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Durand F, Fleury MJ. The association between task interdependence and participation in decision-making: a moderated mediation model in mental healthcare. J Interprof Care 2024; 38:826-835. [PMID: 39117019 DOI: 10.1080/13561820.2024.2383239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024]
Abstract
Participation in decision-making is crucial to healthcare workers collaborating across professions. Important correlates of participation in decision-making include task interdependence, informational role self-efficacy, and beliefs in the benefits of interprofessional collaboration. We hypothesised that although task interdependence is directly related to participation in decision-making, the relationship is mediated by informational role self-efficacy. Beliefs in the benefits in interprofessional collaboration act as a mediator. A sample of 315 mental healthcare workers answered validated questionnaires. Conditional processing was used to test the moderated mediation. Generally, the results confirmed our hypotheses. There was a direct relationship between task interdependence and participation in decision-making and it was mediated by informational role self-efficacy, and both relationships depend on whether healthcare workers believe in the benefits of interprofessional collaboration. However, although the moderation effect of beliefs in the benefits of interprofessional collaboration between task interdependence and informational role self-efficacy was positive, the moderation effect was negative for the relationship between task interdependence and participation in decision-making. Although there is an inherent logic in the positive relationships that were found, the negative moderation might be explained by the contrast between the structural view and the volitional view of task interdependence.
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Affiliation(s)
- François Durand
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Marie-Josée Fleury
- Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
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Brooks SP, Zimmermann GL, Lang M, Scott SD, Thomson D, Wilkes G, Hartling L. A framework to guide storytelling as a knowledge translation intervention for health-promoting behaviour change. Implement Sci Commun 2022; 3:35. [PMID: 35346397 PMCID: PMC8962242 DOI: 10.1186/s43058-022-00282-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/12/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Stories can be a powerful tool to increase uptake of health information, a key goal of knowledge translation (KT). Systematic reviews demonstrate that storytelling (i.e. sharing stories) can be effective in changing health-promoting behaviours. Though an attractive KT strategy, storytelling is a complex approach requiring careful planning and consideration of multiple factors. We sought to develop a framework to assist KT researchers and practitioners in health contexts to consider and develop effective KT interventions that include stories or storytelling. METHODS We conducted a broad search of the literature to identify studies that used storytelling as a KT intervention across different disciplines: health research, education, policy development, anthropology, organizational development, technology research, and media. We extracted purposes, theories, models, mechanisms, and outcomes and then mapped the theoretical and practical considerations from the literature onto the Medical Research Council guidance for complex interventions. The theoretical and practical considerations uncovered comprised the basis of the storytelling framework development. Through discussion and consensus, methodological experts refined and revised the framework for completeness, accuracy, nuance, and usability. RESULTS We used a complex intervention lens paired with existing behaviour change techniques to guide appropriate theory-based intervention planning and practical choices. An intentional approach to the development of story-based KT interventions should involve three phases. The theory phase specifies the goal of the intervention, mechanisms of action, and behaviour change techniques that will achieve the intended effects. The modelling phase involves development and testing using an iterative approach, multiple methods and engagement of end-users. Finally, formal evaluation using multiple methods helps determine whether the intervention is having its intended effects and value added. CONCLUSIONS This framework provides practical guidance for designing story-based KT interventions. The framework was designed to make explicit the requisite considerations when determining the appropriateness and/or feasibility of storytelling KT, clarify intervention goals and audience, and subsequently, support the development and testing of storytelling interventions. The framework presents considerations as opposed to being prescriptive. The framework also offers an opportunity to further develop theory and the KT community's understanding of effectiveness and mechanisms of action in storytelling interventions.
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Affiliation(s)
- Stephanie P Brooks
- Alberta SPOR SUPPORT Unit - Learning Health System Team, Department of Medicine, University of Alberta, Edmonton, Canada.
