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1.
J Adv Nurs ; 2024 Mar 21.
Article in English | MEDLINE | ID: mdl-38515008

ABSTRACT

AIM: Workplace incivility is a barrier to safe and high-quality patient care in nursing workplaces and more broadly in tertiary hospitals. The present study aims to systematically review the existing evidence to provide a comprehensive understanding of the prevalence of co-worker incivility experienced and witnessed by nurses and other healthcare professionals, the effects of incivility on patient safety culture (PSC) and patient outcomes, and the factors which mediate the relationship between incivility and patient safety. METHODS: A systematic review with narrative synthesis and meta-analysis was undertaken to synthesize the data from 41 studies. DATA SOURCES: Databases searched included MEDLINE, PubMed, SCOPUS, CINAHL, PsycInfo, ProQuest, Emcare and Embase. Searches were conducted on 17 August 2021 and repeated on 15 March 2023. RESULTS: The pooled prevalence of experienced incivility was 25.0%. The pooled prevalence of witnessed incivility was 30.1%. Workplace incivility was negatively associated with the PSC domains of teamwork, reporting patient safety events, organization learning/improvement, management support for safety, leadership, communication openness and communication about error. The composite pooled effect size of incivility on these domains of PSC was OR = 0.590, 95% CI [0.515, 0.676]. Workplace incivility was associated with a range of patient safety outcomes (PSOs) including near misses, adverse events, reduced procedural and diagnostic performance, medical error and mortality. State depletion, profession, psychological responses to incivility, information sharing, help seeking, workload and satisfaction with organizational communication were found to mediate the relationship between incivility and patient safety. CONCLUSION: Experienced and witnessed incivility is prevalent in tertiary hospitals and has a deleterious effect on PSC and PSOs. A better understanding of the mechanisms of this relationship will support the development of interventions aimed at reducing both incivility and patient harm. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE IMPACT: This study quantifies the effect of incivility on PSC and outcomes. It provides support that interventions focusing on incivility are a valuable mechanism for improving patient care. It guides intervention design by highlighting which domains of PSC are most associated with incivility. It explores the profession-specific experiences of workplace incivility. REPORTING METHOD: This report adheres to PRISMA reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. The focus of this study is the nursing and healthcare workforce, therefore, patient or public involvement not required.

2.
BMC Health Serv Res ; 23(1): 421, 2023 May 01.
Article in English | MEDLINE | ID: mdl-37127614

ABSTRACT

BACKGROUND: Using management competency-based frameworks to guide developing and delivering training and formal education to managers has been increasingly recognized as a key strategy in building management capacity. Hence, interest in identifying and confirming the competency requirements in various contexts have been witnessed. Therefore, learnings from how competency studies were designed and conducted, how competencies were identified, and strategies in ensuring success in competency identification are of great value to researchers planning and conducting competency studies in their own country. METHODS: A scoping review was conducted guided by the Arksey and O'Malley framework and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). All papers that published empirical studies aiming at identifying and assessing manager's competencies at the peer-reviewed journals were identified from Web of sciences, PubMed, Scopus and Emerald Management between 2000 and 2021. In order to maximize learning, studies focusing on health and non-health sectors are all included. RESULTS: In total, 186 studies were included in the review including slightly more than half of the studies conducted in health sector (54.5%). 60% of the studies focused on mid to senior level managers. Surveys and Interviews were the two most commonly used methods either solely or as part of the mix-method in the studies. Half of the studies used mixed methods approach (51.1%). Large proportion of the papers failed to include all information that is necessary to contribute to learning and improvement in future study design. Based on the results of the scoping review a four steps framework was developed that can guide designing and implementing management competency studies in specific country vs. sector context and to ensure benefits of the studies are maximised. CONCLUSION: The review confirmed the increasing trend in investing in management competency studies and that the management competency identification and development process varied substantially, in the choice of methods and processes. The identification of missing information in majority of the published studies calls for the development of more rigorous guidelines for the peer-review process of journal publications. The proposed framework of improving the quality and impact of the future management competency study provides clear guidance to management competency identification and development that promotes the functional alignment of methods and strategies with intended uses and contexts.


