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1.
Fundam Res ; 4(4): 961-971, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39156567

RESUMO

As the global demand for healthcare services continues to grow, improving the efficiency and effectiveness of the healthcare ecosystem has become a pressing concern. Information systems are transforming the healthcare delivery process, shifting the focus of healthcare services from passive disease treatment to proactive health prevention and the healthcare management model from hospital-centric to patient-centric. This study focuses on reviewing research in IS journals on the topic of e-health and is dedicated to constructing a theoretical model of intelligent health to provide a research basis for future discussions in this field. In addition, as the innovation of intelligent healthcare services has led to changes in its elements (e.g., an increase in the number of stakeholders), there is an urgent need to sort out and analyze the existing research.

2.
Health Informatics J ; 30(3): 14604582241270795, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39139144

RESUMO

Objectives: This article describes how a home visit solution was developed in a co-design process between patients in treatment for severe spasticity, their caregivers and hospital nurses. The solution was developed using a participatory design approach and was based on the identified needs of the participants. Methods: We developed a home visit solution through an iterative process and a collective 'reflection-in-action' approach with patients, caregivers and healthcare professionals. Results: The study revealed the complexities of establishing new routines around home visits. The solution included a new workflow for the nurses and a new route and appointment planning tool. Conclusion: Through a participatory design approach, the users developed a home visit solution that minimised disruption to patients' daily lives and facilitated a dialogue between the nurses and the caregivers about the treatment and the patients' spasticity, which helped to adjust the treatment in line with the patient´s needs.


Assuntos
Agendamento de Consultas , Visita Domiciliar , Espasticidade Muscular , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Cuidadores/psicologia , Adulto
3.
Health Serv Manage Res ; : 9514848241275788, 2024 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-39162342

RESUMO

In view of the growing need for rehabilitation worldwide due to demographic changes and health trends, healthcare organizations are facing increasing pressure to innovate. This study focuses on the institutional dynamics shaping service innovation in orthopedic rehabilitation settings in Germany. Using Scott's framework of institutional pillars and carriers, we conduct a multiple case study analysis. Based on interviews with physicians and managers from six different clinics, conducted in two rounds and supplemented by secondary data analysis, we investigate the influence of regulative, normative, and cultural-cognitive institutions on healthcare service innovation. By distinguishing between the various institutional barriers and facilitators, our research provides valuable insights for healthcare practitioners and managers, equipping them with the necessary knowledge to effectively navigate and utilize the institutional environment.

4.
Health Informatics J ; 30(2): 14604582241260644, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38873836

RESUMO

The use of telemedicine and telehealth has rapidly increased since the start of the COVID-19 pandemic, however, could lead to unnecessary medical service. This study analyzes the contents of telemedicine apps (applications) in South Korea to investigate the use of telemedicine for selective or unnecessary medical treatments and the presence of advertising for the hospital. This study analyzed 49 telemedicine mobile apps in Korea; a content analysis of the apps' features and quality using a Mobile Application Rating Scale was done. The study analyzed 49 mobile telemedicine apps and found that 65.3% of the apps provide immediate telemedicine service without reservations, with an average rating of 4.35. 87% of the apps offered selective care, but the overall quality of the apps was low, with an average total quality score of 3.27. 73.9% of the apps were able to provide selective care for alopecia or morning-after pill prescription, 65.2% of the apps for weight loss, and 52.2% of the apps for erectile dysfunction, with the potential to encourage medical inducement or abuse. Therefore, before introducing telemedicine, it is helpful to prevent the possibility of abuse of telemedicine by establishing detailed policies for methods and scope of telemedicine.


Assuntos
COVID-19 , Aplicativos Móveis , Telemedicina , Humanos , República da Coreia , Telemedicina/estatística & dados numéricos , COVID-19/epidemiologia , Aplicativos Móveis/normas , Aplicativos Móveis/tendências , Aplicativos Móveis/estatística & dados numéricos , SARS-CoV-2 , Pandemias
5.
Health Soc Care Deliv Res ; 12(15): 1-76, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38940736

