Lessons from a Neo-Aristotelian Theory Based on Evolutionary Science to the Field of Organizational Innovation.

This article's goal is to understand innovation factors (e.g., job autonomy and knowledge sharing) through the lens of a neo-Aristotelian theory based on evolutionary science in order to show that this paradigm of analysis provides a richer understanding of this organizational phenomenon, and consequently better support for the deliberation on what measures to implement when the objective is to make the organization prone to innovate.

Determining the Innovativeness of Nurses Who Engage in Activities That Encourage Innovative Behaviors.

BACKGROUND: We sought to understand the innovativeness of nurses engaging in innovative behaviors and quantify the associated characteristics that make nurses more able to innovate in practice. We first compared the innovativeness scores of our population; then we examined those who self-identified as an innovator versus those who did not to explore differences associated with innovativeness between these groups. METHODS: A cross-sectional survey study of nurses in the US engaging in innovative behaviors was performed. We performed an exploratory factor analysis (EFA) to determine the correlates of innovative behavior. RESULTS: Three-hundred and twenty-nine respondents completed the survey. Respondents who viewed themselves as innovators had greater exposure to HCD/DT workshops in the past year (55.8% vs. 36.6%, p = 0.02). The mean innovativeness score of our sample was 120.3 ± 11.2 out of a score of 140. The mean innovativeness score was higher for those who self-identified as an innovator compared with those who did not (121.3 ± 10.2 vs. 112.9 ± 14.8, p =< 0.001). The EFA created four factor groups: Factor 1 (risk aversion), Factor 2 (willingness to try new things), Factor 3 (creativity and originality) and Factor 4 (being challenged). CONCLUSION: Nurses who view themselves as innovators have higher innovativeness scores compared with those who do not. Multiple individual and organizational characteristics are associated with the innovativeness of nurses.

"Geriatric Team Health Care Pathways": An Organizational Innovation to Enhance Care Pathways of Long-Term Care Facilities' Residents in the French Region of Occitania.

Born out of the COVID crisis, an innovative disposal called "Geriatric Team Healthcare Pathways" (GTHPs) has been implemented in the Occitania area in the south of France. GTHPs can be considered as geriatric "hotlines" providing expertise and knowledge to long-term care facility (LTCF) professionals, pursuing the general objective to promote a simplified, direct, and fair access to geriatric care for residents. This article highlights the history of their creation and their current use cases and operating modes for the year 2023, which includes a "quality of care approach" on good practices at a regional level (820 LTCFs), on topics such as the prevention of malnutrition and falls.

Fostering employees' innovative behavior: The importance of proactive personality and work-related flow.

Employees' innovative behaviors (EIB) play a crucial role in driving enterprises' innovation and enabling them to adapt to the complex business environment. The purpose of this study is to examine the role of proactive personality in EIB, whereby a mediating effect of work-related flow is proposed in this relationship. The moderating effect of organizational innovation climate is also examined on the indirect of proactive personality on EIB through work-related flow. With purposive sampling, a questionnaire survey was conducted on front-line employees of two digital cultural and creative industrial parks in Southwest China. A total of 279 valid questionnaires were used for hypothesis verification. The findings indicate that employees' proactive personality has a significant positive effect on EIB. Employees with a proactive personality are more likely to experience work-related flow, which in turn promotes their EIB. However, we did not find evidence of the organizational innovation climate moderating the relationship between proactive personality and EIB.

Change competence: An integrative literature review.