| | - Gabrielle L Zimmermann
- Alberta SPOR SUPPORT Unit - Learning Health System Team, Department of Medicine, University of Alberta, Edmonton, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Michael Lang
- Faculty of Nursing, University of Calgary, Calgary, Canada
| | | | - Denise Thomson
- Alberta SPOR SUPPORT Unit - Learning Health System Team, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Gil Wilkes
- Information Design, School of Communication Studies, Mount Royal University, Calgary, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Canada
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Physicians' Views and Agreement about Patient- and Context-Related Factors Influencing ICU Admission Decisions: A Prospective Study. J Clin Med 2021; 10:jcm10143068. [PMID: 34300235 PMCID: PMC8305175 DOI: 10.3390/jcm10143068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Single patient- and context-related factors have been associated with admission decisions to intensive care. How physicians weigh various factors and integrate them into the decision-making process is not well known. Objectives: First, to determine which patient- and context-related factors influence admission decisions according to physicians, and their agreement about these determinants; and second, to examine whether there are differences for patients with and without advanced disease. Method: This study was conducted in one tertiary hospital. Consecutive ICU consultations for medical inpatients were prospectively included. Involved physicians, i.e., internists and intensivists, rated the importance of 13 factors for each decision on a Likert scale (1 = negligible to 5 = predominant). We cross-tabulated these factors by presence or absence of advanced disease and examined the degree of agreement between internists and intensivists using the kappa statistic. Results: Of 201 evaluated patients, 105 (52.2%) had an advanced disease, and 140 (69.7%) were admitted to intensive care. The mean number of important factors per decision was 3.5 (SD 2.4) for intensivists and 4.4 (SD 2.1) for internists. Patient’s comorbidities, quality of life, preferences, and code status were most often mentioned. Inter-rater agreement was low for the whole population and after stratifying for patients with and without advanced disease. Kappa values ranged from 0.02 to 0.34 for all the patients, from −0.05 to 0.42 for patients with advanced disease, and from −0.08 to 0.32 for patients without advanced disease. The best agreement was found for family preferences. Conclusion: Poor agreement between physicians about patient- and context-related determinants of ICU admission suggests a lack of explicitness during the decision-making process. The potential consequences are increased variability and inequity regarding which patients are admitted. Timely advance care planning involving families could help physicians make the decision most concordant with patient preferences.
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Cullati S, Hudelson P, Ricou B, Nendaz M, Perneger TV, Escher M. Internists' and intensivists' roles in intensive care admission decisions: a qualitative study. BMC Health Serv Res 2018; 18:620. [PMID: 30089526 PMCID: PMC6083517 DOI: 10.1186/s12913-018-3438-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 07/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intensive care Unit (ICU) admission decisions involve collaboration between internists and intensivists. Clear perception of each other's roles is a prerequisite for good collaboration. The objective was to explore how internists and intensivists perceive their roles during admission decisions. METHODS Individual in-depth interviews with 12 intensivists and 12 internists working at a Swiss teaching hospital. Interviews were analyzed using a thematic approach. RESULTS Roles could be divided into practical roles and identity roles. Internist and intensivists had the same perception of each other's practical roles. Internists' practical roles were: recognizing signs of severity when the patient becomes acutely ill, calling the intensivist at the right moment, having the relevant information about the patient and having determined the goals of care. Intensivists' practical roles were: assessing the patient on the ward, giving expert advice, making quick decisions, managing access to the ICU, having the final decision power and, sometimes, deciding whether or not to limit treatment. In complex situations, perceived flaws in performing practical roles could create tensions between the doctors. Intensivists' identity roles included those of leader, gatekeeper, life-death decision maker, and supporting colleague doctors (consultant, senior and helper). These roles could be perceived as emotionally burdensome. Internists' identity roles were those of leader and partner. CONCLUSIONS Despite a common perception of each other's practical roles, tensions can arise between internists and intensivists in complex situations of ICU admission decisions. Training in communication skills and interprofessional education interventions aimed at a better understanding of each other roles would improve collaboration.
