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Mosadeghrad AM, Afshari M, Isfahani P, Ezzati F, Abbasi M, Farahani SA, Zahmatkesh M, Eslambolchi L. Strategies to strengthen the resilience of primary health care in the COVID-19 pandemic: a scoping review. BMC Health Serv Res 2024; 24:841. [PMID: 39054502 PMCID: PMC11270795 DOI: 10.1186/s12913-024-11278-4] [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: 01/14/2024] [Accepted: 07/03/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Primary Health Care (PHC) systems are pivotal in delivering essential health services during crises, as demonstrated during the COVID-19 pandemic. With varied global strategies to reinforce PHC systems, this scoping review consolidates these efforts, identifying and categorizing key resilience-building strategies. METHODS Adopting Arksey and O'Malley's scoping review framework, this study synthesized literature across five databases and Google Scholar, encompassing studies up to December 31st, 2022. We focused on English and Persian studies that addressed interventions to strengthen PHC amidst COVID-19. Data were analyzed through thematic framework analysis employing MAXQDA 10 software. RESULTS Our review encapsulated 167 studies from 48 countries, revealing 194 interventions to strengthen PHC resilience, categorized into governance and leadership, financing, workforce, infrastructures, information systems, and service delivery. Notable strategies included telemedicine, workforce training, psychological support, and enhanced health information systems. The diversity of the interventions reflects a robust global response, emphasizing the adaptability of strategies across different health systems. CONCLUSIONS The study underscored the need for well-resourced, managed, and adaptable PHC systems, capable of maintaining continuity in health services during emergencies. The identified interventions suggested a roadmap for integrating resilience into PHC, essential for global health security. This collective knowledge offered a strategic framework to enhance PHC systems' readiness for future health challenges, contributing to the overall sustainability and effectiveness of global health systems.
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Affiliation(s)
- Ali Mohammad Mosadeghrad
- Health policy and management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Health policy, School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran
| | - Parvaneh Isfahani
- Health management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Farahnaz Ezzati
- Health services management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Abbasi
- Health services management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Akhavan Farahani
- Health services management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Zahmatkesh
- Health Management, School of Business and Management, Royal Holloway University of London, London, UK
| | - Leila Eslambolchi
- Health services management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Iran.
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Mohmad S, Lee KY, Bakit P. Do health-care institutions perform better under leaders with medical or non-medical backgrounds? A scoping review. Leadersh Health Serv (Bradf Engl) 2024; 37:142-156. [PMID: 38809264 DOI: 10.1108/lhs-11-2023-0084] [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] [Indexed: 05/30/2024]
Abstract
PURPOSE This study aims to summarize studies that compared the performance of health-care institutions led by leaders with medical background versus those with no medical background. DESIGN/METHODOLOGY/APPROACH A systematic search was conducted on three databases: PubMed, Ovid Medline and Google Scholar to identify relevant peer-reviewed studies using the keywords "performance," "impact," "physician," "medical," "doctor," "leader," "healthcare institutions" and "hospital." Only quantitative studies that compared the performance of health-care institutions led by leaders with medical background versus non-medical background were included. Articles were screened and assessed for eligibility before the relevant data were extracted to summarize, appraise and make a narrative account of the findings. FINDINGS A total of eight studies were included, four were based in the USA, two in the UK and one from Germany and one from the Arab World. Half of the studies (n = 4) reported overall better health-care institutional performance in terms of hospital quality ranking such as clinical effectiveness and patient safety under leaders with medical background, whereas one study showed poorer performance. The remaining studies reported mixed results among the different performance indicators, especially financial performance. PRACTICAL IMPLICATIONS While medical background leaders may have an edge in clinical competence to manage health-care institutions, it will be beneficial to equip them with essential management skills to optimize leadership competence and enhance organizational performance. ORIGINALITY/VALUE The exclusive inclusion of quantitative empirical studies that compared health-care institutional performance medical and non-medical leaders provides a clearer link between the relationship between health-care institutional performance and the leaders' background.