BACKGROUND: Organizations are in a state of continual evolution, driven by the relentless shifts in their external environments. Numerous theories have been proposed to understand the essential skills and capabilities for successful organizational change. Yet, there remains a gap in capturing a holistic view necessary to fully comprehend the dynamics of competence in today's rapidly changing landscape. OBJECTIVE: This research aims to explore and consolidate the concept of 'competence' in the context of organizational change processes. METHODS: Employing an integrative literature review approach, a total of 3,230 studies were screened. Out of these, 32 studies were selected based on strict relevance and quality criteria, providing a robust foundation for the analysis. RESULTS: The findings reveal a multi-layered nature of organizational change, highlighting that the nature and prerequisites of change vary significantly across different organizational levels. By applying a competence lens, we discern how required competence during change are not uniform but rather vary depending on whether they are applied in an operational or strategic context. This demonstrates a nuanced, level-dependent variability in change competence across the organizational hierarchy. CONCLUSION: We conceptualize 'change competence' as a dual-faceted construct. It encompasses both the capacity to leverage existing organizational competence and the adeptness to develop new competence, thereby meeting the evolving demands imposed by both internal and external drivers of change. This comprehensive understanding paves the way for more effective strategies in managing organizational change.

When Climate Change Shows Up in the Exam Room.

Climate change is considered one of the greatest threats to humanity and the most significant global public health emergency of our lifetime. Millions of people from throughout the globe suffer and die each year from degraded air quality, extreme heat, water and vector-borne diseases as well as the mental health effects of climate change. Because clinicians are considered one of the most trusted sources of climate information, they have a unique opportunity to communicate the many health-related effects of climate change to their patients. It is important for clinicians to understand the most beneficial techniques to use when communicating with patients who may need more information regarding climate change and extreme weather events. These include 1) meeting patients where they are, 2) providing patient education, and 3) telling authentic stories. Developing and delivering effective communication strategies to our patients to prevent and prepare for climate-related health issues are paramount- if we are to make meaningful progress.

Emergency Department and Health Care System Factors Associated with Telehealth Innovation During the COVID-19 Pandemic.

Objective: Telehealth capacity may be an important component of pandemic response infrastructure. We aimed to examine changes in the telehealth use by the US emergency departments (EDs) during COVID-19, and to determine whether existing telehealth infrastructure or increased system integration were associated with increased likelihood of use. Methods: We analyzed 2016-2020 National ED Inventory (NEDI)-USA data, including ED characteristics and nature of telehealth use for all US EDs. American Hospital Association data characterized EDs' system integration. An ordinary least-squares regression model obtained one-step-ahead forecast of the expected proportion of EDs using telehealth in 2020 based on growth observed from 2016 to 2019. Among EDs without telehealth in 2019, we used logistic regression models to examine whether system membership or existing telehealth infrastructure were associated with odds of innovation in telehealth use in 2020, accounting for ED characteristics. Results: Of 4,038 EDs responding to telehealth questions in 2019 and 2020 (73% response rate), 3,015 used telehealth in 2020. Telehealth use by US EDs increased more than expected in 2020 (2016: 58%, 2017: 61%, 2018: 65%, 2019: 67%, 2020: 74%, greater than predicted 71%, p = 0.004). Existing telehealth infrastructure was associated with increased telehealth innovation (OR = 1.88, 95% CI: 1.49-2.36), whereas hospital system membership was not (odds ratio [OR] = 1.00, 95% confidence interval [CI]: 0.80-1.25). Conclusions: Telehealth use by US EDs in 2020 grew more than expected and preexisting telehealth infrastructure was associated with increased innovation in its use. Preparation for future pandemic responses may benefit from considering strategies to invest in local infrastructure to facilitate technology adoption and innovation.

Information technologies as organizational support for the COVID-19 coping actions: Nurses' discourse / Tecnologias da informação como apoio organizacional das ações de enfrentamento da COVID-19: discurso de enfermeiros / Tecnologías de la información como apoyo organizacional para luchar contra el COVID-19: el discurso de los enfermeros

