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Bernardes A, Gabriel CS, Cummings GG, Zanetti ACB, Leoneti AB, Caldana G, Maziero VG. Organizational culture, authentic leadership and quality improvement in Canadian healthcare facilities. Rev Bras Enferm 2021; 73Suppl 5:e20190732. [PMID: 33027497 DOI: 10.1590/0034-7167-2019-0732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 06/10/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate relationships among flexible and hierarchical organizational cultures, quality improvement domains, and authentic leadership competencies in Canadian healthcare facilities. METHOD Observational cross-sectional study conducted in Alberta, Canada. Nurse managers (n=226) completed a survey including validated measures of organizational culture, quality improvement and authentic leadership. Data were analyzed using descriptive statistics, Spearman's correlation coefficient and Chi-squared test (p<0.05). RESULTS Quality improvement through accreditation is related to organizational culture and authentic leadership. We saw a propensity for participants who reported working in a more flexible culture also reported greater quality improvement implementation and authentic leadership practices. CONCLUSION This study assessed and reported the relationships between flexible organizational cultures, quality improvement through the accreditation process, and authentic leadership practices of healthcare managers. Flexible organizational cultures influence the adoption of authentic leadership, participatory management model and also improves quality.
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Affiliation(s)
| | | | - Greta G Cummings
- University of Alberta, Faculty of Nursing. Edmonton-Alberta, Canada
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Lima SBO, Oliveira JLCD, Silva RBZD, Rosa JDS, Ribeiro MRR. Ferramentas da qualidade aplicadas à conferência do carro de emergência: pesquisa de métodos mistos. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo verificar as causas da não conferência do carro de emergência e o efeito sobre a taxa de adesão, por meio do emprego de ferramentas da qualidade em uma Unidade de Terapia Intensiva Neonatal. Método pesquisa mista do desenho exploratório sequencial, desenvolvida com enfermeiros e fonte documental na Unidade de Terapia Intensiva Neonatal de hospital universitário, em três etapas: 1) Brainstorming para levantamento das causas de não conferência/construção de Lista de Verificação; 2) Coleta/análise de dados pela aplicação da Lista de Verificação e Diagrama de Pareto; 3) Análise documental. Utilizou-se o teste qui-quadrado para verificar o efeito do emprego das ferramentas de qualidade na adesão à conferência. Resultados 13 causas de não conferência do carro de emergência foram identificadas, sendo oito evitáveis e cinco não evitáveis. As causas evitáveis (n=63) representaram 87,5%, sendo as principais: falta de hábito (n=17; 27%), priorizar atividades assistenciais (n=17; 27%) e realizar divisão do cuidado dos pacientes/priorizar atividades administrativas (n=9; 14,3%). A aplicação das ferramentas da qualidade teve efeito significativo (p-valor<0,001) na adesão à conferência. Conclusão e implicações para a prática o emprego das ferramentas da qualidade foi factível para a identificação causal da não conferência do carro de emergência e melhoria na sua adesão.
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Koerich C, Erdmann AL, Lanzoni GMDM. Professional interaction in management of the triad: Permanent Education in Health, patient safety and quality. Rev Lat Am Enfermagem 2020; 28:e3379. [PMID: 33027407 PMCID: PMC7529448 DOI: 10.1590/1518-8345.4154.3379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/28/2020] [Indexed: 12/11/2023] Open
Abstract
Objective: to understand how professional interaction takes place in the hospital
organizational structure for the management of Permanent Education in
Health, to guarantee patient safety and the quality of nursing care. Method: this is a qualitative study, which used the structuralist aspect of the
Grounded Theory as a methodological framework. 27 interviewers participated
in the study, who made up four sample groups. Results: six categories and 13 subcategories were presented, representing the studied
phenomenon and highlighting particularities of the public health system and
the influence of the manager’s support and management priority, the
disposition of the organizational structure, the institutional culture, the
external encouragement to institution, and the nurses’ initiative and
leadership in the professional interaction for the management of the
Permanent Education in Health, patient safety, and quality of care triad,
revealing the need for cultural change through interdisciplinarity. Conclusion: the professional interaction in the hospital organizational structure
requires the creation of new management models with an emphasis on more
participative management, in order to improve the care processes in hospital
institutions.
