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Battle K, Lockeman KS, Dow AW, Donohoe KL, Hanley L, Slattum PW. Unpacking interactions among student teams in a practice-based IPE setting: a qualitative evaluation study. J Interprof Care 2024; 38:713-721. [PMID: 38717845 DOI: 10.1080/13561820.2024.2345829] [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: 06/30/2022] [Accepted: 04/16/2024] [Indexed: 05/31/2024]
Abstract
In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.
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Affiliation(s)
- Kimberly Battle
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Kelly S Lockeman
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Alan W Dow
- School of Medicine, Asst. Vice President of Health Sciences for Interprofessional Education and Collaborative Care, Virginia Commonwealth University, Richmond, VA, USA
| | - Krista L Donohoe
- School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA
| | - Lauren Hanley
- Medical Student, Virginia Commonwealth University, Richmond, VA, USA
| | - Patricia W Slattum
- School of Pharmacy, Virginia Center on Aging, Virginia Commonwealth University, Richmond, VA, USA
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2
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Dadich A, Best S. The mobilisation of professional identity: A scoping and lexical review. PLoS One 2024; 19:e0298423. [PMID: 38626144 PMCID: PMC11020764 DOI: 10.1371/journal.pone.0298423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/24/2024] [Indexed: 04/18/2024] Open
Abstract
Interprofessional care obliges different healthcare professions to share decision-making and sometimes, practices. Given established hierarchies, it can be difficult to promote interprofessional care, partly because of the need to reshape professional identities. Despite interest in effective interprofessional care, there is limited research on how professional identity can be mobilised to promote it. A scoping review as well as lexical review of academic publications was conducted to address this void. After searching seven academic databases and screening the identified publications, 22 publications met the inclusion criteria. They collectively reported on 22 interventions, most of which were used in healthcare. The scoping review suggested there is some evidence that professional identities can be mobilised. Yet, of the 22 interventions, only ten explicitly targeted professional identity. The most common intervention was a training or development program, followed by workplace redesign. The need for internal motivation to mobilise professional identity was reported as was the impact of external drivers, like extending the scope of practice. Extending these findings, the lexical review demonstrated that, among the 22 publications, the relationship between professional identity and mobilisation did not feature prominently within the discourse. Furthermore, it seems that geography matters-that is, while all the publications spoke of professional identity, they differed by region on how they did this. Given these findings, concentrated scholarship is needed on the relationship between professional identity and interprofessional care, lest interprofessional care programs have limited, sustained effect. Implications for scholars and practitioners are explicated.
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Affiliation(s)
- Ann Dadich
- School of Business, Western Sydney University, Parramatta, NSW, Australia
| | - Stephanie Best
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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3
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Cleary E, Bloomfield J, Frotjold A, Schneider C. A realist synthesis of interprofessional patient safety activities and healthcare student attitudes towards patient safety. J Interprof Care 2024; 38:346-376. [PMID: 37525993 DOI: 10.1080/13561820.2023.2238772] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 06/29/2023] [Indexed: 08/02/2023]
Abstract
Interprofessional education (IPE) has been used for instilling a positive safety culture within healthcare, yet what interventions work to change healthcare student attitudes and how improved patient safety outcomes are best achieved with this intervention, is unclear and challenging to evaluate. A realist synthesis was undertaken to ascertain how, why, and in what circumstances IPE activities result in a positive change to student attitudes to patient safety. Database searches of CINAHL, MEDLINE, Scopus, and Eric were undertaken in April 2022 to identify relevant studies. Synthesis with a realist framework of analysis, coupled with the development of a program theory was conducted to identify interactions among contexts, intervention, mechanisms, and outcomes (CIMO). Twenty-three articles eligible for inclusion articulated environments in which varied contexts, interventions, and mechanisms were activated to influence student attitudes to patient safety. Findings from this realist synthesis informs awareness into the methods of delivering and evaluating IPE activities and offers new perspectives for educators in planning and evaluating future IPE from a collaborative and positive safety culture perspective.
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Affiliation(s)
- Elizabeth Cleary
- University of Sydney Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jacqueline Bloomfield
- University of Sydney Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Astrid Frotjold
- University of Sydney Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Carl Schneider
- University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Kerins J, Smith SE, Tallentire VR. "Ego massaging that helps": a framework analysis study of internal medicine trainees' interprofessional collaboration approaches. MEDICAL EDUCATION ONLINE 2023; 28:2243694. [PMID: 37535844 PMCID: PMC10402837 DOI: 10.1080/10872981.2023.2243694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION Patient care depends on collaborative practice. Debate remains as to the best approach to providing education for collaboration, with educational interventions often far removed from the realities of the clinical workplace. Understanding the approaches used for collaboration in clinical practice could inform practical strategies for training. For internal medicine trainees, this involves collaboration with other professions but also with other specialties. This study aimed to explore the approaches that internal medicine trainees use for interprofessional collaboration and the ways that these approaches vary when internal medicine trainees interact with different healthcare provider groups. METHODS Following ethical approval and participant consent, interprofessional communication workshops between August 2020 and March 2021 were audio recorded and transcribed verbatim. Workshops involved groups of internal medicine trainees discussing collaboration challenges and the approaches they use in clinical practice. This framework analysis study used the interprofessional collaboration framework described by Bainbridge and Regehr (building social capital, perspective taking and negotiating priorities and resources), and cross-referenced the categorised data with the healthcare groups that trainees collaborate with, to look for patterns in the data. RESULTS Seventeen workshops, involving 100 trainees, were included. Trainees described relationship building, perspective taking and negotiating priorities and resources. Relationship building was a modification to the original framework domain of building social capital. Themes of power and civility transcended domains with evidence of using hierarchy as leverage when negotiating and employing civility as a tactical approach throughout. DISCUSSION This bi-dimensional analysis highlights patterns of perspective taking when collaborating with other specialties and professions, and the approaches to negotiation of courting favour and coercion when interacting with other specialties. This study provides evidence of the strategies currently utilised by internal medicine trainees, with different healthcare groups, and presents a modified framework which could inform the development of training for collaboration.
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Affiliation(s)
- Joanne Kerins
- Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK
- Acute medicine, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Samantha Eve Smith
- Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK
- Medical Education Directorate, NHS Lothian, Edinburgh, UK
| | - Victoria Ruth Tallentire
- Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK
- Medical Education Directorate, NHS Lothian, Edinburgh, UK
- Medical Directorate, NHS Education for Scotland, Edinburgh, Scotland, UK
- College of Medicine and Vetinary Medicine, University of Edinburgh, Edinburgh, Scotland, UK
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Doll J, Malloy J, Gonzales R. Social determinants of health: critical consciousness as the core to collective impact. Front Res Metr Anal 2023; 8:1141051. [PMID: 37822975 PMCID: PMC10562696 DOI: 10.3389/frma.2023.1141051] [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: 01/09/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023] Open
Abstract
Social determinants of health have become widely recognized as important to overall health. Many areas of social determinants of health are growing from policy to reimbursement to the connecting of health and social care. The efforts around social determinants of health require reflection and awareness of structural issues. The work of Paulo Freire in critical consciousness provides guidance for how to engage in social determinants of health efforts. This manuscript offers a summary of the social determinants of health under the guidance of critical consciousness to build skills and interactions to promote social care to build toward health equity.
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Affiliation(s)
- Joy Doll
- Health Informatics, Creighton University, Omaha, NE, United States
| | - Julie Malloy
- American Occupational Therapy Association, Bethesda, MD, United States
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6
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Lucas B. Using reflection in nursing practice to enhance patient care. Nurs Stand 2023; 38:44-49. [PMID: 37005865 DOI: 10.7748/ns.2023.e11598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 06/01/2023]
Abstract
The ability to reflect on, and learn from, practice experiences is essential for nurses when seeking to provide effective person-centred care. This article outlines the various types of reflection that nurses can use, such as reflection-in-action and reflection-on-action. It also details some of the main models of reflection and explains how nurses might develop their skills in reflection to enhance the quality of patient care. The article provides examples of cases and reflective activities to demonstrate how nurses can use reflection in their practice.
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Grundström H, Kilander H, Wikman P, Olovsson M. Demographic and clinical characteristics determining patient-centeredness in endometriosis care. Arch Gynecol Obstet 2023; 307:1047-1055. [PMID: 36576559 PMCID: PMC10023645 DOI: 10.1007/s00404-022-06887-5] [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: 08/24/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE The primary aim of this study was to assess patient-centeredness of endometriosis care in a national sample of Swedish women with endometriosis. The secondary aims were to assess the importance of different dimensions of endometriosis care and to analyze demographic and clinical determinants associated with the experience of patient-centeredness. METHODS This cross-sectional study included 476 women with confirmed endometriosis. An invitation to participate was sent to 1000 randomly selected women aged ≥ 18 years having any endometriosis diagnosis and who had visited a gynecological clinic due to endometriosis problems any time during the past five years. Participants were recruited from ten different-sized gynecology clinics all over Sweden. The invitation letter had a link to the digital survey, which consisted of demographic and clinical questions, and the ENDOCARE questionnaire (ECQ). ECQ measures experiences, importance and patient-centeredness of ten dimensions of endometriosis care. Univariate and multiple regression analyses were used to analyze which patient-specific demographic and clinical determinants were associated with the experience of patient-centeredness. RESULTS The response rate was 48%. The results indicate that Swedish women with endometriosis experience low patient-centeredness and rate relational aspects with healthcare professionals as the most important aspects of care. Having a gynecologist with patient responsibility was an independent predictor for high patient-centeredness. CONCLUSION Women with endometriosis in Sweden experience low patient-centeredness, reflecting the urgent need for improvement. More effort should be given to develop the relational aspects of care. Women with endometriosis should have a responsible gynecologist to care for treatment and follow-up.
