A study on effect of conflicts and organizational changes on the communication process in IT sector.

Change is a noticeable feature of civic, personal, and organizational life. Progress, Goal achievement, and avoidance of contingence were frequently involved in the implementation of planned changes. Workers might completely recognize the motives for the alteration or the ladders needed to implement it through strong and constant communication. Outstanding communication could help decrease confrontation, rally a complex of alteration provision, and deliver evidence essential for individuals to adjust efficiently. Organizational change is essential for corporations to thrive and raise. It permits workers to comprehend and obligate change and effort successfully. The goal of this study is to determine the effect of conflicts and organizational changes on the communication process in the IT sector. Gathered data has been achieved by survey with help of surveys and then the collected data is analyzed using the SPSS software, SEM model and confirmatory factor analysis. The primary data collected are nearly 126 from employees working in various departments in the IT sector. This study analyzes the effects of conflicts and organizational changes on the communication process in the IT sector. The study also recommends that the IT sector improve strategies for tackling the issues faced because of organizational change.

Participatory design in telehealth research: Practical case examples.

Participatory design (PD) is a methodology that emphasizes user participation in the design of new technologies to leverage change within organizations and services. PD originated in the computer science field in the 1970s and 1980s when new programs and technologies were developed to empower workers, by involving them in decisions that affected them. PD in health research has been proven to change clinical practice. Genuine user involvement that includes all stakeholders, and robust collaborations across sciences, sectors, and disciplines are basic elements of successful research to change clinical practice and to implement novel technical and organizational approaches. This paper summarizes seven case studies involving the use of PD in telehealth research. All cases presented promoted organizational changes supported by health information and communications technology, and have been implemented at either international, national, regional, or local levels. We describe how PD can be applied in health sciences and used to facilitate organizational changes, new perspectives, and new communications methods. The relevance and suitability of PD as a research design in health science is explained, and recommendations for conducting PD studies in telehealth research are presented. In PD, mutual learning and co-creation is facilitated. Consequently, learning from users, rather than studying them, corroborates our understanding and the emergence of new knowledge.

Renewal without replication: Expanding Durkheim's theory of disruptions via queer nightlife.

Gay bars are closing in large numbers around the world, but institutional loss provides only a partial narrative for evaluating the larger field of nightlife. Drawing on 112 interviews, we argue that bar closures disrupted the field and consequently encouraged the visibility of alternate nightlife forms, called club nights. Unlike the fixed and emplaced model of bars, club nights are episodic and event-based occasions that are renewing nightlife without replicating the format of the gay bar. By detailing the phenomenology of club nights, we develop a new Durkheimian theory of disruptions that explains how and why some members of a community are motivated to renew rather than replicate existing institutional structures. We bring our framework to organization, sexuality, and nightlife studies-subfields that seldom engage with Durkheim-while subjecting a foundational social theory to an empirical case that can push it forward in important ways.

Multidisciplinary Collaboration in Hospitals via Patient- and Process-Oriented Units: A Longitudinal Study.

Introduction: The complexity of healthcare is increasing, mainly due to the prevalence of multimorbidity in an ageing population. Complex care for patients with multimorbidity requires a multidisciplinary approach. Traditional physician-centered hospital structures do not facilitate the necessary multidisciplinary collaboration. European hospitals are implementing process-based hospital designs with patient- and process-oriented units to stimulate multidisciplinary collaboration. Patient-oriented units are formed based on shared patient groups and focus on care trajectories, while process-oriented units are formed based on having similar processes and focus on efficiency. Purpose: This study has two aims. First, to study the effect of introduction of these units on multidisciplinary collaboration and perceived impact (efficiency, innovation, and effectiveness). Second, to study whether there are differences between patient- and process-oriented units. Methods: A survey-based longitudinal evaluation study was conducted in 2020 and 2022 among physicians in a Dutch hospital to measure multidisciplinary collaboration (relational coordination) and perceived impact (efficiency, innovation, and effectiveness). In addition, open questions were used to enrich the data. Results: Quantitative and qualitative data together suggest that physicians in patient-oriented units notice benefits from the redesign to multidisciplinary units, they perceive higher impact over time. Physicians in process-oriented units achieve a better relationship with the physicians in their unit over time, but they do not perceive impact as high as physicians in patient-oriented units. Conclusion: A process-based design with patient- and process-oriented units is supportive of multidisciplinary collaboration and perceived impact, especially for physicians in patient-oriented units. Physicians in patient-oriented units are positive about the introduction of these units as they feel it contributes to better multidisciplinary patient care. As the results for physicians in process-oriented units may be less directly visible in terms of quality of care, they are less likely to see positive effects, even though their relationships are improving.