Subject(s)
Clinical Competence , Learning , Humans , Research Design , Empirical Research
3.
BMC Med Ethics ; 23(1): 38, 2022 04 08.
Article in English | MEDLINE | ID: mdl-35395761

ABSTRACT

BACKGROUND: Patient-centred care and patient autonomy is one of the key factors to better quality of service provision, hence patient outcomes. It enables the development of patients' trusts which is an important element to a better doctor-patient relationship. Given the increasing number of patient disputes and conflicts between patients and doctors in Chinese public hospital, it is timely to ensure patient-centred care is fully and successfully implemented. However, limited studies have examined the views and practice in different aspects of patient-centred care among doctors in the Chinese public hospitals. METHODS: A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. RESULTS: In total, 614 doctors from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the inconsistent views among doctors in terms of their perception and practice in various aspects patient-centred care and patient autonomy regardless of the hospital where they work (category II or category III), their unit speciality (surgical or non-surgical), their gender or seniority. The high proportion of doctors (more than 20%) who did not perceive the importance of patient consultation prior to determining diagnostic and treatment procedure is alarming. This in in part due to the belief held by more than half of the doctors that patients were unable to make rational decisions and their involvement in treatment planning process did not necessarily lead to better treatment outcomes. CONCLUSION: The study calls for the development of system level policy and organisation wide strategies in encouraging and enabling the practice of patient-centred care and patient autonomy with the purposes of improving the quality of the service provided to patients by Chinese hospitals.


Subject(s)
Physician-Patient Relations , Physicians , China , Hospitals, Public , Humans , Patient-Centered Care
4.
BMC Med Educ ; 22(1): 52, 2022 Jan 22.
Article in English | MEDLINE | ID: mdl-35065649

ABSTRACT

BACKGROUND: Management decisions in health influence patient care outcomes; however, health management development courses in China are rare. This study aims to document and evaluate a transnational Master of Health Administration (MHA) course launched in 2000 for the benefit of Chinese health managers. METHODS: A case study of the MHA program jointly run by an Australian university and a Chinese Medical University was conducted. We reviewed the development of the MHA course through a document analysis (key events recorded in achieves, minutes, and audits) followed by reflection (by two course coordinators), extracting key themes related to adaptative strategies. We then conducted a questionnaire survey of 139 graduates seeking their views on relevance, satisfaction and challenges associated with each subject within the course, the relevance of key management skills (as determined by the Australasian College of Health Service Management competency framework), and the impact of the course on their personal career trajectories. Chi-square tests identified differences in the responses by age, gender, pre-training position, and current workplace. RESULTS: The curriculum pedagogy followed the principles of practice-based reflective learning. Research findings and student feedback shaped the curriculum design and subject content, to enhance management practices of the students. Survey participants expressed high levels of satisfaction and confirmed the relevance of all study subjects. Two subjects, health economics and data management, were perceived as being the most challenging. Of the ten management skills we assessed, relatively low self-rated confidence was found in "strategic thinking" and "planning". Younger and less experienced graduates were more likely to report learning challenges (p < 0.05). Frontline managers were least likely to obtain promotion by changing employers (χ2 = 6.02, p < 0.05) or being seconded to another position (χ2 = 9.41, p < 0.01). CONCLUSIONS: This case study illustrates the suitability of cross-country partnerships in health management training, which offers opportunities for managers to systematically explore and acquire a comprehensive set of management skills applicable to their career needs. Opportunities for developing training aligned to career development opportunities are critical for attracting and developing a competent and well-prepared health service management workforce in China.


Subject(s)
Curriculum , Learning , Australia , Educational Status , Humans , Workforce
5.
BMC Health Serv Res ; 20(1): 281, 2020 Apr 06.
Article in English | MEDLINE | ID: mdl-32252749

ABSTRACT

BACKGROUND: To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency. METHODS: A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n = 498) from three categories of hospital in Jinan, Shandong Province, China. RESULTS: The survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate. The core competencies identified in the Australia context were applicable to the management roles in Chinese hospitals. In addition, the senior executives had low levels of confidence in their management competence. Furthermore, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence. CONCLUSIONS: The study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management.


