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2.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1047812

RESUMO

Objetivo: analisar a percepção da equipe de enfermagem sobre a função do gerente de enfermagem hospitalar, e como essa interfere na qualidade da assistência prestada pela equipe. Método: pesquisa descritiva e exploratória, de abordagem qualitativa dos dados, realizado com 20 profissionais de Enfermagem. Para análise dos resultados, utilizou-se o método do Discurso do Sujeito Coletivo. Resultados: o pensamento coletivo foi agrupado em 04 classes: A função burocrática associada a gerência e as relações gerente-equipe de enfermagem; Competências percebidas pela equipe de enfermagem para o trabalho do gerente de Enfermagem; Desafios na função do gerente de enfermagem percebidos pela equipe de enfermagem; A influência do gerente de enfermagem na qualidade e na assistência prestada ao cliente. Conclusão: a atividade do gerente de enfermagem é extremamente burocrática, e vista pela equipe de Enfermagem como hierarquizada, contribuindo para distanciar o gerente do convívio com a equipe


Objective: to analyze the perception of the nursing team about the role of the hospital nursing manager, and how this interferes with the quality of care provided by the team. Methods: descriptive and exploratory research, qualitative approach of the data, performed with 20 Nursing professionals. For the analysis of the results, the Collective Subject Discourse method was used. Results: collective thinking was grouped in 04 classes: The bureaucratic function associated with management and the manager-nursing team relations; Skills perceived by the nursing team for the work of the Nursing manager; Challenges in the nursing manager's role perceived by the nursing team; The influence of the nursing manager on the quality and the assistance provided to the client. Conclusion: the activity of the nursing manager is extremely bureaucratic, and seen by the Nursing team as hierarchical, contributing to distance the manager from the conviviality with the team. Descriptors: Nursing; Nursing team; Hospital administration


Objetivo: analizar la percepción del equipo de enfermería sobre el papel de gestor de enfermería en el hospital, y cómo esto afecta a la calidad de la atención prestada por el personal. Métodos: estudio descriptivo y exploratorio de abordaje cualitativo, realizado con 20 profesionales de enfermería. Para el análisis de los datos, se utilizó el método del Discurso del Sujeto Colectivo. Resultados: el pensamiento de grupo se agrupan en 04 clases: la función burocrática asociada con la administración y gestión de relaciones con el personal de enfermería; Habilidades percibidas por el equipo de enfermería para el trabajo del administrador de enfermería; Desafíos en la función del gestor de enfermería percibida por el personal de enfermería; La influencia del gerente de enfermería en la calidad y servicio prestado al cliente. Conclusión: la actividad del administrador de enfermería es muy burocrático y visto por el personal de enfermería como jerárquica, ayudando a distanciar al gestor de interacción con el personal. Descriptores: Enfermería; Grupo de enfermería; Administración hospitalaria


Assuntos
Humanos , Administração Hospitalar , Liderança , Equipe de Enfermagem , Brasil
3.
Zhongguo Yi Liao Qi Xie Za Zhi ; 43(6): 462-465, 2019 Nov 30.
Artigo em Chinês | MEDLINE | ID: mdl-31854538

RESUMO

This paper introduced the workflow and use effect of SPD intelligent logistics supply chain management system in medical consumables management, analyzed the problems encountered in the process of hospital introduction of SPD management mode, and used PDCA principle to promote the hospital SPD before and after. using the PDCA principle to SPD before and after the introduction in such aspects as propaganda, information, system, safety management process continuously improve, in order to enhance the level of hospital consumables lean management and provide the reference for the introduction of the management system of hospital.