RESUMO

Background: People living with multiple long-term conditions represent a significant concern for National Health Service policy and practice, and their care is a major theme in the 2019 National Health Service Long Term Plan. The Birmingham RAND and Cambridge Rapid Evaluation Centre team has undertaken a thematic synthesis of the 10 evaluations it has conducted from 2018 to 2023, exploring the needs, priorities and implications for people with multiple long-term conditions. Objectives: The aims for this overarching study were to: (1) build a body of learning about service innovations in primary and community settings for people of all ages with multiple long-term conditions, focused on questions that matter most to people with multimorbidity; and (2) develop methodological insights about how rapid evaluation can be used to inform the scoping, testing and implementation of service innovations for people with multiple long-term conditions. Design: The focus on multiple long-term conditions came from a Birmingham RAND and Cambridge Rapid Evaluation Centre prioritisation process undertaken in 2018 using James Lind Alliance methods. Cross-analysis of the findings from the 10 individual rapid evaluations was supplemented by (1) building aspects of multimorbidity into the design of later evaluations; (2) interviewing national and regional stakeholders (n=19) working in or alongside integrated care systems; (3) undertaking a rapid review of evidence on remote monitoring for people with multiple long-term conditions (19 papers included); and (4) testing overall insights with organisations representing patients and carers through a patient, public and professional engagement workshop with 10 participants plus members of the research team. Results: While living with multiple long-term conditions is common and is the norm for people over the age of 50 using health and care services, it is not often a focus of health service provision or innovation, nor of research and evaluation activity. We discuss six themes emerging from the totality of the study: (1) our health system is mainly organised around single conditions and not multiple long-term conditions; (2) research calls and studies usually focus on single conditions and associated services; (3) building opportunities for engaged, informed individuals and carers and improved self-management; (4) the importance of measures that matter for patients and carers; (5) barriers to developing and implementing service innovations for people with multiple long-term conditions; and (6) what is needed to make patients with multiple long-term conditions a priority in healthcare planning and delivery. Limitations: Care of people with multiple long-term conditions was not the principal focus of several of the rapid evaluations. While this was a finding in itself, it limited our learning about designing and implementing, as well as methodological approaches to evaluating, service innovations for people with multiple long-term conditions. Conclusions: Through a thematic analysis of the portfolio of evaluations, we have deduced a set of suggested implications for how the needs of people with multiple long-term conditions can be better embedded in policy, research and practice. Future work: Areas of uncertainty related to the care of people with multiple long-term conditions should be further explored, including developing and testing measures of patient experience of (un)co-ordinated care across settings, and interrogating the experience of health and care staff when working with people with multiple long-term conditions, to understand what works. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR134284) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 15. See the NIHR Funding and Awards website for further award information.


Many people in England live with two or more physical and/or mental health conditions that are expected to last for years. Estimates vary, but it is likely that a majority of National Health Service services are serving people living with two or more long-term conditions. We wanted to find out how well the needs of this group are taken into account when new types of health care are introduced, or existing services are reorganised. To do this, we went back to all 10 of the health service innovations that had been studied by our Birmingham RAND and Cambridge Evaluation Centre from 2018 to 2023. We did some extra research, including discussions with patient representatives and interviews with National Health Service policy-makers and managers at national and regional levels. We also looked at what new research had been published about one example of a new healthcare technology that is intended to help people who have several long-term health conditions: monitors that can be used by health service staff to measure patients' symptoms when they are in their own home. Our main finding was that most National Health Service attention is given to organising care for single conditions, often treating them in isolation. Patients' many treatments and needs are not routinely considered all at the same time by healthcare staff, nor by researchers. Care for one condition is too often not co-ordinated with care for other health problems that a patient may have. Although the situation of people living with several long-term health conditions is in principle understood by healthcare staff, managers and researchers, relatively little is done in practice to meet their needs. We conclude by suggesting ways that policy-makers, healthcare staff and researchers could improve how they help people living with multiple long-term conditions.


Assuntos
Medicina Estatal , Humanos , Medicina Estatal/organização & administração , Múltiplas Afecções Crônicas/terapia , Múltiplas Afecções Crônicas/epidemiologia , Multimorbidade , Reino Unido , Doença Crônica/terapia
6.
Front Public Health ; 12: 1389057, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38846606

RESUMO

Vertical integration models aim for the integration of services from different levels of care (e.g., primary, and secondary care) with the objective of increasing coordination and continuity of care as well as improving efficiency, quality, and access outcomes. This paper provides a view of the Portuguese National Health Service (NHS) healthcare providers' vertical integration, operationalized by the Portuguese NHS Executive Board during 2023 and 2024. This paper also aims to contribute to the discussion regarding the opportunities and constraints posed by public healthcare organizations vertical integration reforms. The Portuguese NHS operationalized the development and generalization of Local Health Units management model throughout the country. The same institutions are now responsible for both the primary care and the hospital care provided by public services in each geographic area, in an integrated manner. This 2024 reform also changed the NHS organic and organizational structures, opening paths to streamline the continuum of care. However, it will be important to ensure adequate monitoring and support, with the participation of healthcare services as well as community structures and other stakeholders, to promote an effective integration of care.