Abstract Objective: to analyze nurses' discourse about the potentialities in using information technologies as organizational support for the COVID-19 coping actions in Primary Health Care. Method: a qualitative and exploratory study conducted in the Family Health Strategy units from the city of João Pessoa, Paraíba, Brazil. Data collection was carried out from September to November 2021 with 26 nurses selected through the snowball technique, resorting to a semi-structured interview script. The empirical material was organized in the Atlas.ti 9 software and grounded on the theoretical-methodological contribution of Discourse Analysis, French Line. Results: three discursive blocks were evidenced: innovation based on social media; health education actions; resoluteness in organizational actions, presenting the relevance of the WhatsApp®, Instagram® and Facebook® apps as strategic resources, in order to collaborate in the Primary Health Care are with the organization of health actions against COVID-19 by nurses. Conclusion: health units have the potential to strengthen the assistance provided through digital organizational devices; however, they need political support that invests in the structure and strategies to enhance organization of the health actions.

Resumo Objetivo: analisar o discurso de enfermeiros acerca das potencialidades na utilização das tecnologias da informação como apoio organizacional das ações de enfrentamento da COVID-19 na Atenção Primária à Saúde. Método: estudo qualitativo e exploratório, realizado nas unidades da Estratégia Saúde da Família, na cidade de João Pessoa, Paraíba, Brasil. A coleta de dados foi realizada de setembro a novembro de 2021 com 26 enfermeiros selecionados por meio da snowball technique, utilizando-se de roteiro de entrevista semiestruturado. O material empírico foi organizado no software Atlas.ti 9 e fundamentado com base no aporte teórico-metodológico da Análise do Discurso de linha francesa. Resultados: evidenciaram-se três blocos discursivos: inovação a partir das mídias sociais; ações de educação em saúde; resolutividade nas ações organizacionais, apresentando a relevância dos aplicativos WhatsApp®, Instagram® e Facebook® como recursos estratégicos, de forma a colaborar para a área de Atenção Primária à Saúde com a organização das ações de saúde frente à COVID-19 por enfermeiros. Conclusão: as unidades de saúde possuem potencial para fortalecer a assistência por meio dos dispositivos organizacionais digitais, no entanto, necessitam de apoio político que invista na estrutura e em estratégias para potencializar a organização das ações de saúde.

Resumen Objetivo: analizar el discurso de los enfermeros sobre el potencial que tienen las tecnologías de la información como apoyo organizacional a las acciones en la lucha contra el COVID-19 en la Atención Primaria de Salud. Método: estudio cualitativo y exploratorio, realizado en unidades de la Estrategia Salud de la Familia, en la ciudad de João Pessoa, Paraíba, Brasil. La recolección de datos se realizó de septiembre a noviembre de 2021 con 26 enfermeros seleccionados mediante la técnica de bola de nieve, utilizando un formulario de entrevista semiestructurada. El material empírico fue organizado en el software Atlas.ti 9 y se basó en el aporte teórico-metodológico del Análisis del Discurso de la escuela francesa. Resultados: se observaron tres bloques discursivos: innovación desde las redes sociales; acciones de educación para la salud; resolutividad en las acciones organizacionales, que muestran la importancia de las aplicaciones WhatsApp®, Instagram® y Facebook® como recursos estratégicos, que colaboran en el área de Atención Primaria de Salud con la organización de las acciones de salud contra el COVID-19 que llevan a cabo los enfermeros. Conclusión: las unidades de salud tienen potencial para fortalecer la atención a través de dispositivos organizacionales digitales, pero necesitan apoyo político que invierta en la estructura y en estrategias para mejorar la organización de las acciones de salud.

Influence of kindergarten principals' contingent rewards on teachers' creative teaching performance: Testing a moderated-mediated model.