Subject(s)
Delivery of Health Care , Health Facility Merger , Hospital Administrators , Adult , Australia , China , Cross-Sectional Studies , Female , Health Services Administration , Humans , Male , Middle Aged , Professional Competence , Staff Development , Surveys and Questionnaires
6.
BMC Health Serv Res ; 20(1): 721, 2020 Aug 06.
Article in English | MEDLINE | ID: mdl-32762694

ABSTRACT

BACKGROUND: Health service managers are integral to supporting the effective and efficient delivery of services. Understanding their competencies is essential to support reform and improvement of healthcare provision in China. This paper examines the characteristics and educational background of senior managers working in the community health and hospital sectors in China. We also examine their levels of commitment to continued professional development and continuous education. METHODS: A self-administered paper-based questionnaire was administered to 477 level I, II and III managers in community health services and public hospitals in China. The response rate was over 80%. RESULTS: Findings demonstrate significant differences in terms of educational background and commitment to ongoing professional development between the managers in China across levels of management, and between the community and hospital sectors. Hospital managers tend to be older; hospital managers at higher management levels are predominantly male but predominantly female in the community health services. A greater proportion of hospital managers have postgraduate qualifications. In addition, the participants identified specific management tasks that they considered important. CONCLUSIONS: This is the first large scale study examining the educational background and commitment to professional development of senior health service managers in China. This study determined that there are differences between the demographics of managers in China across levels of management, but more importantly between the CHC and the hospital sectors. The identification of important managerial tasks will facilitate the development of appropriate education and training for Chinese healthcare managers. All sectors and levels reported the need for informal education focussed on the core roles of developing organisation image and public relations, improving quality and safety of service provision and provision of leadership. Further research to explore the underlying reasons for the above differences is needed to design appropriate professional development for China's health services managers. In addition, the importance of managerial tasks across sectors and management levels requires further investigation.


Subject(s)
Health Services Administration , Hospitals, Public/organization & administration , Adult , China , Female , Humans , Male , Middle Aged , Surveys and Questionnaires
7.
BMC Med Educ ; 20(1): 501, 2020 Dec 10.
Article in English | MEDLINE | ID: mdl-33302937

ABSTRACT

BACKGROUND: An increase in the number of medical disputes and violence against doctors indicates a lack of trust in the medical profession by society in Chinese public hospitals. Empirical evidence confirms that one cause is the lack of professional identity demonstrated by doctors. Medical professionals are required to maintain high standards of competence and moral responsibility, and demonstrate qualities such as respect, compassion, integrity, responsiveness to needs, and commitment to sound ethical practice in order to maintain professional privilege. These principles and appropriate professional conduct are the foundation of the professional identity of the medical profession. METHODS: A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. FINDINGS: In total, 614 doctors and 1184 inpatients on discharge from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the variation amongst doctors in demonstrating their professionalism in terms of respecting patients' views and preferences when determining diagnostic procedures and treatment plans, and when making ethical decisions. Although 90% patients indicated that they showed respects to doctors, close to 20% of the doctors disagreed that they received high respect from patients. About 12% of doctors prescribed unnecessary diagnostic procedures to patient for the purpose of generating profit and more than 20% of patients indicated that they gave gifts to doctors in order to receive better treatment. CONCLUSIONS: Although about 80% of doctors demonstrated certain aspects of professionalism required by practitioners, the inconsistency across the medical workforce may exacerbate tense doctor-patient relationships. A review of medical curricula and focus of the internship program is required in order to assist medical graduates with forming required professional identity in order to improve patient satisfaction and better clinical outcomes. To be effective, a more systematic approach is recommended.