Assuntos
Prestação Integrada de Cuidados de Saúde , Reforma dos Serviços de Saúde , Programas Nacionais de Saúde , Portugal , Humanos , Programas Nacionais de Saúde/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Medicina Estatal/organização & administração , Atenção Primária à Saúde/organização & administração , Continuidade da Assistência ao Paciente
7.
Artigo em Inglês | MEDLINE | ID: mdl-38791796

RESUMO

BACKGROUND: Given the prevalence of ADHD and the gaps in ADHD care in Australia, this study investigates the critical barriers and driving forces for innovation. It does so by conducting a preparatory evaluation of an ADHD prototype digital service innovation designed to help streamline ADHD care and empower individual self-management. METHODS: Semi-structured interviews with ADHD care consumers/participants and practitioners explored their experiences and provided feedback on a mobile self-monitoring app and related service innovations. Interview transcripts were double coded to explore thematic barriers and the enablers for better ADHD care. RESULTS: Fifteen interviews (9 consumers, 6 practitioners) revealed barriers to better ADHD care for consumers (ignorance and prejudice, trust, impatience) and for practitioners (complexity, sustainability). Enablers for consumers included validation/empowerment, privacy, and security frameworks, tailoring, and access. Practitioners highlighted the value of transparency, privacy and security frameworks, streamlined content, connected care between services, and the tailoring of broader metrics. CONCLUSIONS: A consumer-centred approach to digital health service innovation, featuring streamlined, private, and secure solutions with enhanced mobile tools proves instrumental in bridging gaps in ADHD care in Australia. These innovations should help to address the gaps in ADHD care in Australia. These innovations should encompass integrated care, targeted treatment outcome data, and additional lifestyle support, whilst recognising the tensions between customised functionalities and streamlined displays.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Adulto , Austrália , Masculino , Feminino , Telemedicina , Aplicativos Móveis , Pessoa de Meia-Idade
8.
Front Res Metr Anal ; 9: 1270501, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38352940

RESUMO

Previous studies have primarily focused on product innovation, overlooking the examination of organizational processes. This limited perspective poses a theoretical and practical gap as it primarily considers the external aspects of innovation. On the contrary, organizational processes play a crucial role in improving and creating internal operations necessary for product/service innovation success. To this aim, this paper presents a novel approach to enhancing service innovation within complex organizations by integrating Strategic Organizational Counseling (SOC) and Organizational Network Analysis (ONA) methodologies. More specifically, SOC supports organizations in understanding and defining the professional families that need to be triggered in the service ideation, delivery and commercialization process, especially in the case of complex organizations with multiple departments. Secondly, ONA enables the identification of the intra-organizational nodes within the professional families that, due to their social position and other personal characteristics, can be actively engaged as Ambassadors for the promotion of innovation practices. By focusing on intra-organizational processes, understanding role-related needs, and selecting influential organizational actors, this approach provides a new perspective on the service innovation process, assuming both a micro and macro viewpoint. The paper also highlights the importance of cyclically monitoring the proposed workflow to adapt to the dynamic nature of innovation.

9.
Environ Sci Pollut Res Int ; 31(2): 3060-3075, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38079040

RESUMO

Expansion of business activities comes with various environmental and natural disasters, hence agitating the economies and academia to present the counter and effective solution. Researchers also pinpointed prior that there exists a dark side of business expansion such as lacking of green innovative activities and dynamic capabilities which are creating resistance to achieve sustainability. Besides, literature also claims that green innovation is a crucial segment to achieve competitive edge that leads to sustainable entrepreneurship; however, it is not easier to be achieved as green innovation along green capabilities makes a complex network which consists of embedded partners, hence, also in dire need of green knowledge sharing as well to make the process smooth. In this lieu, the study aims to scrutinize the effectiveness of green knowledge sharing, green dynamic capabilities, and green service innovation on green entrepreneurship in the presence of gender role as a moderator. Empirical estimations calculated through PLS methodology reveal that green knowledge sharing, green dynamic capabilities, and green service innovation has a positive and significant linkage with green entrepreneurship in Vietnam. The outcomes also exposed that the male gender role significantly moderates the said relationship in Vietnam. Findings confirm that adoption sustainability practices such as green knowledge sharing, innovation, and dynamic capabilities are helpful to fulfill sustainable entrepreneurship demand; hence, further research is needed to extend the framework along with existing concepts.