Assuntos
Administração Hospitalar , Hospitais
4.
Hosp Pract (1995) ; 47(5): 217-220, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31674833

RESUMO

Recent studies have documented the alarming degree of physician stress and burnout that has affected physician attitudes, behaviors, and performance. Growing dissatisfaction, irritability, and frustration has negatively impacted physician ideals and attitudes which can lead to compromised health care relationships with impaired communication, collaboration, and coordination that can adversely affect satisfaction, clinical performance, and patient outcomes of care. For the most part physicians on their own have a difficult time recognizing or admitting that they are working under stress and burnout conditions, and even if they do, are reluctant to do anything about it. In this regard it is essential for the organization(s) in which the physician is involved with to take a pro- active role in providing support services to help physicians address this issue in a more empathetic, effective, and constructive manner.


Assuntos
Esgotamento Profissional , Administração Hospitalar , Médicos/psicologia , Esgotamento Profissional/prevenção & controle , Humanos , Satisfação no Emprego
5.
Artigo em Inglês | MEDLINE | ID: mdl-31540517

RESUMO

China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of attaining sustainable development of the social healthcare system in China is that the number of hospital admissions is disproportionate. Superior hospitals are overcrowded, whereas subordinate hospitals are experiencing low admissions. In this paper, we apply the game theory model to coordinate the healthcare supply chain network, which is composed of the government, medical insurance fund, superior hospitals, subordinate hospitals and patients. Especially by taking the reference price effect into account, this paper analyzes different medical insurance reimbursement strategies and their influence on patient choice and the healthcare supply chain network. The result shows that the reference price effect increases the leverage of medical insurance, guides patients' choice, optimizes the allocation of medical resources and reduces the medical expends. In comparison to a decentralized decision- making strategy, a centralized decision- making strategy can stimulate both superior hospital and subordinate hospital's cooperative intentions which benefits the social healthcare system.


Assuntos
Assistência à Saúde/organização & administração , Órgãos Governamentais/organização & administração , Administração Hospitalar , Programas Nacionais de Saúde/organização & administração , China/epidemiologia , Assistência à Saúde/economia , Teoria do Jogo , Órgãos Governamentais/economia , Humanos , Reembolso de Seguro de Saúde , Programas Nacionais de Saúde/economia , Preferência do Paciente
6.
Klin Padiatr ; 231(6): 313-319, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31525782

RESUMO

BACKGROUND: Pediatrics are often regarded as a "victim" of the German Diagnosis related Groups (G-DRG) system because the economic situation of many pediatric hospitals has deteriorated since the introduction of the G-DRG system in 2004. This is often attributed to an insufficient case mix of pediatric diagnoses. It is unknown if revenues are lost due to an insufficient qualification of coding staff. METHODS: All members of the German Society of Pediatric Hospitals and Departments (GKinD) were invited to an online survey by e-mail. RESULTS: 177 (52%) of the 340 german children's hospitals delivered complete questionnaires. 52% of the hospitals employed codings staff that had no additional clinical duties. Coding staff had no specific professional training and did not undergo specific ongoing education in 47 and 32% of the hospitals, respectively. During absence, 35% of coding staff a no substitute or a non-pediatric substitute. 2,8% of the senior physicians judged the established structures as "bad" or "very bad". DISCUSSION: In many german children's hospitals, diagnoses are documented by coding staff with an insufficient qualification. This is associated with the risk of inaccurate or incomplete coding and can threaten the economic success of the hospital. The senior physicians are satisfied with the established coding structures, thus they might be unaware of the great economic potenzial of improvements of the coding quality. CONCLUSION: The economic situation of german children's hospitals could be significantly improved by recruitment of qualified, full-time coding staff.


