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organizational ethics

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https://www.readbyqxmd.com/read/28732028/the-individual-and-contextual-determinants-of-the-use-of-telemedicine-a-descriptive-study-of-the-perceptions-of-senegal-s-physicians-and-telemedicine-projects-managers
#1
Birama Apho Ly, Ronald Labonté, Ivy Lynn Bourgeault, Mbayang Ndiaye Niang
Telemedicine is considered to be an effective strategy to aid in the recruitment and retention of physicians in underserved areas and, in doing so, improve access to healthcare. Telemedicine's use, however, depends on individual and contextual factors. Using a mixed methods design, we studied these factors in Senegal based on a micro, meso and macro framework. A quantitative questionnaire administered to 165 physicians working in public hospitals and 151 physicians working in district health centres was used to identify individual (micro) factors...
2017: PloS One
https://www.readbyqxmd.com/read/28694270/swimming-against-the-tide-primary-care-physicians-views-on-deprescribing-in-everyday-practice
#2
Katharine A Wallis, Abby Andrews, Michelle Henderson
PURPOSE: Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and facilitators to deprescribing in everyday practice to inform the development of an intervention to support safer prescribing. METHODS: We used a snowball sampling technique to identify potential participants...
July 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28687532/studying-scale-up-and-spread-as-social-practice-theoretical-introduction-and-empirical-case-study
#3
James Shaw, Sara Shaw, Joseph Wherton, Gemma Hughes, Trisha Greenhalgh
BACKGROUND: Health and care technologies often succeed on a small scale but fail to achieve widespread use (scale-up) or become routine practice in other settings (spread). One reason for this is under-theorization of the process of scale-up and spread, for which a potentially fruitful theoretical approach is to consider the adoption and use of technologies as social practices. OBJECTIVE: This study aimed to use an in-depth case study of assisted living to explore the feasibility and usefulness of a social practice approach to explaining the scale-up of an assisted-living technology across a local system of health and social care...
July 7, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28676285/-it-feels-like-i-m-the-dirtiest-person-in-the-world-exploring-the-experiences-of-healthcare-providers-who-survived-mers-cov-in-saudi-arabia
#4
Adel F Almutairi, Abdallah A Adlan, Hanan H Balkhy, Oraynab Abou Abbas, Alexander M Clark
In summer 2015, a Saudi 1000-bed tertiary care hospital experienced a serious outbreak among patients of Middle Eastern Respiratory Syndrome (MERS); during which, some healthcare providers contracted the virus, but none died. The outbreak provoked not only fear and stress; but also professional, emotional, ethical, and social conflicts and tension among healthcare providers and patients alike. Therefore, this study aims to explore what healthcare providers, who survived coronavirus infection, have experienced as a MERS patient and how the infection affected their relationship with their colleagues...
July 1, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28674939/the-care-dialog-the-ethics-of-care-approach-and-its-importance-for-clinical-ethics-consultation
#5
Patrick Schuchter, Andreas Heller
Ethics consultation in institutions of the healthcare system has been given a standard form based on three pillars: education, the development of guidelines and concrete ethics consultation in case conferences. The spread of ethics committees, which perform these tasks on an organizational level, is a remarkable historic achievement. At the same time it cannot be denied that modern ethics consultation neglects relevant aspects of care ethics approaches. In our essay we present an "ethics of care" approach as well as an empirical pilot project-"Ethics from the bottom up"-which organizes ethics consultation based on this focus...
July 3, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28668920/communication-and-decision-making-about-end-of-life-care-in-the-intensive-care-unit
#6
Laura Anne Brooks, Elizabeth Manias, Patricia Nicholson
BACKGROUND: Clinicians in the intensive care unit commonly face decisions involving withholding or withdrawing life-sustaining therapy, which present many clinical and ethical challenges. Communication and shared decision-making are key aspects relating to the transition from active treatment to end-of-life care. OBJECTIVES: To explore the experiences and perspectives of nurses and physicians when initiating end-of-life care in the intensive care unit. METHODS: The study was conducted in a 24-bed intensive care unit in Melbourne, Australia...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28661284/a-new-age-of-patient-transparency-an-organizational-framework-for-informed-consent
#7
Kenneth Campbell, Kayhan Parsi
With the many changes occurring in today's healthcare organizations, patients are increasingly equipped with a vast quantity of health care data and being more included in the healthcare decision-making process. The new approach we propose incorporates a new patient-organization framework that examines relevant historical, legal and ethical elements within the doctrine of informed consent in addition to examining the role of new healthcare organizations' obligations to include data to support addressing issues such as population health, health outcomes and health disparities within the informed consent...
