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1.
Salud(i)ciencia (Impresa) ; 23(8): 619-625, abr. 2020. tab.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1100608

RESUMO

Introduction: Despite the great contribution of women to health systems, men still occupy most leadership positions. The gender gap in leadership roles in healthcare is prevalent worldwide. Methods: This is a cross-sectional study that analyses the distribution of the types of appointments defined by hierarchy, duration of employment, and percentage of FTE and the positions occupied by women faculty compared with male counterparts. The unit of analysis corresponds to faculty positions in 2018 since each faculty can have more than one position with different hierarchy, duration, and percentage of FTE. We used logistic multivariate analysis to assess associations, considering the model with the lowest AIC. Results: Age group 31 to 50 years (AOR: 0.66; IC 95%: 0.50-0.87) and FTE appointments (AOR: 0.43; IC 95%: 0.29- 0.64) are significantly associated with positions assigned to women. For appointment type defined by hierarchy TA, is significantly occupied by a female when compared to each group of increased hierarchy, Assistant professor (AOR: 1.39; IC 95%: 1.14-1.70), Associate professor (AOR: 2.67: IC 95%: 1.95- 3.67), Full professor (AOR: 3.47; IC 95%: 2.27-5.30) and authorities (AOR: 5.57; IC 95%: 3.53-8.79). Conclusions: There is almost no representation of women in the highest-ranking positions, which are associated with academic recognition, decision-making, and higher pay. The higher prevalence of full-time positions occupied by women could be linked to women still being responsible for household and family tasks


Introducción: A pesar de la gran contribución de las mujeres a los sistemas de salud, a nivel mundial los hombres son mayoría en los puestos de liderazgo. A nivel mundial, la brecha de género en los cargos de liderazgo en atención médica es persistente. Métodos: Estudio de corte transversal que analiza la distribución de los tipos de cargos docentes ocupados por mujeres de la Facultad de Medicina de la Universidad de Buenos Aires según jerarquía, dedicación y regularidad, comparados con su contraparte masculina. La unidad de análisis corresponde a las posiciones, ya que cada docente puede tener más de un cargo. Usamos regresión logística considerando el modelo con el AIC más bajo. Resultados: Grupo de edad de 31 a 50 años (ORA: 0.66; IC 95%: 0.50 a 0.87) y la dedicación exclusiva (ORA: 0.43; IC 95%: 0.29 a 0.64) están significativamente asociados con posiciones ocupadas por mujeres. Para el tipo de cargos definidos por jerarquía, "ayudante de cátedra" está ocupado significativamente por mujeres, en comparación con cada grupo de jerarquía creciente, Jefe de Trabajos Prácticos (ORA: 1.39; IC 95%: 1.14 a 1.70), Profesor Adjunto (ORA: 2.67; IC 95%: 1.95 a 3.67), Profesor Titular (ORA: 3.47; IC 95%: 2.27 a 5.30) y autoridades (ORA: 5.57; IC 95%: 3.53 a 8.79). Conclusiones: Escasa representación femenina en los puestos de mayor rango asociados con reconocimiento académico, toma de decisiones y mejor salario. La dedicación exclusiva en las mujeres podría estar relacionada con que ellas que siguen siendo responsables de las tareas domésticas y familiares


Assuntos
Humanos , Faculdades de Medicina , Educação Médica/tendências , Docentes , Iniquidade de Gênero , Identidade de Gênero , Conselho Diretor
3.
J Nurs Adm ; 50(2): 104-108, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31929344

RESUMO

OBJECTIVE: The aim of this study was to develop a valid, reliable instrument to measure the effectiveness of shared governance councils BACKGROUND: The work of shared governance, that is, the decisions, takes place in its structures, notably, the councils. A literature search yielded no formal instrument for evaluating how these councils function. METHODS: A 4-phase process was used to generate valid items to measure shared governance council effectiveness, including content validity by experts, a pilot for feasibility, a larger pilot for internal consistency, and an exploratory factor analysis to delineate a final instrument. RESULTS: More than a dozen experts and participants from nearly 30 healthcare organizations contributed to the final development of the 25-item Council Health Survey instrument. Items for measuring council effectiveness at either the unit or division level were grouped in areas of structure, activities, and membership. CONCLUSIONS: When evaluating shared governance, nurses should focus on councils themselves, in which much of the work of shared governance occurs.