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Berduzco-Torres N, Choquenaira-Callañaupa B, Medina P, Chihuantito-Abal LA, Caballero S, Gallegos E, San-Martín M, Delgado Bolton RC, Vivanco L. Factors Related to the Differential Development of Inter-Professional Collaboration Abilities in Medicine and Nursing Students. Front Psychol 2020; 11:432. [PMID: 32292364 PMCID: PMC7135885 DOI: 10.3389/fpsyg.2020.00432] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 02/24/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction For physicians and nurses, teamwork involves a set of communication and social skills, and specific training in interdisciplinary work in order to be able to work together cooperatively, sharing responsibilities, solving problems, and making decisions to carry out actions centered on patients' care. Recent studies demonstrate that in the absence of targeted interdisciplinary educational programs, the development of teamwork abilities is sensitive to the influence of the dominant work environment. The purpose of this study was to characterize the role that environmental and individual factors play in the development of teamwork in environments with a dominant hierarchical work model. Methods Questionnaires were distributed to 1,880 undergraduate students (980 medicine students and 900 nursing students) from three universities of Cusco city (Peru). The Jefferson Scale of Attitudes toward Physician-Nurse Collaboration was used as the main variable. The Jefferson Scales of Empathy and Lifelong Learning, the Social and Emotional Loneliness Scale for Adults, the Scale of Life Satisfaction, sex, discipline, age, and academic semester were used as explanatory variables. After calculating internal reliability and normality of the main measures, descriptive, comparative, and correlation analyses were performed to determine variables influencing the teamwork score. Results A total of 1,518 (81%) surveys were returned fully completed. Adequate reliability was confirmed in all instruments. In the sample, nursing students showed greater inter-professional collaborative abilities than medicine students (p < 0.001). This attitudinal gap was higher in advanced semesters. A three-way ANOVA indicated differences in teamwork were associated with discipline (p < 0.001), sex (p < 0.01), and university (p < 0.001). However, main effects were associated only with discipline (η p2 = 0.14). Teamwork showed an inverse correlation with loneliness (ρ = -0.28; p < 0.001) and a positive correlation with empathy (ρ = + 0.49; p < 0.001) and lifelong learning (ρ = + 0.48; p < 0.001). Teamwork positively correlated with life satisfaction only in the medicine student group (ρ = + 0.15; p < 0.001). Conclusion These findings bring new evidence to support the main effect that social environments, in the absence of targeted interdisciplinary educational programs, play in the development of teamwork.
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Affiliation(s)
- Nancy Berduzco-Torres
- Escuela Profesional de Enfermería, Universidad Nacional San Antonio Abad del Cusco, Cusco, Peru
| | | | - Pamela Medina
- Escuela Profesional de Enfermería, Universidad Nacional San Antonio Abad del Cusco, Cusco, Peru
| | | | - Sdenka Caballero
- Facultad de Ciencias de la Salud, Universidad Andina del Cusco, Cusco, Peru
| | - Edo Gallegos
- Facultad de Ciencias de la Salud, Universidad Andina del Cusco, Cusco, Peru
| | - Montserrat San-Martín
- Departamento de Estadística e Investigación Operativa, Universidad de Granada, Melilla, Spain
| | - Roberto C. Delgado Bolton
- Servicio de Medicina Nuclear, Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, Spain
- Plataforma de Bioética y Educación Médica, Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, Spain
- Centro Nacional de Documentación en Bioética, Fundacion Rioja Salud, Logroño, Spain
| | - Luis Vivanco
- Plataforma de Bioética y Educación Médica, Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, Spain
- Centro Nacional de Documentación en Bioética, Fundacion Rioja Salud, Logroño, Spain
- Area de Salud, Nutrición y Bioética, Fundación Universitaria Iberoamericana (FUNIBER), Barcelona, Spain
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Batista J, Cruz EDDA, Lopez EDCMS, Sarquis LMM, Seiffert LS, Wolff LDG. EFFECT OF THE ADMINISTRATIVE TRANSITION OF HOSPITAL MANAGEMENT ON THE SAFETY CULTURE IN SURGICAL UNITS. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2019-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze the safety culture in surgical units of a teaching hospital in different periods of hospital management. Method: this is a descriptive and analytical study developed with health professionals working at a surgical center and at five surgical inpatient units in two different periods of hospital management in southern Brazil. The Hospital Survey on Patient Safety Culture questionnaire was answered by 73 professionals in period I (2014/2015) and by 158 professionals in period II (2017). The analysis was based on descriptive statistics and on inferential analysis and reliability analysis using Cronbach's alpha coefficient; the dimensions were considered strong when the percentage of positive answers was ≥75%. Results: the administrative transition had a positive influence on the “Staffing” and “Handoffs and transitions” dimensions and a negative influence on “Teamwork within units” (p<0.001), with no difference in the remaining nine dimensions. In both periods, no dimension was considered strong; there were no changes with regard to the notification of adverse events and to the overall safety assessment; and the overall reliability of the instrument was satisfactory (0.89). Conclusion: the administrative transition of hospital management had little impact on the dimensions of the organizational safety culture, and there are still challenges in the progressive development of this predictor of patient safety.