Assuntos
Grupos Diagnósticos Relacionados/economia , Grupos Diagnósticos Relacionados/estatística & dados numéricos , Administração Hospitalar/economia , Administração Hospitalar/estatística & dados numéricos , Hospitais Pediátricos , Médicos/economia , Criança , Alemanha , Humanos , Mecanismo de Reembolso , Inquéritos e Questionários
7.
BMC Surg ; 19(1): 112, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412843

RESUMO

BACKGROUND: Many surgeons report passion for their work, but not all tasks are likely to be satisfying. Little is known about how hospital surgeons spend their days, how they like specific tasks, and the role of core tasks (i.e. surgery-related tasks) versus tasks that may keep them from core tasks (e.g., administrative work). This study aimed at a more detailed picture of hospital surgeons' daily work - how much time they spend with different tasks, how they like them, and associations with satisfaction. METHODS: Hospital surgeons (N = 105) responded to a general survey, and 81 of these provided up to five daily questionnaires concerning daily activities and their attractiveness, as well as their job satisfaction. The data were analyzed using t-tests, analysis of variance, as well as analysis of covariance and repeated measures analysis of variance for comparing means across tasks. RESULTS: Among 14 tasks, surgery-related tasks took 21.2%, patient-related tasks 21.7% of the surgeons' time; 10.4% entailed meetings and communicating about patients, and 18.6% documentation and administration. The remaining time was spent with teaching, research, leadership and management, and not task-related activities (e.g. walking between rooms). Surgery was rated as most (4.25; SD = .66), administration as least attractive (2.63; SD = .78). A higher percentage of administration predicted lower perceived legitimacy; perceived legitimacy of administrative work predicted job satisfaction (r = .47). Residents were least satisfied; there were few gender differences. CONCLUSIONS: Surgeons seem to thrive on their core tasks, most notably surgery. By contrast, administrative duties are likely perceived as keeping them from their core medical tasks. Increasing the percentage of medical tasks proper, notably surgery, and reducing administrative duties may contribute to hospital surgeons' job satisfaction.


Assuntos
Satisfação no Emprego , Cirurgiões/psicologia , Adulto , Pesquisa Biomédica , Comunicação , Documentação , Feminino , Administração Hospitalar , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Cirurgiões/organização & administração , Inquéritos e Questionários , Ensino , Carga de Trabalho
8.
BMC Health Serv Res ; 19(1): 554, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391052

RESUMO

BACKGROUND: Historically, governmental hospital organisation consisted in a heterogeneous distribution of staff and a fragmented logistical organisation without cross-functionality or sharing of resources between departments. This organisation could not last in a context of an evolving healthcare environment, changing patient profiles and hospital expenditure constraints. Cost-effective workforce regulation for optimal patient quality of care was urgently needed. The purpose of the study was to describe the reorganization that led to resource management no longer based on what has been achieved but based on a daily measured workload. METHODS: This prospective study used nursing intensity indicator, mirroring patient care needs, which was reported daily using VALPAReSO® software. Indirect care activities were recorded in departments of medicine, surgery and obstetrics. Based on data collected in 2012, a new organisation strategy was implemented and evaluated in 2015. RESULTS: Nursing intensity indicator analysis led to a reallocation of workforce per department, and the reinforcement unit (float pool) was managed based on this decision-aid tool for replacement and daily adequate staffing. The healthcare workflow audit resulted in the revision of five working tasks: time spent on handover, working time management, connections between services and the pharmacy, housekeeping, and food management. The reorganization took place at the same time as the transition to the development of very short-term care, resulting in a decrease in the number of full inpatient beds, which were therefore mainly occupied by heavier care profile patients. With the integrated strategy, this transition was achieved with constant staffing, and good overall patient satisfaction and working conditions were maintained. CONCLUSION: The reorganisation strategy was managed in a context of institutional commitment, coaching leadership built on close manager-employee interaction, a defragmented management between healthcare and all service providers, and a seamlessly dissemination and sharing of indicator information between healthcare managers, nurses and healthcare assistants. The process optimization allowed a better allocation of tasks and enabled nurses to refocus on patient care. Nursing intensity and indirect care indicators, when widely accepted, can be used as decision support tools for daily adequate staffing.