March 2017: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/28659068/ethical-climate-in-nursing-environment
#8
Janika Koskenvuori, Olivia Numminen, Riitta Suhonen
BACKGROUND: In the past two decades, interest in the concept of ethical climate and in its research has increased in healthcare. Ethical climate is viewed as a type of organizational work climate, and defined as the shared perception of ethically correct behavior, and how ethical issues should be handled in the organization. Ethical climate as an important element of nursing environment has been the focus of several studies. However, scoping reviews of ethical climate research in nursing have not been conducted to guide further research in this area...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28658015/a-framework-for-integrating-implicit-bias-recognition-into-health-professions-education
#9
Javeed Sukhera, Chris Watling
Existing literature on implicit bias is fragmented and comes from a variety of fields like cognitive psychology, business ethics, and higher education, but implicit-bias-informed educational approaches have been underexplored in health professions education and are difficult to evaluate using existing tools. Despite increasing attention to implicit bias recognition and management in health professions education, many programs struggle to meaningfully integrate these topics into curricula. The authors propose a six-point actionable framework for integrating implicit bias recognition and management into health professions education that draws on the work of previous researchers and includes practical tools to guide curriculum developers...
June 27, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28656727/the-eastern-european-experience-on-occupational-skin-diseases-make-underreporting-an-issue
#10
H R Moldovan, S T Voidazan, S M John, P Weinert, G Moldovan, M A Vlasiu, Z A Szasz, G S Tiplica, S Szasz, A C Marin, C M Salavastru
BACKGROUND: While legislation in most of the Eastern European countries is nowadays widely harmonized with the legal safety and health provisions of Western countries, there is still a sustained resistance to the notification of occupational skin diseases (OSD). OBJECTIVE: The aim of the study was to identify the main barriers in notification and recognition of OSD in 22 Eastern European countries. METHODS: An online survey was administered to key persons in the field of occupational safety and health in 22 Eastern European countries...
June 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28645319/architectural-frameworks-defining-the-structures-for-implementing-learning-health-systems
#11
Lysanne Lessard, Wojtek Michalowski, Michael Fung-Kee-Fung, Lori Jones, Agnes Grudniewicz
BACKGROUND: The vision of transforming health systems into learning health systems (LHSs) that rapidly and continuously transform knowledge into improved health outcomes at lower cost is generating increased interest in government agencies, health organizations, and health research communities. While existing initiatives demonstrate that different approaches can succeed in making the LHS vision a reality, they are too varied in their goals, focus, and scale to be reproduced without undue effort...
June 23, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28644792/what-moral-distress-in-nursing-history-could-suggest-about-the-future-of-health-care
#12
Andrew Jameton
The concept of moral distress was defined in 1984 as (a) the psychological distress of (b) being in a situation in which one is constrained from acting (c) on what one knows to be right. A substantial literature on the subject has developed, primarily in nursing ethics. The aforementioned elements of distress are applied here to areas of clinical and organizational significance: (a) distress from causing intimate pain during care of the dying, (b) constraints stemming from proximate and background challenges of health care organizations, and (c) changing perspectives on therapeutic technologies derived from global environmental perspectives...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644789/what-is-the-role-of-ethics-consultation-in-the-moral-habitability-of-health-care-environments
#13
Wendy Austin
Ethics consultation has traditionally focused on the provision of expert guidance to health care professionals when challenging quandaries arise in clinical cases. Its role, however, is expanding as demands on health care organizations are negatively impacting their moral habitability. A sign of this impact can be seen in the moral distress experienced by staff and administrators, such that some leave their positions and their organizations. Ethics consultation, more broadly conceived, can be a major asset in ensuring that ethical practice is meaningfully supported, that moral distress is mitigated, and that the organizational environment is morally habitable...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644788/initiatives-for-responding-to-medical-trainees-moral-distress-about-end-of-life-cases
#14
M Sara Rosenthal, Maria Clay
