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Belrhiti Z, Bigdeli M, Lakhal A, Kaoutar D, Zbiri S, Belabbes S. Unravelling collaborative governance dynamics within healthcare networks: a scoping review. Health Policy Plan 2024; 39:412-428. [PMID: 38300250 PMCID: PMC11005841 DOI: 10.1093/heapol/czae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 02/02/2024] Open
Abstract
In many countries, healthcare systems suffer from fragmentation between hospitals and primary care. In response, many governments institutionalized healthcare networks (HN) to facilitate integration and efficient healthcare delivery. Despite potential benefits, the implementation of HN is often challenged by inefficient collaborative dynamics that result in delayed decision-making, lack of strategic alignment and lack of reciprocal trust between network members. Yet, limited attention has been paid to the collective dynamics, challenges and enablers for effective inter-organizational collaborations. To consider these issues, we carried out a scoping review to identify the underlying processes for effective inter-organizational collaboration and the contextual conditions within which these processes are triggered. Following appropriate methodological guidance for scoping reviews, we searched four databases [PubMed (n = 114), Web of Science (n = 171), Google Scholar (n = 153) and Scopus (n = 52)] and used snowballing (n = 22). A total of 37 papers addressing HN including hospitals were included. We used a framework synthesis informed by the collaborative governance framework to guide data extraction and analysis, while being sensitive to emergent themes. Our review showed the prominence of balancing between top-down and bottom-up decision-making (e.g. strategic vs steering committees), formal procedural arrangements and strategic governing bodies in stimulating participative decision-making, collaboration and sense of ownership. In a highly institutionalized context, the inter-organizational partnership is facilitated by pre-existing legal frameworks. HN are suitable for tackling wicked healthcare issues by mutualizing resources, staff pooling and improved coordination. Overall performance depends on the capacity of partners for joint action, principled engagement and a closeness culture, trust relationships, shared commitment, distributed leadership, power sharing and interoperability of information systems To promote the effectiveness of HN, more bottom-up participative decision-making, formalization of governance arrangement and building trust relationships are needed. Yet, there is still inconsistent evidence on the effectiveness of HN in improving health outcomes and quality of care.
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Affiliation(s)
- Zakaria Belrhiti
- International School Mohammed VI of Public Health, Mohammed VI University of Sciences and Health (UM6SS), UM6SS – Anfa City : Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca 20230, Morocco
- Knowledge for Health Policies, UM6SS, Anfa City : Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca 20230, Morocco
- Mohammed VI Center for Research and Innovation (CM6RI), Rue Mohamed Al Jazouli – Madinat Al Irfane Rabat 10 100, Rabat Rue, Mohamed Al Jazouli – 10 100, Morocco
| | - Maryam Bigdeli
- World Health Organization, 3 Av. S.A.R. Sidi Mohamed, Rabat, Geneva 10170, Morocco
| | - Aniss Lakhal
- Knowledge for Health Policies, UM6SS, Anfa City : Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca 20230, Morocco
- Directorate of Hospitals and Ambulatory Care, Ministry of Health and Social Protection, Route d’El Jadida, Agdal, Rabat 10100, Morocco
| | - Dib Kaoutar
- Knowledge for Health Policies, UM6SS, Anfa City : Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca 20230, Morocco
- Directorate of Hospitals and Ambulatory Care, Ministry of Health and Social Protection, Route d’El Jadida, Agdal, Rabat 10100, Morocco
| | - Saad Zbiri
- International School Mohammed VI of Public Health, Mohammed VI University of Sciences and Health (UM6SS), UM6SS – Anfa City : Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca 20230, Morocco
- Knowledge for Health Policies, UM6SS, Anfa City : Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca 20230, Morocco
- Mohammed VI Center for Research and Innovation (CM6RI), Rue Mohamed Al Jazouli – Madinat Al Irfane Rabat 10 100, Rabat Rue, Mohamed Al Jazouli – 10 100, Morocco
| | - Sanaa Belabbes
- International School Mohammed VI of Public Health, Mohammed VI University of Sciences and Health (UM6SS), UM6SS – Anfa City : Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca 20230, Morocco
- Knowledge for Health Policies, UM6SS, Anfa City : Bld Mohammed Taïeb Naciri, Commune Hay Hassani 82 403, Casablanca 20230, Morocco
- Mohammed VI Center for Research and Innovation (CM6RI), Rue Mohamed Al Jazouli – Madinat Al Irfane Rabat 10 100, Rabat Rue, Mohamed Al Jazouli – 10 100, Morocco
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Fakhri N, Jallal M, Belabbes S, Khudur K, Kaddar R, Oubaasri A, Elhadraoui N, Mohammed Abdallahi N, Al Hassani W, Nejjari C, Belouali R, Khalis M. COVID-19 and Moroccan nursing students: A multicentre cross-sectional survey on their related knowledge, attitudes and practices. Nurs Open 2021; 8:1634-1641. [PMID: 33675185 PMCID: PMC8186718 DOI: 10.1002/nop2.790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/06/2021] [Accepted: 01/29/2021] [Indexed: 12/23/2022] Open
Abstract
Aim To assess knowledge, attitudes and practices of Moroccan nursing students towards COVID‐19. Design Cross‐sectional study. Method Data were collected using an online questionnaire consisted of demographic characteristics and 24 items about COVID‐19‐related knowledge, attitudes and practices. Results A total of 1,216 nursing students participated in this study. About 82% of the participants reported that the COVID‐19 virus spreads via respiratory droplets of infected individuals. The most clinical symptoms of COVID‐19 correctly identified by participants were fever (97.6%), dry cough (92.4%), dyspnoea (82%) and fatigue (74.9%). More than 56.6% of the participants were afraid of being affected by COVID‐19. Almost all participants reported that they avoid crowded places frequently. About 93.4% of the participants declared frequently wearing face mask when leaving home, and 85.5% maintained social distancing frequently. However, only 47.4% reported that they frequently washed their hands. About 51% stated that coronavirus outbreak has considerably changed their daily routines.