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George A, Campbell J, Ghaffar A. Advancing the science behind human resources for health: highlights from the Health Policy and Systems Research Reader on Human Resources for Health. HUMAN RESOURCES FOR HEALTH 2018; 16:35. [PMID: 30103757 PMCID: PMC6090660 DOI: 10.1186/s12960-018-0302-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/22/2018] [Indexed: 06/08/2023]
Abstract
Health workers are central to people-centred health systems, resilient economies and sustainable development. Given the rising importance of the health workforce, changing human resource for health (HRH) policy and practice and recent health policy and systems research (HPSR) advances, it is critical to reassess and reinvigorate the science behind HRH as part of health systems strengthening and social development more broadly. Building on the recently published Health Policy and Systems Research Reader on Human Resources for Health (the Reader), this commentary reflects on the added value of HPSR underpinning HRH. HPSR does so by strengthening the multi-disciplinary base and rigour of HRH research by (1) valuing diverse research inferences and (2) deepening research enquiry and quality. It also anchors the relevance of HRH research for HRH policy and practice by (3) broadening conceptual boundaries and (4) strengthening policy engagement. Most importantly, HPSR enables us to transform HRH from being faceless numbers or units of health producers to the heart and soul of health systems and vital change agents in our communities and societies. Health workers' identities and motivation, daily routines and negotiations, and training and working environments are at the centre of successes and failures of health interventions, health system functioning and broader social development. Further, in an increasingly complex globalised economy, the expansion of the health sector as an arena for employment and the liberalisation of labour markets has contributed to the unprecedented movement of health workers, many or most of whom are women, not only between public and private health sectors, but also across borders. Yet, these political, human development and labour market realities are often set aside or elided altogether. Health workers' lives and livelihoods, their contributions and commitments, and their individual and collective agency are ignored. The science of HRH, offering new discoveries and deeper understanding of how universal health coverage and the Sustainable Development Goals are dependent on millions of health workers globally, has the potential to overcome this outdated and ineffective orthodoxy.
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Affiliation(s)
- A.S. George
- School of Public Health, University of the Western Cape, Private Bag x17, Bellville, Cape Town, 7535 South Africa
| | - J. Campbell
- Health Workforce, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - A. Ghaffar
- The Alliance for Health Policy and Systems Research, 20 Avenue Appia, 1211 Geneva, Switzerland
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George A, Campbell J, Ghaffar A. Advancing the science behind human resources for health: highlights from the Health Policy and Systems Research Reader on Human Resources for Health. Health Res Policy Syst 2018; 16:80. [PMID: 30103778 PMCID: PMC6090771 DOI: 10.1186/s12961-018-0346-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
Health workers are central to people-centred health systems, resilient economies and sustainable development. Given the rising importance of the health workforce, changing human resource for health (HRH) policy and practice and recent health policy and systems research (HPSR) advances, it is critical to reassess and reinvigorate the science behind HRH as part of health systems strengthening and social development more broadly. Building on the recently published Health Policy and Systems Research Reader on Human Resources for Health (the Reader), this commentary reflects on the added value of HPSR underpinning HRH. HPSR does so by strengthening the multi-disciplinary base and rigour of HRH research by (1) valuing diverse research inferences and (2) deepening research enquiry and quality. It also anchors the relevance of HRH research for HRH policy and practice by (3) broadening conceptual boundaries and (4) strengthening policy engagement. Most importantly, HPSR enables us to transform HRH from being faceless numbers or units of health producers to the heart and soul of health systems and vital change agents in our communities and societies. Health workers' identities and motivation, daily routines and negotiations, and training and working environments are at the centre of successes and failures of health interventions, health system functioning and broader social development. Further, in an increasingly complex globalised economy, the expansion of the health sector as an arena for employment and the liberalisation of labour markets has contributed to the unprecedented movement of health workers, many or most of whom are women, not only between public and private health sectors, but also across borders. Yet, these political, human development and labour market realities are often set aside or elided altogether. Health workers' lives and livelihoods, their contributions and commitments, and their individual and collective agency are ignored. The science of HRH, offering new discoveries and deeper understanding of how universal health coverage and the Sustainable Development Goals are dependent on millions of health workers globally, has the potential to overcome this outdated and ineffective orthodoxy.
