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1.
Stud Health Technol Inform ; 264: 1999-2000, 2019 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-31438448

RESUMEN

Teaching soft skills for change management in healthcare organizations is becoming increasingly necessary, even more, when implementing health information systems (HIS). There is little evidence that these skills can be learned through online teaching environments. This paper describes the experience of having taught soft skills to health informatics master's degree students, through blended learning environments.


Asunto(s)
Gestión del Cambio , Informática Médica , Humanos , Aprendizaje , Estudiantes
2.
J Med Radiat Sci ; 66(3): 212-217, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31317665

RESUMEN

One of the largest change operations to take place in South Australia was the moving of the Royal Adelaide Hospital (RAH) to its new site in 2017. Change can influence workplace effectiveness and staff satisfaction and morale. Understanding the stages of change, staff experience and carefully managing the process is important. This paper aims to describe the successful move of the radiation therapy department at the RAH to its new site, focusing on the staff experience and management strategies to ensure the success of the move. A four-stage model of change was used to guide understand, manage and reflect upon the transition of the RAH radiation therapy department to a new site. Key change events and management strategies are described and aligned with the four stages of change. The move to the new site was a great success with a transition period working across two sites enabling a slower ramp up of activity at the new site supporting staff and patients in adjusting to the new environment. The four-stage model of change assisted in the smooth implementation of a transition plan for radiation oncology. At the RAH, innovation and development are encouraged, along with management having a comprehensive understanding of organisational change enabling the radiation oncology department to successfully navigate rapid change.


Asunto(s)
Gestión del Cambio , Servicio de Oncología en Hospital/organización & administración , Oncólogos de Radiación/organización & administración , Servicio de Radiología en Hospital/organización & administración , Servicio de Oncología en Hospital/normas , Oncólogos de Radiación/normas , Servicio de Radiología en Hospital/normas , Australia del Sur
3.
Fam Syst Health ; 37(2): 173-175, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31180709

RESUMEN

In addition to providing critical behavioral health services for those with mental health issues and substance use disorders, some Community Mental Health Centers (CMHCs) in the United States have begun integrating primary care services, referred to as "reverse integration". Representing the interests of CMHCs across the United States, the National Council for Behavioral Health (NCBH) represents over 3,000 member organizations delivering mental health and/or addictions treatment and services to roughly 10 million patients and families. This article reflects a recent wide-ranging conversation with Linda Rosenberg, the president and CEO of NCBH. Trained as a social worker, Rosenberg was senior deputy commissioner of the New York State Office of Mental Health prior to joining the NCBH and is a dynamic and high-energy strategist and thought leader in the field of community mental health and integrated care. We discussed issues impacting payment for integrated care, including private equity investment, capitated payment, and the role of risk, and how these market dynamics impact vulnerable populations. For the sake of brevity, we summarize our conversation with Ms. Rosenberg and offer her perspective to integrated care practitioners and researchers who largely operate outside of this world of business built on calculated risks and rewards. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Gestión del Cambio , Centros Comunitarios de Salud Mental/tendencias , Prestación Integrada de Atención de Salud/tendencias , Centros Comunitarios de Salud Mental/organización & administración , Prestación Integrada de Atención de Salud/métodos , Prestación Integrada de Atención de Salud/organización & administración , Femenino , Humanos , Liderazgo , Trastornos Mentales/psicología , Trastornos Mentales/terapia , New York , Atención Primaria de Salud/métodos , Atención Primaria de Salud/tendencias , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/terapia , Estados Unidos
4.
Lakartidningen ; 1162019 Feb 26.
Artículo en Sueco | MEDLINE | ID: mdl-31192417

RESUMEN

This article provides insight from the Sustainable Development Unit, a top down policy, monitoring and delivery unit to support a large complex health system, the National Health Service, to embed sustainable development. The dedicated unit nurtured and supported bottom up action through top down change, it translated legal requirements, embedded good governance and engaged with stakeholders.By identifying a specific and manageable topic area the unit created an entry point to broader change and enabled action, in this case the unit started with carbon footprinting and reduction. Engagement of stakeholders was a mandate for strong governance and provided feedback of successes and future challenges. Progress was monitored through carbon reduction (18.5% over ten years), with over £1.8bn energy related savings, board approved Sustainable Development Measurement Plans (71% of trusts), and public annual sustainability reporting (85% of Clinical Commissioning Groups and trusts).