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Affiliation(s)
- Nada Fakhri
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco.,High Institute of Nursing Professions and Health Technics of Agadir, Agadir, Morocco
| | - Manar Jallal
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Sanaa Belabbes
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | | | - Rochdi Kaddar
- Regional Direction of Health of Souss Massa, Agadir, Morocco
| | - Ahmed Oubaasri
- High Institute of Nursing Professions and Health Techniques of Guelmim, Guelmim, Morocco
| | - Najia Elhadraoui
- High Institute of Nursing Professions and Health Techniques of Casablanca, Casablanca, Morocco
| | | | - Wafaa Al Hassani
- Faculty of Nursing and Allied Health Sciences, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Chakib Nejjari
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Radouane Belouali
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Mohamed Khalis
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
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Belabbes S, En-Nafaa I, Ziadi T, Zainoun B, El Fenni J. [An acute abdominal pain of unusual cause]. Rev Med Interne 2020; 41:500-501. [PMID: 32651012 DOI: 10.1016/j.revmed.2020.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 01/19/2020] [Indexed: 10/23/2022]
Affiliation(s)
- S Belabbes
- Département de radiologie, faculté de médecine et de pharmacie Sidi Mohammed Ben Abdellah, Fès, Maroc.
| | - I En-Nafaa
- Service de radiologie, hôpital militaire d'instruction Mohammed V, Rabat, Maroc
| | - T Ziadi
- Département de radiologie, faculté de médecine et de pharmacie Sidi Mohammed Ben Abdellah, Fès, Maroc
| | - B Zainoun
- Département de radiologie, faculté de médecine et de pharmacie Sidi Mohammed Ben Abdellah, Fès, Maroc
| | - J El Fenni
- Service de radiologie, hôpital militaire d'instruction Mohammed V, Rabat, Maroc
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Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J, Vaugier G, Potron G, Colona P, Oberling F, Thomas M, Tchernia G, Jacquillat C, Boivin P, Lesty C, Duault MT, Monconduit M, Belabbes S, Gremy F. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer 1981; 48:198-206. [PMID: 7237385 DOI: 10.1002/1097-0142(19810701)48:1<198::aid-cncr2820480131>3.0.co;2-v] [Citation(s) in RCA: 1112] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Survivals of two series of CLL patients (99 from a retrospective series and 196 from a prospective series) were studied separately. The three main staging systems (Rai, Binet, Rundles) agreed well, but as far as survival is concerned, too many stages are defined. The authors performed a Cox multivariate analysis of survival in order to isolate important prognostic factors at diagnosis and to use them to build a simple three-stage classification. Thrombopenia and anemia appeared as the most important risk factors. Among the nonanemic and nonthrombopenic patients, the number of involved areas was clearly related to prognosis in the authors' two series. This study allowed the authors to propose a new classification in three prognostic groups. Group C: anemia (Hb less than 10 g) and/or thrombopenia (platelets less than 100,000/mm3); about 15% of the patients; median of 2 years. Group B: no anemia, no thrombopenia, three or more involved areas (counting as one each of the following: axillary, cervical, inguinal, lymph nodes, whether unilateral or bilateral, spleen and liver); about 30% of patients; median of 7 years. Group A: no anemia, no thrombopenia, less than three involved areas; about 55% of patients; the survival of this group does not seem different from that of the French population of the same age and sex distribution. This three-stage classification only requires clinical examination and routine hemogram, has a good prognostic value which was confirmed on the series of Montserrat and Rozman (146 patients), and should therefore be helpful in planning new clinical trials.
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