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Change leadership

Donald M Hilty, Terry Rabinowitz, Robert M McCarron, David J Katzelnick, Trina Chang, Amy M Bauer, John Fortney
INTRODUCTION: In this era of patient-centered care, telepsychiatry (TP; video or synchronous) provides quality care with outcomes as good as in-person care, facilitates access to care, and leverages a wide range of treatments at a distance. METHOD: This conceptual review article explores TP as applied to newer models of care (e.g., collaborative, stepped, and integrated care). RESULTS: The field of psychosomatic medicine (PSM) has developed clinical care models, educates interdisciplinary team members, and provides leadership to clinical teams...
December 26, 2017: Psychosomatics
Zornitza Stark, Sebastian Lunke, Gemma R Brett, Natalie B Tan, Rachel Stapleton, Smitha Kumble, Alison Yeung, Dean G Phelan, Belinda Chong, Miriam Fanjul-Fernandez, Justine E Marum, Matthew Hunter, Anna Jarmolowicz, Yael Prawer, Jessica R Riseley, Matthew Regan, Justine Elliott, Melissa Martyn, Stephanie Best, Tiong Y Tan, Clara L Gaff, Susan M White
PurposeThe purpose of the study was to implement and prospectively evaluate the outcomes of a rapid genomic diagnosis program at two pediatric tertiary centers.MethodsRapid singleton whole-exome sequencing (rWES) was performed in acutely unwell pediatric patients with suspected monogenic disorders. Laboratory and clinical barriers to implementation were addressed through continuous multidisciplinary review of process parameters. Diagnostic and clinical utility and cost-effectiveness of rWES were assessed.ResultsOf 40 enrolled patients, 21 (52...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
J Stansfield, J South
This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues...
March 1, 2018: Journal of Public Health
Jacqueline Counts, Rebecca Gillam, Teri A Garstka, Ember Urbach
The challenge of maximizing the well-being of children, youth, and families is recognizing that change occurs within complex social systems. Organizations dedicated to improving practice, advancing knowledge, and informing policy for the betterment of all must have the right approach, structure, and personnel to work in these complex systems. The University of Kansas Center for Public Partnerships and Research cultivates a portfolio of innovation, research, and data science approaches positioned to help move social service fields locally, regionally, and nationally...
March 14, 2018: Journal of Evidence-informed Social Work
Katrina E Donahue, Alfred Reid, Elizabeth G Baxley, Charles Carter, Peter J Carek, Mark Robinson, Warren P Newton
BACKGROUND AND OBJECTIVES: The I3 POP Collaborative sought to improve health of patients attending North Carolina, South Carolina, and Virginia primary care teaching practices using the triple aim framework of better quality, appropriate utilization, and enhanced patient experience. We examined change in triple aim measures over 3 years, and identified correlates of improvement. METHODS: Twenty-nine teaching practices representing 23 residency programs participated...
March 2018: Family Medicine
Bernadette Brown, Jane Young, David P Smith, Andrew B Kneebone, Andrew J Brooks, Sam Egger, Miranda Xhilaga, Amanda Dominello, Dianne L O'Connell, Mary Haines
BACKGROUND: This study assessed whether a theoretically conceptualised tailored intervention centred on multidisciplinary teams (MDTs) increased clinician referral behaviours in line with clinical practice guideline recommendations. METHODS: Nine hospital Sites in New South Wales (NSW), Australia with a urological MDT and involvement in a state-wide urological clinical network participated in this pragmatic stepped wedge, cluster randomised implementation trial...
March 12, 2018: Implementation Science: IS
Julianne Payne, Laurie Cluff, Jason Lang, Dyann Matson-Koffman, Antonio Morgan-Lopez
PURPOSE: We investigated the impact of elements of a workplace culture of health (COH) on employees' perceptions of employer support for health and lifestyle risk. DESIGN: We used 2013 and 2015 survey data from the National Healthy Worksite Program, a Centers for Disease Control and Prevention (CDC)-led initiative to help workplaces implement health-promoting interventions. SETTING: Forty-one employers completed the CDC Worksite Health Scorecard to document organizational changes...