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Affiliation(s)
- Shazwani Mohmad
- Centre for Leadership and Professional Development, Institute for Health Management, National Institutes of Health (NIH), Shah Alam, Malaysia and Seremban District Health Office, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Kun Yun Lee
- Centre for Leadership and Professional Development, Institute for Health Management, National Institutes of Health (NIH), Shah Alam, Malaysia
| | - Pangie Bakit
- Centre for Leadership and Professional Development, Institute for Health Management, National Institutes of Health (NIH), Shah Alam, Malaysia
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Ahmed Z, Ellahham S, Soomro M, Shams S, Latif K. Exploring the impact of compassion and leadership on patient safety and quality in healthcare systems: a narrative review. BMJ Open Qual 2024; 13:e002651. [PMID: 38719520 PMCID: PMC11086414 DOI: 10.1136/bmjoq-2023-002651] [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: 10/16/2023] [Accepted: 03/05/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Patient safety and healthcare quality are considered integral parts of the healthcare system that are driven by a dynamic combination of human and non-human factors. This review article provides an insight into the two major human factors that impact patient safety and quality including compassion and leadership. It also discusses how compassion is different from empathy and explores the impact of both compassion and leadership on patient safety and healthcare quality. In addition, this review also provides strategies for the improvement of patient safety and healthcare quality through compassion and effective leadership. METHODS This narrative review explores the existing literature on compassion and leadership and their combined impact on patient safety and healthcare quality. The literature for this purpose was gathered from published research articles, reports, recommendations and guidelines. RESULTS The findings from the literature suggest that both compassion and transformational leadership can create a positive culture where healthcare professionals (HCPs) prioritise patient safety and quality. Leaders who exhibit compassion are more likely to inspire their teams to deliver patient-centred care and focus on error prevention. CONCLUSION Compassion can become an antidote for the burnout of HCPs. Compassion is a behaviour that is not only inherited but can also be learnt. Both compassionate care and transformational leadership improve organisational culture, patient experience, patient engagement, outcomes and overall healthcare excellence. We propose that transformational leadership that reinforces compassion remarkably improves patient safety, patient engagement and quality.
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Affiliation(s)
- Zakiuddin Ahmed
- Institute of Innovation Leadership in Medicine, Karachi, Pakistan
- Riphah Institute of Healthcare Improvement and Safety (RIHIS), Islamabad, Pakistan
| | | | | | - Sohaima Shams
- Institute of Innovation Leadership in Medicine, Karachi, Pakistan
| | - Kanwal Latif
- Health Research Advisory Board, Karachi, Pakistan
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Oskarsson IML, Vik E. Suggesting a holistic framework for understanding healthcare services leadership competence - a critical interpretive synthesis. Leadersh Health Serv (Bradf Engl) 2024; 37:99-129. [PMID: 38619933 DOI: 10.1108/lhs-08-2023-0059] [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] [Indexed: 04/17/2024]
Abstract
PURPOSE Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners. DESIGN/METHODOLOGY/APPROACH In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence. FINDINGS Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal - and technical, and organisational internal and - external competencies. RESEARCH LIMITATIONS/IMPLICATIONS This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books. PRACTICAL IMPLICATIONS The holistic framework for healthcare leadership competences offers a common understanding of a "fuzzy" concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders. ORIGINALITY/VALUE This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.
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Affiliation(s)
| | - Erlend Vik
- Department of Business Administration and Social Sciences, Molde University College, Molde, Norway
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Mosadeghrad AM, Isfahani P, Eslambolchi L, Zahmatkesh M, Afshari M. Strategies to strengthen a climate-resilient health system: a scoping review. Global Health 2023; 19:62. [PMID: 37641052 PMCID: PMC10463427 DOI: 10.1186/s12992-023-00965-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Climate change is a major global threat to human health and puts tremendous pressure on health systems. Therefore, a resilient health system is crucial to enhance, maintain, and restore the population's health. This study aimed to identify interventions and actions to strengthen a climate-resilient health system to deal with the adverse health effects of climate change. METHOD This study was a scoping review. Five databases and Google Scholar search engine were searched using relevant keywords. Initially, 4945 documents were identified, and 105 were included in the review. Content thematic analysis method was applied using MAXQDA 10 software. RESULTS Overall, 87 actions were identified for building a climate-resilient health system and were classified into six themes (i.e., governance and leadership; financing; health workforce; essential medical products and technologies; health information systems; and service delivery). The most commonly reported actions were formulating a national health and climate change adaptation plan, developing plans for essential services (electricity, heating, cooling, ventilation, and water supply), assessing the vulnerabilities and capacities of the health system, and enhancing surveillance systems targeting climate-sensitive diseases and their risk sources. CONCLUSIONS A holistic and systemic approach is needed to build a climate-resilient health system owing to its complex adaptive nature. Strong governance and leadership, raising public awareness, strategic resource allocation, climate change mitigation, emergency preparedness, robust health services delivery, and supporting research, are essential to building a climate-resilient health system.
