sydney, Australia
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27
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Bullock A, Barnes E, Morris ZS, Fairbank J, de Pury J, Howell R, Denman S. Getting the most out of knowledge and innovation transfer agents in health care: a qualitative study. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BackgroundKnowledge and innovation transfer (KIT) is recognised internationally as a complex, dynamic process that is difficult to embed in organisations. There is growing use of health service–academic–industry collaborations in the UK, with knowledge brokers linking producers with the users of knowledge and innovation.AimFocusing on KIT ‘agent’ roles within Academic Health Science Networks in England and Partnerships in Wales, we show how individual dispositions, processes and content contribute to desired outcomes.MethodsWe studied the KIT intentions of all Academic Health Science Networks in England, and the South East Wales Academic Health Science Partnership. Using a qualitative case study design, we studied the work of 13 KIT agents purposively sampled from five networks, by collecting data from observation of meetings, documentation, KIT agent audio-diaries, and semistructured interviews with KIT agents, their line managers and those they supported (‘Links’). We also used a consensus method in a meeting of experts (nominal group technique) to discuss the measurement of outcomes of KIT agent activity.FindingsThe case study KIT agents were predominantly from a clinical background with differing levels of experience and expertise, with the shared aim of improving services and patient care. Although outside of recognised career structures, the flexibility afforded to KIT agents to define their role was an enabler of success. Other helpful factors included (1) time and resources to devote to KIT activity; (2) line manager support and a team to assist in the work; and (3) access and the means to use data for improvement projects. The organisational and political context could be challenging. KIT agents not only tackled local barriers such as siloed working, but also navigated shifting regional and national policies. Board-level support for knowledge mobilisation together with a culture of reflection (listening to front-line staff), openness to challenges and receptivity to research all enabled KIT agents to achieve desired outcomes. Nominal group findings underscored the importance of relating measures to specific intended outcomes. However, the case studies highlighted that few measures were employed by KIT agents and their managers. Using social marketing theory helped to show linkages between processes, outcomes and impact, and drew attention to how KIT agents developed insight into their clients’ needs and tailored work accordingly.LimitationsLevel of KIT agent participation varied; line managers and Links were interviewed only once; and outcomes were self-reported.ConclusionsSocial marketing theory provided a framework for analysing KIT agent activity. The preparatory work KIT agents do in listening, understanding local context and building relationships enabled them to develop ‘insight’ and adapt their ‘offer’ to clients to achieve desired outcomes.Future workThe complexity of the role and the environment in which it is played out justifies more research on KIT agents. Suggestions include (1) longitudinal study of career pathways; (2) how roles are negotiated within teams and how competing priorities are managed; (3) how success is measured; (4) the place of improvement methodologies within KIT work; (5) the application of social marketing theory to comparative study of similar roles; and (6) patients as KIT agents.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Alison Bullock
- The Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), Cardiff University, Cardiff, UK
| | - Emma Barnes
- The Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), Cardiff University, Cardiff, UK
| | | | | | | | - Rosamund Howell
- Aneurin Bevan University Health Board, Clinical Research and Innovation Centre, St Woolos Hospital, Newport, UK
| | - Susan Denman
- School of Medicine, Cardiff University, Cardiff, UK
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28
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Abstract
A firm’s growth and survival depends on the ability of its managers to explore for new business and knowledge; yet, exploration is challenging for most large, established firms. Extending prior research into networks and exploration, we propose that a key characteristic of managers’ external networks – the extent to which their networks include relationships built using predominately individual rather than firm resources – is positively related to managers’ abilities to explore for new business and knowledge in large firms. We propose that networks with more individual ties provide more diverse knowledge, enable greater autonomy and ease access to resources from contacts, hence facilitating exploration. Analysis of an original dataset of external networks of 77 senior managers in a large global consulting firm provides support for our arguments. We find that individual ties are positively related to exploration and, furthermore, that the positive (negative) relationship between sparse (dense) networks and exploration increases with the number of individual ties in managers’ networks.