Understanding the capacity development of faculty development programs: a sequential explanatory mixed methods study.

BACKGROUND: Faculty development programs can bring about both individual and organizational capacity development by enhancing individuals' attitudes, values, and skillsto enable them to implement organizational change. Understanding how faculty development programs produce capacity development, and the influencing factors, requires further understanding. This study aimed to explore the perceptions of the participants of a faculty development program about the capacity development features of the program and the influencing factors. METHODS: A sequential explanatory mixed methods design was used. Faculty members were surveyed about their perspectives on capacity development of faculty development. Subsequently, 22 interviews were conducted with the respondents to deepem understanding of the survey results. Interview transcripts underwent conventional content analysis. RESULTS: A total of 203 completed the questionnaire. Most of the faculty highly agreed that the faculty development programs had produced capacity development. The combined data identified (a) "quality of faculty development programs", underscoring the significance of robust and comprehensive initiatives, (b) "development in instruction", emphasizing the importance of continuous improvement in pedagogical approaches (c) "development in professionalism", highlighting the necessity for cultivating a culture of professionalism among faculty members, (d) "development in attitude towards education", emphasizing the role of mindset in fostering effective teaching practices, and (e) "supporting faculty development programs", with fostering organizational growth and innovation. Important barriers and facilitators of the capacity development process included several organizational, interpersonal, and individual factors. CONCLUSION: The study identified specific features of the capacity development process in the context of a faculty development program and highlighted the importance of these programs in producing changes in both individuals and within the wider organizational system. Several factors that enabled and constrained the capacity development process were also identified. The findings of the study can inform future implementation of faculty development programs for capacity development.

Healthcare workers' views on decentralized primary health care management in Lesotho: a qualitative study.

BACKGROUND: Lesotho experienced high rates of maternal (566/100,000 live births) and under-five mortality (72.9/1000 live births). A 2013 national assessment found centralized healthcare management in Ministry of Health led to fragmented, ineffective district health team management. Launched in 2014 through collaboration between the Ministry of Health and Partners In Health, Lesotho's Primary Health Care Reform (LPHCR) aimed to improve service quality and quantity by decentralizing healthcare management to the district level. We conducted a qualitative study to explore health workers' perceptions regarding the effectiveness of LPHCR in enhancing the primary health care system. METHODS: We conducted 21 semi-structured key informant interviews (KII) with healthcare workers and Ministry of Health officials purposively sampled from various levels of Lesotho's health system, including the central Ministry of Health, district health management teams, health centers, and community health worker programs in four pilot districts of the LPHCR initiative. The World Health Organization's health systems building blocks framework was used to guide data collection and analysis. Interviews assessed health care workers' perspectives on the impact of the LPHCR initiative on the six-health system building blocks: service delivery, health information systems, access to essential medicines, health workforce, financing, and leadership/governance. Data were analyzed using directed content analysis. RESULTS: Participants described benefits of decentralization, including improved efficiency in service delivery, enhanced accountability and responsiveness, increased community participation, improved data availability, and better resource allocation. Participants highlighted how the reform resulted in more efficient procurement and distribution processes and increased recognition and status in part due to the empowerment of district health management teams. However, participants also identified limited decentralization of financial decision-making and encountered barriers to successful implementation, such as staff shortages, inadequate management of the village health worker program, and a lack of clear communication regarding autonomy in utilizing and mobilizing donor funds. CONCLUSION: Our study findings indicate that the implementation of decentralized primary health care management in Lesotho was associated a positive impact on health system building blocks related to primary health care. However, it is crucial to address the implementation challenges identified by healthcare workers to optimize the benefits of decentralized healthcare management.

Ongoing Decline in Continuity With GPs in English General Practices: A Longitudinal Study Across the COVID-19 Pandemic.