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Affiliation(s)
- Hanna Grundström
- Department of Obstetrics and Gynecology in Norrköping, Linköping University, Linköping, Sweden.
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden.
| | - Helena Kilander
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Per Wikman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Dadich A, Wells R, Williams SJ, Taskin N, Coskun M, Grenier C, Ponsignon F, Scahill S, Best S. Cues Disseminated by Professional Associations That Represent 5 Health Care Professions Across 5 Nations: Lexical Analysis of Tweets. J Med Internet Res 2023; 25:e42927. [PMID: 36920443 PMCID: PMC10131722 DOI: 10.2196/42927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/09/2023] [Accepted: 01/27/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Collaboration across health care professions is critical in efficiently and effectively managing complex and chronic health conditions, yet interprofessional care does not happen automatically. Professional associations have a key role in setting a profession's agenda, maintaining professional identity, and establishing priorities. The associations' external communication is commonly undertaken through social media platforms, such as Twitter. Despite the valuable insights potentially available into professional associations through such communication, to date, their messaging has not been examined. OBJECTIVE This study aimed to identify the cues disseminated by professional associations that represent 5 health care professions spanning 5 nations. METHODS Using a back-iterative application programming interface methodology, public tweets were sourced from professional associations that represent 5 health care professions that have key roles in community-based health care: general practice, nursing, pharmacy, physiotherapy, and social work. Furthermore, the professional associations spanned Australia, Canada, New Zealand, the United Kingdom, and the United States. A lexical analysis was conducted of the tweets using Leximancer (Leximancer Pty Ltd) to clarify relationships within the discourse. RESULTS After completing a lexical analysis of 50,638 tweets, 7 key findings were identified. First, the discourse was largely devoid of references to interprofessional care. Second, there was no explicit discourse pertaining to physiotherapists. Third, although all the professions represented in this study support patients, discourse pertaining to general practitioners was most likely to be connected with that pertaining to patients. Fourth, tweets pertaining to pharmacists were most likely to be connected with discourse pertaining to latest and research. Fifth, tweets about social workers were unlikely to be connected with discourse pertaining to health or care. Sixth, notwithstanding a few exceptions, the findings across the different nations were generally similar, suggesting their generality. Seventh and last, tweets pertaining to physiotherapists were most likely to refer to discourse pertaining to profession. CONCLUSIONS The findings indicate that health care professional associations do not use Twitter to disseminate cues that reinforce the importance of interprofessional care. Instead, they largely use this platform to emphasize what they individually deem to be important and advance the interests of their respective professions. Therefore, there is considerable opportunity for professional associations to assert how the profession they represent complements other health care professions and how the professionals they represent can enact interprofessional care for the benefit of patients and carers.
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Affiliation(s)
- Ann Dadich
- School of Business, Western Sydney University, Parramatta, Australia
| | - Rebecca Wells
- Department of Management, Policy and Community Health, University of Texas, Texas, TX, United States
| | - Sharon J Williams
- School of Health & Social Care, Swansea University, Swansea, United Kingdom
| | - Nazim Taskin
- Department of Management Information Systems, Boğaziçi University, Istanbul, Turkey
| | - Mustafa Coskun
- Department of Management Information Systems, Boğaziçi University, Istanbul, Turkey
| | | | | | - Shane Scahill
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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McMahon CJ, Hickey EJ, Nolke L, Penny DJ. Organizational Culture as a Determinant of Outcome in Teams: Implications for the Pediatric Cardiac Specialist. Pediatr Cardiol 2023; 44:530-539. [PMID: 36322202 PMCID: PMC9950153 DOI: 10.1007/s00246-022-03041-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Although enormous effort has focussed on how to build an effective culture in the business community, relatively little effort has addressed how to achieve this in the hospital environment, specifically related to the field of congenital heart disease teams. The examination of culture in pediatric cardiac care is particularly important for several key reasons: first, it represents high-stakes medicine, second, there are multiple stakeholders requiring collaboration between cardiologists, surgeons, anaesthesiologists, perfusionists, nursing staff, and allied health care professionals, and finally, both the patient and the family are intimately involved in the care pathway. This review article investigates some of the critical components to building an effective culture, drawing upon similarities in other disciplines, thereby fostering high performance multidisciplinary teams in congenital cardiology care. Strategies to change culture such as Kotter's model of change are also discussed. High performance teams share one common vital characteristic: psychological safety for team members to speak their minds, thereby fostering an open culture, in which creativity can flourish to facilitate major breakthroughs. Adoption of the "Flight Plan" review promotes patient centric care and champions a psychologically safe culture.
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Affiliation(s)
- Colin J McMahon
- Department of Paediatric Cardiology, Children's Health Ireland, Crumlin, Dublin 12, Ireland.
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
- School of Health Professions Education, Maastricht University, Maastricht, Netherlands.
| | - Edward J Hickey
- Department of Cardiothoracic Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Lars Nolke
- Department of Cardiothoracic Surgery, Children's Health Ireland, Crumlin, Dublin 12, Ireland
| | - Daniel J Penny
- Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, 77030, USA
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Keshmiri F. Exploring the experiences of the team members in the interprofessional socialization process for becoming a interprofessional Collaborator. BMC Nurs 2022; 21:366. [PMID: 36550533 PMCID: PMC9773577 DOI: 10.1186/s12912-022-01147-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The current study aimed to explore the team members' experiences in the socialization process for becoming a collaborator in an interprofessional team. METHOD This qualitative study is conducted using an inductive qualitative content analysis approach. Participants consisted of 32 physicians (n = 16) and nurses (n = 16) who participated by purposeful sampling. Data were collected through in-depth semi-structured interviews and analyzed by Graneheim and Lundman approach. RESULTS In the study, "the perceived confrontation between interprofessional professionalism and uni-professionalism in the interprofessional socialization process" is explored as the theme, including two categories: "interprofessional professionalism commitment" as a facilitator and "uni-professional centrism" as a barrier. CONCLUSION A reciprocal dimension in interprofessional socialization was explored. Interprofessional professionalism adherence and team-centered accountability among team members were explored as a facilitator. The uni-professional culture and immature interprofessional collaboration competencies of team members disrupted the interprofessional socialization process.
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Affiliation(s)
- Fatemeh Keshmiri
- grid.412505.70000 0004 0612 5912Medical Education Department, Educational Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,grid.412505.70000 0004 0612 5912Faculty of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Schilling S, Armaou M, Morrison Z, Carding P, Bricknell M, Connelly V. Understanding teamwork in rapidly deployed interprofessional teams in intensive and acute care: A systematic review of reviews. PLoS One 2022; 17:e0272942. [PMID: 35980893 PMCID: PMC9387792 DOI: 10.1371/journal.pone.0272942] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/31/2022] [Indexed: 12/04/2022] Open
Abstract
The rapid increase of acute and intensive care capacities in hospitals needed during the response to COVID-19 created an urgent demand for skilled healthcare staff across the globe. To upscale capacity, many hospitals chose to increase their teams in these departments with rapidly re-deployed inter-professional healthcare personnel, many of whom had no prior experience of working in a high-risk environment and were neither prepared nor trained for work on such wards. This systematic review of reviews examines the current evidence base for successful teamwork in rapidly deployed interprofessional teams in intensive and acute care settings, by assessing systematic reviews of empirical studies to inform future deployments and support of rapidly formed clinical teams. This study identified 18 systematic reviews for further analysis. Utilising an integrative narrative synthesis process supported by thematic coding and graphical network analysis, 13 themes were found to dominate the literature on teams and teamwork in inter-professional and inter-disciplinary teams. This approach was chosen to make the selection process more transparent and enable the thematic clusters in the reviewed papers to be presented visually and codifying four factors that structure the literature on inter-professional teams (i.e., team-internal procedures and dynamics, communicative processes, organisational and team extrinsic influences on teams, and lastly patient and staff outcomes). Practically, the findings suggest that managers and team leaders in fluid and ad-hoc inter-professional healthcare teams in an intensive care environment need to pay attention to reducing pre-existing occupational identities and power-dynamics by emphasizing skill mix, establishing combined workspaces and break areas, clarifying roles and responsibilities, facilitating formal information exchange and developing informal opportunities for communication. The results may guide the further analysis of factors that affect the performance of inter-professional teams in emergency and crisis deployment.
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Affiliation(s)
- Stefan Schilling
- Department of Psychology, Health & Professional Development, Oxford Brookes University, Oxford, United Kingdom
- School of Security Studies, King’s College London, London, United Kingdom
- * E-mail:
| | - Maria Armaou
- Department of Psychology, Health & Professional Development, Oxford Brookes University, Oxford, United Kingdom
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Zoe Morrison
- Aberdeen Business School, Robert Gordon University, Aberdeen, United Kingdom
| | - Paul Carding
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Martin Bricknell
- School of Security Studies, King’s College London, London, United Kingdom
| | - Vincent Connelly
- Department of Psychology, Health & Professional Development, Oxford Brookes University, Oxford, United Kingdom
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Antoniadou M. Leadership and Managerial Skills in Dentistry: Characteristics and Challenges Based on a Preliminary Case Study. Dent J (Basel) 2022; 10:dj10080146. [PMID: 36005244 PMCID: PMC9406896 DOI: 10.3390/dj10080146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/19/2022] [Accepted: 08/02/2022] [Indexed: 11/19/2022] Open
Abstract
Dentistry is changing rapidly in a dynamic and challenging mode and is incorporating digital technology, communication, and managerial skills for profitable enterprises. On the new dental horizon, the profession requires engaging and inspiring role models and leaders. Ιdentifying and developing human soft skills can improve quality issues and guarantee a sustainable dental business. The concept of leadership is a very complex and multidimensional phenomenon as observed from the current literature. In different commercial environments, there has been a huge discussion on the specific characteristics of an effective leader. In dentistry, the subject needs further investigation. This article aims to bring up the importance of dental leadership and highlights the need of identifying dental leaders committed to excellency. It also challenges the need for educational shift on dental leadership management. Finally, it aims to support and develop educational transformations based on positive preliminary data observed by incorporating a new, relevant subject in the dental curriculum.
