Transformational nurse leadership attributes in German hospitals pursuing organization-wide change via Magnet® or Pathway® principles: results from a qualitative study.

BACKGROUND: Budget constraints, staff shortages and high workloads pose challenges for German hospitals. Magnet® and Pathway® are concepts for implementing organization-wide change and redesigning work environments. There is limited research on the key elements that characterize nurse leaders driving the implementation of Magnet®/Pathway® principles outside the U.S. We explored the key attributes of nurse leaders driving organization-wide change through Magnet®/Pathway® principles in German hospitals. METHODS: Using a qualitative study design, semi-structured interviews (n = 18) were conducted with nurse leaders, managers, and clinicians, in five German hospitals known as having started implementing Magnet® or Pathway® principles. The interviews were recorded and transcribed verbatim. Data were analyzed in Atlas.ti using content analysis. For the analysis, a category system was created using a deductive-inductive approach. RESULTS: Five leadership attributes and eleven sub-attributes were identified as main themes and sub-themes: Visionary leaders who possess and communicate a strong vision and serve as role models to inspire change. Strategic leaders who focus on strategic planning and securing top management support. Supportive leaders who empower, emphasizing employee motivation, individualized support, and team collaboration. Stamina highlights courage, assertiveness, and resilience in the face of challenges. Finally, agility which addresses a leader's presence, accessibility, and rapid responsiveness, fostering adaptability. CONCLUSIONS: The study demonstrates leadership attributes explicitly focusing on instigating and driving organization-wide change through Magnet®/Pathway® principles in five German hospitals. The findings suggest a need for comprehensive preparation and ongoing development of nurse leaders aimed at establishing and sustaining a positive hospital work environment.

Reforms and innovations in primary health care in different countries: scoping review.

INTRODUCTION: The World Health Organization (WHO) recommends focusing on primary health care (PHC) as the first strategy of countries to achieve the improvement of the health level of communities and has emphasized it again in 2021. Therefore, we intend to take a different look at the PHC system with reform, innovation, and initiative by using the experiences of leading countries and identify practical and evidence-based solutions to achieve greater health. METHODS: This is a scoping review study that has identified innovations and reforms related to PHC since the beginning of 2000 to the end of 2022. In this study, Scopus, Web Of Science, and PubMed databases have been searched using appropriate keywords. This study is done in six steps using Arkesy and O'Malley framework. In this study, the framework of six building blocks of WHO was used to summarize and report the findings. RESULTS: By searching in different databases, we identified 39426 studies related to reforms in primary care, and after the screening process, 106 studies were analyzed. Our findings were classified and reported into 9 categories (aims, stewardship/leadership, financing & payment, service delivery, health workforce, information, outcomes, policies/considerations, and limitations). CONCLUSION: The necessity and importance of strengthening PHC is obvious to everyone due to its great consequences, which requires a lot of will, effort, and coordination at the macro-level of the country, various organizations, and health teams, as well as the participation of people and society.

Activation and valence in responses to organizational change: Development and validation of the change response circumplex scale.

Organizational members' responses to organizational change have a key role in determining the success of the change. The predominant conceptualization of responses to change has focused on the valence of responses-the degree to which they are positive (e.g., openness to change) versus negative (e.g., resistance to change). Yet, recent theory suggests that rather than a single continuum, ranging from negative to positive, responses to change are better represented with a bidimensional framework including both a valence-based continuum and an activation-based continuum (active vs. passive; Oreg et al., 2018), comprising a change response circumplex. Based on this theoretical framework, we develop and validate a scale for measuring the four dimensions of the change response circumplex (i.e., change acceptance, change proactivity, change disengagement, change resistance). We conducted five studies in which we develop the scale and demonstrate its content validity (Study 1, N = 208), circumplex structure and construct validity (Study 2, N = 221; Study 3, N = 315), concurrent validity (Study 4, N = 588), and predictive validity (Study 5, N = 146). We also demonstrate the usefulness of distinguishing among the four responses for predicting the amount and types of feedback that change recipients provide, and show the particular value of active responses, above and beyond valence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"We don't experiment with our patients!" An ethnographic account of the epistemic politics of (re)designing nursing work.