PURPOSE: Relationship continuity of care has declined across English primary health care, with cross-sectional and longitudinal variations between general practices predicted by population and service factors. We aimed to describe cross-sectional and longitudinal variations across the COVID-19 pandemic and determine whether practice factors predicted the variations. METHODS: We conducted a longitudinal, ecological study of English general practices during 2018-2022 with continuity data, excluding practices with fewer than 750 patients or National Health Service (NHS) payments exceeding £500 per patient. Variables were derived from published data. The continuity measure was the product of weighted responses to 2 General Practice Patient Survey questions. In a multilevel mixed-effects model, the fixed effects were 11 variables' interactions with time: baseline continuity, NHS region, deprivation, location, percentage White ethnicity, list size, general practitioner and nurse numbers, contract type, NHS payments per patient, and percentage of patients seen on the same day as booking. The random effects were practices. RESULTS: Main analyses were based on 6,010 practices (out of 7,190 active practices). During 2018-2022, mean continuity in these practices declined (from 29.3% to 19.0%) and the coefficient of variation across practices increased (from 48.1% to 63.6%). Both slopes were steepest between 2021 and 2022. Practices having more general practitioners and higher percentages of patients seen the same day had slower declines. Practices having higher baseline continuity, located in certain non-London regions, and having higher percentages of White patients had faster declines. The remaining variables were not predictors. CONCLUSIONS: Variables potentially associated with greater appointment availability predicted slower declines in continuity, with worsening declines and relative variability immediately after the COVID-19 lockdown, possibly reflecting surges in demand. To achieve better levels of continuity for those seeking it, practices can increase appointment availability within appointment systems that prioritize continuity.Annals Early Access article.

Improving tobacco cessation interventions in hospitals: Pre-post evaluation of an innovative health systems intervention in Catalonia (Spain).

This study measured changes in healthcare professionals' (HCPs) performance in tobacco cessation intervention before and 6 months after a health system intervention. The intervention involved exposure to online training for staff and the implementation of a structured organizational change-level practice model that included some strategies, comprising establishing tobacco cessation steering groups with champions in each hospital, developing tailored protocols and guidelines within each organization, conducting on-site workshops for clinicians, and creating posters and pocket materials summarizing the intervention. Pre-post evaluation in four hospitals in Barcelona province (Catalonia, Spain). We assessed the knowledge, attitudes, behaviors, and organizational factors (KABO) and the performance of each of the components of the 5As Model for Treating Tobacco Use according to a scale from 0 ("Never") to 10 ("Always") among HCPs. We performed Wilcoxon signed-rank tests for paired samples and assessed changes in performance by performing linear regression. A total of 255 HCPs completed the pre-post evaluation. All components of the 5As Model increased, with "Assist" and "Arrange a follow-up" showing the greatest improvement. Several KABO dimensions significantly increased, including individual skills (mean score: 3.3-5.7, P < .001), attitudes and beliefs (4.8-5.4, P < .001), individual commitment (5.9-6.6, P < .001), and perception of having positive organizational support (4.3-4.7, P < .001). An increase in each point in individual skills and support of the organization was associated with increased rates of 5As delivery, with the greatest associations found for "Assist" (0.60 and 0.17, respectively) and "Arrange a follow-up" (0.71 and 0.18, respectively). The intervention was successful in increasing HCPs individual skills, attitudes and beliefs, individual commitment, and perception of having positive organizational support and the performance of all components of the 5As. Future research should focus on strategies that promote organizational support, a dimension that is essential to increasing Assist and Arrange, which were less implemented at baseline.

This study aimed to assess the impact of a health system intervention on healthcare professionals' (HCPs) ability to help patients quit tobacco use. The intervention involved exposure to online training for staff and the implementation of a structured organizational change-level practice model that included some strategies, comprising establishing tobacco cessation steering groups with champions in each hospital, developing tailored protocols and guidelines within each organization, conducting on-site workshops for clinicians, and creating posters and pocket materials summarizing the intervention. The study took place in four hospitals in Barcelona province. We measured changes in HCPs' knowledge, attitudes, behaviors, and organizational factors related to tobacco cessation interventions. We also evaluated the performance of different components of the 5As Model, which guides tobacco cessation interventions (Ask, Advise, Assess, Assist, and Arrange a follow-up). The results showed significant improvements in all components of the 5As Model, with "Assist" and "Arrange a follow-up" showing the most substantial enhancement. Several key dimensions, including individual skills, attitudes, commitment, and perception of organizational support, also improved significantly. Furthermore, we found that increased individual skills and organizational support were associated with higher rates of delivering the 5As components, particularly "Assist" and "Arrange a follow-up." In conclusion, the health system intervention successfully enhanced HCPs' skills, attitudes, commitment, and perception of organizational support, leading to improved performance in helping patients quit tobacco use. Future research should explore strategies to further promote organizational support, especially for components like "Assist" and "Arrange a follow-up" that were less commonly implemented initially.