BACKGROUND: Although research has increased the current understanding of creative teaching, evidence on the factors that influence this behavior and the underlying mechanisms remains limited. OBJECTIVE: This study, grounded in conservation of resources theory, proposed and empirically examined the relation between contingent reward leadership (CRL) among Chinese kindergarten principals and teachers' creative teaching performance (CTP). In addition, the study assessed the mediating effect of organizational innovation support (OIS), bureaucratic organizational culture (BOC), and innovative organizational culture (IOC), as well as the moderating effect of ideological psychological contracts (IPCs), to provide robust insights into how CRL can motivate kindergarten teachers' CTP. METHODS: A total of 518 kindergarten teachers aged 20-55 years participated in the study. Structural equation model analysis was conducted to examine the multiple mediating effects of OIS, BOC, and IOC, as well as the moderating effect of IPC in the relation between CRL and CTP. RESULTS: OIS served as a mediator in the relation between CRL and CTP. OIS and BOC played a chain mediating role in the relation between CRL and CTP. OIS and BOC played a chain mediating role in the relation between CRL and CTP. Additionally, IPC positively moderated the indirect relation of CRL on CTP via OIS. CONCLUSIONS: Kindergarten principals should pay attention to the positive impact of leadership style and organizational culture on teachers' innovative behavior. Moreover, prioritizing the improvement of IPCs would benefit the development of innovative behavior.

Innovations in Tele-Critical Care Nursing During the COVID-19 Pandemic.

For decades, tele-critical care (TCC) programs have provided expert population surveillance with standardized clinical interventions for critically ill patients. The COVID-19 pandemic created massive strains on critical care resources. For this report, standard questions were used to solicit COVID-19 pandemic workflow and service modifications from a network of TCC leaders to describe the rapid expansion of TCC-supported services during the pandemic. In this article, leaders from 7 TCC programs report on the effective use of services to support changing hospital needs during the pandemic in areas such as clinical education, personal protective equipment stewardship, expansion of virtual care, and creative staffing models, among others.

Bridging language barriers in developing valid health policy research tools: insights from the translation and validation process of the SHEMESH questionnaire.

BACKGROUND: The use of research tools developed and validated in one cultural and linguistic context to another often faces challenges. One major challenge is poor performance of the tool in the new context. This potentially impact the legitimacy of health policy research conducted with informal adaptations of existing tools which have not been subjected to formal validation. Best practices exist to guide researchers in adapting and validating research tools effectively. We present here, as an extended example, our validation of the SHEMESH questionnaire ('Organizational Readiness to Change Assessment'; In Hebrew: 'SHE'elon Muchanut Ergunit le'SHinuy'), a Hebrew-language version of the Organizational Readiness to Change Assessment (ORCA). SHEMESH is tailored to support implementation science projects, whose aim is to promote a more rapid and complete adoption of evidence-based health policies and practices. METHODS: The SHEMESH included originally eleven questions from the Evidence (item 1-4) and Context (items 5-11) domains. We validated SHEMESH through the following steps: 1. Professional translation to Hebrew and discussion of the translation by multidisciplinary committee; 2. Back-translation into English by a different translator to detect discrepancies; 3. Eleven cognitive interviews with psychiatric emergency department physicians and nurses; and 4. Pilot testing and psychometric analyses, including Cronbach's alpha for subscales and factor analyses. RESULTS: Following translation and cognitive interviews, SHEMESH was administered to 222 psychiatrists and nurses. Pearson correlation showed significant and strong correlations of items 1-4 to the Evidence construct and items 6-11 to the Context construct. Item 5 did not correlate with the other items, and therefore was removed from the other psychometric procedures and eventually from the SHEMESH. Factor analysis with the remaining 10 items yielded two factors, which together explained a total of 69.7% of variance. Cronbach's Alpha scores for the two subscales were high (Evidence, 0.887, and Context, 0.852). CONCLUSIONS: This multi-step validation process of the SHEMESH questionnaire may serve as a comprehensive guideline for others who are willing to adapt research tools that were developed in other languages. Practically, SHEMESH has been validated for use in implementation science research projects in Israel.

The district operation centres in one of the largest local health authorities in Italy to manage COVID-19 surveillance and homecare: first implementation and results of a survey addressed to general practitioners.