Assuntos
Empreendedorismo , Desastres Naturais , Masculino , Humanos , Comércio , Conhecimento , Pesquisadores
10.
Physiother Theory Pract ; : 1-16, 2023 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-37676077

RESUMO

BACKGROUND: A person-centered and collaborative practice is considered crucial in contemporary physiotherapy. These ideals are often embraced in theory but are difficult to put into practice. As problems and solutions are related, understanding and refining theory on practical problems can close the knowing-doing gap and link the problem to the development of possible solutions. OBJECTIVE: To explore the challenges with providing physiotherapy as part of collaborative and person-centered rehabilitation services. METHODS: This article reports on an all-day interactive workshop with eight focus group discussions where physiotherapists from six different professional settings participated. We draw on theories of institutional logics to interpret the results. RESULTS: Challenges were linked to: 1) Professional level: Services being based on what the profession can offer - not on users' needs; 2) Organizational level: Rewarding efficiency instead of user outcomes; and 3) System level: Not knowing the other service providers involved or what they are doing. CONCLUSION: An innovative practice was constrained by multilevel social systems: the professional logic shaping the perceived professional scope, the organizational logic shaping the understanding of what was expected in the organizational context, and a system logic within a biomedical paradigm. Transforming and transcending these social systems is needed to realize collaborative and person-centered practice.

11.
Heliyon ; 9(4): e14868, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37025827

RESUMO

Despite the fact that hackathons and digital innovation contests have emerged as substantial intermediaries in open innovation and entrepreneurship, knowledge about how hackathons and digital innovation contests impact innovation in cities is restricted. There is also a scarcity of models that aid in the organization and evaluation of digital innovation contests. The purpose of this article is to examine the stages for organizing hackathons and digital innovation contests and identifies factors leading to the successful implementation of open data hackathons and digital innovation competitions. Three hackathons and innovation contests held in Thessaloniki between 2014 and 2018 were studied. The proposed framework provides practitioners with options to hold digital contests while also advancing the state of the art in the fields of open data and innovation competitions. Organizers of hackathon events may find this paper useful because they can learn about the factors that must be taken into account to ensure the success of these events.

12.
Heliyon ; 9(3): e13967, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36915496

RESUMO

This study investigates the role of service innovation as a mediator between FinTech adoption and firm growth. Furthermore, the study also explores the role of human resource competency in FinTech adoption. Survey questionnaires were given to participants in this study, which used a quantitative methodology and were distributed to fifty-five United States banks. A sample of 311 responses was collected and analyzed using Structural Equation Modeling (SEM). The results show that human resource competencies such as creating, adapting (to change), deciding to initiate action and interpreting analysis positively impact FinTech adoption. This study also discovered that service innovation contributes to firm growth. The findings confirmed the influence of human resource competencies on FinTech adoption in banks. This study suggests implementing effective human resource practices to develop employee competencies. Employee performance can be optimized to impact service innovation and business growth, which promotes the adoption of FinTech. The research adds to the body of knowledge already available by providing evidence of mediating role between FinTech adoption and firm growth.

13.
Artigo em Inglês | MEDLINE | ID: mdl-36901591

RESUMO

For several decades, health systems in developed countries have faced rapidly rising healthcare costs without concomitant improvements in health outcomes. Fee for service (FFS) reimbursement mechanisms (RMs), where health systems are paid based on volume, contribute to this trend. In Singapore, the public health service is trying to curb rising healthcare costs by transitioning from a volume-based RM to a capitated payment for a population within a geographical catchment area. To provide insight into the implications of this transition, we developed a causal loop diagram (CLD) to represent a causal hypothesis of the complex relationship between RM and health system performance. The CLD was developed with input from government policymakers, healthcare institution administrators, and healthcare providers. This work highlights that the causal relationships between government, provider organizations, and physicians involve numerous feedback loops that drive the mix of health services. The CLD clarifies that a FFS RM incentivizes high margin services irrespective of their health benefits. While capitation has the potential to mitigate this reinforcing phenomenon, it is not sufficient to promote service value. This suggests the need to establish robust mechanisms to govern common pool resources while minimizing adverse secondary effects.