This article draws on ethnographic research investigating experimental reform projects in local nursing practices. These are aimed at strengthening nursing work and fostering nurses' position within healthcare through bottom-up nurse-driven innovations. Based on literature on epistemic politics and critical nursing studies, the study examines and conceptualizes how these nurses promote professional and organizational change. The research draws on data from two pilot projects to show how epistemic politics frame the production and use of knowledge within reform efforts. The study finds that knowledge produced through such experimenting is often not considered valid within the contexts of broader organizational transitions. The nurse-driven innovations fail to meet established legitimate criteria for informing change, both among stakeholders in the nurses' socio-political environment, as well as within the nursing community. The research reveals that the processes inadvertently reinforce normative knowledge hierarchies, perpetuating forms of epistemic injustice, limiting both nurses' ability to function as change agents and healthcare organizations' capacity to learn.

Regional health innovation strategy for the Western Pacific

The Regional Health Innovation Strategy for the Western Pacific outlines a vision and recommends key actions for governments to leverage health innovations to solve problems, accelerate impact, and shape the future of health and well-being. The implementation of the strategy should be guided by a mission-oriented approach, leverage collective intelligence and actions, focus on learning from the innovation process, and aim for a purposeful impact. In doing so, governments are encouraged to assume leadership in health innovation, create enabling ecosystems for innovation, and foster spaces for learning.

Does green innovation facilitate firms' access to trade credit?

Employing a large sample of Chinese firms, this study examined the influence of corporate green innovation on firms' access to trade credit. The results indicated a positive association between green innovation and firms' capability to access trade credit, suggesting that suppliers value firms' green innovation capabilities. This relationship was strengthened after the implementation of the new Environmental Protection Law (EPL) in 2015, which enhanced the value of green innovation. The findings remained robust to several robustness tests. The results suggest that green innovation helps firms access trade credit through better environmental, social, and governance (ESG) scores and more state subsidy channels and plays a more pronounced role for financially constrained firms, non-state-owned enterprises, firms with lower bargaining power, and firms located in regions with better intellectual property rights protections. Green innovation is valuable for future corporate growth and shareholder value. Overall, this study reveals the value of green innovation through informal corporate financing.

Using Agile Science for Rapid Innovation and Implementation of a New Care Model.

As industry consolidation leads to a growing number of large new healthcare delivery networks, patients and their clinicians are losing the important human-centric and relationship-based nature of medical care. The leadership of Hackensack Meridian Health (HMH), a New Jersey-based network of hospitals, research center, and medical school, made an organizational commitment to reverse such loss and restore the social nature of medicine. To attain that goal, HMH engaged both clinicians and administrators to confirm the demand for change, foster a collaborative culture design, and address the unique nature of the individual components in the HMH network. Efforts to transform the HMH care delivery model illustrate the effectiveness of Agile science and its problem-solving methods.

Financial subsidies, tax incentives, and new energy vehicle enterprises' innovation efficiency: Evidence from Chinese listed enterprises.

Financial subsidies and tax incentives play essential roles in the innovation efficiency of enterprises. This paper selects Chinese listed NEV enterprises from 2010 to 2022 as a research sample and investigates various impacts under various circumstances. We find that both financial subsidies and tax incentives can promote the innovation efficiency of NEV enterprises. Compared to financial subsidies, tax incentives are more effective; the interaction between financial subsidies and tax incentives has a weaker impact on the innovation efficiency of NEV enterprises. Both financial subsidies and tax incentives have more potent innovation effects on enterprises with higher financing constraints. In addition, financial subsidies and tax incentives have a stronger innovation efficiency effect on private enterprises than state-owned enterprises. Further research shows that marketization and market distortion affect the innovation efficiency of NEV enterprises. This study provides a new perspective for understanding the effects of financial subsidies, tax incentives, and innovation efficiency of NEV enterprises, and the conclusions and suggestions are relevant references for the government to improve the quality of policy-making.

An Exploration of Organizational Characteristics and Training Adoption in Irish Community Drug Treatment Services.