BACKGROUND: COVID-19 pandemic represented a shock for healthcare systems. Italy was one of the first country to deal with a huge number of patients to be diagnosed, isolated, and treated with scarce evidence-based guidelines and resources. Several organizational and structural changes were needed to face the pandemic at local level. The article aims at studying the perceived impact of the newly implemented District Operation Centres (DOCs) of Local Health Authority (LHA) Roma 1 in managing active surveillance and home care of COVID-19 patients and their close contacts in cooperation with general practitioners (GPs). METHODS: A questionnaire, developed according to Delphi methodology, was validated by 7 experts and administered to a randomized sample of GPs and family paediatricians (FPs). All medical doctors selected received a phone interview between December 2020 and January 2021. The questionnaire investigated general characteristics of the sample, relations with DOC and its usefulness, and potential developments. A descriptive analysis was performed and inferential statistical tests were used to assess differences. RESULTS: In April 2020 the LHA Roma 1 implemented one DOCs in each local health district. 215 medical doctors were interviewed, reaching the sample target for health districts (80% CL and 10% MOE) and the whole LHA (90% CL and 5% MOE). Several aspects in the management of COVID-19 cases and close contacts of COVID-19 cases, and of the support of DOCs to GPs/FPs were investigated. More than 55% of the GPs and FPs interviewed found the DOCs useful and more than 78% would recommend a service DOC-like to other LHAs. The medical professionals interviewed would use DOCs in the future as support in treating vulnerable patients, utilizing digital health tools, enlisting specialist doctors, establishing networks, and facilitating professional counselling by nurses. CONCLUSIONS: This study is an attempt to evaluate an organizational change happened during COVID-19 pandemic. DOCs were created to support GPs and FPs as a link between primary healthcare and public health. Although several difficulties were disclosed, DOCs' experience can help to overcome the fragmentation of the systems and the duality between primary care and public health and make the system more resilient.

Enabling Expedited Disposition of Emergencies Using Telepsychiatry in Israel: Protocol for a Hybrid Implementation Study.

BACKGROUND: Telepsychiatry is the use of virtual communication, such as a video link, to deliver mental health assessment, treatment, and follow-up. Previous studies have shown telepsychiatry to be feasible, accurate compared with in-person practice, and satisfying for psychiatrists and patients. Telepsychiatry has also been associated with reduced waiting times for evaluation and, in some studies, lower admission rates. However, most previous studies focused on using telepsychiatry in community settings and not on involuntary admission. OBJECTIVE: The aim of this study is to examine the effectiveness and implementation process of patient assessment for involuntary admissions in the psychiatric emergency department (ED) using a video link. METHODS: This type 1 hybrid implementation study will examine telepsychiatry effectiveness and the implementation process, by comparing telepsychiatry (n=240) with historical controls who had a face-to-face evaluation (n=240) during the previous, usual care period in 5 psychiatric EDs in Israel. A temporary waiver of the standing policy requiring in-person evaluations only, for the purpose of research, was obtained from the Israeli Ministry of Health. During the telepsychiatry phase, clinical staff and patients will join a video call from the ED, while the attending physician will log in elsewhere. The Promoting Action on Research Implementation in Health Services (PARIHS) framework will guide the evaluation of the telepsychiatry implementation process in the ED. PARIHS has the following 3 constructs: (1) evidence: staff's opinions regarding the innovation's viability and practicality, their satisfaction levels with its use, and patients' perceptions of the change; (2) context: level of approval of new strategies in the ED, decision-making processes, and the manner in which clinical teams converse and work together; (3) facilitation: adequacy of the facilitation efforts using champions reports. Primary clinical outcomes include ED length of stay and violent incidents obtained from medical records. RESULTS: This study received Helsinki approval from the Ethics Committee of Abarbanel Mental Health Center (174; March 13, 2023), Jerusalem Mental Health Center (22-21; November 6, 2022), Lev-Hasharon Mental Health Medical Center (LH12023; February 12, 2023), Tel-Aviv Medical Center (TLV-22-0656; January 3, 2023), and Sha'ar Menashe (1-4-23; April 18, 2023). Data collection began in July 2023 in 2 study sites and will begin soon at the others. CONCLUSIONS: Telepsychiatry could have significant benefits for patients in the psychiatric ED. Examining telepsychiatry effectiveness in the ED, in addition to identifying the facilitators and barriers of implementing it in different emergency settings, will facilitate better policy decisions regarding its implementation. TRIAL REGISTRATION: ClinicalTrials.gov NCT05771545; https://clinicaltrials.gov/study/NCT05771545. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/49405.