Assuntos
Governança Clínica/organização & administração , Eficiência Organizacional , Conselho Diretor/organização & administração , Colaboração Intersetorial , Cuidados de Enfermagem/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
4.
J Nurs Adm ; 50(2): 61-62, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977942

RESUMO

In this Inspiration Column, Pat Reid Ponte interviews Lisa J. Sundean, PhD, MHA, RN, associate professor, University of Massachusetts Boston. Dr Sundean has devoted her career to support the inclusion of nurses on boards.


Assuntos
Conselho Diretor/organização & administração , Papel do Profissional de Enfermagem , Cuidados de Enfermagem/organização & administração , Boston , Feminino , História do Século XX , História do Século XXI , Humanos
6.
Farm. hosp ; 44(supl.1): 61-65, 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-190481

RESUMO

Los servicios de farmacia hospitalaria (SFH) en España se han visto afectados por la crisis sanitaria provocada por SARS-CoV-2 y han tenido que adoptar sus procedimientos de atención farmacéutica (AF) al paciente externo (PE) mediante estrategias de Telefarmacia, con los objetivos de maximizar los resultados en salud y reducir el riesgo de contagio. El objetivo de ese artículo es describir y analizar los procedimientos AFPE durante la pandemia SARS-CoV-2 y comunicar las lecciones aprendidas en los SFH. En relación con las consultas externas de AF presenciales, se han adoptado medidas para minimizar el contagio viral de pacientes y profesionales, siguiendo las recomendaciones nacionales e internacionales de referencia de distanciamiento temporal, espacial y recomendaciones higiénicas. En cuanto a las consultas externas de AF no presenciales, se han potenciado las teleconsultas con dispensación del tratamiento en base a cinco procedimientos básicos, cada uno de ellos con sus ventajas y limitaciones: dispensación domiciliaria desde SFH que presenta las ventajas de la universalidad de acceso, pero requiere una elevada inversión en recursos; coordinación del SHF con farmacéuticos de atención primaria, que con-lleva una nula inversión en recursos, pero limita el acceso a determinadas zonas geográficas; coordinación del SFH con farmacéuticos comunitarios, que utiliza una amplia red de oficinas de farmacia, pero exige el desplazamiento del paciente sin garantías de confidencialidad para todos los casos; geolocalización y dispensación hospitalaria, que permite un acceso universal y trazabilidad directa, pero requiere un incremento en recursos humanos; y coordinación del SFH con asociaciones de pacientes, que no requiere inversión económica, pero limita el acceso a las patologías de los asociados. Destacamos finalmente tres lecciones aprendidas: la capacidad de AFPE de SFH españoles ante una crisis sanitaria; la utilidad de la Telefarmacia para el seguimiento clínico, la coordinación asistencial, información al PE, dispensación y entrega informada (con elevada satisfacción de los pacientes); y la necesidad de potenciar la Telefarmacia como herramienta complementaria, en un modelo mixto de AFPE que incorpore las ventajas de cada uno de los procedimientos adaptándose a las necesidades individuales de los pacientes en un entorno de humanización de la asistencia sanitaria