Unveiling the paradoxes of implementing post graduate competency based medical education programs.

PURPOSE: Competency-based medical education (CBME) has gained prominence as an innovative model for post-graduate medical education, yet its implementation poses significant challenges, especially with regard to its sustainability. Drawing on paradox theory, we suggest that revealing the paradoxes underlying these challenges may contribute to our understanding of post graduate competency-based medical education (PGCBME) implementation processes and serve as a first-step in enhancing better implementation. Thus, the purpose of the current study is to identify the paradoxes associated with PGCBME implementation. METHOD: A qualitative study was conducted, as part of a larger action research, using in-depth semi-structured interviews with fellows and educators in eight Neonatal wards. RESULTS: Analysis revealed that the PGCBME program examined in this study involves three different levels of standardization, each serving as one side of paradoxical tensions; (1) a paradox between the need for standardized assessment tools and for free-flow flexible assessment tools, (2) a paradox between the need for a standardized implementation process across all wards and the need for unique implementation protocols in each ward; and 3) a paradox between the need for a standardized meaning of competency proficiency and the need for flexible and personal competency achievement indicators. CONCLUSIONS: Implementing PGCBME programs involves many challenges, some of which are paradoxical, i.e. two contradictory challenges in which solving one challenge exacerbates another. Revealing these paradoxes is important in navigating them successfully.

Power Dynamics Perpetuate DEI Inaction: A Qualitative Study of Community Health Clinic Teams.

PURPOSE: Despite increased clinician awareness of systemic racism, lack of substantial action toward antiracism exists within health care. Clinical staff perspectives, particularly those of racial-ethnic minorities/persons of color (POC) who disproportionately occupy support staff roles with less power on the team, can yield insights into barriers to progress and can inform future efforts to advance diversity, equity, and inclusion (DEI, also referred to as EDI) within health care settings. This qualitative study explored the perspectives of staff members on race and role power dynamics within community health clinic teams. METHODS: We conducted semistructured 45-minute interviews with staff members working in community health clinics in a large urban health care system from May to July 2021. We implemented purposeful recruitment to oversample POC and support staff and to achieve equal representation from the 13 community health clinics in the system. Interviews were audio recorded, transcribed, and analyzed over 6 months using a critical-ideological paradigm. Themes reflecting experiences related to race and role power dynamics were identified. RESULTS: Our cohort had 60 participants: 42 (70%) were support staff (medical assistants, front desk clerks, care navigators, nurses) and 18 (30%) were clinicians and clinic leaders. The large majority of participants were aged 26 to 40 years (60%), were female (83%), and were POC (68%). Five themes emerged: (1) POC face hidden challenges, (2) racial discrimination persists, (3) power dynamics perpetuate inaction, (4) interpersonal actions foster safety and equity, and (5) system-level change is needed for cultural shift. CONCLUSIONS: Understanding the race and role power dynamics within care teams, including experiences of staff members with less power, is critical to advancing DEI in health care.

Corporate zero deforestation commitments and company-internal organizational change.

This paper addresses knowledge gaps related to implementation of corporate zero deforestation commitments (ZDCs). Drawing on an analytical framework of organizational change, we scrutinize changes and processes internal to a company in adjusting to zero deforestation supply chains. The empirical data consists of 48 online questionnaires and 49 online interviews with actors involved in forest-risk commodity supply chains, both internal actors in companies and external actors (e.g., non-governmental organizations). Concerning organizational changes, the findings show that diverse drivers have triggered companies to adopt ZDCs, but most are external drivers. Organizational change following ZDCs has taken place within companies but only to a limited extent. Our study concludes that while corporate ZDCs can be seen as having advanced private governance in the fight against deforestation, more is needed still for effective implementation. Public governance and regulations could play an increasing role in stimulating adoption and implementation of private governance initiatives, like corporate ZDCs.

Work from home: Facilitators for an effective ergonomic work system.

Previous studies on Human Factors and Ergonomics (HFE) have primarily examined the impact of Work-From-Home (WFH) on worker health and well-being, yet little research has examined the optimal implementation process of WFH programs. Work systems perspective suggests that organizational policies, leadership, and psychological factors collectively influence the success of organizational change efforts. Our study explored the roles of managerial/supervisory, psychological, and organizational policy factors in facilitating the relationship between employees' HFE awareness and their acceptance and satisfaction with the WFH arrangement. Using data from 3195 knowledge workers in the US who use computers as their primary work tool and have worked from home at least one day in the past 30 days, we employed structural equation modeling to test our hypotheses. Transformational HFE leadership and employees' general self-efficacy are pivotal in implementing ergonomic WFH arrangements. The combination of employees' HFE awareness, transformational HFE leadership, and adequate levels of self-efficacy may foster positive process outcomes (e.g., readiness for WFH arrangement, workspace design satisfaction) in WFH arrangements. Efforts that are coordinated across organizational levels determine the effectiveness of organizational change.