Addressing anti-black racism in an academic preterm birth initiative: perspectives from a mixed methods case study.

BACKGROUND: Growing recognition of racism perpetuated within academic institutions has given rise to anti-racism efforts in these settings. In June 2020, the university-based California Preterm Birth Initiative (PTBi) committed to an Anti-Racism Action Plan outlining an approach to address anti-Blackness. This case study assessed perspectives on PTBi's anti-racism efforts to support continued growth toward racial equity within the initiative. METHODS: This mixed methods case study included an online survey with multiple choice and open-ended survey items (n = 27) and key informant interviews (n = 8) of leadership, faculty, staff, and trainees working within the initiative. Survey and interview questions focused on perspectives about individual and organizational anti-racism competencies, perceived areas of initiative success, and opportunities for improvement. Qualitative interview and survey data were coded and organized into common themes within assessment domains. RESULTS: Most survey respondents reported they felt competent in all the assessed anti-racism skills, including foundational knowledge and responding to workplace racism. They also felt confident in PTBi's commitment to address anti-Blackness. Fewer respondents were clear on strategic plans, resources allocated, and how the anti-racism agenda was being implemented. Suggestions from both data sources included further operationalizing and communicating commitments, integrating an anti-racism lens across all activities, ensuring accountability including staffing and funding consistent with anti-racist approaches, persistence in hiring Black faculty, providing professional development and support for Black staff, and addressing unintentional interpersonal harms to Black individuals. CONCLUSIONS: This case study contributes key lessons which move beyond individual-level and theoretical approaches towards transparency and accountability in academic institutions aiming to address anti-Black racism. Even with PTBi's strong commitment and efforts towards racial equity, these case study findings illustrate that actions must have sustained support by the broader institution and include leadership commitment, capacity-building via ongoing coaching and training, broad incorporation of anti-racism practices and procedures, continuous learning, and ongoing accountability for both short- and longer-term sustainable impact.

Innovative shortcuts and initiatives in primary health care for rural/remote localities: a scoping review on how to overcome the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has emerged as one of the greatest challenges to societies, world health systems and science in the past century, making it imperative to restructure care networks. Therefore, it is essential to discuss the role and initiatives of primary health care (PHC) to deal with it. However, regarding the response to the pandemic, including the current global effort against COVID-19, the nuances of the rural/remote PHC context in the pandemic is barely visible. Rural and remote communities have differentiated health risks, such as socioeconomic disadvantages, difficulties in mobility and access to health services, in addition to linguistic and cultural barriers. This scoping review aimed to analyze the set of individual and collective initiatives and innovations developed to face the COVID-19 pandemic, within the PHC scope, in rural and remote areas. METHODS: A scoping review methodology was applied to peer-reviewed articles. Eight databases were searched to identify scientific articles published in English, Spanish and Portuguese, initially from January 2020 to July 2021, complemented by a rapid review of articles published from January 2022 to April 2023. The main focus sought in the literature was the set of initiatives and innovations carried out within the PHC scope in rural and remote locations during the pandemic, as well as the comparison with pre-pandemic situations and between different countries. The bibliographic information of each search result was imported into Rayyan (Intelligent Systematic Review), followed by the screening and eligibility stages, performed independently by two reviewers, with a third reviewer being accessed in case of conflicts. RESULTS: This review included 54 studies, with publications mostly from Australia, Canada, the US and India. The main PHC initiatives were related to access; to the roles of community health workers and health surveillance; and to the importance of placing, retaining and valuing human resources in health. Cultural, equity and vulnerability issues occupy a major place among the initiatives. Regarding the innovations, telehealth and customized communication are highlighted. From an organizational point of view, rural and remote locations showed enormous flexibility to deal with the pandemic and to improve intersectoral activities at the local level. The description of rurality and remoteness is practically coincident with that of the specific populations, present in geographic areas of difficult sociospatial and cultural access. Rarely, there is an index to measure rurality, or its description deals with the need to overcome distances and obstacles. CONCLUSION: The findings highlight and summarize knowledge about initiatives and innovations developed to face the COVID-19 pandemic, within the PHC scope in rural and remote areas in the world. This review has identified collective, clinical, intersectoral and, mainly, organizational health initiatives. An articulation between different government levels would be paramount in evaluating the implementation of policies and protocols in rural and remote locations for future sanitary crises. Innovations and lessons learned are equally relevant in strengthening health services and systems. This issue calls for considerable further exploration by new reviews and empirical research that seek evidence to assess the sustainability and effectiveness of the implemented measures to face post-pandemic difficulties and other adversities.