Hospital Pharmacy Service (HPS) in Spain have been impacted by the health crisis caused by the COVID-19 pandemic. Thus, the outbreak has forced HPSs to adapt their outpatient consultation services to Telepharmacyto optimize clinical outcomesand reduce the risk of contagion. The purpose of this article is to describe and analyze the experience of HPSs with out-patient Telepharmacy during the COVID-19 pandemic and expose the les-sons learned. Measures have been adopted in on-site outpatient pharmacy clinics to prevent exposure of patients and professionals to the virus. These measures are based on national and international recommendations on social distancing and hygiene. With regard to remote outpatient pharmacy services, teleconsultation with drug dispensing has been promoted based on five basic procedures, each with its advantages and limitations: home drug delivery from HPSs, with the advantage of universal access and the limitation of entailing a substantial investment in resources; HPS coordination with primary care pharmacists, which requires no investments but with limited access to some geographic areas; HPS coordination with community pharmacists based on a large network of pharmacies, which requires the patient to go to the pharmacy, without confidentiality being guaranteed for any patient; geolocation and hospital-based medication dispensing, which provides universal access and direct traceability, but entails investment in human resources; and HPS coordination with associations of patients, which does not entail any additional cost but limits the information available on the diseases of society members. Three main lessons have been learned during the pandemic: the satisfactory capacity of HPS to provide outpatient pharmacy consultation services in the setting of a public health crisis; the usefulness of Telepharmacy for the clinical follow-up, healthcare coordination, outpatient counseling, and informed dispensing and delivery of medication (with a high level of satisfaction among patients); and the need to foster Telepharmacy as a complementary tool through a mixed model of outpatient pharmacy consultation service that incorporates the advantages of each procedure and adapts to the individual needs of each patient in a context of humanized healthcare


Assuntos
Humanos , Assistência Ambulatorial/organização & administração , Betacoronavirus , Infecções por Coronavirus , Assistência à Saúde/organização & administração , Telemedicina/organização & administração , Pneumonia Viral , Serviço de Farmácia Hospitalar/organização & administração , Assistência à Saúde/estatística & dados numéricos , Conselho Diretor , Geografia Médica , Necessidades e Demandas de Serviços de Saúde , Educação de Pacientes como Assunto/organização & administração , Espanha , Sistemas de Medicação no Hospital/organização & administração , Pacientes Ambulatoriais
7.
Rev. psicol. trab. organ. (1999) ; 35(3): 165-176, dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-188134

RESUMO

En este estudio analizamos la relación del estilo de apego adulto con las propiedades estructurales de las redes personales y el capital social de 67 directivos de la provincia de Quebec (Canadá). A través del análisis de conglomeramos detectamos dos perfiles relacionales diferenciados. El apego seguro se asocia con redes densas de lazos fuertes, comparativamente pequeñas. El estilo de evitación se relaciona en cambio con redes más amplias y centralizadas, con más lazos débiles. No se observaron diferencias significativas en la satisfacción con la carrera profesional en función del estilo de apego. Sin embargo, la satisfacción con la carrera mostró una relación significativa con la centralización de la red personal


In this study, we analyze the relationship of adult attachment style with the structural properties of personal networks and the social capital of 67 managers in the province of Quebec (Canada). Through cluster analysis, two differentiated relational profiles were detected. Secure attachment is associated with dense and comparatively small networks of strong ties. The avoidance dimension is related instead to larger and more centralized networks, with weaker ties. There were no significant differences in satisfaction with the professional career depending on the attachment style. However, satisfaction with the career showed a significant relationship with the centralization of the personal network


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Apoio Social , Satisfação no Emprego , Apego ao Objeto , Capital Social Cognitivo , Conselho Diretor/classificação , Canadá , Análise por Conglomerados , Estudos de Casos Organizacionais , Responsabilidade Técnica , Autocontrole/psicologia , Escolha da Profissão , Psicometria/instrumentação
8.
BMC Health Serv Res ; 19(1): 725, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638988

RESUMO

BACKGROUND: Patients are sometimes harmed in the course of receiving hospital care. Existing research has highlighted a positive association between board engagement in healthcare quality activities and healthcare outcomes. However, most research has been undertaken through surveys examining board engagement in a limited number of governance processes. This paper presents evidence of a comprehensive range of processes related to governing healthcare quality undertaken at the corporate governance level. This provides a more detailed picture than previously described of how corporate governance of healthcare quality is enacted by boards and management. METHODS: A comparative case study of eight Australian public hospitals was undertaken. Case studies varying is size and location were selected from two Australian states. Data collection included a review of key governance documentation, semi structured interviews with board members and senior management and an observation of a board quality committee meeting. Thematic analysis was undertaken to identify processes related to key tasks in governing healthcare quality. RESULTS: Two key tasks in the corporate governance of healthcare quality, evaluating healthcare quality and overseeing quality priorities, were examined. Numerous processes related to these two tasks were found. Case studies, while found to be similar in engagement on previously identified processes, were found to differ in engagement in these additional processes. While generally low levels of engagement in processes of overseeing quality priorities were found, cases differed markedly in their engagement in evaluating healthcare quality processes. Additional processes undertaken at some case studies represent innovative and mature responses to the need for effective corporate governance of healthcare quality. In addition, a group of processes, related to broader governance taskwork, were found to be important in enabling effective corporate governance of healthcare quality. CONCLUSION: The work of governing healthcare quality, undertaken at the corporate governance level, is redefined in terms of these more detailed processes. This paper highlights that it is how well these key tasks are undertaken that is important in effective governance. When processes related to key tasks are omitted, the rituals of governance may appear to be satisfied but the responsibility may not be met. Boards and managers need to differentiate between common approaches to governance and practices that enable the fulfilment of governance responsibilities. This study provides practical guidance in outlining processes for effective corporate governance of healthcare quality and highlights areas for further examination.