Subject(s)
Physicians , China , Hospitals, Public , Humans , Physician-Patient Relations , Professionalism
8.
BMC Health Serv Res ; 18(1): 976, 2018 Dec 18.
Article in English | MEDLINE | ID: mdl-30563505

ABSTRACT

BACKGROUND: Competent managers are essential to the productivity of organisations and the sustainability of health systems. Effective workforce development strategies sensitive to the current competency development needs of health service managers (HSMs) are required. PURPOSE: To conduct a 360° assessment of the competence of Australian HSMs to identify managerial competence levels, and training and development needs. METHODS: Assessment of 93 middle-level HSMs from two public hospitals (n = 25) and five community health services (CHS) (n = 68), using the Managerial Competency Assessment Partnership (MCAP) framework and tool, conducted between 2012 and 2014 in Victoria, Australia. RESULTS: Mean competency scores from both self- and combined colleagues' assessments indicated competence (scores greater than five but less than six) without guidance, but many HSMs have not had extensive experience. Around 12% of HSMs were unable to demonstrate the competency of 'evidence-informed decision-making' and 4% of HSMs were unable to demonstrate the competency of 'enabling and managing change'. CONCLUSION: The assessments confirmed managerial competence for the majority of middle-level HSMs from hospitals and CHS in Victoria, but found competency gaps. In addition, the assessment confirmed managerial strengths and weaknesses varied across management groups from different organisations. These findings suggest that the development of strategies to strengthen the health service management workforce should be multifaceted. PRACTICE IMPLICATIONS: A focus on competency in performance evaluation and development using the MCAP framework and tool not only provides insights into performance of HSMs, but also has the potential to provide an organisation strategic advantage through succession planning and advancing managers' competence via learning needs analysis and targeted professional development. Linking competencies of HSMs to organisational objectives and strategies provides optimal use of the human resource capacity, improving the organisation's productivity and sustainability.


Subject(s)
Health Workforce/standards , Personnel, Hospital/standards , Professional Competence/standards , Staff Development , Administrative Personnel/standards , Clinical Decision-Making , Community Health Services/organization & administration , Community Health Services/standards , Evidence-Based Practice , Hospitals, Public/organization & administration , Hospitals, Public/standards , Humans , Needs Assessment , Organizational Innovation , Problem Solving , Victoria
10.
Stud Health Technol Inform ; 310: 1206-1210, 2024 Jan 25.
Article in English | MEDLINE | ID: mdl-38270006

ABSTRACT

Health service managers play a crucial role in managing and leading in the digital health environment. Development of the health management workforce that is ready to lead and manage digital health transformation requires partnerships across sectors, in not only developing workforce competence but also in developing supportive mechanisms that can translate competencies into practice. A framework presenting a systematic approach in enabling the development of a competent health management workforce in the digital health era has recently been published. The purpose of this paper is to explore and discuss the application of the framework in the Australian context, informed by the findings of a PhD research project that uses an empirically validated four-step approach to confirm the health service management workforce development needs in the digital health context. The PhD project has already confirmed: 1) the paucity of Australian Health Informatics Competency Framework (AHICF) competencies being included in Australian health service management postgraduate program curricula; 2) five key strategies that contribute to developing health management workforce competency and capacity; and 3) seven key factors that enable health management workforce development in the digital health context. Further understanding of the barriers and enablers for health service managers to develop capability and manage in the digital health environment, and the factors that influence digital health policy and practice will be developed, by critically analysing findings from focus group discussions with health managers and semi-structured interviews with digital health leaders, to be completed by May 2023.


Subject(s)
Curriculum , Health Services , Australia , Digital Health , Health Policy
11.
JMIR Res Protoc ; 13: e52067, 2024 Jan 25.
Article in English | MEDLINE | ID: mdl-38271100