Implementing Whole Person Primary Care: Results from a Year-Long Learning Collaborative.

PURPOSE: The National Academies of Medicine report on Implementing High-Quality Primary Care calls for a transformation of the primary care to a "whole person" model that is person-centered, relationship-based and takes into account the social, spiritual, emotional and behavioral aspects of health. However, our current delivery tools, such as the SOAP Note, do not sufficiently capture and organize the delivery of these elements in practice. To explore how to remedy this, an Integrative Health Learning Collaborative (IHLC) was established to implement and test new tools for changing primary care practices toward whole person care. METHODS: The IHLC comprised primary care practices committed to changing to a whole person care model of care along with a panel of experts in integrative health and change management. The IHLC met virtually monthly. Representatives from each practice and an assigned expert met to strategize and adapt the tools to their environment and practice. The practices used previously developed tools (the HOPE Note toolkit), change management tools, and quality improvement techniques to introduce, implement, and evaluate the changes. RESULTS: Sixteen clinics completed the process after 1 year. Overall, practices used the HOPE Note tools in 942 patients. Participants reported changes on the effectiveness of the collaborative (1) on clinical practice, (2) on the skills and attitudes of participants; and (3) the support in change management. CONCLUSIONS: This online learning collaborative supported practices implementing a whole person care model in primary care and improved the understanding, skills, and delivery ability of whole person care in all clinics completing the program.

[Nursing collaboration in the implementation of an ABI in psychiatric emergencies]. / La collaboration infirmière dans l'implantation d'un IPA aux urgences psychiatriques.

Since September 2021, at the Paris Psychiatry and Neurosciences University Hospital Group, an advanced practice nurse has been providing post-emergency consultations for people who were initially seen in the emergency department, for whom an indication for outpatient care was given and who had problems accessing care. Collaboration with the nursing team is an important element not to be neglected in the implementation of this new profession.

Models for Delivering Weight Management in Primary Care: Qualitative Results from the MOST Obesity Study.

BACKGROUND: Obesity is a leading cause of morbidity and mortality in the United States (US). Primary care medical practices can educate patients about the health effects of obesity and help patients with obesity lose and manage their weight. However, implementation of weight management in primary care is challenging. We sought to examine how practices that implement weight management services do so feasibly. METHODS: Multiple methods including site visits, observations, interviews, and document reviews were utilized to identify and learn from primary care practices located across the US. A qualitative multidimensional classification of empirical cases was performed to identify unique delivery features that were feasible to implement in primary care. RESULTS: Across 21 practices, 4 delivery models were identified: group, integrated into standard primary care, hiring an "other" professional, and using a specific program. Model characteristics included who delivered the weight management services, whether delivered to an individual or group, the types of approaches used, and how the care was reimbursed or paid. Most practices integrated weight management services and primary care delivery, although some created specific carve-out programs. CONCLUSION: This study identified 4 models that may serve to overcome challenges in delivering weight management services in primary care. Based on practice characteristics, preferences, and resources, primary care practices can identify a model for successfully implementing weight management services that best fits their context and needs. It is time for primary care to truly address obesity care as the health issue it is and make it a standard of care for all patients with obesity.