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Affiliation(s)
- Ali Mohammad Mosadeghrad
- Professor of Health policy and management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Leila Eslambolchi
- PhD in Health management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Maryam Zahmatkesh
- School of Business and Management, Royal Holloway University of London, Egham, England
| | - Mahnaz Afshari
- School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
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Ezzati F, Mosadeghrad AM, Jaafaripooyan E. Resiliency of the Iranian healthcare facilities against the Covid-19 pandemic: challenges and solutions. BMC Health Serv Res 2023; 23:207. [PMID: 36859284 PMCID: PMC9975873 DOI: 10.1186/s12913-023-09180-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/14/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Health care facilities are responsible for preventing and controlling diseases and must be resilient enough to deal with crises. The Iranian health care facilities have faced challenges in managing COVID-19 pandemic. The purpose of this study was to identify the challenges faced by the Iranian health care facilities during the Covid-19 epidemic and to provide solutions. METHODS This qualitative study was conducted with a phenomenological approach and using semi-structured interviews with 59 healthcare policy makers, managers, and employees, and medical university faculty members. The participants were selected through purposive and snowball sampling. Thematic analysis was used to analyze the data. RESULTS Overall, 43 challenges to the resilience of health care facilities during the Covid-19 pandemic were identified and grouped into 8 themes (i.e., leadership and management, planning, organizational culture, organizational learning, employee management, customer management, resource management, and process management. The most important resilience challenges were: fragmented management system; poor leadership; incompatible health network structure; lack of a national holistic plan; poor case detection; insufficient resources; inefficient information system; negative attitude of managers and employee; organizational inertia; failure to build on lessons learned from crises; low workforce preparedness; lack of community-based management; and improper monitoring and evaluation. Managers should use community-based, evidence-based, and integrated management to build health system resilience against COVID-19, have sufficient knowledge and experience to organize operations, use appropriate and effective coordination models, develop a creative and participatory culture, reengineer processes, and provide necessary resources. CONCLUSION The Iranian health care facilities face challenges that prevent them from becoming resilient, responsive, and efficient in managing COVID-19. Policy makers and managers should increase the resilience of health care facilities to shocks and crises by using the suggested measures.
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Affiliation(s)
- Farahnaz Ezzati
- grid.411705.60000 0001 0166 0922Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammad Mosadeghrad
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ebrahim Jaafaripooyan
- grid.411705.60000 0001 0166 0922Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Hadian SA, Yarmohammadian MH, Shaarbafchizadeh N. The organizational health components for small-sized health-care organizations: A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:37. [PMID: 37034860 PMCID: PMC10079190 DOI: 10.4103/jehp.jehp_1307_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 12/29/2021] [Indexed: 06/19/2023]
Abstract
BACKGROUND Organizational health (OH) is an organizational aspect in which staff is encouraged to be clearly involved and participate in decision-making, problem solving, and collaborating to improve organizational climate and culture. Multilevel staff involvement facilitates strengthened relationships, open communication, trust, and organizational commitment. The purpose of this study was to find components of OH for small-sized health-care organizations. METHODS A systematic review across three key databases by using an extensive list of keywords components and interventions was conducted. This survey included studies that explored various OH elements, components and interventions. RESULTS It comprises 34 full-text studies from 221 received studies. Afterward, the OH elements were classified into three main categories (OH elements, organizational health literacy, and organizational health interventions). Then, according to the reviewed data, 23 dimensions were defined similarly for all groups of studies and relevant explanations related to them were reported. CONCLUSION The OH encompasses multiple dimensions. Empirical research is required for designing a questionnaire according to the final extracted components and measuring its validation in small-sized health organizations.