Assuntos
Hospitais , Melhoria de Qualidade/organização & administração , Recursos Humanos/organização & administração , Análise Custo-Benefício , Técnicas de Apoio para a Decisão , Feminino , Administração Hospitalar , Humanos , Gravidez , Estudos Prospectivos
9.
J. bras. econ. saúde (Impr.) ; 11(2): 161-169, Agosto/2019.
Artigo em Português | LILACS, ECOS | ID: biblio-1021180

RESUMO

Objetivo: Verificar se o Memorando de Entendimento sobre Condicionalismos Específicos de Política Económica (MECPE), imposto em Portugal em período de crise pelo Fundo Monetário Internacional, Banco Central Europeu e Comissão Europeia, gerou melhoria nos resultados de eficiência no sector da Saúde. Métodos: Foi realizado um estudo de caso para avaliação dos resultados de eficiência nos departamentos clínicos da Unidade Local de Saúde de Castelo Branco (ULSCB), localizada em uma das áreas economicamente mais desfavorecidas Recorreu-se à técnica da Análise Envoltória de Dados, levando em consideração como insumos os custos e como resultados a produção registada de cada departamento clínico em três períodos de tempo antes (2002-2010), durante (2011-2014) e após a austeridade (2015-2017). Os dados referentes ao custo e produção foram fornecidos pelo Gabinete de Apoio à Gestão e pelo Gabinete de Contabilidade do hospital. Em complemento da análise quantitativa, utilizou-se o método qualitativo de análise do conteúdo das entrevistas semiestruturadas, aos diretores e administradores do hospital, que permitiu avaliar a informação que detém e que é resultado do seu treinamento e sua experiência. Resultados: Durante o período de austeridade e execução do MECPE, a unidade hospitalar estudada obteve eficiência técnica média de 0,84, que significou um aumento de 16% em relação ao período anterior. Em particular, apenas um departamento clínico (neurologia) não registou essa melhoria em sua eficiência técnica. Na análise qualitativa do estudo, a maioria dos entrevistados sentiu que a austeridade teve impacto negativo na eficiência de seus departamentos e de seu hospital, o que não se confirma pelos resultados obtidos. Conclusões: O MECPE não apenas aumentou a eficiência técnica, mas também incentivou medidas inovadoras para aumentar os ganhos nos anos subsequentes.


Objective: To verify that the Memorandum of Understanding (MuO), imposed on Portugal in the period of crisis by the International Monetary Fund, the European Central Bank and the European Commission, generated an improvement in the efficiency results in the Health area. Methods: To evaluate the results of efficiency carried out a case study in the hospital clinical services Local Health Unit Castelo Branco (ULSCB), located in one of the areas with more economic constraints. Resorted to the technique of Data Envelopment Analysis, considering as input costs and as a result the recorded production of each clinical service in three time periods before (2002-2010) during (2011-2014) and after the crisis (2015-2017). The data relating to cost and production were provided by the Office of Support and the Hospital Accountability Office. In addition to the quantitative analysis, the qualitative method of content analysis of the semi-structured interviews was used, to the directors and administrators of the hospital, which allowed the evaluation of the information that it holds and which is the result of its training and experience. Results: During the period of austerity and execution of the MoU, the hospital unit under study obtained a technical efficiency average of 0.84, which meant an increase of 16% over the previous period. In particular, only one clinical service has failed to record this improvement in its technical efficiency. In the qualitative analysis of the study, most interviewees felt that austerity had a negative impact on the efficiency of their departments and their hospital, which is not confirmed by the results obtained. Conclusions: The Memorandum of Understanding not only increased technical efficiency but also promoted innovative measures that allowed for increased gains in subsequent years.


Assuntos
Humanos , Custos Hospitalares , Eficiência , Administração Hospitalar
10.
Soins Pediatr Pueric ; 40(309): 14-15, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31331595

RESUMO

The last decade has witnessed an increasing number of reforms of the French healthcare system. The main objectives are to control healthcare costs by reducing spending and pooling resources. This is not achieved without difficulties, the economic criteria sometimes overshadowing humanist and altruistic values. These changes influence the organisation of care, even in paediatrics.