Asunto(s)
Prestación de Atención de Salud , Desarrollo Sostenible , Dióxido de Carbono/análisis , Huella de Carbono , Gestión del Cambio , Inglaterra , Gases de Efecto Invernadero/análisis , Humanos
6.
Int J Radiat Oncol Biol Phys ; 104(5): 999-1008, 2019 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-31108141

RESUMEN

PURPOSE: Women remain underrepresented at all levels within the field of radiation oncology. We sought to study current female residents' experiences and concerns to inform interventions to promote gender equity. Furthermore, we evaluated interest in a professional society specifically for women radiation oncologists. METHODS AND MATERIALS: An anonymous 76-item survey was designed and distributed to current women residents in radiation oncology in 2017-2018. Analyses describe personal, program, and family characteristics and experiences before and after joining the field. RESULTS: Of 170 female residents surveyed, 125 responded (74% response rate). Over one-quarter were in programs with ≤2 female residents (29%) and ≤2 female attendings (29%). One-third (34%) reported having children. Over half (51%) reported that lack of mentorship affected career ambitions. Over half (52%) agreed that gender-specific bias existed in their programs, and over a quarter (27%) reported they had experienced unwanted sexual comments, attention, or advances by a superior or colleague. Only 5% reported no symptoms of burnout. Almost all (95%) agreed that radiation oncology is perceived as family friendly; however, only 52% agreed that it actually is. An overwhelming majority (90%) expressed interest in joining a professional group for women in radiation oncology. CONCLUSIONS: In the first study to our knowledge to focus specifically on the experiences of women residents in radiation oncology, a number of areas for potential improvement were highlighted, including isolation and underrepresentation, mentorship needs, bias and harassment, and gender-based obstacles such as need for support during pregnancy and motherhood. These findings support the organization of groups such as the Society for Women in Radiation Oncology, which seeks to target these needs to promote gender equity.


Asunto(s)
Gestión del Cambio , Internado y Residencia/organización & administración , Mentores/estadística & datos numéricos , Oncología por Radiación/organización & administración , Sexismo , Agotamiento Profesional/epidemiología , Movilidad Laboral , Femenino , Humanos , Internado y Residencia/estadística & datos numéricos , Embarazo , Oncología por Radiación/estadística & datos numéricos , Grupos de Autoayuda , Sexismo/estadística & datos numéricos , Acoso Sexual/estadística & datos numéricos , Apoyo Social , Encuestas y Cuestionarios/estadística & datos numéricos
7.
Artículo en Inglés | MEDLINE | ID: mdl-31108843

RESUMEN

Due to the current digital transition, companies are under pressure to pursue digitalization and often initiate far-reaching transformation processes. As a result, managers must drive change within a company and are involved in important decision-making processes. In the present study, we focused on two cognitive job demands in managers related to change due to digital transformation: perceived choice overload and pressure from digitalization. We assumed that the extent of challenging cognitive demands at work is rising and negatively influencing managers' psychological well-being. We conducted an online survey with a sample of 368 upper-level managers from a large ICT-company, where, at the time of the study, extensive transformation processes were taking place. Using multivariate regression analysis, potential prognostic effects on well-being were tested. Results showed that lower well-being was significantly associated with higher choice overload, but not with perceived pressure from digitalization. In our explorative study, we investigated two potential job demands in managers that, to our knowledge, have not yet been scientifically tested. Given the unsettled state of the field, it is important to try to further understand when choice overload and pressure from digitalization occur and when these may trigger negative health consequences.