Strategies to implement evidence-informed decision making at the organizational level: a rapid systematic review.

BACKGROUND: Achievement of evidence-informed decision making (EIDM) requires the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice. This rapid systematic review synthesizes evidence for strategies for the implementation of EIDM across organizations, mapping facilitators and barriers to the COM-B (capability, opportunity, motivation, behaviour) model for behaviour change. The review was conducted to support leadership at organizations delivering public health services (health promotion, communicable disease prevention) to drive change toward evidence-informed public health. METHODS: A systematic search was conducted in multiple databases and by reviewing publications of key authors. Articles that describe interventions to drive EIDM within teams, departments, or organizations were eligible for inclusion. For each included article, quality was assessed, and details of the intervention, setting, outcomes, facilitators and barriers were extracted. A convergent integrated approach was undertaken to analyze both quantitative and qualitative findings. RESULTS: Thirty-seven articles are included. Studies were conducted in primary care, public health, social services, and occupational health settings. Strategies to implement EIDM included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Facilitators and barriers align with the COM-B model for behaviour change. Facilitators for capability include the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization, though staff turnover and subsequent knowledge loss was a barrier to capability. For opportunity, facilitators include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time, and barriers include competing priorities. Facilitators identified for motivation include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. Barriers include negative attitudes toward new practices, and lack of understanding and support from management. CONCLUSION: This review provides a comprehensive analysis of facilitators and barriers for the implementation of EIDM in organizations for public health, mapped to the COM-B model for behaviour change. The existing literature for strategies to support EIDM in public health illustrates several facilitators and barriers linked to realizing EIDM. Knowledge of these factors will help senior leadership develop and implement EIDM strategies tailored to their organization, leading to increased likelihood of implementation success. REVIEW REGISTRATION: PROSPERO CRD42022318994.

The effect of organizational culture in health services on employee flourishing.

BACKGROUND: Culture has an important role in maximizing the value of human capital, which is regarded as the main source of organizational effectiveness. OBJECTIVE: The research was conducted to determine the effect of organizational culture perceptions of healthcare professionals working in a university hospital on employee flourishing. METHODS: It is a descriptive study conducted with 299 healthcare professionals working in a university hospital. "Structured Personal Information Form", "Denison Organizational Culture Survey" and "New Flourishing Index" to collect the data. In the analysis descriptive statistical methods such as percentage, frequency, arithmetic mean and standard deviation as well as Pearson correlation, linear regression and multiple linear regression analyses were performed to determine the relationship between variables. RESULTS: According to the results of linear regression analysis, it was determined that organizational culture and flourishing were related (F: 88.229; p <  0.05). The organizational culture alone explained 22.6% of flourishing. As a result of multiple regression analysis, it was determined that the relationship between organizational culture sub-dimensions and flourishing was significant (F = 25.975; p <  0.05). The sub-dimensions of organizational culture explained 25.1% of the flourishing. CONCLUSIONS: As a result of the study, it is observed that the perception of organizational culture of healthcare professionals has an impact on flourishing, and therefore the favorable development of organizational culture will contribute positively to employee flourishing. In present conditions, it has become a necessity for health organizations to provide the circumstances that will make all investments that will contribute positively to the flourishing of their employees a part of the organizational culture.

Association of Hospitals' Experience with Bundled Payment for Care Improvement Model with the Diffusion of Acute Hospital Care at Home.