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Affiliation(s)
- Shirin Alsadat Hadian
- Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Yarmohammadian
- Health Management and Economics Research Center, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Shaarbafchizadeh
- Health Management and Economics Research Center, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Poursheikhali A, Alkhaldi M, Dehnavieh R, Haghdoost A, Masoud A, Noorihekmat S, Cheshmyazdan MR, Bamir M. What the policy and stewardship landscape of a national health research system looks like in a developing country like Iran: a qualitative study. Health Res Policy Syst 2022; 20:116. [PMID: 36307850 PMCID: PMC9617330 DOI: 10.1186/s12961-022-00905-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/02/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The health research system (HRS) is an important national priority that requires a systematic and functional approach. Evaluating the HRS of Iran as a developing country and identifying its challenges reveals the stewardship-related role in how the whole system is operating well. This study aims to assess the HRS in terms of stewardship functions and highlight the enhancement points. METHODS This study was carried out between March 2020 and April 2021 using a systematic review and meta-synthesis of evidence to examine the Iranian HRS stewardship challenges and interview 32 stakeholders, using a critical case sampling and snowballing approach which included both semi-structured and in-depth interviews. The interviewees were selected based on criteria covering policy-makers, managers, research bodies and nongovernmental organizations (NGOs) in health research-related fields like higher education, research, technology, innovation and science. All data were analysed using content analysis to determine eight main groups of findings under three levels: macro, meso, and micro. RESULTS Analysis of the findings identified eight main themes. The most critical challenges were the lack of an integrated leadership model and a shared vision among different HRS stakeholders. Their scope and activities were often contradictory, and their role was not clarified in a predetermined big picture. The other challenges were legislation, priority-setting, monitoring and evaluation, networking, and using evidence as a decision support base. CONCLUSIONS Stewardship functions are not appropriately performed and are considered the root causes of many other HRS challenges in Iran. Formulating a clear shared vision and a work scope for HRS actors is critical, along with integrating all efforts towards a unified strategy that assists in addressing many challenges of HRS, including developing strategic plans and future-oriented and systematic research, and evaluating performance. Policy-makers and senior managers need to embrace and use evidence, and effective networking and communication mechanisms among stakeholders need to be enhanced. An effective HRS can be achieved by redesigning the processes, regulations and rules to promote transparency and accountability within a well-organized and systematic framework.
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Affiliation(s)
- Atousa Poursheikhali
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, Iran
| | - Mohammed Alkhaldi
- McGill University Health Center, Faculty and Department of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Health System Impact Fellowship, Canadian Institutes of Health Research, Ottawa, Canada
- Department of Environmental Health Sciences, Canadian University Dubai, Dubai, United Arab Emirates
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Reza Dehnavieh
- Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - AliAkbar Haghdoost
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, Iran.
| | - Ali Masoud
- Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Somayeh Noorihekmat
- Social Determinant of Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Cheshmyazdan
- Department of Medical Library and Information Science, Kerman University of Medical Sciences, Kerman, Iran
| | - Mousa Bamir
- Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Mketo AR, Ringo CJ, Nuhu S, Mpambije CJ. Enhancing community participation for environmental health improvement in rural Tanzania: Evidence from Bukombe district. EVALUATION AND PROGRAM PLANNING 2022; 94:102152. [PMID: 35944329 DOI: 10.1016/j.evalprogplan.2022.102152] [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: 11/15/2021] [Revised: 06/10/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
Community participation has become a dominant approach in environmental health-related projects, yet, its enhancement has remained a challenge. This study examines ways of enhancing community participation in environmental health-related initiatives in rural areas of Tanzania. A total of one hundred people (n = 100) were engaged in this study. An embedded case study design was employed, in which multiple methods such as household questionnaires, in-depth interviews, focus group discussions, and document analysis were used in collecting empirical data. Findings show that integration of the community into the development agenda and facilitating communities to access required equipment and tools is vital for enabling participation in environmental health-related matters. Effective and efficient leadership, mobilisation, and sensitisation of communities are operational and functioning strategies to improve environmental health through community participation, while retribution measures may prevent environmental pollution. There is a definite need for the integration of community participation as a key aspect of environmental-related projects and programs in the development policy aiming at improving the environmental health of communities.
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Affiliation(s)
- Ally Rajab Mketo
- Geita Regional Commissioner's Office, P. O. Box 315, Geita, Tanzania.
| | - Cliford J Ringo
- Department of Public Services and Human Resource Management, School of Public Administration and Management, Mzumbe University, P. O. Box 2, Morogoro, Tanzania.
| | - Said Nuhu
- Institute of Human Settlements Studies, Ardhi University, P. O. Box 35124, Dar es Salaam, Tanzania.
| | - Chakupewa Joseph Mpambije
- Mkwawa University College of Education (MUCE), University of Dar es Salaam, P. O. Box 2513, Iringa, Tanzania.