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29
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Wallis SK, Jehan K, Woodhead M, Cleary P, Dee K, Farrow S, McMaster P, Wake C, Walker J, Sloan DJ, Squire SB. Health professionals' experiences of tuberculosis cohort audit in the North West of England: a qualitative study. BMJ Open 2016; 6:e010536. [PMID: 26983949 PMCID: PMC4800141 DOI: 10.1136/bmjopen-2015-010536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Tuberculosis cohort audit (TBCA) was introduced across the North West (NW) of England in 2012 as an ongoing, multidisciplinary, systematic case review process, designed to improve clinical and public health practice. TBCA has not previously been introduced across such a large and socioeconomically diverse area in England, nor has it undergone formal, qualitative evaluation. This study explored health professionals' experiences of the process after 1515 cases had been reviewed. DESIGN Qualitative study using semistructured interviews. Respondents were purposively sampled from 3 groups involved in the NW TBCA: (1) TB nurse specialists, (2) consultant physicians and (3) public health practitioners. Data from the 26 respondents were triangulated with further interviews with key informants from the TBCA Steering Group and through observation of TBCA meetings. ANALYSIS Interview transcripts were analysed thematically using the framework approach. RESULTS Participants described the evolution of a valuable 'community of practice' where interprofessional exchange of experience and ideas has led to enhanced mutual respect between different roles and a shared sense of purpose. This multidisciplinary, regional approach to TB cohort audit has promoted local and regional team working, exchange of good practices and local initiatives to improve care. There is strong ownership of the process from public health professionals, nurses and clinicians; all groups want it to continue. TBCA is regarded as a tool for quality improvement that improves patient safety. CONCLUSIONS TBCA provides peer support and learning for management of a relatively rare, but important infectious disease through discussion in a no-blame atmosphere. It is seen as an effective quality improvement strategy which enhances TB care, control and patient safety. Continuing success will require increased engagement of consultant physicians and public health practitioners, a secure and ongoing funding stream and establishment of clear reporting mechanisms within the public health system.
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Affiliation(s)
- Selina K Wallis
- Department of Clinical Sciences and Centre for Applied Health Research & Delivery, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
| | - Kate Jehan
- Department of Public Health and Policy, University of Liverpool, Liverpool, Merseyside, UK
| | | | | | - Katie Dee
- Public Health England, Liverpool, UK
| | | | | | | | | | - D J Sloan
- Department of Clinical Sciences and Centre for Applied Health Research & Delivery, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
- Liverpool Heart and Chest Hospital, Liverpool, UK
| | - S B Squire
- Department of Clinical Sciences and Centre for Applied Health Research & Delivery, Liverpool School of Tropical Medicine, Liverpool, Merseyside, UK
- Royal Liverpool University Hospital, Liverpool, UK
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30
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Kinnison T, Guile D, May SA. Veterinary team interactions, part 2: the personal effect. Vet Rec 2015; 177:541. [DOI: 10.1136/vr.103313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2015] [Indexed: 11/03/2022]
Affiliation(s)
- T. Kinnison
- The Royal Veterinary College; Hawkshead Lane, Hatfield Hertfordshire AL9 7TA UK
| | - D. Guile
- Lifelong and Comparative Education; The Institute of Education; 20 Bedford Way London WC1H 0AL UK
| | - S. A. May
- The Royal Veterinary College; Hawkshead Lane, Hatfield Hertfordshire AL9 7TA UK
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31
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Kinnison T, May SA, Guile D. Veterinary team interactions, part one: the practice effect. Vet Rec 2015; 177:419. [PMID: 26446881 DOI: 10.1136/vr.103312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 11/04/2022]
Abstract
Veterinary practices have evolved since the era of solo practitioners working on one site. Today veterinary practices tend to include veterinary surgeons, veterinary nurses, receptionists and business managers, leading to the notion of the veterinary team and the rise of interprofessional working. In addition, practices have grown in size and frequently include several branches, creating a distributed team. Research regarding veterinary teamwork is lacking. This paper uses Social Network Analysis (SNA) to address this issue. SNA measures interactions between members of a network. The types of interactions in practice and the effects of practice size and location (branches) are considered. Information sharing and asking for advice are straightforward, lower order interactions. Problem solving and being influenced by another are complex, higher order interactions. Smaller practices have higher densities of interactions, implying a more cohesive team. However, individuals in smaller practices still do not interact with everyone and therefore actively choose with whom to interact. Practices with little staff rotation across branches experience limited interactions across locations. The results of this study have implications for practices aiming to expand their team, either in a single site or by acquiring more branches. Suggestions for ways to maintain and improve interactions are made.
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Affiliation(s)
- T Kinnison
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - S A May
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - D Guile
- Department of Lifelong and Comparative Education, The Institute of Education, 20 Bedford Way, London WC1H 0AL, UK
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