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Affiliation(s)
- Maria Antoniadou
- Dental School, National and Kapodistrian University of Athens, ACSTH by ICF and AC Accredited Coach, Thivon 2, Goudi, GR-11527 Athens, Greece
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Suriyankietkaew S, Kungwanpongpun P. Strategic leadership and management factors driving sustainability in health-care organizations in Thailand. J Health Organ Manag 2021. [DOI: 10.1108/jhom-05-2021-0165] [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 This empirical study aims to identify the essential strategic leadership and management factors underlying sustainability in healthcare. It also examines which factors drive sustainability performance outcomes (SPO) in health-care organizations, an analysis lacking to date. It provides a strategic leadership and management perspective toward sustainable healthcare, responding to the United Nations Sustainable Development Goals.Design/methodology/approachThe investigation adopted Sustainable Leadership as its research framework. Using a cross-sectional survey, 543 employees working in health-care and pharmaceutical companies in Thailand voluntarily provided responses. Factor analyses and structural equation modeling were employed.Findings The results revealed an emergent research model and identified 20 unidimensional strategic leadership and management factors toward sustainability in healthcare. The findings indicate significant positive effects on SPO in health-care organizations. Significant factors include human resource management/development, ethics, quality, environment and social responsibility, and stakeholder considerations.Research limitations/implicationsThe study was conducted in one country. Future studies should examine these relationships in diverse contexts. In practice, health-care firms should foster significant strategic leadership and management practices to improve performance outcomes for sustainability in healthcare.Originality/value This paper is the first empirical, multidisciplinary study with a focus on strategic leadership, health-care management and organizational sustainability. It identifies a proxy for measuring the effects of essential strategic leadership and managerial factors for sustainability in pharmaceutical health-care companies. It advances our currently limited knowledge and provides managerial implications for improving performance outcomes toward sustainable healthcare.
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Simen JH, Meyer T. Leadership education in professional and graduate schools. New Dir Stud Leadersh 2021; 2021:113-122. [PMID: 34658177 DOI: 10.1002/yd.20461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This article makes a case for the need of graduate leadership curricula, including professional programs such as health care, law, and engineering. Diversity, equity, and inclusion is focused on as a critical piece of this leadership curricula.
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De Baetselier E, Van Rompaey B, Dijkstra NE, Sino CG, Akerman K, Batalha LM, Fernandez MID, Filov I, Grøndahl VA, Heczkova J, Helgesen AK, Keeley S, Kolovos P, Langer G, Ličen S, Lillo-Crespo M, Malara A, Padyšáková H, Prosen M, Pusztai D, Raposa B, Riquelme-Galindo J, Rottková J, Talarico F, Tziaferi S, Dilles T. The NUPHAC-EU Framework for Nurses' Role in Interprofessional Pharmaceutical Care: Cross-Sectional Evaluation in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157862. [PMID: 34360162 PMCID: PMC8345454 DOI: 10.3390/ijerph18157862] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 11/16/2022]
Abstract
Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is unclear to what extent healthcare professionals consider pharmaceutical care (PC) activities to be nurses’ responsibility in order to obtain best care quality. This study aimed to create and evaluate a framework describing potential nursing tasks in PC and to investigate nurses’ level of responsibility. A framework of PC tasks and contextual factors was developed based on literature review and previous DeMoPhaC project results. Tasks and context were cross-sectionally evaluated using an online survey in 14 European countries. A total of 923 nurses, 240 physicians and 199 pharmacists responded. The majority would consider nurses responsible for tasks within: medication self-management (86–97%), patient education (85–96%), medication safety (83–95%), monitoring adherence (82–97%), care coordination (82–95%), and drug monitoring (78–96%). The most prevalent level of responsibility was ‘with shared responsibility’. Prescription management tasks were considered to be nurses’ responsibility by 48–81% of the professionals. All contextual factors were indicated as being relevant for nurses’ role in PC by at least 74% of the participants. No task nor contextual factor was removed from the framework after evaluation. This framework can be used to enable healthcare professionals to openly discuss allocation of specific (shared) responsibilities and tasks.
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Affiliation(s)
- Elyne De Baetselier
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing and Midwifery Science, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium; (B.V.R.); (T.D.)
- Correspondence:
| | - Bart Van Rompaey
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing and Midwifery Science, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium; (B.V.R.); (T.D.)
| | - Nienke E. Dijkstra
- Research Group Care for the Chronically III, University of Applied Sciences Utrecht, 3584 CH Utrecht, The Netherlands; (N.E.D.); (C.G.S.)
| | - Carolien G. Sino
- Research Group Care for the Chronically III, University of Applied Sciences Utrecht, 3584 CH Utrecht, The Netherlands; (N.E.D.); (C.G.S.)
| | - Kevin Akerman
- Department of Nursing, Swansea University, Swansea SA2 8PP, UK;
| | - Luis M. Batalha
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046851 Coimbra, Portugal; (L.M.B.); (M.I.D.F.)
| | - Maria I. D. Fernandez
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046851 Coimbra, Portugal; (L.M.B.); (M.I.D.F.)
| | - Izabela Filov
- Higer Medical School, University “St. Kliment Ohridski”, 7000 Bitola, North Macedonia;
| | - Vigdis A. Grøndahl
- Faculty of Health and Welfare, Østfold University College, 1757 Halden, Norway; (V.A.G.); (A.K.H.)
| | - Jana Heczkova
- First Faculty of Medicine, Institute of Nursing Theory and Practice, Charles University, 11000 Prague, Czech Republic;
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, 1757 Halden, Norway; (V.A.G.); (A.K.H.)
| | - Sarah Keeley
- Department of Nursing and Clinical Science, Bournemouth University, Bournemouth BH12 5BB, UK;
| | - Petros Kolovos
- Department of Nursing, University of Peloponnese, 22100 Tripolis, Greece; (P.K.); (S.T.)
| | - Gero Langer
- Medical Faculty, Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, 06108 Halle/Saale, Germany;
| | - Sabina Ličen
- Department of Nursing, Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (S.L.); (M.P.)
| | - Manuel Lillo-Crespo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.L.-C.); (J.R.-G.)
| | - Alba Malara
- ANASTE-Humanitas Foundation, 00192 Rome, Italy; (A.M.); (F.T.)
| | - Hana Padyšáková
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, 83101 Bratislava, Slovakia; (H.P.); (J.R.)
| | - Mirko Prosen
- Department of Nursing, Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (S.L.); (M.P.)
| | - Dorina Pusztai
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (D.P.); (B.R.)
| | - Bence Raposa
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (D.P.); (B.R.)
| | - Jorge Riquelme-Galindo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.L.-C.); (J.R.-G.)
| | - Jana Rottková
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, 83101 Bratislava, Slovakia; (H.P.); (J.R.)
| | | | - Styliani Tziaferi
- Department of Nursing, University of Peloponnese, 22100 Tripolis, Greece; (P.K.); (S.T.)
| | - Tinne Dilles
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing and Midwifery Science, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium; (B.V.R.); (T.D.)
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Lyman B, Biddulph ME, Hopper VG, Horton MK, Mendon CR, Thorum KC, Smith EL. Creating a Work Environment Conducive to Organizational Learning. J Contin Educ Nurs 2021; 52:281-285. [PMID: 34048303 DOI: 10.3928/00220124-20210514-07] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Through organizational learning, health care teams can consistently provide excellent patient care in a complex and changing environment. Nurse managers, educators, and other leaders can facilitate organizational learning within their teams by promoting certain contextual factors in the clinical work environment. This article provides an overview of contextual factors associated with organizational learning, includes practice-based examples of these factors, and offers evidence-based recommendations for creating a learning-focused work environment. [J Contin Educ Nurs. 2021;52(6):281-285.].
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Jansen I, Stalmeijer RE, Silkens MEWM, Lombarts KMJMH. An act of performance: Exploring residents' decision-making processes to seek help. MEDICAL EDUCATION 2021; 55:758-767. [PMID: 33539615 PMCID: PMC8247982 DOI: 10.1111/medu.14465] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 05/16/2023]
Abstract
CONTEXT Residents are expected to ask for help when feeling insufficiently confident or competent to act in patients' best interests. While previous studies focused on the perspective of supervisor-resident relationships in residents' help-seeking decisions, attention for how the workplace environment and, more specifically, other health care team members influence these decisions is limited. Using a sociocultural lens, this study aimed to explore how residents' decision-making processes to seek help are shaped by their workplace environment. METHODS Through a constructivist grounded theory methodology, we purposively and theoretically sampled 18 residents: 9 juniors (postgraduate year 1/2) and 9 seniors (postgraduate year 5/6) at Amsterdam University Medical Centers. Using semi-structured interviews, participating residents' decision-making processes to seek help during patient care delivery were explored. Data collection and analysis were iterative; themes were identified using constant comparative analysis. RESULTS Residents described their help-seeking decision-making processes as an 'act of performance': they considered how asking for help could potentially impact their assessments. They described this act of performance as the product of an internal 'balancing act' with at its core the non-negotiable priority for providing safe and high-quality patient care. With this in mind, residents weighed up demonstrating the ability to work independently, maintaining credibility and becoming an accepted member of the health care team when deciding to seek help. This 'balancing act' was influenced by sociocultural characteristics of the learning environment, residents' relationships with supervisors and the perceived approachability of other health care team members. CONCLUSIONS This study suggests that sociocultural forces influence residents to experience help-seeking as an act of performance. Especially, a safe learning environment resulting from constructive relationships with supervisors and the approachability of other health care team members lowered the barriers to seek help. Supervisors could address these barriers by having regular conversations with residents about when to seek help.