Moral distress frequently arises for medical trainees exposed to end-of-life cases. We review the small literature on best practices for reducing moral distress in such cases and propose two areas to target for moral distress reduction: medical education and organizational ethics programs. Students require training in end-of-life dialogues and truthful prognostication, which are not generally available without skilled mentors. But physician-mentors and teachers can suffer from lingering moral residue themselves, which can affect the teaching culture and student expectations...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644786/antecedents-and-consequences-of-medical-students-moral-decision-making-during-professionalism-dilemmas
#15
Lynn Monrouxe, Malissa Shaw, Charlotte Rees
Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students' action (or inaction) runs counter to their perceived moral values-often due to organizational constraints or power hierarchies-they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance)...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28632445/critique-and-contribute-a-practice-based-framework-for-improving-critical-data-studies-and-data-science
#16
Gina Neff, Anissa Tanweer, Brittany Fiore-Gartland, Laura Osburn
What would data science look like if its key critics were engaged to help improve it, and how might critiques of data science improve with an approach that considers the day-to-day practices of data science? This article argues for scholars to bridge the conversations that seek to critique data science and those that seek to advance data science practice to identify and create the social and organizational arrangements necessary for a more ethical data science. We summarize four critiques that are commonly made in critical data studies: data are inherently interpretive, data are inextricable from context, data are mediated through the sociomaterial arrangements that produce them, and data serve as a medium for the negotiation and communication of values...
June 2017: Big Data
https://www.readbyqxmd.com/read/28603156/conflicts-of-interest-and-distribution-of-resources-to-community-partners-an-organizational-ethics-dilemma
#17
Allison M Cole, Laura-Mae Baldwin, Gina A Keppel, Ellen Kuwana, Brenda L Mollis, Benjamin S Wilfond
BACKGROUND: Conflicts of interest can arise when faculty and staff administer programs that distribute research funds, training opportunities, and other resources across academic and community partners. We describe the ethical concerns encountered by a Clinical Translational Science Award (CTSA) program in administering its community-focused pilot grant program and how its Research Bioethics Consultation service helped to address them.Ethical Concerns: CTSA program faculty and staff identified ethical concerns in several areas, including appropriateness of including Regional Research Collaborations (RRC) faculty as principal or co-investigators on applications, determining how much help RRC faculty and staff should provide to prospective applicants, and creating a fair and effective application review process...
2017: Progress in Community Health Partnerships: Research, Education, and Action
https://www.readbyqxmd.com/read/28580892/harmonizing-health-technology-assessment-practices-in-university-hospitals-to-what-extent-is-the-mini-hta-model-suitable-in-the-french-context
#18
Nicolas Martelli, Capucine Devaux, Hélène van den Brink, Mathilde Billaux, Judith Pineau, Patrice Prognon, Isabelle Borget
BACKGROUND: The number of new medical devices for individual use that are launched annually exceeds the assessment capacity of the French national health technology assessment (HTA) agency. This has resulted in hospitals, and particularly university hospitals (UHs), developing hospital-based HTA initiatives to support their decisions for purchasing innovative devices. However, the methodologies used in such hospitals have no common basis. The aim of this study was to assess a mini-HTA model as a potential solution to harmonize HTA methodology in French UHs...
June 5, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28573927/psychometric-evaluation-of-the-moral-distress-risk-scale-a-methodological-study
#19
Rafaela Schaefer, Elma Lcp Zoboli, Margarida M Vieira
BACKGROUND: Moral distress is a kind of suffering that nurses may experience when they act in ways that are considered inconsistent with moral values, leading to a perceived compromise of moral integrity. Consequences are mostly negative and include physical and psychological symptoms, in addition to organizational implications. OBJECTIVE: To psychometrically test the Moral Distress Risk Scale. RESEARCH DESIGN: A methodological study was realized...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28555958/industrial-safety-and-utopia-insights-from-the-fukushima-daiichi-accident
#20
Sébastien Travadel, Franck Guarnieri, Aurélien Portelli
Feedback from industrial accidents is provided by various state or even international, institutions, and lessons learned can be controversial. However, there has been little research into organizational learning at the international level. This article helps to fill the gap through an in-depth review of official reports of the Fukushima Daiichi accident published shortly after the event. We present a new method to analyze the arguments contained in these voluminous documents. Taking an intertextual perspective, the method focuses on the accident narratives, their rationale, and links between "facts," "causes," and "recommendations...
May 29, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
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