ABSTRACT

BACKGROUND: Women are at high risk of experiencing trauma, guilt, and stress when forced to separate from their companion animals when fleeing domestic violence. Where little support is available for women and pets to stay together, women may be forced to delay leaving the abusive relationship or leave the pet with the abuser. Forced separation places both women and pets at substantial risk, where pets may be used as a coercive control measure. However, little evidence exists regarding the extent to which Australian services or policies offer support in these circumstances. OBJECTIVE: This research aims to increase the understanding and the impacts of forced separation between women and their pets in domestic violence situations. The research will investigate the effectiveness of service responses for both women and animals, aiming to develop a policy framework that guides service improvement with the goal of enhancing outcomes for women and pets fleeing domestic violence. METHODS: This protocol paper describes the process of developing a conceptual framework of 4 studies that include a scoping review, policy analysis, focus groups, and interviews that guide the design of the qualitative research project. RESULTS: A scoping review of the literature on forced separation from pets in domestic violence, natural disasters, and homelessness situations has led to the development of a conceptual framework that guided the design of the proposed study. The review also confirmed the necessity of the proposed research project in addressing the lack of Australian national frameworks and guidance available for women and pets seeking formal support in domestic violence situations. As of August 2023, supporting organizations have commenced the distribution of the research flyers. Expected data collection will be completed between August and October 2023. The results are expected to be published in June 2025. CONCLUSIONS: Via a systematic process, the importance of the proposed study in improving the understanding of the impact of forced separation between women and their pets at times of domestic violence and the gaps in best supporting both women and their pets has been confirmed. A study design based on the learnings from previous studies and the focus of the current research has been finalized. The impact of the research project in developing an Australian national framework for best supporting women and their pets in crisis situations is anticipated. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/52067.

12.
Aust Health Rev ; 37(5): 566-73, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23601561

ABSTRACT

OBJECTIVE: The purpose of this paper is to confirm the core competencies required for middle to senior level managers in Victorian public hospitals in both metropolitan and regional/rural areas. METHODS: This exploratory mixed-methods study used a three-step approach which included position description content analysis, focus group discussions and online competency verification and identification survey. RESULTS: The study validated a number of key tasks required for senior and middle level hospital managers (levels II, III and IV) and identified and confirmed the essential competencies for completing these key tasks effectively. As a result, six core competencies have been confirmed as common to the II, III and IV management levels in both the Melbourne metropolitan and regional/rural areas. CONCLUSIONS: Six core competencies are required for middle to senior level managers in public hospitals which provide guidance to the further development of the competency-based educational approach for training the current management workforce and preparing future health service managers. With the detailed descriptions of the six core competencies, healthcare organisations and training institutions will be able to assess the competency gaps and managerial training needs of current health service managers and develop training programs accordingly.


Subject(s)
Hospital Administrators , Professional Competence , Attitude of Health Personnel , Focus Groups , Humans , Task Performance and Analysis
13.
Aust J Prim Health ; 19(3): 256-63, 2013.
Article in English | MEDLINE | ID: mdl-23007275

ABSTRACT

The Australian health system has been subjected to rapid changes in the last 20 years to meet increasingly unmet health needs. Improvement of the efficiency and comprehensiveness of community-based services is one of the solutions to reducing the increasing demand for hospital care. Competent managers are one of the key contributors to effective and efficient health service delivery. However, the understanding of what makes a competent manager, especially in the community health services (CHS), is limited. Using an exploratory and mixed-methods approach, including focus group discussions and an online survey, this study identified five key competencies required by senior and mid-level CHS managers in metropolitan, regional and rural areas of Victoria: Interpersonal, communication qualities and relationship management; Operations, administration and resource management; Knowledge of the health care environment; Leading and managing change; and Evidence-informed decision-making. This study confirms that core competencies do exist across different management levels and improves our understanding of managerial competency requirements for middle to senior CHS managers, with implications for current and future health service management workforce development.