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Affiliation(s)
- Iris Jansen
- Professional Performance and Compassionate Care Research GroupDepartment of Medical PsychologyAmsterdam UMC/University of AmsterdamAmsterdamThe Netherlands
| | - Renée E. Stalmeijer
- School of Health Professions EducationFaculty of Health, Medicine, and Life SciencesMaastricht UniversityMaastrichtThe Netherlands
| | - Milou E. W. M. Silkens
- Research Department of Medical EducationUCL Medical SchoolUniversity College LondonLondonUK
| | - Kiki M. J. M. H. Lombarts
- Professional Performance and Compassionate Care Research GroupDepartment of Medical PsychologyAmsterdam UMC/University of AmsterdamAmsterdamThe Netherlands
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De Baetselier E, Dilles T, Batalha LM, Dijkstra NE, Fernandes MI, Filov I, Friedrichs J, Grondahl VA, Heczkova J, Helgesen AK, Jordan S, Keeley S, Klatt T, Kolovos P, Kulirova V, Ličen S, Lillo-Crespo M, Malara A, Padysakova H, Prosen M, Pusztai D, Riquelme-Galindo J, Rottkova J, Sino CG, Talarico F, Tziaferi S, Van Rompaey B. Perspectives of nurses' role in interprofessional pharmaceutical care across 14 European countries: A qualitative study in pharmacists, physicians and nurses. PLoS One 2021; 16:e0251982. [PMID: 34043650 PMCID: PMC8158867 DOI: 10.1371/journal.pone.0251982] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To understand healthcare professionals' experiences and perceptions of nurses' potential or ideal roles in pharmaceutical care (PC). DESIGN Qualitative study conducted through semi-structured in-depth interviews. SETTING Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. PARTICIPANTS In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. DATA COLLECTION AND ANALYSIS All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. RESULTS 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses' autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. CONCLUSIONS European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.
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Affiliation(s)
- Elyne De Baetselier
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- * E-mail:
| | - Tinne Dilles
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Luis M. Batalha
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Nienke E. Dijkstra
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Maria I. Fernandes
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Izabela Filov
- University "St. Kliment Ohridski" Bitola, Bitola, Republic of North-Macedonia
| | - Juliane Friedrichs
- Medical Faculty, Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Vigdis A. Grondahl
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Jana Heczkova
- Institute of Nursing Theory and Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea, Wales, United Kingdom
| | - Sarah Keeley
- Department of Nursing and Clinical Science, Bournemouth University, Bournemouth, England, United Kingdom
| | - Thomas Klatt
- Medical Faculty, Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Petros Kolovos
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Sparti, Greece
| | - Veronika Kulirova
- Institute of Nursing Theory and Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Sabina Ličen
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Izola, Slovenia
| | - Manuel Lillo-Crespo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | | | - Hana Padysakova
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Bratislava, Slovak Republic
| | - Mirko Prosen
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Izola, Slovenia
| | - Dorina Pusztai
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Jorge Riquelme-Galindo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Jana Rottkova
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Bratislava, Slovak Republic
| | - Carolien G. Sino
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | | | - Styliani Tziaferi
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Sparti, Greece
| | - Bart Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Cunningham U, De Brún A, Willgerodt M, Blakeney E, McAuliffe E. Team interventions in acute hospital contexts: protocol for the evaluation of an initial programme theory using realist methods. HRB Open Res 2021; 4:32. [PMID: 35677894 PMCID: PMC9051586 DOI: 10.12688/hrbopenres.13225.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction: Literature on multi-disciplinary healthcare team interventions to improve quality and safety of care in acute hospital contexts tends to focus on evaluating the success of the intervention by assessing patient outcomes. In contrast, there is little focus on the team who delivered the intervention, how the team worked to deliver the intervention or the context in which it was delivered. In practice, there is therefore a poor understanding of why some interventions work and are sustained and why others fail. There is little emphasis in the literature on how the team delivering the intervention might impact success or failure. Given that team is the vehicle through which these interventions are introduced, it is important to understand interventions from their perspectives. This research seeks to deepen understanding of enablers and barriers for effective team interventions. Using two case studies, we will evaluate previously developed initial programme theories to understand, what worked for whom, in what conditions, why, to what extent and how? Methods and analysis: A realist evaluation approach will be employed to test the previously formed set of initial programme theories. Two multi-disciplinary acute hospital team interventions in two different geographical and organisational contexts will be identified. In case study 1, a theory based approach to interviewing will be used. In case study 2, interview transcripts obtained using a semi- structured approach for primary research purposes will undergo secondary analysis. This will enable a more sensitive look at patterns and variations in patterns of multi-disciplinary team interventions. Researchers will first iteratively interrogate each respective dataset to identify the characteristics or resources present within the specific context that influenced how the team intervention worked to produce particular outcomes. Data will then be synthesised across contexts in order to produce middle range theories and thereby more generalisable insights.
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Affiliation(s)
- Una Cunningham
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
- Pillar Centre for Transformative Healthcare, Mater Misericordiae University Hospital, Eccles St, Dublin 7, D07 R2WY, Ireland
| | - Aoife De Brún
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - Mayumi Willgerodt
- School of Nursing, Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, 98195, USA
| | - Erin Blakeney
- School of Nursing, Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, 98195, USA
| | - Eilish McAuliffe
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
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20
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Hanks S, Cotton D, Spowart L. Leadership in Dental Practice: a Three Stage Systematic Review and Narrative Synthesis. J Dent 2020; 102:103480. [PMID: 32961259 PMCID: PMC7501777 DOI: 10.1016/j.jdent.2020.103480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/16/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To review leadership for dentists in patient facing, primary care dental practice. METHODS A three stage systematic review with narrative synthesis included stage 1: a scoping overview of management and leadership policy context; stage 2: systematic review of review of leadership in healthcare; and stage 3: systematic focused review of leadership in patient-facing dental practice. RESULTS The healthcare literature mirrors the generic literature in relation to the temporal evolution of leadership theories. Policy papers influence healthcare literature, though these are generally written by independent bodies, link solely to medical publications, and are often commissioned from the grand strategic level thereby grounding them in a politicised system. The healthcare leadership literature offers few studies at the operational (patient care) level of leadership, with none of these focused explicitly on dentistry and dental practice. Numerous aims, definitions, models, conceptualisations, and links to theories of leadership are reported. The stage 1 literature demonstrates more contemporaneous ideas of leadership, while the dental practice literature is too often grounded in outdated concepts and theories. CONCLUSIONS The overarching trend is from leaders to leadership; with no unified definition, model, theory, concept nor aim recognised. The fundamental importance of specific context and the reaction of others to leadership is reinforced. Leadership theories aligned to healthcare include Engaging, Authentic, Collective and the Transformational-Transactional continuum. Leadership is a dynamic, socially constructed process, only occurring in a group setting. Consisting of multiple moderating variables that demonstrate reciprocal influence on one another, these influences are neither equal nor stable. (246 words) CLINICAL SIGNIFICANCE: Leadership is embedded in regulatory guidance and standards relating to general dental practice. It is therefore crucial to have an evidenced based understanding of what leadership means in this context, and what further work is necessary to support clinicians in the leadership domain.
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Affiliation(s)
- Sally Hanks
- Associate Head of School, Teaching and Learning, Peninsula Dental School (Faculty of Health), University of Plymouth, United Kingdom.
| | - Debby Cotton
- Deputy Vice-Chancellors Office, Plymouth Marjon University & Visiting Professor Peninsula Dental School, University of Plymouth, United Kingdom
| | - Lucy Spowart
- Postgraduate Education and Programme Lead Clinical Education at Peninsula Medical School (Faculty of Health), University of Plymouth, United Kingdom
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Harris R, Fletcher S, Sims S, Ross F, Brearley S, Manthorpe J. Understanding key mechanisms of successfully leading integrated team-based services in health and social care: protocol for a realist synthesis. BMJ Open 2020; 10:e038591. [PMID: 32647024 PMCID: PMC7351270 DOI: 10.1136/bmjopen-2020-038591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION As systems of health and social care in England move towards more integrated and collaborative models, leaders will need different skills than their predecessors to enable system leadership, building partnerships and working across organisations and sectors. There is little understanding of what the mechanisms for effective leadership across integrated health and social care systems might be, the contexts that influence good leadership, or the nature of the resulting outcomes. This review aims to identify, refine and test programme theories of leadership of integrated team-based services in health and social care, exploring what works, for whom and in what circumstances. METHODS AND ANALYSIS This study uses a realist synthesis approach, following RAMESES guidelines, supported by stakeholder consultation. Stage 1 will develop initial programme theories about leadership of integrated health and social care based on a review of the scientific and grey literature and a stakeholder consultation workshop. Stage 2 will involve focused searching of empirical literature, data extraction and synthesis to refine the initial programme theories and identify relationships between identified contexts, mechanisms and outcomes. A second stakeholder event will guide the focus of the review. Stage 3 will further refine and interrogate the theories testing them against substantive theory on leadership of complex systems and through the experiences and expertise of the stakeholder group. ETHICS AND DISSEMINATION Our study does not require ethics committee approval. This research will contribute to building an in-depth understanding of what aspects of leadership of integrated team-based services work, for whom and in what circumstances. It will identify the professional development needs of leaders and provide recommendations about optimal organisational and interorganisational structures and processes that support effective leadership in integrated health and social care systems. Findings will be disseminated through peer-reviewed journal publications, conference presentations and formal and informal reports. PROSPERO REGISTRATION NUMBER CRD42018119291.