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Affiliation(s)
- Stéphane Cullati
- Pain and Palliative Care Consultation, Division of Clinical Pharmacology and Toxicology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Patricia Hudelson
- Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Bara Ricou
- Intensive Care Unit, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Mathieu Nendaz
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of General Internal Medicine, Department of General Internal Medicine, Geriatrics and Rehabilitation, University Hospitals of Geneva, Geneva, Switzerland
| | - Thomas V. Perneger
- Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
| | - Monica Escher
- Pain and Palliative Care Consultation, Division of Clinical Pharmacology and Toxicology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Blondal AB, Jonsson JS, Sporrong SK, Almarsdottir AB. General practitioners’ perceptions of the current status and pharmacists’ contribution to primary care in Iceland. Int J Clin Pharm 2017; 39:945-952. [DOI: 10.1007/s11096-017-0478-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
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The antecedents and consequences of a strong professional identity among medical specialists. SOCIAL THEORY & HEALTH 2014. [DOI: 10.1057/sth.2014.16] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Renkema E, Broekhuis M, Ahaus K. Conditions that influence the impact of malpractice litigation risk on physicians' behavior regarding patient safety. BMC Health Serv Res 2014; 14:38. [PMID: 24460754 PMCID: PMC3905283 DOI: 10.1186/1472-6963-14-38] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 01/22/2014] [Indexed: 11/13/2022] Open
Abstract
Background Practicing safe behavior regarding patients is an intrinsic part of a physician’s ethical and professional standards. Despite this, physicians practice behaviors that run counter to patient safety, including practicing defensive medicine, failing to report incidents, and hesitating to disclose incidents to patients. Physicians’ risk of malpractice litigation seems to be a relevant factor affecting these behaviors. The objective of this study was to identify conditions that influence the relationship between malpractice litigation risk and physicians’ behaviors. Methods We carried out an exploratory field study, consisting of 22 in-depth interviews with stakeholders in the malpractice litigation process: five physicians, two hospital board members, five patient safety staff members from hospitals, three representatives from governmental healthcare bodies, three healthcare law specialists, two managing directors from insurance companies, one representative from a patient organization, and one representative from a physician organization. We analyzed the comments of the participants to find conditions that influence the relationship by developing codes and themes using a grounded approach. Results We identified four factors that could affect the relationship between malpractice litigation risk and physicians’ behaviors that run counter to patient safety: complexity of care, discussing incidents with colleagues, personalized responsibility, and hospitals’ response to physicians following incidents. Conclusion In complex care settings procedures should be put in place for how incidents will be discussed, reported and disclosed. The lack of such procedures can lead to the shift and off-loading of responsibilities, and the failure to report and disclose incidents. Hospital managers and healthcare professionals should take these implications of complexity into account, to create a supportive and blame-free environment. Physicians need to know that they can rely on the hospital management after reporting an incident. To create realistic care expectations, patients and the general public also need to be better informed about the complexity and risks of providing health care.
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Affiliation(s)
- Erik Renkema
- University of Groningen, Faculty of Economics and Business, Operations Department, P,O, Box 800, 9700, AV Groningen, The Netherlands.
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Hazy JK, Uhl-Bien M. Towards operationalizing complexity leadership: How generative, administrative and community-building leadership practices enact organizational outcomes. LEADERSHIP 2013. [DOI: 10.1177/1742715013511483] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over five years ago, The Leadership Quarterly published a special issue on complexity to advance a new way of thinking about leadership. In shifting attention away from the individual to the organizing process itself, complexity added an important focus on process and context to leadership and management research. Yet, the complexity approach creates challenges for researchers who must combine or replace individual level constructs—like those built through surveys or factor analysis—with richer theories that investigate networked meso dynamics, multilevel phenomena, emergent processes, and organizational outcomes. To address this challenge, the present analysis draws on theoretical and empirical work over the last several years to identify five specific areas where complexity inspired research has led to new insights about the mechanisms that enable the organization to perform and adapt. It suggests propositions that describe how leadership and management, defined holistically, might activate complexity mechanisms to perform five essential organizing functions.
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Affiliation(s)
- James K Hazy
- Adelphi University, Garden City, NY, USA; Mälardalen University, Sweden
- University of Nebraska, Lincoln, NE, USA
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Curşeu PL. Demographic diversity, communication and learning behaviour in healthcare groups. Int J Health Plann Manage 2012; 28:238-47. [PMID: 22847617 DOI: 10.1002/hpm.2130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 06/26/2012] [Accepted: 07/05/2012] [Indexed: 11/07/2022] Open
Abstract
An integrative model of group learning was tested in a sample of 40 healthcare groups (434 respondents), and the results show that age diversity reduces the frequency of face-to-face communication whereas educational diversity reduces the frequency of virtual communication in healthcare groups. Frequency of communication (both face-to-face and virtual), in turn, positively impacts on the emergence of trust and psychological safety, which are essential drivers of learning behaviours in healthcare groups. Additional results show that average educational achievement within groups is conducive for communication frequency (both face-to-face and virtual), whereas mean age within groups has a negative association with the use of virtual communication in healthcare groups.
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Affiliation(s)
- Petru Lucian Curşeu
- Department of Organisation Studies, Tilburg University, Tilburg, The Netherlands.
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Grutterink H, Van der Vegt GS, Molleman E, Jehn KA. Reciprocal Expertise Affirmation and Shared Expertise Perceptions in Work Teams: Their Implications for Coordinated Action and Team Performance. APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE 2012. [DOI: 10.1111/j.1464-0597.2012.00484.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Broekhuis M, Pieter van Donk D. Coordination of physicians' operational activities: a contingency perspective. INTERNATIONAL JOURNAL OF OPERATIONS & PRODUCTION MANAGEMENT 2011. [DOI: 10.1108/01443571111111919] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Daniels K, Jonge J. Match making and match breaking: The nature of match within and around job design. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2010. [DOI: 10.1348/096317909x485144] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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