Subject(s)
Administrative Personnel/standards , Community Health Services/organization & administration , Health Knowledge, Attitudes, Practice , Leadership , Professional Competence/standards , Decision Making , Evidence-Based Practice , Focus Groups , Health Care Surveys , Humans , Interdisciplinary Communication , Interpersonal Relations , Organizational Innovation , Victoria , Workforce
14.
Patient Prefer Adherence ; 17: 385-400, 2023.
Article in English | MEDLINE | ID: mdl-36819644

ABSTRACT

Purpose: Patient feedback plays a significant role in hospital service improvement. However, how to encourage patient feedback that can guide hospital service improvement is still being explored. By examining patient feedback data related to a tertiary hospital in China that was collected from the "12345" Government Service Convenience Hotline (GSCH), the paper discusses the learnings from GSCH in encouraging patient feedback and how quality improvement initiatives have effected the number and types of complaints made by patients and their families via GSCH. Methods: The study retrospectively collected and analyzed complaints on a Tertiary General University-affiliated hospital made via GSCH between 2016 and 2020. Patient care process-related complaints were coded using the health care complaint analysis tool (HCAT) and other complaint data were categorized based on the nature of the complaints. The autoregressive integrated moving average (ARIMA) models and mosaic plots were used to observe complaints trends and different complaint variables, respectively. The relationship between various quality improvement initiatives introduced since 2018 and patient complaints was also tested. Results: Close to 67% (n=2688) of calls made to the GSCH hotlines about the hospital were classified as a complaint including 60.6% vs 39.4% related to patient care process and nonpatient care process, respectively. For patient care process-related complaints, specifically against departments and personnel, 57.72% (n=961) were on clinical departments and 55.87% (n=471) were on doctors. Comparing the proportion of the complaint data in different categories in the two-year period of 2017-2018 and 2019-2020, an increase in management problems (47.73% vs 58.50%, P<0.001) and decrease in relationship problems (33.65% vs 25.69%, P=0.002) were recorded. Conclusion: A unified, transparent, and impartial GSCH platform greatly encourages feedback from patients and families. Feedbacks provide evidence to guide health care organizations in improving the overall experience of patients and the quality of services that they provide.

15.
JMIR Res Protoc ; 12: e51884, 2023 Nov 03.
Article in English | MEDLINE | ID: mdl-37921855

ABSTRACT

BACKGROUND: Globally, the health care system is experiencing a period of rapid and radical change. In response, innovative service models have been adopted for the delivery of high-quality care that require a health workforce with skills to support transformation and new ways of working. OBJECTIVE: The aim of this research protocol is to describe research that will contribute to developing the capability of health service managers in the digital health era and enabling digital transformation within the Australian health care environment. It also explains the process of preparing and finalizing the research design and methodologies by seeking answers to the following three research questions: (1) To what extent can the existing health service management and digital health competency frameworks guide the development of competence for health service managers in understanding and managing in the digital health space? (2) What are the competencies that are necessary for health service managers to acquire in order to effectively work with and manage in the digital health context? (3) What are the key factors that enable and inhibit health service managers to develop and demonstrate digital health competence in the workplace? METHODS: The study has adopted a qualitative approach, guided by the empirically validated management competency identification process, using four steps: (1) health management and digital health competency mapping, (2) scoping review of literature and policy analysis, (3) focus group discussions with health service managers, and (4) semistructured interviews with digital health leaders. The first 2 steps were to confirm the need for updating the current health service management curriculum to address changing competency requirements of health service managers in the digital health context. RESULTS: Two initial steps have been completed confirming the significance of the study and study design. Step 1, competency mapping, found that nearly half of the digital competencies were only partially or not addressed at all by the health management competency framework. The scoping review articulated the competencies health service managers need to effectively demonstrate digital health competence in the workplace. The findings effectively support the importance of the current research and also the appropriateness of the proposed steps 3 and 4 in answering the research questions and achieving the research aim. CONCLUSIONS: This study will provide insights into the health service management workforce performance and development needs for digital health and inform credentialing and professional development requirements. This will guide health service managers in leading and managing the adoption and implementation of digital health as a contemporary tool for health care delivery. The study will develop an in-depth understanding of Australian health service managers' experiences and views. This research process could be applied in other contexts, noting that the results need contextualization to individual country jurisdictions and environments. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51884.