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Affiliation(s)
- Ruth Harris
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Simon Fletcher
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK
| | - Sarah Sims
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Fiona Ross
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK
| | - Sally Brearley
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK
| | - Jill Manthorpe
- NIHR Health & Social Care Workforce Research Unit, King's College London, London, UK
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Savarimuthu D. The potential role of nurses in leading positive behaviour support. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:414-418. [PMID: 32279557 DOI: 10.12968/bjon.2020.29.7.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Positive behaviour support (PBS) has become the preferred intervention in the management of challenging behaviour in learning disability and mental health services. However, there is an absence of literature on nurses' views and experience of PBS. Nurses are passive in PBS plan development while other professionals, such as clinical psychologists, often take the lead. While nurses see clinical psychologists as experts in PBS, they feel this could create a barrier that hinders its full potential and a more multidisciplinary approach would be beneficial. Nurses could take a pivotal role in delivering PBS plans if they were able to take a leading role, and this would benefit service users as nurses work far more closely with them than other professionals.
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Thakur A, Sockalingam S, Varatharajan T, Soklaridis S. "You are in Some Sort of Occupational Adolescence": An Exploratory Study to Understand Knowledge, Skills, and Experiences of CanMEDS Leader Role in Psychiatry. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2020; 44:184-191. [PMID: 31863412 DOI: 10.1007/s40596-019-01162-3] [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: 03/13/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The study explored knowledge, attitude, and practices of Canadian Medical Education Directions for Specialists (CanMEDS) "'Leader" role in faculty psychiatrists in a university setting. METHODS This is a qualitative study using a thematic analysis approach. Participants were identified by purposive, convenience, and snowball sampling. Telephone interviews were conducted to explore participants' perceptions of leadership. Qualitative analysis was carried out using a constant comparative analysis approach to identify themes across the interview data. Data was transcribed and coded into themes and categories to form an analysis of physicians' knowledge, attitude, and practices of the CanMEDS "Leader" role. RESULTS Twenty-eight faculty psychiatrists participated in the study. The following themes and subthemes emerged from analysis: (a) characteristics of leadership and lack of clarity regarding CanMEDS "Leader" role (subthemes: differences between manager and leader, lack of specificity and practicality, relevance to practice) and (b) the meaning of leadership (subthemes: "positional leadership" and "everyday leadership," physician as team leader, developing leadership skills, getting beyond "occupational adolescence"). CONCLUSION Participants perceived CanMEDS "Leader" role description as a high-level vision, which needs practice-oriented guidance. Participants conceptualized the dual nature of physician leadership at an individual level and at an organizational level. Leadership training is important both in residency as well as lifelong learning.
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Affiliation(s)
- Anupam Thakur
- Depatment of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Addiction and Mental Health, Toronto, Canada.
| | - Sanjeev Sockalingam
- Depatment of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Thepikaa Varatharajan
- Depatment of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Sophie Soklaridis
- Depatment of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
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Wilk S, Kezadri-Hamiaz M, Amyot D, Michalowski W, Kuziemsky C, Catal N, Rosu D, Carrier M, Giffen R. An ontology-driven framework to support the dynamic formation of an interdisciplinary healthcare team. Int J Med Inform 2020; 136:104075. [PMID: 31958670 DOI: 10.1016/j.ijmedinf.2020.104075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/14/2019] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND PURPOSE Teamwork has become a modus operandi in healthcare and delivery of patient care by an interdisciplinary healthcare team (IHT) is now a prevailing modality of care. We argue that a formal and automated support framework is needed for an IHT to properly leverage information technology resources. Such a framework should allow for patient preferences and expand a representation of a clinical workflow with a formal model of dynamic formation of a team, especially with regards to team leader- and membership, and the assignment of tasks to team members. Our goal was to develop such a support framework, present its prototype software implementation and verify the implementation using a proof-of-concept use case. Specifically, we focused on clinical workflows for in-patient tertiary care and on patient preferences with regards to selecting team members and team leaders. MATERIALS AND METHODS Drawing on the research on clinical teamwork we defined the conceptual foundations for the proposed framework. Then, we designed its architecture and used ontology-driven design and first-order logic with associated reasoning methods to create and operationalize architectural elements. Finally, we incorporated existing solutions for business workflow modeling and execution as a backend for implementing the proposed framework. RESULTS We developed a Team and Workflow Management Framework (TWMF) with semantic components that allow for formalizing and operationalizing team formation in in-patient tertiary care setting and support provider-related patient preferences. We also created a prototype software implementation of TWMF using the IBM Business Process Manager platform. This implementation was evaluated in several simulated patient scenarios. CONCLUSIONS TWMF integrates existing workflow technologies and extends them with the capabilities to support dynamic formation of an IHT. Results of this research can be used to support real-time execution of clinical workflows, or to simulate their execution in order to assess the impact of various conditions (e.g., patterns of work shifts, staffing) on IHT operations.
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Affiliation(s)
- Szymon Wilk
- Institute of Computing Science, Poznan University of Technology, Piotrowo 2, 60-965, Poznan, Poland; Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada.
| | - Mounira Kezadri-Hamiaz
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada
| | - Daniel Amyot
- School of Electrical Engineering and Computer Science, University of Ottawa, 800 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Wojtek Michalowski
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada
| | - Craig Kuziemsky
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada
| | - Nihan Catal
- School of Electrical Engineering and Computer Science, University of Ottawa, 800 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Daniela Rosu
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada
| | - Marc Carrier
- The Ottawa Hospital Research Institute, 725 Parkdale Ave, Ottawa, ON, K1Y 4E9, Canada
| | - Randy Giffen
- Telfer School of Management, University of Ottawa, 55 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada; Business Analytics Solutions, IBM, 3600 Steeles Avenue, East Markham, ON, L3R 9Z7, Canada
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Grealish L, Armit L, Shaw J, Frommolt V, Mitchell C, Mitchell M, van de Mortel T, Billett S. Learning through structured peer discussion: An observational study. NURSE EDUCATION TODAY 2019; 82:99-105. [PMID: 31470212 DOI: 10.1016/j.nedt.2019.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/08/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Clinical experiences are an essential foundation of nursing education. While there have been many significant investigations into models of clinical education and student learning, how students 'make sense' of their experiences is less well investigated. Senior nursing staff in a tertiary health service partnered with nurse researchers to explore how students can learn more about practice through structured discussions with peers to promote shared understandings. OBJECTIVES The study aimed to evaluate the contributions to student learning from structured peer discussions about patient care. DESIGN Exploratory observational study of the effects of learning circle discussions on individual understanding of patient care. SETTING A metropolitan health service in southeast Queensland, Australia. PARTICIPANTS 72 Bachelor of Nursing students in Years 2 and 3. METHODS Students developed concept maps about patient care prior to peer discussions, and subsequently added further concepts (in another colour of text) after those discussions. Researchers' review of student generated concept maps and coded concepts indicated a five a priori ways of knowing categories: empirical, aesthetic, ethical, personal and socio-political. Descriptive analysis of categories was then conducted. RESULTS Empirical knowing was high in both groups, with more concepts included in Year 3 student maps. Aesthetic knowing was relatively high in both groups. Socio-political knowing was lower than anticipated overall. Personal and ethical forms of knowing were rarely included on the concept maps. CONCLUSIONS While clinical placement is valued for developing empirical and aesthetic forms of knowing, the other forms of knowing have value for patient and family care and warrant strategies to improve their further development. Developing strategies to support student learning of ethical and personal forms of knowing deserves further investigation.
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Affiliation(s)
- Laurie Grealish
- Gold Coast Campus, Griffith University, Southport, QLD 4215, Australia; Gold Coast Health, 1 Hospital Blvd, Southport Q 4215, Australia.
| | - Lyn Armit
- Gold Coast Health, 1 Hospital Blvd, Southport Q 4215, Australia.
| | - Julie Shaw
- CQUniversity Brisbane Campus, Level 20, 160 Ann St, Brisbane, QLD 4000, Australia.
| | - Valda Frommolt
- Logan Campus, Griffith University, 68 University Dr, Meadowbrook QLD 4131, Australia.
| | - Creina Mitchell
- Gold Coast Campus, Griffith University, Southport, QLD 4215, Australia.
| | - Marion Mitchell
- Nathan Campus, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia; Nurse Practice Development Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, QLD 4102, Australia.
| | | | - Stephen Billett
- Mt Gravatt Campus, Griffith University, 176 Messines Ridge Road, Mount Gravatt, QLD 4122, Australia.
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Ong YH, Koh MYH, Lim WS. Shared leadership in interprofessional teams: beyond team characteristics to team conditions. J Interprof Care 2019; 34:444-452. [PMID: 31573358 DOI: 10.1080/13561820.2019.1653834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Shared leadership has been shown to enhance processes, effectiveness, and performances in interprofessional teams. While earlier studies suggest the association of internal team environment (ITE) and transactive memory system (TMS) with shared leadership, the relative influence of these team conditions vis-a-vis team characteristics (such as team size, stability, and interprofessional roles) on shared leadership is not well understood. This study aims to examine the comparative influence of team characteristics versus team conditions of ITE and TMS on shared leadership during interprofessional team meetings (IPTMs). We compared interprofessional teams from two departments, namely larger and more diverse teams of Geriatric Medicine versus the smaller and more homogeneous Palliative Medicine. We administered a questionnaire survey to healthcare professionals who attended IPTMs in both departments (N = 133). Our results revealed significantly higher scores in shared leadership, ITE and TMS in Palliative Medicine (p < .05). Using hierarchical regression analysis adjusting for team conditions, department and number of IPTMs attended were not significant in the final model (both p > .05). Instead, TMS (β= 0.250, p < .01) and ITE (β= 0.584, p < .01) outperformed team characteristics as conditions that are highly associated with shared leadership, explaining an additional 29.8% and 19.0%, respectively, of model variance. Further analysis revealed a stronger correlation between shared leadership subdomains with TMS in Geriatric Medicine and with ITE in Palliative Medicine. Our results demonstrate how a positive working environment with a high level of shared memory engendered a perception of shared leadership, and how these team conditions can be tapped upon to circumvent differences in team characteristics to facilitate shared leadership. Identifying key conditions that are highly associated with shared leadership is critical for the teaching of dynamic leadership roles to junior clinicians which in turn, can enhance patient care.