January 1, 2018: American Journal of Health Promotion: AJHP
Phillip Baker, Corinna Hawkes, Kate Wingrove, Alessandro Rhyl Demaio, Justin Parkhurst, Anne Marie Thow, Helen Walls
Introduction: Generating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016-2025). In this review of the empirical nutrition policy literature, we ask: what factors generate, sustain and constrain political commitment for nutrition, how and under what circumstances? Our aim is to inform strategic 'commitment-building' actions. Method: We adopted a framework synthesis method and realist review protocol...
2018: BMJ Global Health
Bronwyn Louise Pearse, Claire M Rickard, Samantha Keogh, Yoke Lin Fung
BACKGROUND: Bleeding management in cardiac surgery is challenging. Many guidelines exist to support bleeding management; however, literature demonstrates wide variation in practice. In 2012, a quality initiative was undertaken at The Prince Charles Hospital, Australia to improve bleeding management for cardiac surgery patients. The implementation of the quality initiative resulted in significant reductions in the incidence of blood transfusion, re-exploration for bleeding; superficial leg and chest wound infections; length of hospital stay, and cost...
March 8, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Phillip Baker, Sharon Friel, Adrian Kay, Fran Baum, Lyndall Strazdins, Tamara Mackean
BACKGROUND: Despite decades of evidence gathering and calls for action, few countries have systematically attenuated health inequities (HI) through action on the social determinants of health (SDH). This is at least partly because doing so presents a significant political and policy challenge. This paper explores this challenge through a review of the empirical literature, asking: what factors have enabled and constrained the inclusion of the social determinants of health inequities (SDHI) in government policy agendas? METHODS: A narrative review method was adopted involving three steps: first, drawing upon political science theories on agenda-setting, an integrated theoretical framework was developed to guide the review; second, a systematic search of scholarly databases for relevant literature; and third, qualitative analysis of the data and thematic synthesis of the results...
November 11, 2017: International Journal of Health Policy and Management
Isabelle Scholl, Allison LaRussa, Pola Hahlweg, Sarah Kobrin, Glyn Elwyn
BACKGROUND: Shared decision-making (SDM) is poorly implemented in routine care, despite being promoted by health policies. No reviews have solely focused on an in-depth synthesis of the literature around organizational- and system-level characteristics (i.e., characteristics of healthcare organizations and of healthcare systems) that may affect SDM implementation. A synthesis would allow exploration of interventions to address these characteristics. The study aim was to compile a comprehensive overview of organizational- and system-level characteristics that are likely to influence the implementation of SDM, and to describe strategies to address those characteristics described in the literature...
March 9, 2018: Implementation Science: IS
Kristin Akerjordet, Trude Furunes, Annie Haver
AIM: To provide a synthesis of the evidence of health-promoting leadership related to nursing by exploring definitions, core attributes and critical conditions. BACKGROUND: Increasing pressure in health-care settings due to efficiency requirements, population aging with complex illnesses and projected global shortage of nurses, is a potential threat to nurses' health and job satisfaction, as well as patient quality of care and safety. New ways of thinking about nursing leadership and evidence-based human resource management are required to improve nursing environments...
March 9, 2018: Journal of Advanced Nursing
Eva M Luo, Henry S Opare-Ado, Joseph Adomako, Kwabena A Danso, Talya Peltzman, Frank W J Anderson
Introduction To provide a qualitative perspective on the changes that occurred after newly placed OB/GYNs began working at district hospitals in Ashanti, Ghana. Methods Structured interviews of healthcare professionals were conducted at eight district hospitals located throughout the Ashanti district of Ghana, four with and four without a full-time OB/GYN on staff. Individuals interviewed include: medical superintendents, medical officers, district hospital administrators, OB/GYNs (where applicable), and nurse-midwives...