Assuntos
Assistência à Saúde/organização & administração , Reforma dos Serviços de Saúde , Administração Hospitalar , Criança , Assistência à Saúde/economia , França , Humanos , Pediatria/organização & administração
13.
Int J Evid Based Healthc ; 17 Suppl 1: S15-S17, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31283571

RESUMO

BACKGROUND: The Spanish Best Practice Guidelines (BPG) Implementation Project is part of the Best Practice Spotlight Organizations international program, coordinated by the Registered Nurses' Association of Ontario (RNAO). AIMS: To influence the uptake of nursing BPG across healthcare organizations, to enable practice excellence and positive client outcomes. METHODS: After translating the RNAO's BPG into Spanish, the Host Organization published a formal call for proposals to select healthcare settings in Spain to implement the RNAO's BPG and evaluate the results. The approach is nursing-led and multidisciplinary; context specific; and involving a wide range of stakeholders. The implementation of BPG Toolkit guides the process: cascade training, selection of recommendations to be implemented, 3 years of planned implementation activities, monitoring of process and outcome results for patients discharged 60 days every year. The Host Organization supports healthcare settings selected. RESULTS/DISCUSSION: The first call was launched in 2012. Eight healthcare settings (11 sites), serving 1.3 million people, were selected (hospitals and primary healthcare centers). They chose 10 BPG, according to their needs. In 2015 and 2018, 16 more healthcare settings have joined the program with a total of 263 sites. And in 2019, three complete regions will join the program as a regional host. Currently, more than 3200 nurses and 40 other healthcare professionals have been trained, evidence-based protocols have been developed or updated, patient education has been promoted, and international Best Practice Spotlight Organizations indicators have been evaluated in an electronic platform. CONCLUSION: The results obtained acknowledge that the RNAO implementation method could be replicated with success internationally. The strategies based on local context have worked and we have consolidated a network that shares knowledge and strategies and promotes evidence-based culture among Spanish healthcare settings and evidence-based care to patients.


Assuntos
Enfermagem Baseada em Evidências/normas , Guias como Assunto/normas , Administração Hospitalar , Hospitais , Humanos , Educação de Pacientes como Assunto , Atenção Primária à Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Espanha , Traduções
14.
Int J Health Care Qual Assur ; 32(6): 1022-1033, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31282258

RESUMO

PURPOSE: The purpose of this paper is to investigate managers' leadership styles, from the perspective of registered nurses, and its effects on the quality of nursing care in both the private and public healthcare sectors. An additional aim is to assess the relationship between leadership styles and particular organisational outcomes. DESIGN/METHODOLOGY/APPROACH: The sample for this quantitative research study was comprised of 400 respondents, among which 50 were nurse managers, 150 were staff nurses and the remaining respondents were patients. Two questionnaires were used in this study: the multi-factor leadership questionnaire (MLQ) 5X short and a patient satisfaction with nursing care quality questionnaire (PSNCQQ). FINDINGS: A positive correlation was found between the transformational leadership style with leadership outcomes and the quality of nursing care (r=0.811**, 0.759**, 0.789** and 0.877** for extra effort, job satisfaction, leader effectiveness and quality, respectively). PRACTICAL IMPLICATIONS: Although the sample study was extensive, a possible limitation is that the research utilised convenient sample who are working in the private and public healthcare sectors thus limiting the generalisability of the study. ORIGINALITY/VALUE: This study was proposed as a baseline for upcoming studies in areas of education, nursing practice, research and quality. Moreover, this study was expected to be imperative to the hospital's management, in order to improve the current level of leadership, education models and advancement programs for the healthcare sector's senior staff.