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Mindfulness–based positive transformative leadership development for health organisations. Leadersh Health Serv (Bradf Engl) 2022. [DOI: 10.1108/lhs-04-2022-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Positive transformative leadership development practices in health care are perhaps the most important pathway that, collectively, can be pursued while heading towards a post-corona virus disease 2019 world, and race towards 2030. As a practitioner paper, based on front line and leadership experience, this study aims to argue that we need transformational leaders who will go beyond knowing to practice and implementation. While the findings from research is presented from different organisations and companies, they all have something in common – people. Hence, important lessons can be extrapolated to health-related organisations in the future.
Design/methodology/approach
The approach is based on practical research findings based on the literature. The approach uses real practical examples from companies and organisations to demonstrate the need for a new, radical way forward.
Findings
The findings from the literature clearly indicate that mindfulness-based transformative leadership development program is a worthwhile investment for decision-makers and organisations. A new transformative leader for the future of health care needs to be developed with care with investment in that development.
Research limitations/implications
Implications of this paper show that health-care organisations need to begin this journey. There is a paucity in the literature to demonstrate the implementation of mindfulness-based transformative leadership development programs.
Practical implications
Organisations of the future face even greater challenges brought about by intelligent technology, new pandemics and even tighter government regulation. The time to prepare for such eventualities is now. This is not a choice but an imperative for organisations to know what to do rather than react with regret.
Originality/value
There is a paucity in the health-care literature that tracks, measures, and reports on the long-term results of a mindfulness-based transformative leadership development program. This needs to be addressed, and health care should be a leader in the field of mindfulness and transformative leadership of the future.
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Gharasi Manshadi M, Mosadeghrad AM, Jaafaripooyan E. Reasons for turnover of hospital managers in Iran: A qualitative study. Int J Health Plann Manage 2022; 37:2869-2888. [PMID: 35766139 DOI: 10.1002/hpm.3526] [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: 12/19/2021] [Revised: 04/28/2022] [Accepted: 05/18/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Managerial stability is believed to play a crucial role in the success of health care organisations and health managers. High managerial turnover seems to be a common phenomenon of the Iranian health system. This study thus aimed to investigate the reasons for managerial turnover in Iranian hospitals. METHODS Following a qualitative approach, 53 semi-structured interviews were conducted with different managerial levels in the hospitals, the high officials of medical universities, and health policymakers. Interviewees were selected using the purposive sampling techniques. Interviews were continued up to the data saturation. Data analysis was conducted thematically using MAXQDA 10. RESULTS Four groups of reasons were identified leading into the managerial turnover in hospitals, ranging from the micro to macro level factors, that is, those related to the managers, hospitals, medical universities, and the country. Insufficient support from the officials, managerial poor performance, conflict with other managers and colleagues, changes of senior managers, and presidential and parliamentary elections representing the key reasons underlying the turnover of hospital managers in Iran. CONCLUSION Given the variety of reasons emerged behind the managerial turnover, the efforts to improve the awareness and engage the all actors ranging from health policymakers to organisational decision-makers could be a valuable step to regulate and optimise the managerial turnover and stability in health care organisations in order to enhance the productivity and accountability in healthcare industry, particularly in the hospitals.
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Affiliation(s)
- Mahdi Gharasi Manshadi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammad Mosadeghrad
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Jaafaripooyan
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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12
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Jodaki K, Esmaeili M, Cheraghi MA, Mazaheri M. Intensive care unit nurses' conflict of conscience: Walking the Razor's edge. Nurs Health Sci 2022; 24:265-273. [PMID: 35061324 DOI: 10.1111/nhs.12921] [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: 11/21/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/28/2022]
Abstract
The study aimed to explore the conditions that accompany conflict of conscience experienced by nurses in intensive care units. A qualitative approach guided the study, which was undertaken between April 2020 and April 2021. A total of 15 registered nurses working in intensive care units were recruited through purposive sampling. Individual semistructured interviews were conducted. The data were analyzed using a qualitative content analysis. The analysis revealed two themes: "conflict of conscience in relation to the structure" and "conflict of conscience based on context." Conflict of conscience in relation to the structure consisted of two categories: conflict of interest and conflict of conscience and law. Conflict of conscience based on context consisted of two categories: care dilemmas and arbitrary behaviors with end-stage patients. A variety of factors were accompanied by a conflict of conscience for nurses in intensive care units. Given that conflict of conscience has negative consequences for the health and quality of nursing care, health care managers need to tailor strategies to reduce the negative consequences considering the findings of the study.