Asunto(s)
Gestión del Cambio , Conducta de Elección , Liderazgo , Estrés Psicológico , Adulto , Recolección de Datos , Femenino , Humanos , Masculino , Análisis Multivariante , Encuestas y Cuestionarios
8.
Creat Nurs ; 25(2): 154-156, 2019 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-31085670

RESUMEN

Resistance to change is a prevalent issue in nursing, with ongoing interventions needed to increase awareness and to support nurses on the journey to becoming change agents. The purpose of this article is to illustrate the foundations of change learned during nursing school, and their applicability as nursing students transition to the professional nurse role. Additional focus explores the vital role experienced nurses play in mitigating resistance to change, and strategies to support fellow nurses in adapting to change.


Asunto(s)
Adaptación Psicológica , Satisfacción en el Trabajo , Rol de la Enfermera/psicología , Personal de Enfermería en Hospital/psicología , Resiliencia Psicológica , Estudiantes de Enfermería/psicología , Lugar de Trabajo/psicología , Adulto , Actitud del Personal de Salud , Gestión del Cambio , Femenino , Humanos , Relaciones Interprofesionales , Masculino , Persona de Mediana Edad , Adulto Joven
10.
Nurs Leadersh (Tor Ont) ; 32(SP): 8-15, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31099743

RESUMEN

In the fully digital practice realm, a new relationship has emerged between nurses, patients and technology. Nursing leadership in this unique practice setting requires new and enhanced skills, knowledge and abilities. Maintaining the principles of patient and family centredness, attentiveness to nurses' concerns regarding workflows and involvement of nurses in the design of technologies is critical for creating a safe, professional practice environment in the fully digital hospital. Technology cannot replace the humanness of caring. Mindfulness of the digital impact on the therapeutic relationship is necessary. Competency in technology is the new proficiency that nursing leaders will need to acquire.


Asunto(s)
Liderazgo , Enfermeras Administradoras/tendencias , Gestión del Cambio , Alfabetización Digital/tendencias , Humanos , Invenciones
12.
J Foot Ankle Res ; 12: 23, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31015864

RESUMEN

Background: The delivery of healthcare is changing and aligned with this, the podiatry profession continues to change with evidence informed practice and extending roles. As change is now a constant, this gives clinicians the opportunity to take ownership to drive that change forward. In some cases, practitioners and their teams have done so, where others have been reluctant to embrace change. It is not clear to what extent good practice is being shared, whether interventions to bring about change have been successful, or what barriers exist that have prevented change from occurring. The aim of this article is to explore the barriers to changing professional practice and what lessons podiatry can learn from other health care professions. Main body: A literature search was carried out which informed a narrative review of the findings. Eligible papers had to (1) examine the barriers to change strategies, (2) explore knowledge, attitudes and roles during change interventions, (3) explore how the patients/service users contribute to the change process (4) include studies from predominantly primary care in developed countries.Ninety-two papers were included in the final review. Four papers included change interventions involving podiatrists. The barriers influencing change were synthesised into three themes (1) the organisational context, (2) the awareness, knowledge and attitudes of the professional, (3) the patient as a service user and consumer. Conclusions: Minimal evidence exists about the barriers to changing professional practice in podiatry. However, there is substantial literature on barriers and implementation strategies aimed at changing professional practices in other health professions. Change in practice is often resisted at an organisational, professional or service user level. The limited literature about change in podiatry, a rapidly changing healthcare workforce and the wide range of contexts that podiatrists work, highlights the need to improve the ways in which podiatrists can share successful attempts to change practice.


Asunto(s)
Innovación Organizacional , Podiatría/tendencias , Práctica Profesional/tendencias , Actitud del Personal de Salud , Gestión del Cambio , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/tendencias , Humanos , Reino Unido
13.
J Contin Educ Nurs ; 50(4): 148-149, 2019 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-30942888

RESUMEN

The McKinsey consulting group reports data that 70% of all change management efforts fail. A 30% success rate is troubling, particularly when considering the associated costs in the form of loss of competitive position, confidence of the workforce in leadership, and quality improvements and anticipated costs reductions. The ADKAR Model offers a contemporary set of tools to more effectively address change. [J Contin Educ Nurs. 2019;50(4):148-149.].