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Affiliation(s)
- Yu Han Ong
- Health Outcomes and Medical Education Research (HOMER), National Healthcare Group , Singapore
| | | | - Wee Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital , Singapore, Singapore
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Booth V, Harwood R, Hancox JE, Hood-Moore V, Masud T, Logan P. Motivation as a mechanism underpinning exercise-based falls prevention programmes for older adults with cognitive impairment: a realist review. BMJ Open 2019; 9:e024982. [PMID: 31221867 PMCID: PMC6588958 DOI: 10.1136/bmjopen-2018-024982] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 03/13/2019] [Accepted: 05/21/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This review aimed to identify mechanisms underlying participation in falls prevention interventions, in older adults with cognitive impairment. In particular we studied the role of motivation. DESIGN A realist review of the literature. DATA SOURCES EMBASE, MEDLINE, CINAHL, the Cochrane Library, PsycINFO and PEDRO. ELIGIBILITY CRITERIA Publications reporting exercise-based interventions for people with cognitive impairment, including dementia, living in the community. DATA EXTRACTION AND SYNTHESIS A 'rough programme theory' (a preliminary model of how an intervention works) was developed, tested against findings from the published literature and refined. Data were collected according to elements of the programme theory and not isolated to outcomes. Motivation emerged as a key element, and was prioritised for further study. RESULTS An individual will access mechanisms to support participation when they think that exercise will be beneficial to them. Supportive mechanisms include having a 'gate-keeper', such as a carer or therapist, who shares responsibility for the perception of exercise as beneficial. Lack of access to support decreases adherence and participation in exercise. Motivational mechanisms were particularly relevant for older adults with mild-to-moderate dementia, where the exercise intervention was multicomponent, in a preferred setting, at the correct intensity and level of progression, correctly supported and considered, and flexibly delivered. CONCLUSION Motivation is a key element enabling participation in exercise-based interventions for people with cognitive impairment. Many of the mechanisms identified in this review have parallels in motivational theory. Clinically relevant recommendations were derived and will be used to further develop and test a motivationally considered exercise-based falls intervention for people with mild dementia. PROSPERO REGISTRATION NUMBER CRD42015030169.
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Affiliation(s)
- Vicky Booth
- Division of Rehabilitation Ageing and Wellbeing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rowan Harwood
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Jennie E Hancox
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Victoria Hood-Moore
- Division of Rehabilitation Ageing and Wellbeing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tahir Masud
- Health Care of the Older Person, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Phillipa Logan
- Division of Rehabilitation Ageing and Wellbeing, School of Medicine, University of Nottingham, Nottingham, UK
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Abstract
Adverse patient outcomes are often the result of conflict or poor communication among healthcare professionals. Use of interprofessional care teams can improve healthcare and delivery of services. Healthcare systems have been historically hierarchical in nature with physicians regularly taking a leadership position. The presence of hierarchy can be a source of conflict in interprofessional healthcare teams. This article analyzes qualitative data from a four-day interprofessional training for family medicine residents, pharmacy students, nurse practitioner students, and counseling psychology students. Data was collected through journals, participant observation, and focus groups. Findings from this study demonstrate three key themes related to hierarchy: (1) tension regarding the idea that the physician is the team leader or "quarterback," (2) experiences of marginalization by team members while working in interprofessional teams, and (3) the tendency for issues regarding hierarchy to go unresolved. Additionally, authors briefly address structures within healthcare that contribute to hierarchy as well as a discussion of alternative models of teamwork and healthcare delivery.
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Affiliation(s)
- Erika Gergerich
- School of Social Work, New Mexico State University , Las Cruces , NM , USA
| | - Daubney Boland
- Southern New Mexico Family Medical Residency Program , Las Cruces , NM , USA
| | - Mary Alice Scott
- Department of Anthropology, New Mexico State University , Las Cruces , NM , USA
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Exploring healthcare professionals' perceptions of medication errors in an adult oncology department in Saudi Arabia: A qualitative study. Saudi Pharm J 2018; 27:176-181. [PMID: 30766427 PMCID: PMC6362166 DOI: 10.1016/j.jsps.2018.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 10/15/2018] [Indexed: 11/23/2022] Open
Abstract
Objective Adverse events which result from medication errors are considered to be one of the most frequently encountered patient safety issues in clinical settings. We undertook a qualitative investigation to identify and explore factors relating to medication error in an adult oncology department in Saudi Arabia from the perspective of healthcare professionals. Methods This was a qualitative study conducted in an adult oncology department in Saudi Arabia. After obtaining required ethical approvals and written consents from the participants, semi-structured interviews and focus group discussions were carried out for data collection. A stratified purposive sampling strategy was used to recruit medical doctors, pharmacists, and nurses. NVivo Pro version 11 was used for data analyses. Inductive thematic analysis was adopted in the primary coding of data while secondary coding of data was carried out deductively applying the Hospital Survey of Patient Safety Culture (HSOPSC) framework. Result The total number of participants were 38. Majority of the participants were nurses (n = 24), females (n = 30), and not of Saudi nationality (n = 31) with an average age of 36 years old. Causes of medication errors were categorized into 6 themes. These causes were related teamwork across units, staffing, handover of medication related information, accepted behavioural norms, frequency of events reported, and non-punitive response to error. Conclusion There were numerous causes for medication errors in the adult oncology department. This means substantive improvement in medication safety is likely to require multiple, inter-relating, complex interventions. More research should be conducted to examine context-specific interventions that may have the potential to improve medication safety in this and similar departments.
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Shin DS, Choi YJ. A pilot study of team-based primary health care for people with disabilities in South Korea. J Interprof Care 2018; 33:129-132. [DOI: 10.1080/13561820.2018.1531832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Dong-Soo Shin
- Division of Nursing, Hallym University, Chuncheon, Gangwon, South Korea
- Research Institute of Nursing Science, Hallym University, Chuncheon, Gangwon, South Korea
| | - Yong-jun Choi
- Department of Social and Preventive Medicine, College of Medicine, Hallym University, Chuncheon, Gangwon, South Korea
- Health Services Research Center, Hallym University, Chuncheon, Gangwon, South Korea
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Iachini AL, DeHart DD, Browne T, Dunn BL, Blake EW, Blake C. Examining collaborative leadership through interprofessional education: findings from a mixed methods study. J Interprof Care 2018; 33:235-242. [DOI: 10.1080/13561820.2018.1516635] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Aidyn L. Iachini
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Dana D. DeHart
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Teri Browne
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Brianne L. Dunn
- South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Elizabeth W. Blake
- South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Christine Blake
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Cunningham U, Ward ME, De Brún A, McAuliffe E. Team interventions in acute hospital contexts: a systematic search of the literature using realist synthesis. BMC Health Serv Res 2018; 18:536. [PMID: 29996820 PMCID: PMC6042358 DOI: 10.1186/s12913-018-3331-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 06/26/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Research on team effectiveness in healthcare has focussed on whether effective teams yield positive outcomes for patients and on the effectiveness of team interventions to improve performance. Limited understanding exists of what works for whom within an effective team, or how and why the context in which the team operates enables team members both as individuals and as a collective to enact behaviours that promote positive outcomes. METHODS This realist synthesis of the literature explores the relationship between team interventions, underlying teamwork mechanisms generated by those interventions, and the resultant impact on patient outcomes in an acute hospital context. A systematic search of five healthcare and healthcare management academic databases: PubMed, PsychINFO, CINAHL, ABInform, Emerald Management and three grey literature databases: ERIC, OpenDOAR and Open Grey was undertaken. Five experts in the field were also contacted to source relevant literature. Using PRISMA guidelines, relevant studies published between January 2006 and January 2017 were systematically searched by a team of three people. Drawing on realist methodology, data were synthesised using context, mechanism and outcome configurations as the unit of analysis to identify enablers and barriers to effective team interventions. RESULTS Out of 3347 papers retrieved, 18 were included in the final synthesis. From these, five contextual enablers were identified: an inter-disciplinary focus and flattened hierarchy; effective communication; leadership support and alignment of team goals with organisational goals; credibility of intervention; and appropriate team composition with physician involvement. Ten recurring mechanisms were identified, the most frequently occurring of which was shared responsibility. CONCLUSIONS The advantage of using realist synthesis to extrapolate data from the literature is that it considers the context and mechanisms that will impact effectiveness of healthcare team interventions. This methodological approach provides a different perspective to other types of syntheses and offers insight as to why certain contextual elements may yield more success than others. Findings therefore tend to have more practical implications. Specificity of detail in terms of how external drivers impact on healthcare team interventions was limited in the articles extracted for analysis. This broader perspective is therefore an important consideration for future research.
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Affiliation(s)
- U. Cunningham
- Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - M. E. Ward
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - A. De Brún
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - E. McAuliffe
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Fu L, Liu Z. Distributed leadership in organizations: an investigation of antecedent conditions. CHINESE MANAGEMENT STUDIES 2018. [DOI: 10.1108/cms-10-2017-0312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to investigate antecedent conditions that lead to the development of distributed leadership (DL). The authors examine how the emergence of DL is affected by empowerment and internal context, which consists of shared purpose, social support and voice. The moderating effects of training are also investigated.