OBJECTIVE: To examine whether hospitals' experience in a prior payment model incentivizing care coordination is associated with their decision to adopt a new payment program for a care delivery innovation. DATA SOURCES: Data were sourced from Medicare fee-for-service claims in 2017, the list of participants in Bundled Payment for Care Improvement initiatives (BPCI and BPCI-Advanced), the list of hospitals approved for Acute Hospital Care at Home (AHCaH) between November 2020 and August 2022, and the American Hospital Association Survey. STUDY DESIGN: Retrospective cohort study. Hospitals' adoption of AHCaH was measured as a function of hospitals' BPCI experiences. Hospitals' BPCI experiences were categorized into five mutually exclusive groups: (1) direct BPCI participation, (2) indirect participation through physician group practices (PGPs) after dropout, (3) indirect participation through PGPs only, (4) dropout only, and (5) no BPCI exposure. DATA COLLECTION/EXTRACTION METHODS: All data are derived from pre-existing sources. General acute hospitals eligible for both BPCI initiatives and AHCaH are included. PRINCIPAL FINDINGS: Of 3248 hospitals included in the sample, 7% adopted AHCaH as of August 2022. Hospitals with direct BPCI experience had the highest adoption rate (17.7%), followed by those with indirect participation through BPCI physicians after dropout (11.8%), while those with no exposure to BPCI were least likely to participate (3.2%). Hospitals that adopted AHCaH were more likely to be located in communities where more peer hospitals participated in the program (median 10.8% vs. 0%). After controlling for covariates, the association of the adoption of AHCaH with indirect participation through physicians after dropout was as strong as with early BPCI adopter hospitals (average marginal effect: 5.9 vs. 6.2 pp, p < 0.05), but the other categories were not. CONCLUSIONS: Hospitals that participated in the bundled payment model either directly or indirectly PGPs were more likely to adopt a care delivery innovation requiring similar competence in the next period.

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.

Enabling successful change in a high-demand working environment: a case study in a health care organization.

PURPOSE: The anticipation of organizational change and the transition process often creates uncertainty for employees and can lead to stress and anxiety. It is therefore essential for all organizations, especially those that operate in high-demand working environments, to support the well-being of staff throughout the change process. DESIGN/METHODOLOGY/APPROACH: Research on how employees respond to the organizational change of relocating to a new work space is limited. To fill this gap in the research, we present a case study examining the well-being of clinical and health care employees before and after a disruptive change: relocation in workplace facilities. In addition, factors that enabled successful change in this high-stress, high-demand working environment were investigated. Interviews were conducted with 20 participants before the relocation and 11 participants after relocation. Following an inductive approach, data were analyzed using thematic analysis to identify key themes. FINDINGS: Our findings suggest that a supportive team, inclusive leadership and a psychologically safe environment, may buffer negative employee well-being outcomes during disruptive organizational change. ORIGINALITY/VALUE: This research contributes to the literature on successful organizational change in health care by highlighting the resources which support well-being throughout the change process and enabling the successful transition to a new facility.

Increasing support for the prevention of adverse childhood experiences and substance use: Implementation of narrative change strategies in local health departments.

Adverse childhood experiences (ACEs) are potentially traumatic but preventable experiences that occur before the ages of 18, including child abuse, witnessing violence, and parental substance use. ACEs have been linked with increased risk for substance use, along with a variety of other negative health outcomes. However, there is limited evidence of community-level strategies that link ACEs and substance to increase awareness of prevention efforts. This article reports on a $2.9 million program to promote health equity and inform narratives for the prevention of ACEs and substance use within three Midwestern communities. Program partners sought to create new transformational narratives that linked ACEs and substance use, while underscoring the importance of addressing social determinants of health (SDOH) that lead to disparities in ACEs and substance use. A mixed-methods evaluation design included document review, in-depth interviews with program staff (N = 8) and community liaisons (N = 2), and site reports from program staff (N = 8) and their community partners (N = 17). Analyses showed that successful implementation efforts had early leadership buy-in and support, set clear and manageable expectations at the outset of implementation, and developed strong relationships with organizations that engage in health equity work. Training and technical assistance were critical to helping community partners build trust, recognize each other's perspectives, broaden and reframe their world view, and better understand narrative efforts for the primary prevention of ACEs and substance use.

"We must be mentally strong": exploring barriers to mental health in correctional services.

Introduction: The inherent nature of work in correctional services can have negative effects on correctional worker mental health and well-being. Methods: The current study, a replication, analyzes survey data collected from provincial and territorial correctional workers staffed in six regions across Canada (n = 192). Specifically, participants were asked at the end of an extensive mental health and well-being survey an open-ended question requesting any additional feedback or information. Results: Four predominant themes were identified in the data: (1) stigma pertaining to a need to recognize mental health concerns within correctional services; (2) the idea that correctional services wear on the mind and body; (3) a need for better relationships with and support from correctional supervisors, upper management, and ministerial leadership; and (4) suggestions to improve correctional services to help the sector realize its full potential and maximize workplace health. Discussion: We discuss the implications of these findings, with an emphasis on finding ways to promote positive organizational and cultural change in correctional services.