Assuntos
Relações Interprofissionais/ética , Liderança , Enfermeiras e Enfermeiros/estatística & dados numéricos , Cuidados de Enfermagem/organização & administração , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Adulto , Análise de Variância , Estudos de Avaliação como Assunto , Feminino , Administração Hospitalar/métodos , Humanos , Jordânia , Masculino , Recursos Humanos de Enfermagem no Hospital/organização & administração , Amostragem , Arábia Saudita
15.
Int J Health Care Qual Assur ; 32(6): 958-977, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31282263

RESUMO

PURPOSE: The purpose of this paper is to examine the use of power tactics by hospital administrators in order to gain employee compliance. It attempts to understand the influence of power bases of hospital administrators on the employee compliance using an analytic hierarchy process (AHP) technique. DESIGN/METHODOLOGY/APPROACH: The study adopted a mixed method technique and was conducted in two phases. In the first phase, qualitative analysis was carried out through content analysis of the anecdotes collected from the employees working in tertiary hospitals. Content analysis of responses aided in obtaining a list of criteria and sub-criteria affecting employee behavioural compliance. In the second phase, quantitative analysis was carried out using the AHP technique. While applying AHP, the issue pertaining to employee behavioural compliance with hospital's policies, procedures and related instructions was formulated in form of a hierarchy of one objective, two criteria, six sub-criteria and five alternatives established through literature review and content analysis. Furthermore, the subject matter experts were asked to conduct pairwise comparison wherein priority rankings were achieved. FINDINGS: The results indicated that reward power (25 per cent) is the most significant power style exercised by effective hospital administrators in achieving employee behavioural compliance followed by expert (24 per cent), referent (22 per cent) and legitimate powers (17 per cent). As coercive (12 per cent) came out to be the least preferred power style, it should be cautiously exercised by hospital administrators in the present day scenario. RESEARCH LIMITATIONS/IMPLICATIONS: The major limitation of this study is that the sample was drawn only from three tertiary hospitals in Jammu district that limits the generalizability of the findings in all the hospital settings across different regions. No attempt is made in this study to understand the variations with regard to demographics of the respondents that can be taken as a future research study. This study is cross-sectional in nature and provides the perspective of specific time. A longitudinal study could further provide insights into different time variations and the comparison and henceforth can be more comprehensive, thus supporting the generalizability of this study. PRACTICAL IMPLICATIONS: The study empirically identifies the relative importance of exercising power styles in order to gain employee behavioural compliance. The study helps in understanding the complex problem of behavioural compliance in hospital setting by examining the intensity of each factor affecting employee behavioural compliance. This knowledge is very critical in effective hospital management and getting the work done. The priority rankings obtained for power styles can be used for developing selection batteries and performance records of hospital administrators. As the behaviour of the employees is not static, there may exist the inherent limitations of adopted cross-sectional design for the present study. Furthermore, longitudinal study can be conducted at different time periods, to understand the variations in the patterns of employee's compliance behaviour and associated practiced power styles by hospital administrators. ORIGINALITY/VALUE: This is perhaps the first study that has scientifically attempted to integrate the power styles and analyzed their effective use in hospital administration. This research study has attempted to develop an elementary base for academicians, scholars as well as management practitioners on the effective use of power styles for achieving employee behavioural compliance in hospitals.


Assuntos
Assistência à Saúde/organização & administração , Fidelidade a Diretrizes , Corpo Clínico Hospitalar/organização & administração , Estudos Transversais , Feminino , Administração Hospitalar , Humanos , Índia , Comunicação Interdisciplinar , Liderança , Masculino , Inovação Organizacional , Centros de Atenção Terciária
16.
J Health Organ Manag ; 33(4): 396-412, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31282810