BACKGROUND: Changes in patterns of drug use and population needs necessitate the adoption of new technologies. Despite high failure rates in adopting new technologies acquired in training, little is known about the process that can support successful change. This study explores the impact that staff and service characteristics have on the process of training adoption in Irish opiate substitution therapy services, with a specific focus on the concept of organizational readiness to change. METHODS: A cross-sectional survey was conducted on a convenience sample of 132 staff members across 12 services in Ireland. The relationship between staff demographics, their perceptions of organizational readiness to change, burnout, and a four-stage process of training adoption were considered. RESULTS: Discipline, job tenure, and educational levels are important predictors of engagement in the adoption process. Staff in services with higher institutional needs, greater pressures for change, and poorer resources were less likely to be exposed to, or adopt, training. Having lower levels of stress and more influence with peers was associated with better adoption of training. CONCLUSIONS: Planners and service managers need to carefully consider the composition or dynamics of services when initiating change. Organizational readiness to change and staff characteristics as measured by instruments used in this study are important determinants of the process of innovation or training adoption and provide a good basis for developing further understanding of how treatment services work. This article expands on results from previous studies conducted in the United States to a European context.

Predicting Therapists' Intentions to Use Innovations: Comparing the Role of Individual, Organizational, and Innovation Characteristics.

Theories emphasize the role of individual and organizational characteristics in implementation outcomes, yet research indicates that these characteristics account for only a small amount of variance in those outcomes. Innovation characteristics might be important proximal determinants of implementation outcomes but are infrequently examined in mental health services research. This study examined the relative variance explained by individual, organizational, and innovation characteristics on behavioral intentions, a central implementation outcome in implementation theories. Data were collected from 95 therapists and 28 supervisors who participated in a cluster randomized trial that tested the effectiveness of two clinical decision-making innovations. Multilevel models compared individual, organizational, and innovation characteristics as predictors of therapists' intentions to use the innovations. Subsequent mediational path analyses tested whether innovation characteristics mediated the effect of innovation type on intentions. Individual and organizational characteristics explained 29% of the variability in therapists' intentions. Approximately 75% of the variability in therapists' intentions was accounted for by innovation characteristics. Individual and organizational characteristics were not statistically significant predictors of intentions after controlling for innovation characteristics. The indirect effect of innovation type on intentions through therapists' beliefs was statistically significant (B = 0.410, 95% Bootstrapped CI = [0.071, 0.780]), but the direct effect of innovation type was not (B = 0.174, p = .365). Innovation characteristics are related to therapist intentions and might explain why some innovations are received more favorably than others. Future studies should explore the complex interrelationships between these beliefs alongside other individual or organizational characteristics.

Green innovation and political embeddedness in China's heavily polluted industry: role of environmental disclosure, gender diversity, and enterprise growth.

Innovation in green technology is an efficient approach to reducing carbon emissions and achieving energy conservation, which is essential for fostering sustainable and green economic development. Even though the development of eco-friendly technologies is accelerating, the grasp of how political ties affect firms' adoption of green technologies remains hazy. This paper examines the effect of a firm's total political embeddedness (government ownership and political connections) along with the influencing mechanisms by employing a panel fixed effect regression approach on a dataset of Chinese A-share enterprises operating in pollution-intensive industries spanning 2012 to 2021. The findings offer conclusive evidence that political embeddedness encourages the enterprises' development of green technologies and boosts their output of innovation. In addition, mechanism analysis reveals that companies' political embedding influences their green innovation behavior through environmental disclosure. Moreover, board gender diversity and company growth rate are found to reinforce the impact of political embeddedness on green innovation. Besides expanding the current research on green innovation and corporate political involvement, the findings also provide important policy recommendations for the sustainable development of companies in emerging markets.

Unpacking Contexting and Institutionalizing as Complex Sustaining Practices Comment on "Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis".

This article discusses the work of Borst et al in which they suggest 'sustaining work' as a term that covers the efforts of actors to sustain the use of health research in policy and practice through three practices. I suggest that two of these, contexting and institutionalizing, need to be further unpacked to understand how and why they are important for sustaining work in knowledge translation (KT). To contribute here, I discuss KT as processes of organizational change that occurs within and across organizations, often involving actors with different views on and approaches to the use of health research in policy and practice. These actors will likely have very different understandings of what the context for using research is and they are likely be members of competing or conflicting institutions. Future research needs to take such elements into account to improve our understanding and practice of sustaining work.