Design/methodology/approach
To test the hypotheses, this empirical analysis of the relationship between the variables was based on the results of a questionnaire survey on 62 teams in high-tech enterprises of mainland China.
Findings
Results indicate that empowerment and internal context in the team significantly predict the extent of DL and that training has positive moderating effects on the relationships.
Practical implications
The results imply that firms must carefully analyze specific team conditions to ensure shared purpose, social support and voice in each team. This study also suggests the importance of empowerment. Moreover, enterprises can use training, a human resource tool, to enhance the positive effects of internal context and empowerment on DL.
Originality/value
By building on upper echelons theory and integrating insights from contingency theory, this study extends prior research by examining the direct effects of both empowerment managerial system and internal context on DL and the moderating effect of training.
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Communication and Relational Ties in Inter-Professional Teams in Norwegian Specialized Health Care: A Multicentre Study of Relational Coordination. Int J Integr Care 2018; 18:9. [PMID: 30127693 PMCID: PMC6095090 DOI: 10.5334/ijic.3432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: The delivery of integrated care depends on the quality of communication and relationships among health-care professionals in inter-professional teams. The main aim of this study was to investigate individual and team communication and relational ties of teams in specific care processes within specialized health care. Methods: This cross-sectional multi-centre study used data from six somatic hospitals and six psychiatric units (N = 263 [response rate, 52%], 23 care processes) using a Norwegian version of the Relational Coordination Survey. We employed linear mixed-effect regression models and one-way analyses of variance. Results: The mean (standard deviation) relational coordination total score ranged from 4.5 (0.33) to 2.7 (0.50). The communication and relationship sub-scale scores were significantly higher within similar functional groups than between contrasting functional groups (P < .05). Written clinical procedures were significantly associated with higher communication scores (P < .05). The proportion of women in a team was associated with higher communication and relationship scores (P < .05). Conclusion: The Relational Coordination Survey shows a marked variation in team functions within inter-professional teams in specialized health-care settings. Further research is needed to determine the reasons for these variations.
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O'Sullivan GA, Hanlon C, Dentry T, Morris T, Banting L. A qualitative exploration of the client experience of inter-professional practice in the delivery of ActivePlus: a combined smoking cessation and physical activity intervention. BMC Health Serv Res 2018; 18:195. [PMID: 29562905 PMCID: PMC5863488 DOI: 10.1186/s12913-018-3004-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 03/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research investigating interprofessional practice (IPP) frameworks has predominately focused on the service delivery of IPP or educating practitioners through interprofessional education. Minimal research has addressed client outcomes or the experience of clients with IPP in real world contexts. In this paper, we explore the experience of seven participants in the ActivePlus program, an IPP-based smoking cessation intervention combined with physical activity promotion. METHODS Participants informed on their program experiences through post-program in-depth interviews. A thematic analysis drew out themes pertaining to participant experiences of the joint practice element of the IPP model of care. RESULTS Analysis identified two major themes: the joint practice experience, and the client-centered approach of the IPP model of care. Participants reflected on the ways that having two health practitioners in joint sessions benefited their intervention experience, as well as providing some critical feedback. Participants also reported observing and valuing aspects of client-centered practice that strengthened the rapport within the practitioner-client team and aided their behaviour change progress. The client-centered practice was instrumental in overcoming initial teething issues with joint session delivery and alleviating pre-program participant concerns about being outnumbered by multiple practitioners. CONCLUSION Despite some early teething issues, participants reported a positive acceptance of the IPP and joint session delivery model, which added value to the overall ActivePlus program. Results from this research can provide practitioners with a client perspective on the key aspects they perceive as important in IPP joint session delivery. Further investigation into the client perception in similar interventions is recommended with larger samples and non-clinical groups.
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Affiliation(s)
- G A O'Sullivan
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia.
| | - Clare Hanlon
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia
| | - T Dentry
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia
| | - T Morris
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia
| | - L Banting
- Institute for Health and Sport, Victoria University, PO Box 14428 MC, Melbourne, VIC, 8001, Australia
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Vosman F, Niemeijer A. Rethinking critical reflection on care: late modern uncertainty and the implications for care ethics. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2017; 20:465-476. [PMID: 28332007 DOI: 10.1007/s11019-017-9766-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Care ethics as initiated by Gilligan, Held, Tronto and others (in the nineteen eighties and nineties) has from its onset been critical towards ethical concepts established in modernity, like 'autonomy', alternatively proposing to think from within relationships and to pay attention to power. In this article the question is raised whether renewal in this same critical vein is necessary and possible as late modern circumstances require rethinking the care ethical inquiry. Two late modern realities that invite to rethink care ethics are complexity and precariousness. Late modern organizations, like the general hospital, codetermined by various (control-, information-, safety-, accountability-) systems are characterized by complexity and the need for complexity reduction, both permeating care practices. By means of a heuristic use of the concept of precariousness, taken as the installment of uncertainty, it is shown that relations and power in late modern care organizations have changed, precluding the use of a straightforward domination idea of power. In the final section a proposition is made how to rethink the care ethical inquiry in order to take late modern circumstances into account: inquiry should always be related to the concerns of people and practitioners from within care practices.
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Affiliation(s)
- Frans Vosman
- Department of Care Ethics, University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD, Utrecht, The Netherlands
| | - Alistair Niemeijer
- Department of Care Ethics, University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD, Utrecht, The Netherlands.
- Department of Social Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
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McKinlay EM, Morgan SJ, Gray BV, Macdonald LM, Pullon SR. Exploring interprofessional, interagency multimorbidity care: case study based observational research. JOURNAL OF COMORBIDITY 2017; 7:64-78. [PMID: 29090190 PMCID: PMC5556439 DOI: 10.15256/joc.2017.7.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/03/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The increase in multimorbidity or co-occurring chronic illnesses is a leading healthcare concern. Patients with multimorbidity require ongoing care from many different professionals and agencies, and often report a lack of integrated care. OBJECTIVE To explore the daily help-seeking behaviours of patients with multimorbidity, including which health professionals they seek help from, how professionals work together, and perceptions and characteristics of effective interprofessional, interagency multimorbidity care. DESIGN Using a case study observational research design, multiple data sources were assembled for four patients with multimorbidity, identified by two general practitioners in New Zealand. In this paper, two case studies are presented, including the recorded instances of contact and communication between patients and professionals, and between professionals. Professional interactions were categorized as consultation, coordination, or collaboration. RESULTS The two case studies illustrated two female patients with likely similar educational levels, but with different profiles of multimorbidity, social circumstances, and personal capabilities, involving various professionals and agencies. Engagement between professionals showed varying levels of interaction and a lack of clarity about leadership or care coordination. The majority of interactions were one-to-one consultations and rarely involved coordination and collaboration. Patients were rarely included in communications between professionals. CONCLUSION Cases constructed from multiple data sources illustrate the complexity of day-to-day, interprofessional, interagency multimorbidity care. While consultation is the most frequent mode of professional interaction, targeted coordinated and collaborative interactions (including the patient) are highly effective activities. Greater attention should be given to developing and facilitating these interactions and determining who should lead them.
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Affiliation(s)
- Eileen M. McKinlay
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - Sonya J. Morgan
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - Ben V. Gray
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - Lindsay M. Macdonald
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - Susan R.H. Pullon
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
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Prystajecky M, Lee T, Abonyi S, Perry R, Ward H. A case study of healthcare providers' goals during interprofessional rounds. J Interprof Care 2017; 31:463-469. [PMID: 28406339 DOI: 10.1080/13561820.2017.1306497] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Daily interprofessional rounds enhance collaboration among healthcare providers and improve hospital performance measures. However, it is unclear how healthcare providers' goals influence the processes and outcomes of interprofessional rounds. The purpose of this case study was to explore the goals of healthcare providers attending interprofessional rounds in an internal medicine ward. The second purpose was to explore the challenges encountered by healthcare providers while pursuing these goals. Three focus groups were held with healthcare providers of diverse professional backgrounds. Focus group field notes and transcripts were analysed using thematic analysis. The data indicated that there was no consensus among healthcare providers regarding the goals of interprofessional rounds. Discharge planning and patient care delivery were perceived as competing priorities during rounds, which limited the participation of healthcare providers. Nevertheless, study participants identified goals of rounds that were relevant to most care providers: developing shared perspectives of patients through direct communication, promoting collaborative decision making, coordinating care, and strengthening interprofessional relationships. Challenges in achieving the goals of interprofessional rounds included inconsistent attendance, exchange of irrelevant information, variable participation by healthcare providers, and inconsistent leadership. The findings of this study underscore the importance of shared goals in the context of interprofessional rounding.
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Affiliation(s)
- Michael Prystajecky
- a Department of Medicine , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Tiffany Lee
- a Department of Medicine , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Sylvia Abonyi
- b Department of Community Health and Epidemiology , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Robert Perry
- c College of Education , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
| | - Heather Ward
- a Department of Medicine , University of Saskatchewan , Saskatoon , Saskatchewan , Canada
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Forsyth C, Mason B. Shared leadership and group identification in healthcare: The leadership beliefs of clinicians working in interprofessional teams. J Interprof Care 2017; 31:291-299. [DOI: 10.1080/13561820.2017.1280005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Craig Forsyth
- Department of Specialist Services, Hounslow Learning Disability Team, Hounslow & Richmond Community Healthcare NHS Trust, Hounslow, UK
| | - Barbara Mason
- Department of Psychology, University of Hertfordshire, Hatfield, UK
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Kulnik ST, Pöstges H, Brimicombe L, Hammond J, Jones F. Implementing an interprofessional model of self-management support across a community workforce: A mixed-methods evaluation study. J Interprof Care 2016; 31:75-84. [DOI: 10.1080/13561820.2016.1246432] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Stefan Tino Kulnik
- Faculty of Health, Social Care and Education, Kingston University and St. George’s, University of London, London, UK
- Bridges Self-Management Limited, London, UK
| | - Heide Pöstges
- Faculty of Health, Social Care and Education, Kingston University and St. George’s, University of London, London, UK
- Bridges Self-Management Limited, London, UK
| | - Lucinda Brimicombe
- Faculty of Health, Social Care and Education, Kingston University and St. George’s, University of London, London, UK
- Bridges Self-Management Limited, London, UK
| | - John Hammond
- Faculty of Health, Social Care and Education, Kingston University and St. George’s, University of London, London, UK
| | - Fiona Jones
- Faculty of Health, Social Care and Education, Kingston University and St. George’s, University of London, London, UK
- Bridges Self-Management Limited, London, UK
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Anderson ES. Evaluating interprofessional education: An important step to improving practice and influencing policy. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2016.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Sandoff M, Nilsson K. How staff experience teamwork challenges in a new organizational structure. TEAM PERFORMANCE MANAGEMENT 2016. [DOI: 10.1108/tpm-05-2016-0021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to explore challenges arising from the development of teamwork in a new organizational structure, based on the experiences of the staff involved.