RESUMO

PURPOSE: The purpose of this paper is to describe persuasive speech and discourses in multi-professional organizational change facilitation meetings at a hospital through rhetorical discourse analysis. Previous research has often considered organizational change to be a managerial issue, with other employees given the rather passive role of implementators. This study takes an alternative approach in assuming that organizational change could benefit by involving those who are most familiar with the tasks to be changed. DESIGN/METHODOLOGY/APPROACH: The study employed a qualitative, case study approach and focused on the construction of a hospitalist model within multi-professional change facilitation meetings. Eight videos of these multi-professional change facilitation meetings - which occurred between January and September 2017 - were observed and the material was analyzed by rhetorical discourse analysis. An average of 10-20 actors from different professional groups participated in the meetings. The change actors comprised physicians, nursing staff and nursing managers, along with a secretary and hospitalist. The meetings were conducted by a change facilitator. FINDINGS: The persuasive speech in the analyzed organizational change meetings occurred within five distinct discourses: constructing the change together, positive feedback, strategic change in speech, patient perspective and driving change. The content of these discourses revealed topics that are relevant to persuading members of healthcare organizations to adopt a planned change. ORIGINALITY/VALUE: The presented research provides new knowledge about how persuasive speech is used in organizational change and describes the discourses in which persuasive speech is used in a healthcare context.


Assuntos
Processos Grupais , Inovação Organizacional , Comunicação Persuasiva , Administração Hospitalar/métodos , Humanos , Recursos Humanos em Hospital/psicologia , Fala
17.
J Health Organ Manag ; 33(4): 413-425, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31282811

RESUMO

PURPOSE: The purpose of this paper is to investigate how the participants talk about their experiences as newly graduated nurses, managers and nursing colleagues in the context of "newcomers' establishment in the profession" and to identify how they portray the healthcare organisation in their narratives. DESIGN/METHODOLOGY/APPROACH: A narrative approach is used to reveal and illustrate three perspectives on the topic "new-comers' establishment". In total, 14 interviews are conducted with 4 managers, 4 nursing colleagues and 6 newly graduated registered nurses. The focus of this study is how a healthcare organisation embraces and retains newly graduated registered nurses and how this is perceived. FINDINGS: The newcomers' establishment is facilitated by an orientation programme and an orientation period, individual support provided by managers and colleagues, and the creation of trust to boost confidence in nursing situations. The organisation is portrayed as struggling with high workloads, nursing shortages, high levels of responsibility and showing concern and an interest in the newcomer. The parties criticise the university for not teaching the most basic knowledge, thereby revealing the existence of a theory-practice gap. ORIGINALITY/VALUE: The research shows how building trust amongst the organisation's members is essential for creating a satisfying workplace and the retention of newly graduated registered nurses. Empirical descriptions of newly graduated nurses, managers and nursing colleagues experiences of "newcomers establishment" are rare, which is why the description of such "establishment" in this research increases the value of the paper.


Assuntos
Narração , Enfermeiras e Enfermeiros , Adulto , Atitude do Pessoal de Saúde , Feminino , Administração Hospitalar , Humanos , Satisfação no Emprego , Masculino , Enfermeiras e Enfermeiros/organização & administração , Enfermeiras e Enfermeiros/psicologia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Suécia , Confiança , Local de Trabalho/organização & administração , Local de Trabalho/psicologia , Adulto Jovem
18.
J Health Organ Manag ; 33(4): 488-510, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31282812