Asunto(s)
Gestión del Cambio , Liderazgo , Enfermeras Administradoras , Humanos , Modelos Organizacionales , Innovación Organizacional
14.
Health Care Manag (Frederick) ; 38(2): 156-165, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30932927

RESUMEN

Shared vision has been used by the nursing community for over 20 years, but this concept and its language are not presented consistently. At its most basic level, shared vision consists of identifying what a group wants to create. The main objective of this study is to provide a concept analysis of shared vision from an evolutionary nursing perspective within health care organizations. Forty-eight nursing journal articles from 1989 to 2016 were included in the analysis. The concept is presented within the nursing literature as a process or an outcome relying on top-down or bottom-up approaches to defining the future of care. Nurses are central and active in visioning while patients and families are passive recipients. Leaders have an important role to play in shared vision.


Asunto(s)
Gestión del Cambio , Prestación de Atención de Salud/métodos , Liderazgo , Enfermería/organización & administración , Humanos , Rol de la Enfermera
15.
Int J Health Policy Manag ; 8(2): 101-111, 2019 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-30980623

RESUMEN

BACKGROUND: This paper presents findings from a study which sought to understand why health workers working under the results-based financing (RBF) arrangements in Zimbabwe reported being satisfied with the improvements in working conditions and compensation, but paradoxically reported lower motivation levels compared to those not working under RBF arrangements. METHODS: A qualitative study was conducted amongst health workers and managers working in health facilities that were implementing the RBF arrangements and those that were not. Through purposeful sampling, 4 facilities in RBF implementing districts that reported poor motivation and satisfaction, were included as study sites. Four facilities located in non-RBF districts which reported high motivation and satisfaction were also included. Data was collected through in-depth interviews and analyzed using the framework approach. RESULTS: Results based financing arrangements introduce a wide range of new institutional arrangements, roles, tasks, and ways of doing things, for facility staff, facility managers and, district and provincial health management teams. Findings reveal that insufficient preparedness of people and processes for this change, constrained managers and workers performance. Results based financing arrangements introduce explicit and tacit changes, including but not limited to, incentive logics, in the system. Findings show that unless systematic efforts are made to enable the absorption of these changes in the system: eg, through reconfiguring the decision space available at various levels, through clarification of accountability relationships, through building personnel and process capacities, before instituting changes, the full potential of the RBF arrangements cannot be realised. CONCLUSION: Our study demonstrates the importance of analysing existing institutional, management and governance arrangements and capabilities and taking these into account when designing and implementing RBF interventions. Introducing RBF arrangements cannot alone overcome chronic systemic weaknesses. For a system wide change, as RBF arguably is, to be effected, explicit organisational change management processes need to be put in place, across the system. Carefully designed processes, which take into account the interest and willingness of various actors to change, and which are cognizant of and constructively engage with potential bottlenecks and points of resistance, should accompany any health system change initiative.


Asunto(s)
Actitud del Personal de Salud , Programas de Gobierno , Satisfacción en el Trabajo , Motivación , Calidad de la Atención de Salud , Reembolso de Incentivo , Salarios y Beneficios , Creación de Capacidad , Gestión del Cambio , Toma de Decisiones , Femenino , Reforma de la Atención de Salud , Instituciones de Salud , Personal de Salud , Financiación de la Atención de la Salud , Humanos , Liderazgo , Masculino , Investigación Cualitativa , Responsabilidad Social , Encuestas y Cuestionarios , Zimbabwe
16.
J Nurs Care Qual ; 34(4): 370-375, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30889080

RESUMEN

BACKGROUND: As the level of acuity of pediatric hospital admissions continues to increase, additional pressure is being placed on hospital resources and the nursing workforce. LOCAL PROBLEM: Currently, there is no formalized approach to care for high-acuity patients on our pediatric inpatient unit. METHODS: We used a qualitative descriptive design, guided by the Theoretical Domains Framework and Capability, Opportunity, Motivation-Behaviour (COM-B) model, to conduct focus groups and interviews with clinicians and administrators to identify potential barriers and enablers to implementing a high-dependency care (HDC) model. An HDC model focuses on the relationship between adequate nursing staff resources and patient acuity to improve patient health outcomes. RESULTS: Participants identified the need for clear guidelines and supportive physical structures to facilitate HDC implementation. Anticipated benefits included enhanced nursing confidence and family-centered care. CONCLUSIONS: Study findings highlight multilevel factors to consider prior to implementing an HDC model on a pediatric inpatient unit.