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Affiliation(s)
- A.S. George
- School of Public Health, University of the Western Cape, Private Bag x17, Bellville, Cape Town, 7535 South Africa
| | - J. Campbell
- Health Workforce, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - A. Ghaffar
- The Alliance for Health Policy and Systems Research, 20 Avenue Appia, 1211 Geneva, Switzerland
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Camargo FC, Iwamoto HH, Galvão CM, Monteiro DAT, Goulart MB, Garcia LAA. MODELOS PARA A IMPLEMENTAÇÃO DA PRÁTICA BASEADA EM EVIDÊNCIAS NA ENFERMAGEM HOSPITALAR: REVISÃO NARRATIVA. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-07072017002070017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: identificar modelos para implementação da prática baseada em evidências na Enfermagem hospitalar. Método: Revisão narrativa da literatura. Após a identificação dos modelos, realizou-se uma busca de referências específicas sobre o tópico de interesse e procedeu-se a leitura dos artigos publicados. Resultados: são apresentados 16 modelos para a utilização de pesquisas na prática de enfermeiros hospitalares, publicadas no período de 1970 a 2015. Foram descritas as etapas para a implementação dos modelos, com ênfase nos tipos de evidências e abordagens para utilização das pesquisas. Conclusão: na análise dos pressupostos dos modelos descritos, pode-se inferir que a utilização de pesquisas na prática de enfermeiros hospitalares requer conhecimento e competências para além dos usuais no exercício cotidiano do trabalho. Desta maneira, o desafio para o cenário nacional perfaz o desenvolvimento de modelos próprios, específicos para a realidade vivenciada ou, ainda, a elaboração de iniciativas que retratem a implementação e/ou adaptação dos modelos propostos em âmbito internacional.
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Goulart BF, Camelo SHH, Simões ALDA, Chaves LDP. Teamwork in a coronary care unit: facilitating and hindering aspects. Rev Esc Enferm USP 2017; 50:482-9. [PMID: 27556720 DOI: 10.1590/s0080-623420160000400015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 05/24/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify, within a multidisciplinary team, the facilitating and hindering aspects for teamwork in a coronary care unit. METHOD A descriptive study, with qualitative and quantitative data, was carried out in the coronary care unit of a public hospital. The study population consisted of professionals working in the unit for at least one year. Those who were on leave or who were not located were excluded. The critical incident technique was used for data collection, by means of semi-structured interviews. For data analysis, content analysis and the critical incident technique were applied. RESULTS Participants were 45 professionals: 29 nursing professionals; 11 physicians; 4 physical therapists; and 1 psychologist. A total of 49 situations (77.6% with negative references); 385 behaviors (54.2% with positive references); and 182 consequences emerged (71.9% with negative references). Positive references facilitate teamwork, whereas negative references hinder it. A collaborative/communicative interprofessional relationship was evidenced as a facilitator; whereas poor collaboration among agents/inadequate management was a hindering aspect. CONCLUSION Despite the prevalence of negative situations and consequences, the emphasis on positive behaviors reveals the efforts the agents make in order to overcome obstacles and carry out teamwork. OBJETIVO Identificar, junto à equipe multiprofissional, aspectos facilitadores e dificultadores do trabalho em equipe em Unidade Coronariana. MÉTODO Estudo descritivo, com dados qualitativos e quantitativos, realizado em Unidade Coronariana/Hospital público. População constituída de profissionais atuantes na Unidade há, pelo menos, um ano. Excluídos os afastados do trabalho e os que não foram não localizados. Para a coleta de informações, utilizou-se da Técnica do Incidente Crítico por meio de entrevista semiestruturada. Para a análise dos dados, utilizaram-se da Análise de Conteúdo e Técnica do Incidente Crítico. RESULTADOS Participaram 45 profissionais: 29 profissionais de enfermagem; 11 médicos; quatro fisioterapeutas e um psicólogo. Emergiram 49 situações (77,6% com referências negativas); 385 comportamentos (54,2% com referências positivas); e 182 consequências (71,9% com referências negativas). Referências positivas facilitam o trabalho em equipe, e as negativas o dificultam. Relacionamento interprofissional colaborativo/comunicativo foi evidenciado como facilitador; baixa colaboração entre agentes/gerenciamento inadequado como dificultador. CONCLUSÃO Apesar de predominarem situações e consequências negativas, ênfase em comportamentos positivos revela esforço dos agentes para vencer obstáculos e realizar trabalho em equipe.
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Affiliation(s)
- Bethania Ferreira Goulart
- Universidade Federal do Triângulo Mineiro, Departamento Didático-Científico de Enfermagem em Educação e Saúde Comunitária, Uberaba, MG, Brazil.,Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa Interunidades, Ribeirão Preto, SP, Brazil
| | | | | | - Lucieli Dias Pedreschi Chaves
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Geral e Especializada, Ribeirão Preto, SP, Brazil
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