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Affiliation(s)
- Kurosh Jodaki
- PhD Candidate of Nursing, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Esmaeili
- Associate Professor, Nursing and Midwifery care research center, School of Nursing and Midwifery, Tehran University of Medical Sciences; Health Sciences Phenomenology Association, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Ali Cheraghi
- Associate Professor, Nursing and Midwifery care research center, School of Nursing and Midwifery, Tehran University of Medical Sciences; Health Sciences Phenomenology Association, Ministry of Health and Medical Education, Tehran, Iran
| | - Monir Mazaheri
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden
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Mosadeghrad AM, Ghazanfari F. Developing a hospital accreditation model: a Delphi study. BMC Health Serv Res 2021; 21:879. [PMID: 34445975 PMCID: PMC8393439 DOI: 10.1186/s12913-021-06904-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/17/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Hospital accreditation (HA) is an external evaluation of a hospital's structures, processes and results by an independent professional accreditation body using pre-established optimum standards. The Iranian hospital accreditation system faces several challenges. The overall aim of this study was to develop a model for Iran national hospital accreditation program. METHODS This research uses the modified Delphi technique to develop and verify a model of hospital accreditation. The first draft of the HA model was introduced through a critical review of 20 pioneer accreditation models and semi-structured interviews with 151 key informants from Public, private, semi-public, charity and military hospitals in Iran. Three rounds of Delphi were conducted with 28 experts of hospital accreditation to verify the proposed model. Panel members were selected from authors of research articles and key speakers in the area of hospital accreditation, senior managers of the country's health system, university professors in the fields of health policy and management across the country. RESULTS A comprehensive model for hospital accreditation was introduced and verified in this study. The HA model has ten constructs of which seven are enablers ("Management and leadership", "Planning", "Education and Research", "employee management", "patient management", "resource management", and "process management") and three are the results ("employee results", "patient and society results" and "hospital results"). These constructs were further broken into 43 sub-constructs. The enablers and results scored 65 and 35% of the model's total scores respectively. Then, about 150 accreditation standards were written and verified. CONCLUSIONS A comprehensive hospital accreditation model was developed and verified. Proper attention to structures, processes and outcomes and systemic thinking during the development of the model is one of the advantages of the hospital accreditation model developed in this study. Hospital accreditation bodies can use this model to develop or revise their hospital accreditation models.
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Affiliation(s)
- Ali Mohammad Mosadeghrad
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghazanfari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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14
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Suti Ismawati ND, Supriyanto S, Haksama S, Hadi C. The influence of knowledge and perceptions of doctors on the quality of medical records. J Public Health Res 2021; 10. [PMID: 33855413 PMCID: PMC8129755 DOI: 10.4081/jphr.2021.2228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Medical record reflects the quality of health services provided, which is influenced by existing resources, such as the doctors in charge. This study aims to determine whether doctors’ knowledge and perceptions affect the quality of the medical record. Design and Methods: This is a quantitative and cross-sectional study carried out at Dr. Soetomo’s general and academic hospital Surabaya, Indonesia, in September and October 2020. Data were purposively obtained from a total of 45 doctors working at the hospital’s inpatient service surgery ward using the questionnaire and checklist medical record quality. Furthermore, ethical clearance and doctors’ informed consent were obtained, with the data statistically processed and analyzed by multiple linear regressions. Results: The results and conclusion showed that doctors’ knowledge and perceptions of the quality of medical records were influence to medical record quality (p<0.05). Conclusions: Hospital management needs to regularly increase doctors’ knowledge and perceptions by socializing and monitoring medical records. Significance for public health The medical record is the benchmark, and an important instrument used to support health services. Therefore, this paper describes the influence of doctors' knowledge and their perceptions on the quality of medical records.