16.
Int J Med Inform ; 169: 104909, 2023 01.
Article in English | MEDLINE | ID: mdl-36347141

ABSTRACT

INTRODUCTION: Health informatics and digital health, two rapidly growing disciplines, are becoming increasingly important to the sustainability of health service provision, highlighted especially through the COVID-19 pandemic. To maximise the benefits of the adoption and growth of health informatics and digital health, health service managers play a critical role in leading and managing the implementation and transformation of the system, both strategically and operationally, whilst still needing to manage 'business as usual'. OBJECTIVES: The objectives of the paper are to present and discuss the findings from a scoping review identifying: 1) competencies required for health service managers leading the implementation and transformation of informatics and digital technology in the health sector; and 2) factors that are critical to building the management workforce capacity in the era of health informatics and digital health. METHODS: A scoping review of the literature was conducted in 2020 focussing on identifying empirical articles published in the English language since the year 2000 using a number of keywords such as 'health informatics', 'digital health', 'electronic health', 'competencies', 'capability', 'proficiency', 'qualification', 'certification', 'health manager', 'health executive' and 'health administrator'. The literature search was guided by a PRISMA approach searching within eight databases: Scopus, ProQuest, Web of Science, ACM Digital Library, CINAHL, PubMed, Google Scholar and ProQuest Dissertations. RESULTS: After duplicates were removed, 941 publications were included for title screening as the result of an initial review. Title screening selected 185 articles to be included for abstract screening by two reviewers confirming 19 papers relevant to the focus of the current paper which were included in data extraction and content analysis. The analysis identified the additional competency of 'information and data management' be included as a core competency for health service managers. The analysis also confirmed additional elements for the following four core management competencies that are important to health service managers working in the digital health context, including: 1) leadership; 2) operational and resource management; 3) personal, interpersonal and professional qualities, and 4) understanding the industry and environment. Factors that are critical to developing the system and organization capacity in the use of health informatics and digital health technology, and leading and managing the adoption in the healthcare organizations were identified in three categories: 1) policy/system; 2) organizational structure and processes; and 3) people factors. CONCLUSIONS: This paper has taken an important step in confirming the competency requirements for health services managers that are relevant to leading and managing in the health informatics and digital health space, consequently indicating the directions for developing a competent workforce in meeting the existing and emerging healthcare delivery challenges, both now and in the future.


Subject(s)
COVID-19 , Pandemics , Humans , Health Services
17.
Aust J Prim Health ; 29(1): 56-63, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36283681

ABSTRACT

BACKGROUND: Community pharmacists are highly accessible for advice, as most pharmacies are open long hours and no appointment is needed. Community pharmacists, as essential community health workers, play a critical role in the fight against coronavirus disease 2019 (COVID-19). This study aimed to determine the general wellbeing and work impacts of pharmacists and the factors important for adaptability and resilience during the COVID-19 pandemic. METHODS: This study adopted a cross-sectional design. Community pharmacists from various professional networks in Australia were invited through emails and social media posts to complete an anonymous online survey during the second wave of the COVID-19 pandemic in Victoria, Australia. RESULTS: Sixty-five community pharmacists completed the online survey. The respondents reported fair levels of general wellbeing during the COVID-19 pandemic, with a mean self-related health score of 33.57 (s.d.=13.19) out of a maximal of 96, despite relatively high levels of job stress and emotional labour. Lower levels of general wellbeing were correlated with higher levels of job stress (r =0.645, P <0.01) and emotional labour (r =0.513, P <0.01), and lower levels of occupational self-efficacy (r =-0.566, P <0.01). Leader member exchange was negatively correlated with job stress (r =-0.419, P <0.01) and positively correlated with psychological safety (r =0.693, P <0.01). The linear regression models showed that female pharmacists had lower occupational self-efficacy (ß =-0.286, P =0.024), but higher psychological safety (ß =0.234, P =0.042). Higher work ability was associated with lower job stress (ß =-0.529, P <0.001), higher occupational self-efficacy (ß =0.511, P =0.001), and poorer self-related health (ß =-0.659, P <0.001). CONCLUSIONS: The findings highlight the importance of a supportive work environment in helping community pharmacists to feel psychologically safe and reduce stress during a crisis.


