1
|
Mirbahaeddin E, Chreim S. Transcending technology boundaries and maintaining sense of community in virtual mental health peer support: a qualitative study with service providers and users. BMC Health Serv Res 2024; 24:510. [PMID: 38658968 PMCID: PMC11040832 DOI: 10.1186/s12913-024-10943-y] [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: 01/12/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND This qualitative study explores the experiences of peer support workers (PSWs) and service users (or peers) during transition from in-person to virtual mental health services. During and following the COVID-19 pandemic, the need for accessible and community-based mental health support has become increasingly important. This research aims to understand how technological factors act as bridges and boundaries to mental health peer support services. In addition, the study explores whether and how a sense of community can be built or maintained among PSWs and peers in a virtual space when connections are mediated by technology. This research fills a gap in the literature by incorporating the perspectives of service users and underscores the potential of virtual peer support beyond pandemic conditions. METHODS Data collection was conducted from a community organization that offers mental health peer support services. Semi-structured interviews were conducted with 13 employees and 27 service users. Thematic analysis was employed to identify key themes and synthesize a comprehensive understanding. RESULTS The findings highlight the mental health peer support needs that were met through virtual services, the manifestation of technology-based boundaries and the steps taken to remove some of these boundaries, and the strategies employed by the organization and its members to establish and maintain a sense of community in a virtual environment marked by physical distancing and technology-mediated interrelations. The findings also reveal the importance of providing hybrid services consisting of a mixture of in person and virtual mental health support to reach a broad spectrum of service users. CONCLUSIONS The study contributes to the ongoing efforts to enhance community mental health services and support in the virtual realm. It shows the importance of virtual peer support in situations where in-person support is not accessible. A hybrid model combining virtual and in-person mental health support services is recommended for better accessibility to mental health support services. Moreover, the importance of organizational support and of equitable resource allocation to overcome service boundaries are discussed.
Collapse
Affiliation(s)
- Elmira Mirbahaeddin
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, K1N 6N5, Ottawa, ON, Canada.
| | - Samia Chreim
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, K1N 6N5, Ottawa, ON, Canada
| |
Collapse
|
2
|
Choi KE(A, Lindert L, Schlomann L, Pfaff H. "I'll leave that to the case managers." Healthcare Service Providers' Perceptions of Organizational Readiness for Change in a Randomized Controlled Trial-A Qualitative Analysis Exploring Implementation Success. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095782. [PMID: 35565177 PMCID: PMC9104361 DOI: 10.3390/ijerph19095782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/24/2022] [Accepted: 05/07/2022] [Indexed: 11/16/2022]
Abstract
Up to 50% of unsuccessful implementations of organizational change are due to a lack of organizational readiness for change (ORC). This qualitative study aims to investigate the experiences of occupational physicians (OPs) and staff of test and training centers (ETTCs) with team effectiveness in the context of ORC. The change setting is the implementation of a new occupational health program in a multicentric randomized controlled trial for musculoskeletal disorders (MSD) in Germany. Two rounds of expert interviews with OPs (1st round: n = 10, 2nd round: n = 13) and one round of expert interviews with ETTCs (n = 9) were conducted and analyzed with a deductive-inductive procedure. The focus of the analysis was the assessment of change commitment and change efficacy, as well as their influence on general ORC on a collective level according to Weiner's model (2009). Differential critical assessment of change by the care providers led to a missing collective change commitment and consequently to a missing organizational change commitment. Main inhibiting factors include lacking feedback about (e.g., recruitment) success, limited time resources of and narrow communication between responsible study staff, along with a low rate of utilization and limited adherence of the study population. Main facilitators include standardized procedures and documentation along with easy-access digital tools. Researchers may use the findings to improve the development of new intervention studies, especially in a randomized setting.
Collapse
Affiliation(s)
- Kyung-Eun (Anna) Choi
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany;
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Medicine, University Hospital Cologne, Faculty of Human Sciences, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany; (L.S.); (H.P.)
- Health Services Research, MIAAI group, Faculty of Medicine/Dentistry, Danube Private University, Steiner Landstr. 124, 3500 Krems an der Donau, Austria
- Correspondence: ; Tel.: +49-(0)33638-83987
| | - Lara Lindert
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Str. 38, 16816 Neuruppin, Germany;
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Medicine, University Hospital Cologne, Faculty of Human Sciences, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany; (L.S.); (H.P.)
| | - Lara Schlomann
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Medicine, University Hospital Cologne, Faculty of Human Sciences, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany; (L.S.); (H.P.)