RESUMO

PURPOSE: The purpose of this paper is to review original research on lean management (LM) in health care to identify potential research gaps and present recommendations for future research. The paper also discusses the current state of implementing LM practices in health care. In addition, it presents and highlights "lean bundles" imported from manufacturing, namely, total quality management (TQM), human resource management, just-in-time and total productive maintenance, as a potential implementation strategy of LM in hospitals to optimize overall health care performance. DESIGN/METHODOLOGY/APPROACH: The scoping review was conducted based on the guidelines specified by Arksey and O'Malley (2005). Relevant included studies were retrieved by searching various electronic databases. The PRISMA guidelines were applied to identify and select eligible studies. FINDINGS: The majority of previous studies used selected practices to measure LM in health care. In most cases, these practices reflected a narrow and biased view of LM. Lean bundles which comprehensively view LM and reflect all its aspects have rarely been discussed in the health care literature. Evidence about the contribution of lean bundles to hospital performance needs to be addressed in future studies. PRACTICAL IMPLICATIONS: This paper demonstrates the implementation of the four lean bundles in hospitals. It argues that, instead of adopting one dimension or selected practices of LM, hospitals viewing LM as a comprehensive multi-dimensional approach through the adoption of the four lean bundles are expected to maximize their performances. ORIGINALITY/VALUE: This is one of the first works to comprehensively review and discuss lean bundles in the context of health care. It argues that the adoption of the four lean bundles by hospitals will enable them to yield the maximum LM performance benefits. In addition, a proposed survey questionnaire based on the literature review is provided to assist researchers in conducting future empirical studies.


Assuntos
Assistência à Saúde/organização & administração , Gestão da Qualidade Total , Administração Hospitalar/métodos , Humanos , Administração de Recursos Humanos , Qualidade da Assistência à Saúde , Gestão da Qualidade Total/organização & administração
19.
Rev Chilena Infectol ; 36(2): 123-125, 2019 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-31344150

RESUMO

The care of cancer patients, including recipients of hematopoietic stem cell transplantation, has numerous challenges for hospitals that must provide safe environments in which exposure to pathogens that generate morbidity and mortality is reduced at maximum. At the same time, they must have established protocols that allow a rational study of the possible infectious etiologies and the existence of an adequate therapeutic arsenal together with timely treatment algorithms, updated according to consensus guidelines and effective according to the suspected or confirmed infection. This article introduces some of the arguments that support these requirements, then that are developed in three successive articles dedicated to the hospital environment, diagnostic protocols and therapeutic arsenal.


Assuntos
Infecções Bacterianas/prevenção & controle , Equipamentos e Provisões Hospitalares/normas , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/terapia , Hospitais/normas , Infecção Hospitalar/prevenção & controle , Transplante de Células-Tronco Hematopoéticas/normas , Administração Hospitalar/normas , Humanos , Fatores de Risco
20.
Med Care ; 57(9): 742-749, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31274782

RESUMO

BACKGROUND: Rigorous measurement of organizational performance requires large, unbiased samples to allow inferences to the population. Studies of organizations, including hospitals, often rely on voluntary surveys subject to nonresponse bias. For example, hospital administrators with concerns about performance are more likely to opt-out of surveys about organizational quality and safety, which is problematic for generating inferences. OBJECTIVE: The objective of this study was to describe a novel approach to obtaining a representative sample of organizations using individuals nested within organizations, and demonstrate how resurveying nonrespondents can allay concerns about bias from low response rates at the individual-level. METHODS: We review and analyze common ways of surveying hospitals. We describe the approach and results of a double-sampling technique of surveying nurses as informants about hospital quality and performance. Finally, we provide recommendations for sampling and survey methods to increase response rates and evaluate whether and to what extent bias exists. RESULTS: The survey of nurses yielded data on over 95% of hospitals in the sampling frame. Although the nurse response rate was 26%, comparisons of nurses' responses in the main survey and those of resurveyed nonrespondents, which yielded nearly a 90% response rate, revealed no statistically significant differences at the nurse-level, suggesting no evidence of nonresponse bias. CONCLUSIONS: Surveying organizations via random sampling of front-line providers can avoid the self-selection issues caused by directly sampling organizations. Response rates are commonly misinterpreted as a measure of representativeness; however, findings from the double-sampling approach show how low response rates merely increase the potential for nonresponse bias but do not confirm it.


Assuntos
Administração Hospitalar/normas , Hospitais/normas , Garantia da Qualidade dos Cuidados de Saúde/métodos , Projetos de Pesquisa , Inquéritos e Questionários/normas , Viés , Humanos , Viés de Seleção
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