Subject(s)
COVID-19 , Community Pharmacy Services , Occupational Stress , Humans , Female , Pharmacists/psychology , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Victoria
18.
Int J Biol Macromol ; 242(Pt 2): 124958, 2023 Jul 01.
Article in English | MEDLINE | ID: mdl-37217057

ABSTRACT

Lignin in black liquor can be used to manufacture carbon nanomaterials on a large scale. However, the effect of nitrogen doping on the physicochemical properties and photocatalytic performance of carbon quantum dots (NCQDs) remains to be explored. In this study, NCQDs with different properties were prepared hydrothermally by using kraft lignin as the raw material and EDA as a nitrogen dopant. The amount of EDA added affects the carbonization reaction and surface state of NCQDs. Raman spectroscopy showed that the surface defects increased from 0.74 to 0.84. Photoluminescence spectroscopy (PL) showed that NCQDs had different intensities of fluorescence emission at 300-420 nm and 600-900 nm. Meanwhile, NCQDs can photo-catalytically degrade 96 % of MB under simulated sunlight irradiation within 300 min. After three months of storage, the fluorescence intensity of NCQDs remained above 94 %, showing remarkable fluorescence stability. After four times of recycling, the photo-degradation rate of NCQDs was maintained above 90 %, confirming its outstanding stability. As a result, a clear understanding of the design of carbon-based photo-catalyst fabricated from the waste of the paper-making industry has been gained.


Subject(s)
Nitrogen , Quantum Dots , Nitrogen/chemistry , Carbon/chemistry , Lignin/chemistry , Methylene Blue , Quantum Dots/chemistry
19.
Aust Health Rev ; 36(3): 284-9, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22935119

ABSTRACT

OBJECTIVE: The objective of this paper is to present and provide justification for a framework to improve evidence-informed management decision-making among health service managers. Three research questions informed the study: How have different perspectives influenced how evidence has been defined? What are the barriers to the practice of evidence-informed decision-making (EIDM)? What are the factors that may encourage the application of evidence to guide management decision-making processes? METHODS: A literature review was conducted to identify studies that examined the practice of EIDM among health service managers. Information relevant to the three research questions was collectively analysed, compared and contrasted based on their relevance to the EIDM process. CONCLUSION: Several factors have played different but significant roles in affecting the practice of EIDM among health service managers. Although interaction between these factors is complex, the framework developed in this paper may guide the development of strategies to encourage and improve the utilisation of evidence in management decision-making process.


Subject(s)
Decision Making, Organizational , Evidence-Based Medicine , Health Facility Administrators , Quality Improvement/organization & administration , Australia , Humans , National Health Programs , Risk Management
20.
Article in English | MEDLINE | ID: mdl-36360722

ABSTRACT

BACKGROUND: The COVID-19 pandemic has sped up digital health transformation across the health sectors to enable innovative health service delivery. Such transformation relies on competent managers with the capacity to lead and manage. However, the health system has not adopted a holistic approach in addressing the health management workforce development needs, with many hurdles to overcome. The objectives of this paper are to present the findings of a three-step approach in understanding the current hurdles in developing a health management workforce that can enable and maximize the benefits of digital health transformation, and to explore ways of overcoming such hurdles. METHODS: A three-step, systematic approach was undertaken, including an Australian digital health policy documentary analysis, an Australian health service management postgraduate program analysis, and a scoping review of international literatures. RESULTS: The main findings of the three-step approach confirmed the strategies required in developing a digitally enabled health management workforce and efforts in enabling managers in leading and managing in the digital health space. CONCLUSIONS: With the ever-changing landscape of digital health, leading and managing in times of system transformation requires a holistic approach to develop the necessary health management workforce capabilities and system-wide capacity. The proposed framework, for overall health management workforce development in the digital health era, suggests that national collaboration is necessary to articulate a more coordinated, consistent, and coherent set of policy guidelines and the system, policy, educational, and professional organizational enablers that drive a digital health focused approach across all the healthcare sectors, in a coordinated and contextual manner.


Subject(s)
COVID-19 , Pandemics , Humans , Australia , COVID-19/epidemiology , Delivery of Health Care , Health Workforce
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