Design/methodology/approach
An explorative and qualitative approach was used, with individual interviews as the data collection method. These interviews were analyzed using qualitative and interpretative analysis with a modified editing style.
Findings
The results describe how the lack of essential organizational prerequisites for teamwork and the absence of the leadership qualities needed to facilitate teamwork contribute to difficulties in working in a team-orientated way. Shortage of information among the team members and few scheduled meetings signify insufficient coordination within the working team. Without a team leader who can keep things together, read the team members’ needs and support and guide them, team work is difficult to uphold because the members will need to seek support elsewhere. Assumed synergies from working together as team member experts will be thwarted.
Originality/value
This study contributes knowledge about the difficulties in creating team-orientated cooperation in a new organizational structure when leadership as well as structures and processes supporting team work are absent. The challenges described are drawn from the experiences of the staff concerned, providing insights to form a basis for theoretical and practical discussion.
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Dubus N, Howard H. Current realities and future vision: Developing an interprofessional, integrated health care workforce. SOCIAL WORK IN HEALTH CARE 2016; 55:766-778. [PMID: 27649460 DOI: 10.1080/00981389.2016.1223260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article shares findings from an interprofessional symposium that took place in Boston in the spring of 2015. Educators and practitioners from various disciplines shared challenges, successes, and ideas on best interprofessional collaboration (IPC) and curricula development. The findings include the importance of patient-and-family-centered care, which includes the patient and his/her family in the decision-making process; increased education regarding IPC in universities and major hospitals; and educational opportunities within health care systems.
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Affiliation(s)
- Nicole Dubus
- a Department of Social Work , San Jose State University , San Jose , California , USA
| | - Heather Howard
- b Department of Social Work , Wheelock College , Boston , Massachusetts , USA
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Klinga C, Hansson J, Hasson H, Sachs MA. Co-Leadership - A Management Solution for Integrated Health and Social Care. Int J Integr Care 2016; 16:7. [PMID: 27616963 PMCID: PMC5015547 DOI: 10.5334/ijic.2236] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 05/11/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Co-leadership has been identified as one approach to meet the managerial challenges of integrated services, but research on the topic is limited. In the present study, co-leadership, practised by pairs of managers - each manager representing one of the two principal organizations in integrated health and social care services - was explored. AIM To investigate co-leadership in integrated health and social care, identify essential preconditions in fulfilling the management assignment, its operationalization and impact on provision of sustainable integration of health and social care. METHOD Interviews with eight managers exercising co-leadership were analysed using directed content analysis. Respondent validation was conducted through additional interviews with the same managers. RESULTS Key contextual preconditions were an organization-wide model supporting co-leadership and co-location of services. Perception of the management role as a collective activity, continuous communication and lack of prestige were essential personal and interpersonal preconditions. In daily practice, office sharing, being able to give and take and support each other contributed to provision of sustainable integration of health and social care. CONCLUSION AND DISCUSSION Co-leadership promoted robust management by providing broader competence, continuous learning and joint responsibility for services. Integrated health and social care services should consider employing co-leadership as a managerial solution to achieve sustainability.
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Affiliation(s)
- Charlotte Klinga
- Medical Management Centre (MMC), Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, SE
- Department of Social Work, Karolinska University Hospital, SE
| | - Johan Hansson
- Medical Management Centre (MMC), Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, SE
| | - Henna Hasson
- Medical Management Centre (MMC), Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, SE
- Centre for Epidemiology and Community Medicine, Stockholm County
Council, SE
| | - Magna Andreen Sachs
- Medical Management Centre (MMC), Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet, SE
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Olson R, Bidewell J, Dune T, Lessey N. Developing cultural competence through self-reflection in interprofessional education: Findings from an Australian university. J Interprof Care 2016; 30:347-54. [DOI: 10.3109/13561820.2016.1144583] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dimas ID, Renato Lourenço P, Rebelo T. The effects on team emotions and team effectiveness of coaching in interprofessional health and social care teams. J Interprof Care 2016; 30:416-22. [PMID: 27135137 DOI: 10.3109/13561820.2016.1149454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to examine the effects of coaching behaviours provided by peers and by the leader on the emotions experienced by interprofessional health and social care teams and on members' satisfaction with the team, as well as on team performance. Data were obtained from a survey among 344 employees working in 52 interprofessional health and social care teams from nine Portuguese organizations. The results show that leader coaching and peer coaching have a positive effect on the level of team members' satisfaction with the team and on positive emotions, and a negative effect on negative emotions. Furthermore, coaching provided by peers presents a positive effect on team performance as assessed by the leader of the team. Our findings put forward the importance of engaging in coaching behaviours to promote quality of the team experience, as well as the achievement of team performance objectives. Further studies should explore how coaching behaviours impact the patient, whose well-being is the ultimate objective of a team in the health and social care system, namely in terms of the patient's perception of quality care or patient outcomes.
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Affiliation(s)
- Isabel Dórdio Dimas
- a ESTGA, University of Aveiro , Aveiro , Portugal.,b GOVCOPP, University of Aveiro , Aveiro , Portugal
| | - Paulo Renato Lourenço
- c FPCEUC, University of Coimbra , Coimbra , Portugal.,d IPCDVS, University of Coimbra , Coimbra , Portugal
| | - Teresa Rebelo
- e Faculty of Psychology, University of Coimbra , Coimbra , Portugal
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Using Semantic Components to Represent Dynamics of an Interdisciplinary Healthcare Team in a Multi-Agent Decision Support System. J Med Syst 2015; 40:42. [DOI: 10.1007/s10916-015-0375-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
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Naeger DM, Hua EW, Ahearn B, Webb EM. Reflective Writing: A Potential Tool to Improve Interprofessional Teamwork with Radiologists. Acad Radiol 2015; 22:1221-5. [PMID: 26292918 DOI: 10.1016/j.acra.2015.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/14/2015] [Accepted: 07/17/2015] [Indexed: 11/15/2022]
Abstract
RATIONALE AND OBJECTIVES Studies show that problems with interprofessional collaboration can result in adverse patient outcomes. These problems are common in the field of radiology, where technology has decreased opportunities for direct communication and collaboration with referring physicians. To our knowledge, critical reflection has not been studied as an intervention to better understand one's own and/or others' roles in the context of an interprofessional team, or more specifically, to improve interprofessional collaboration between radiologists and other physicians. MATERIALS AND METHODS We trialed a reflective journaling assignment in our fourth year medical student general radiology elective. Student journal content was scored by percentage of comments reflecting on elective experiences versus recounting events. Content was categorized as "reflection" using an established measurement tool. Reflective content was evaluated to identify common themes. RESULTS A total of 31 journals (178 entries and 26,749 words) were analyzed. Reflective content accounted for 43% of overall content and was subdivided into three categories: insight into one's own role and responsibilities as an ordering physician (20%), insight into a radiologist's role and responsibilities (12%), and thoughts on improving interprofessional collaboration with radiologists (11%). CONCLUSIONS Reflective writing allows students to explore their own role and responsibilities in the context of an interprofessional team and may improve interprofessional teamwork with radiologists.
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Affiliation(s)
- David M Naeger
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628.
| | - Ethan W Hua
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628
| | - Bren Ahearn
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628
| | - Emily M Webb
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628
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Hewitt G, Sims S, Greenwood N, Jones F, Ross F, Harris R. Interprofessional teamwork in stroke care: Is it visible or important to patients and carers? J Interprof Care 2014; 29:331-9. [PMID: 25158116 DOI: 10.3109/13561820.2014.950727] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Interprofessional teamwork is seen in healthcare policy and practice as a key strategy for providing safe, efficient and holistic healthcare and is an accepted part of evidence-based stroke care. The impact of interprofessional teamwork on patient and carer experience(s) of care is unknown, although some research suggests a relationship might exist. This study aimed to explore patient and carer perceptions of good and poor teamwork and its impact on experiences of care. Critical incident interviews were conducted with 50 patients and 33 carers in acute, inpatient rehabilitation and community phases of care within two UK stroke care pathways. An analytical framework, derived from a realist synthesis of 13 'mechanisms' (processes) of interprofessional teamwork, was used to identify positive and negative 'indicators' of teamwork. Participants identified several mechanisms of teamwork, but it was not a subject most talked about readily. This suggests that interprofessional teamwork is not a concept that is particularly important to stroke patients and carers; they do not readily perceive any impacts of teamwork on their experiences. These findings are a salient reminder that what might be expected by healthcare professionals to be important influences on experience may not be perceived to be so by patients and carers.
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Affiliation(s)
- Gillian Hewitt
- Cardiff School of Social Sciences, Cardiff University , Cardiff , UK and
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