Assuntos
Planos de Pagamento por Serviço Prestado , Serviços de Saúde , Custos de Cuidados de Saúde , Salários e Benefícios , Programas Governamentais
14.
Health Informatics J ; 29(1): 14604582231153523, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36745514

RESUMO

Background: Pregnancy and the postpartum period are difficult times with increased risks of weight gain and weight retention. This study aims to provide new insights into developing and designing information an communication technology interventions to support a healthy postpartum lifestyle through behavioral changes.Methods: A participatory design approach, combined with the behavior change wheel, was applied. The intervention was based on outcomes from co-creation with postpartum parents, healthcare professionals, IT consultants, and researchers.Results: An intervention was developed that reflects users' requests and needs to support a healthy postpartum lifestyle through behavioral change. The intervention includes podcasts, video exercises, weight tracking, and weekly push notifications.Conclusion: Developing an intervention to support a healthy postpartum lifestyle is feasible using both a participatory design and the behavior change wheel.


Assuntos
Estilo de Vida Saudável , Período Pós-Parto , Gravidez , Feminino , Humanos , Exercício Físico
15.
Front Psychol ; 14: 988808, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36818099

RESUMO

Introduction: In this qualitative study, we examine digital leadership (DL) capabilities and their positive influence on the management of technology-driven change by leveraging service innovations. The context of digital transformation (DT) has triggered a new leadership paradigm, among others referred to as digital leadership (DL). However, despite its practical relevance, leadership research has yet paid little attention to conceptualise DL as an approach to digitally transform organisations. Methods: Drawing on mid- and top-level mangers' experiences with service innovation projects, and based on Grounded Theory, we develop a taxonomy of DL-related capabilities and a conceptual framework which exemplifies their influences on dynamic service innovation capabilities (DSICs). DSICs build on the dynamic capabilities view (DCV) and represent the "organisational muscle" to repeatedly deliver service innovations indicating an effective management of technology-driven change. Results and Discussion: Taxonomy results show that aggregated dimensions in terms of a digital leader's personal, social, and organisational capital serve as underpinnings (DL-related capabilities) to drive strategic change in DT contexts. The conceptual framework further reveals that especially the personal and organisational capital of a digital leader owns several strong and moderate influences on DSICs which demonstrates DL's "long arm" on the management of technology-driven change. Our findings contribute to leadership research by advancing the conceptualisation of DL and by adding a novel micro-foundational perspective towards the DCV discourse. As organisations struggle to realise the full benefits of DT initiatives, our results also provide a valuable contribution for practitioners by supporting them to strategically prepare for the human-related challenges of DT.

16.
Behav Sci (Basel) ; 12(12)2022 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-36546989

RESUMO

The basis of organizational innovation is employee innovation, which is of great significance for organizations to gain a competitive advantage. At present, the research on the influencing factors of employee service innovation behavior is increasing. This study, based on the social cognitive theory, with relative deprivation as the mediator and attribution style as the moderator, explores the mechanism of the effect of organizational fairness on employee service innovation behavior. Taking 342 employees of service-oriented enterprises as the subjects of investigation, this paper empirically tests the theoretical model by using Amos and SPSS. The results indicated the following, organizational fairness was positively related to employees' service innovation behavior. Relative deprivation partially mediated the relationship between organizational fairness and service innovation behavior. An external attribution style positively moderated the relationship between relative deprivation and employee service innovation behavior. An external attribution style also positively moderated the mediation effect of the relationship between organizational fairness and service innovation behavior. The internal attribution style negatively moderated the relationship between relative deprivation and employee service innovation behavior. The internal attribution style also negatively moderated the mediation effect of the relationship between organizational fairness and service innovation behavior. The conclusion of this study has managerial implications on how to promote employee service innovation behavior in service-oriented enterprises.