Successful operational integration of healthcare analytics at Seattle Children's.

Introduction: As the quantity and complexity of health data grows, it is critical for healthcare organizations to devise analytic strategies that power data innovation so they can take advantage of new opportunities and improve outcomes. Seattle Children's Healthcare System (Seattle Children's) is an example of an organization that has built an operating model that integrates analytics into their business and daily operations. We present a roadmap for how Seattle Children's consolidated its fragmented analytics operations into a unified cohesive ecosystem capable of supporting advanced analytics capabilities and operational integration to transform care and accelerate research. Methods: In-depth interviews were conducted with ten leaders at Seattle Children's who have been instrumental in developing their enterprise analytics program. Interviews included the following leadership roles: Chief Data & Analytics Officer, Director of Research Informatics, Principal Systems Architect, Manager of Bioinformatics and High Throughput Analytics, Director of Neurocritical Care, Strategic Program Manager & Neuron Product Development Lead, Director of Dev Ops,Director of Clinical Analytics, Data Science Manager, and Advance Analytics Product Engineer. The interviews were unstructured and consisted of conversations intended to gather information from leadership about their experiences in building out Enterprise Analytics at Seattle Children's. Results: Seattle Children's has built an advanced enterprise analytics ecosystem that is integrated into its daily operations by applying an entrepreneurial mindset and agile development practices that are common in a startup environment. Analytics efforts were approached iteratively by selecting high-value projects that were delivered through Multidisciplinary Delivery Teams that were integrated into service lines. Service line leadership, in partnership with the Delivery Team leads, were responsible for the success of the team by setting project priorities, determining project budgets, and maintaining overall governance of their analytics endeavors. This organizational structure has led to the development of a wide range of analytic products that have been used to improve both operations and clinical care at Seattle Children's. Conclusions: Seattle Children's has demonstrated how a leading healthcare system can successfully create a robust, scalable, near real-time analytics ecosystem- one that delivers significant value to the organization from the ever-expanding volume of health data we see today.

The impact of entrepreneurial team psychological capital on innovation performance: The mediating role of knowledge sharing and knowledge hiding.

Introduction: The important role of psychological capital on corporate innovation has attracted the attention of academics, more and more scholars have conducted related studies. Although most scholars have explored the mechanisms and paths of psychological capital on innovation performance, few scholars have explored the inner relationship between them from the perspective of knowledge management. Based on the knowledge management perspective, We explore the influence effect of the psychological capital of entrepreneurial teams on the innovation performance of startups in the entrepreneurial situation. Methods: We conducted hypothesis testing using data from 113 Chinese entrepreneurial teams, and conducted reliability analysis, correlation analysis, and regression analysis on the questionnaire data with the help of SPSS software and AMOS software. Results: The results showed that (1) entrepreneurial team psychological capital has a significant positive effect on innovation performance of startups; (2) entrepreneurial team psychological capital positively promotes their knowledge sharing behavior and reduces knowledge hiding behavior; (3) entrepreneurial team knowledge sharing and knowledge hiding play a partially mediating role between entrepreneurial team psychological capital and innovation performance of startups; (4)organizational innovation climate plays a moderating role in the influence of entrepreneurial team knowledge sharing and knowledge hiding on the innovation performance of startups. Discussion: The findings are consistent with the hypothesis model proposed in this paper, indicating that as the psychological capital of entrepreneurial teams increases, the innovation performance of startups can benefit from higher levels of knowledge sharing and lower levels of knowledge hiding.