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Medicine, University Hospital Cologne, Faculty of Human Sciences, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany; (L.S.); (H.P.)
| |
Collapse
|
3
|
Kadakia N, Horn E, Fawcett N, Ou A, Illingworth K. Utilization of an implementation framework to obtain provider perspectives of pharmacist-led clinical services. J Am Pharm Assoc (2003) 2022; 62:1659-1665.e3. [DOI: 10.1016/j.japh.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/02/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
|
4
|
Le K, Chen TA, Martinez Leal I, Correa-Fernández V, Obasi EM, Kyburz B, Williams T, Casey K, Brown HA, O’Connor DP, Reitzel LR. Organizational-Level Moderators Impacting Tobacco-Related Knowledge Change after Tobacco Education Training in Substance Use Treatment Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7597. [PMID: 34300052 PMCID: PMC8305177 DOI: 10.3390/ijerph18147597] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 02/02/2023]
Abstract
Tobacco use is disproportionately elevated among patients with substance use disorders relative to the general U.S. population. Tobacco interventions are lacking within substance use treatment centers (SUTCs) due to lack of knowledge and training. This study examined knowledge gain and the organizational factors that might moderate knowledge gains following tobacco education training provided to employees (N = 580) within 15 SUTCs that were participating in a tobacco-free workplace program. The number of total annual patient visits, unique annual patient visits, number of full-time employees, and organizational readiness for implementing change (ORIC) as assessed prior to implementation were examined as potential moderators. Results demonstrated significant knowledge gain (p < 0.001) after training overall; individually, 13 SUTCs had significant knowledge gain (p's < 0.014). SUTCs with fewer total annual patient visits and fewer full-time employees showed greater knowledge gains. The ORIC total score and all but one of its subscales (Resource Availability) moderated knowledge gain. SUTCs with greater initial Change Efficacy (p = 0.029), Valence (p = 0.027), and Commitment (p < 0.001) had greater knowledge gain than SUTCs with lower scores on these constructs; SUTCs with greater Task Knowledge (p < 0.001) regarding requirements for change exhibited less knowledge gain. Understanding the organizational-level factors impacting training effectiveness can inform efforts in organizational change and tobacco control program implementation.
Collapse
Affiliation(s)
- Kathy Le
- Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA;
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA; (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (H.A.B.)
- HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Tzuan A. Chen
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA; (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (H.A.B.)
- HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Isabel Martinez Leal
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA; (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (H.A.B.)
- HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Virmarie Correa-Fernández
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA; (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (H.A.B.)
- HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Ezemenari M. Obasi
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA; (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (H.A.B.)
- HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Bryce Kyburz
- Integral Care, 1430 Collier Street, Austin, TX 78704, USA; (B.K.); (T.W.); (K.C.)
| | - Teresa Williams
- Integral Care, 1430 Collier Street, Austin, TX 78704, USA; (B.K.); (T.W.); (K.C.)
| | - Kathleen Casey
- Integral Care, 1430 Collier Street, Austin, TX 78704, USA; (B.K.); (T.W.); (K.C.)
| | - Haleem A. Brown
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA; (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (H.A.B.)
- HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Daniel P. O’Connor
- Department of Health & Human Performance, The University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204, USA;
| | - Lorraine R. Reitzel
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA; (T.A.C.); (I.M.L.); (V.C.-F.); (E.M.O.); (H.A.B.)
- HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| |
Collapse
|
5
|
Côté A, Abasse KS, Laberge M, Gilbert MH, Breton M, Lemaire C. Orthopedist involvement in the management of clinical activities: a case study. BMC Health Serv Res 2021; 21:299. [PMID: 33794873 PMCID: PMC8017788 DOI: 10.1186/s12913-021-06299-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 03/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rapid shift in hospital governance in the past few years suggests greater orthopedist involvement in management roles, would have wide-reaching benefits for the efficiency and effectiveness of healthcare delivery. This paper analyzes the dynamics of orthopedist involvement in the management of clinical activities for three orthopedic care pathways, by examining orthopedists' level of involvement, describing the implications of such involvement, and indicating the main responses of other healthcare workers to such orthopedist involvement. METHODS We selected four contrasting cases according to their level of governance in a Canadian university hospital center. We documented the institutional dynamics of orthopedist involvement in the management of clinical activities using semi-structured interviews until data saturation was reached at the 37th interview. RESULTS Our findings show four levels (Inactive, Reactive, Contributory and Active) of orthopedist involvement in clinical activities. With the underlying nature of orthopedic surgeries, there are: (i) some activities for which decisions cannot be programmed in advance, and (ii) others for which decisions can be programmed. The management of unforeseen events requires a higher level of orthopedist involvement than the management of events that can be programmed. CONCLUSIONS Beyond simply identifying the underlying dynamics of orthopedists' involvement in clinical activities, this study analyzed how such involvement impacts management activities and the quality-of-care results for patients.