17.
Health Informatics J ; 28(4): 14604582221146720, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36548199

RESUMO

New technology that aims to tackle the systemic and societal problems face challenges bringing together diverse stakeholder perspectives effectively. We evaluate how an emotion-led approach, with a Living Lab process may be effective in these situations. We discuss findings and their implications for this in the context of the development and ongoing maintenance of a web app called "Ask Izzy". Ask Izzy supports people who are homeless or are otherwise disadvantaged by providing information and consequently improving their everyday life and wellbeing. We present a mixed-method evaluation of the web app: firstly, we evaluate impact of key design decisions upon engagement. Secondly, we conducted semi-structured interviews with 30 participants who are either homeless, ex-homeless or service providers and used content analysis. Then we demonstrate that our emotion-led approach brings a novel perspective on concerns from key actors influencing the refinement of the app. The results section outlines emotional goals such as a feeling of control that were important to consider in order to meet the needs of both end users and the wider service provision network. Our study provides recommendations and an approach that may inform others in developing and delivering similar health care and related systems and services.


Assuntos
Pessoas Mal Alojadas , Aplicativos Móveis , Humanos , Emoções , Tecnologia
18.
Health Informatics J ; 28(4): 14604582221135431, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36318245

RESUMO

This study assesses the perceived impact and benefits of Project ECHO (Extension for Community Healthcare Outcomes), a tele-mentoring intervention for health and social care providers, patients and the health system in Northern Ireland. Having access to a specialist, a space to share experiences, and being able to disseminate up-to-date best practice were all cited as improving provider knowledge as well as improving quality of care for patients. Healthcare providers reported being more confident in managing patients and that relationships had been improved between different levels of the health system. ECHO was described as improving access to education and training by removing geographic and time barriers. This is one of the first studies to qualitatively analyse impact across a number of different clinical and social care ECHO networks. The results strongly indicate the perceived benefit of ECHO in improving provider, patient and health system outcomes such as increased healthcare provider knowledge and confidence to manage patients at primary levels of the health system. This has implications for future service design, particularly within the context of COVID-19 in which virtual and online training is necessitated by social distancing requirements.


Assuntos
COVID-19 , Humanos , Irlanda do Norte , Serviços de Saúde Comunitária , Apoio Social , Pessoal de Saúde/educação
19.
BMC Health Serv Res ; 22(1): 1250, 2022 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-36243699

RESUMO

BACKGROUND: In Scandinavia, various public reforms are initiated to enhance trust in the healthcare services and the public sector in general. This study explores experiences from a two-step service innovation project in municipal home care in Norway, coined as the Trust Model (TM), aiming at developing an alternative to the purchaser-provider split (PPS) and enhancing employee motivation, user satisfaction, and citizen trust. The PPS has been the prevalent model in Norway since the 1990s. There is little empirical research on trust-based alternatives to the PPS in healthcare. The overall objectives of this study were to explore facilitators and barriers to trust-based service innovation of municipal homecare and to develop a framework for how to support the implementation of the TM. METHODS: The TM elements were developed through a comprehensive participatory process, resulting in the decision to organize the home care service in small, self-managed and multidisciplinary teams, and trusting the teams with full responsibility for care decisions and delivery within a limited area. Through a longitudinal mixed methods case study design a) patients' expressed values and b) factors facilitating or preventing the service innovation process were explored through two iterations. The first included three city districts, three teams and 80 patients. The second included four districts, eight teams and 160 patients. RESULTS: The patient survey showed patients valued and trusted the service. The team member survey showed increased motivation for work aligned with TM principles. Both quantitative and qualitative methods revealed a series of facilitators and barriers to the innovation process on different organizational levels (teams, team leaders, system). The key message arising from the two iterations is to keep patients' values in the centre and recognize the multilevelled organizational complexity of successful trust-based innovation in homecare. Synthesizing the results, a framework for how to support trust-based service innovation was constructed. CONCLUSIONS: Trust-based innovation of municipal homecare is feasible. The proposed framework may serve as a tool when planning trust-based innovation, and as a checklist for implementation and improvement strategies. Further research is needed to explore the validity of the framework and its replicability in other areas of healthcare.


Assuntos
Serviços de Assistência Domiciliar , Confiança , Atenção à Saúde , Humanos , Noruega
20.
Health Informatics J ; 28(4): 14604582221135440, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36300324

RESUMO

Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.


Assuntos
COVID-19 , Depressão Pós-Parto , Intervenção Baseada em Internet , Criança , Feminino , Humanos , Ansiedade/prevenção & controle , Chile , COVID-19/prevenção & controle , Depressão Pós-Parto/prevenção & controle , Estudos de Viabilidade , Mães/psicologia , Pandemias
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