Asunto(s)
Gestión del Cambio , Hospitales Pediátricos , Ciencia de la Implementación , Atención Dirigida al Paciente/normas , Enfermería Pediátrica/normas , Índice de Severidad de la Enfermedad , Niño , Grupos Focales , Humanos , Pacientes Internos , Entrevistas como Asunto , Modelos de Enfermería , Motivación , Investigación Cualitativa
18.
Mil Med ; 184(1-2): 1-2, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30805616
19.
Med Humanit ; 45(3): 247-257, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29954854

RESUMEN

Healthcare systems redesign and service improvement approaches are adopting participatory tools, techniques and mindsets. Participatory methods increasingly used in healthcare improvement coalesce around the concept of coproduction, and related practices of cocreation, codesign and coinnovation. These participatory methods have become the new Zeitgeist-the spirit of our times in quality improvement. The rationale for this new spirit of participation relates to voice and engagement (those with lived experience should be engaged in processes of development, redesign and improvements), empowerment (engagement in codesign and coproduction has positive individual and societal benefits) and advancement (quality of life and other health outcomes and experiences of services for everyone involved should improve as a result). This paper introduces Mental Health Experience Co-design (MH ECO), a peer designed and led adapted form of Experience-based Co-design (EBCD) developed in Australia. MH ECO is said to facilitate empowerment, foster trust, develop autonomy, self-determination and choice for people living with mental illnesses and their carers, including staff at mental health services. Little information exists about the underlying mechanisms of change; the entities, processes and structures that underpin MH ECO and similar EBCD studies. To address this, we identified eight possible mechanisms from an assessment of the activities and outcomes of MH ECO and a review of existing published evaluations. The eight mechanisms, recognition, dialogue, cooperation, accountability, mobilisation, enactment, creativity and attainment, are discussed within an 'explanatory theoretical model of change' that details these and ideal relational transitions that might be observed or not with MH ECO or other EBCD studies. We critically appraise the sociocultural and political movement in coproduction and draw on interdisciplinary theories from the humanities-narrative theory, dialogical ethics, cooperative and empowerment theory. The model advances theoretical thinking in coproduction beyond motivations and towards identifying underlying processes and entities that might impact on process and outcome. TRIAL REGISTRATION NUMBER: The Australian and New Zealand Clinical Trials Registry, ACTRN12614000457640 (results).


Asunto(s)
Gestión del Cambio , Prestación de Atención de Salud/normas , Servicios de Salud Mental/normas , Modelos Teóricos , Mejoramiento de la Calidad , Australia , Humanos , Participación de los Interesados
20.
J Nurs Manag ; 27(1): 4-9, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30015392

RESUMEN

AIM: To offer a new conceptual framework for formalizing nurses' work in managing emergent organisation in health and social care. BACKGROUND: Much health and social care requires continuous oversight and adjustments in response to contingencies. Nurses have an important role in managing these relationships. EVALUATION: A longstanding programme of research on the social organisation of health and social care work provided the foundations for the article. KEY ISSUE: Nurses' work in managing emergent organisation may be conceptualized as care trajectory management and factors contributing to trajectory complexity are explored. CONCLUSIONS: Care trajectory management is essential for the quality and safety of health and social care but poorly served by existing management frameworks. IMPLICATIONS FOR NURSING MANAGEMENT: Care trajectory management offers a conceptual framework for the development of new management structures to support an important but poorly supported element of nursing practice.


Asunto(s)
Gestión del Cambio , Enfermeras Administradoras/tendencias , Humanos
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