Collapse
Affiliation(s)
- André Côté
- Centre de recherche en gestion des services de santé, Université Laval, Québec City, Canada.,Faculté des sciences de l'administration (FSA), Université Laval, Québec, QC, G1V 0A6, Canada.,Centre de recherche en soins et services de première ligne- Université Laval, Québec, Canada.,Centre de recherche du centre hospitalier de l'Université Laval, Québec, Canada.,Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Québec, Canada
| | - Kassim Said Abasse
- Centre de recherche en gestion des services de santé, Université Laval, Québec City, Canada. .,Faculté des sciences de l'administration (FSA), Université Laval, Québec, QC, G1V 0A6, Canada. .,Centre de recherche en soins et services de première ligne- Université Laval, Québec, Canada. .,Centre de recherche du centre hospitalier de l'Université Laval, Québec, Canada. .,Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Québec, Canada.
| | - Maude Laberge
- Faculté des sciences de l'administration (FSA), Université Laval, Québec, QC, G1V 0A6, Canada.,Centre de recherche en soins et services de première ligne- Université Laval, Québec, Canada.,Centre de recherche du centre hospitalier de l'Université Laval, Québec, Canada.,Département d'opérations et systèmes de décision
- , Faculté des sciences de l'administration (FSA) Université Laval, Québec, QC, G1V 0A6, Canada
| | - Marie-Hélène Gilbert
- Centre de recherche en gestion des services de santé, Université Laval, Québec City, Canada.,Faculté des sciences de l'administration (FSA), Université Laval, Québec, QC, G1V 0A6, Canada
| | - Mylaine Breton
- Université de Sherbrooke, Longueuil Campus, Sherbrooke, Canada
| | - Célia Lemaire
- EM Strasbourg Business School, Université de Strasbourg, HuManiS (UR 7308), Strasbourg, France
| |
Collapse
|
6
|
Abstract
Introduction Person-centred integrated care is often at odds with how current health care systems are structured, resulting in slower than expected uptake of the model worldwide. Adopting goal-oriented care, an approach which uses patient priorities, or goals, to drive what kinds of care are appropriate and how care is delivered, may offer a way to improve implementation. Description This case report presents three international cases of community-based primary health care models in Ottawa (Canada), Vermont (USA) and Flanders (Belgium) that adopted goal-oriented care to stimulate clinical, professional, organizational and system integration. The Rainbow Model of Integrated Care is used to demonstrate how goal-oriented care drove integration at all levels. Discussion The three cases demonstrate how goal-oriented care has the potential to catalyse integrated care. Exploration of these cases suggests that goal-oriented care can serve to activate formative and normative integration mechanisms; supporting processes that enable integrated care, while providing a framework for a shared philosophy of care. Lessons learned By establishing a common vision and philosophy to drive shared processes, goal-oriented care can be a powerful tool to enable integrated care delivery. Offering plenty of opportunities for training in goal-oriented care within and across teams is essential to support this shift.
Collapse
|
7
|
Persaud DD, Murphy M. The ELIAS framework: A prescription for innovation and change. Healthc Manage Forum 2020; 34:56-61. [PMID: 32844685 DOI: 10.1177/0840470420950361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Healthcare is a complex adaptive system with multiple stakeholders and dynamic environments. Therefore, healthcare organizations must continuously learn, innovate, adapt, and co-evolve to be successful. This article describes a systematic, comprehensive, and holistic performance management framework that healthcare managers can use to achieve these goals. The framework involves the ongoing assessment, modification, or replacement of current programs or services aimed at adapting successfully to achieve the organization's strategic objectives. This is engendered by the presence of a culture that is premised on continuous learning and innovation. The foundation of the framework is based on accountability, the organization's strategy, and its culture. This then acts as the basis for an ongoing process of measurement, disconfirmation, contextualization, implementation, and routinization that enhances learning, innovation, adaptation, and sustainability within the healthcare organization.
Collapse
Affiliation(s)
| | - Matthew Murphy
- 432234Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| |
Collapse
|