March 8, 2018: Maternal and Child Health Journal
Barbara G Bokhour, Gemmae M Fix, Nora M Mueller, Anna M Barker, Sherri L Lavela, Jennifer N Hill, Jeffrey L Solomon, Carol VanDeusen Lukas
BACKGROUND: Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little is known about how best to transform the culture of care in these organizations. We sought to understand key organizational factors for implementing patient-centered care cultural transformation through an examination of efforts in the US Department of Veterans Affairs. METHODS: We conducted multi-day site visits at four US Department of Veterans Affairs medical centers designated as leaders in providing patient-centered care...
March 7, 2018: BMC Health Services Research
Fathima Ahmed
The ever-evolving nature of nursing requires professionals to keep their knowledge up to date and uphold the Nursing and Midwifery Council (NMC) Code by engaging themselves in ongoing personal and professional development (PPD). This article aims to highlight the importance of good leadership and management in healthcare and to explore the literature surrounding leadership and management, such as the current NHS healthcare leadership model ( NHS Leadership Academy 2013 ), the Leading Change, Adding Value Framework underpinned by the 10 commitments and 6Cs ( NHS England 2016 ) and the NMC Code ( NMC 2015a ) in relation to PPD...
March 7, 2018: Nursing Children and Young People
Deepti Shanbhag, Ian D Graham, Karen Harlos, R Brian Haynes, Itzhak Gabizon, Stuart J Connolly, Harriette Gillian Christine Van Spall
BACKGROUND: The uptake of guideline recommendations that improve heart failure (HF) outcomes remains suboptimal. We reviewed implementation interventions that improve physician adherence to these recommendations, and identified contextual factors associated with implementation success. METHODS: We searched databases from January 1990 to November 2017 for studies testing interventions to improve uptake of class I HF guidelines. We used the Cochrane Effective Practice and Organisation of Care and Process Redesign frameworks for data extraction...
March 6, 2018: BMJ Open
Jennifer Broom, Chin Li Tee, Alex Broom, Mark D Kelly, Tahira Scott, David A Grieve
BACKGROUND: Antimicrobial therapy for intra-abdominal infections is often inappropriately prolonged. An intervention addressing factors influencing the duration of intravenous antibiotic use was undertaken. This study reports the antibiotic prescribing patterns before and after the intervention and a qualitative analysis of the experience of the intervention. METHODS: Quantitative: A retrospective audit of patients with complicated intra-abdominal infection before and after a multifaceted persuasive intervention was performed...
March 6, 2018: ANZ Journal of Surgery
Marianna Virtanen, Marko Elovainio
Modern work life is characterized by constant change, reorganizations, and requirements of efficiency, which make the distribution of resources and obligations, as well as justice in decisionmaking, highly important. In the work life context, it is a question not only of distributing resources and obligations, but also of the procedures and rules that guide the decisionmaking in the organization. Studies of these rules and procedures have provided the basis for a new line of research that evaluates leadership and social relationships in working communities; that is, distributive, procedural, and relational justice...
April 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Gudbjörg Erlingsdottir, Anders Ersson, Jonas Borell, Christofer Rydenfält
Purpose The purpose of this paper is to describe five salient factors that emerge in two successful change processes in healthcare. Organizational changes in healthcare are often characterized by problems and solutions that have been formulated by higher levels of management. This top-down management approach has not been well received by the professional community. As a result, improvement processes are frequently abandoned, resulting in disrupted and dysfunctional organizations. This paper presents two successful change processes where managerial leadership was used to coach the change processes by distributing mandates and resources...
March 19, 2018: Journal of Health Organization and Management
Allan Best, Alex Berland, Trisha Greenhalgh, Ivy L Bourgeault, Jessie E Saul, Brittany Barker
Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders...
March 19, 2018: Journal of Health Organization and Management
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