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Affiliation(s)
| | - Stefanus Supriyanto
- Health Policy and Administration Department, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Setya Haksama
- Health Policy and Administration Department, Faculty of Public Health, Universitas Airlangga, Surabaya.
| | - Cholicul Hadi
- Faculty of Psychology, Universitas Airlangga, Surabaya.
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15
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Zarei L, Shahabi S, Sadati AK, Tabrizi R, Heydari ST, Lankarani KB. Expectations of citizens from the government in response to COVID-19 pandemic: a cross-sectional study in Iran. BMC Public Health 2021; 21:686. [PMID: 33832471 PMCID: PMC8027969 DOI: 10.1186/s12889-021-10722-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 03/28/2021] [Indexed: 02/08/2023] Open
Abstract
Background The government is the main body in charge of controlling epidemics; hence, expectations from the intention and capacities of the government would affect the flexibility and behaviors of citizens. Given the severity of COVID-19 pandemic and the urgent need for cooperation of people in the prevention and combat processes, understanding the public perspectives would be crucial and instructive. This study aimed to explore such perspectives towards the current pandemic among the Iranian. Indeed, we sought to provide a favorable platform for effective policies in the face of the COVID-19 pandemic through recognizing public expectations. Methods This cross-sectional survey used an open-ended online questionnaire to investigate the common perspectives of the Iranian towards the response of government to COVID-19 pandemic. The participants were selected using snowball and convenient sampling techniques across the country. The collected data were analyzed and described using a thematic analysis. Results In general, 2547 participants agreed to participate in this study and completed the online questionnaire. According to the findings, the Iranian exhibited several expectations regarding the response of the government to COVID-19 pandemic. Three main themes were extracted based on these expectations: (1) health-related expectations, (2) policy-related expectations, and (3) Information-related expectations. In this study, a majority of participants highlighted the need to consider and follow-up the patients and their families, providing the financial and hygiene support during the pandemic, applying strict restrictions, and using close monitoring and controlling procedures. Furthermore, they mentioned that authorities and news agencies should observe the principals honesty and transparency. Conclusions Our findings revealed that people expect the government and other responsible institutions to minimize the burden of this pandemic through adopting effective policies. Also, they could help policy-makers become aware of the expectations of people and develop better strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10722-y.
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Affiliation(s)
- Leila Zarei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Ahmad Kalateh Sadati
- Department of Social Sciences, Yazd University, PO Box: 98195-741, University Blvd, Safayieh, Yazd, Iran.
| | - Reza Tabrizi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
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Musie A, Wolvaardt JE. Risk and reward: Experiences of healthcare professionals caring for drug-resistant tuberculosis patients. SOUTH AFRICAN JOURNAL OF HUMAN RESOURCE MANAGEMENT 2021. [DOI: 10.4102/sajhrm.v19i0.1191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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17
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Shaqura II, Baroud R, Sari AA. Collaboration among healthcare professionals at the public hospitals in Gaza: a quantitative study. JOURNAL OF INTEGRATED CARE 2020. [DOI: 10.1108/jica-09-2020-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PurposeThis study aimed at assessing the current interprofessional collaboration (IPC) among healthcare professionals at the public hospitals in the Gaza Strip in 2016 through measuring the average level, and also examind the influence of professionals' characteristics on their collaboration.Design/methodology/approachA quantitative, cross-sectional study using a valid and reliable self-administered questionnaire on a 5-point Likert scale was conducted. A total of 323 participants from six health professions completed the questionnaire which was analyzed using SPSS version 20 by applying descriptive tests, t-test, ANOVA and inferential analysis (Scheffe test); the statistical significance was considered at p = 0.05.FindingsThe interprofessional collaboration was moderate (71.66%). “General relationships” elicited the highest mean score (3.943) due to participants' belief in its importance, whereas “community linkages and coordination of care” was the lowest (3.181) as a result of the restricted policy in this regard. Gender, age, profession and position have shown statistically significant variables on the overall collaboration. In short, there are differences in the performance of IPC domains and even within items of the same domain.Research limitations/implicationsThis study was conducted at only public hospitals; in addition, it was a cross-sectional study, so the causation relationships are difficult to assess. Moreover, the questionnaire was on self-administered basis which might result in misread or misunderstood bias.Originality/valueThis was the first study in the Palestinian context on collaboration between multiple professions using a comprehensive and reliable assessment tool.
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