Assuntos
Conselho Diretor/organização & administração , Hospitais Públicos/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Austrália/epidemiologia , Estudos de Casos e Controles , Administração Hospitalar , Humanos , Qualidade da Assistência à Saúde/normas
10.
J Leg Med ; 39(3): 229-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31626576

RESUMO

Lapses in professionalism are a common cause of disciplinary action against physicians by U.S. medical boards. However, the exact definition of "professionalism" is unclear, making it likely that a physician will not train or practice under the same framing of professionalism and so may fail to develop certain skills. The goal of this study was to identify and compare the professionalism framings of medical boards. The medical board web pages for all 50 states, the District of Columbia, and four territories were examined in June 2017 for use of the word "professionalism" or "professional" in their application, rules, or laws, which was then coded as a best fit to one of six core framings of professionalism. Of the 55 states and territories, integrity was the most common professionalism framing (40.0%), followed by excellence (23.6%), behavior (12.7%), mixed (9.1%), unclear (9.1%), and absent (5.5%). Although integrity was the most common framing, diversity exists among medical boards, which could lead to board misunderstandings of incidents labeled as professionalism violations and ineffective remediation of offenses. In order to best communicate the nature of the offense and thus best facilitate remediation, the incident should be called by its true name rather than the all-encompassing term "professionalism."


Assuntos
Papel do Médico , Médicos/normas , Prática Profissional/normas , Profissionalismo/normas , Conselho Diretor/legislação & jurisprudência , Conselho Diretor/normas , Humanos , Má Conduta Profissional , Profissionalismo/tendências , Conselhos de Especialidade Profissional/legislação & jurisprudência , Conselhos de Especialidade Profissional/normas , Estados Unidos
11.
J Prof Nurs ; 35(5): 346-352, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31519336

RESUMO

The complexities of today's health care environment require organizational governing boards to have deeper understanding of health needs, influences, and outcomes with diverse board leadership. Nurses understand the complexities and demands of health care, but few nurses are engaged on boards of directors and many nurses feel unprepared for the governance leadership role. The nurse of the future requires governance knowledge and competencies to influence organizational policies that will improve health care outcomes and advance health promotion. Governance education is a necessary component of preparing the nurse of the future to influence health care transformation. Until nurses can confidently embrace governance leadership as a part of their professional identity, convincing and expecting non-nurse board leaders to appoint nurses to boards will continue to be a challenge. This paper describes a strategy for incorporating governance competencies into nursing curricula across all education levels by leveraging the American Hospital Association Governance Core Competencies (2009) and the Massachusetts Nurse of the Future Core Competencies©-RN (Massachusetts Department of Higher Education Nursing Initiative, 2016).


Assuntos
Conselho Diretor/organização & administração , Liderança , Enfermeiras Administradoras/organização & administração , Papel Profissional , Currículo , Educação em Enfermagem , Humanos
12.
Nurs Forum ; 54(4): 575-581, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31373014

RESUMO

In an environment in which there is little or no nursing presence on governing boards in healthcare organizations (HCOs), physicians, and nonclinicians take responsibility for keeping the other board members apprised of the quality of patient care, including nursing-generated, patient safety initiatives. Governing boards in HCOs are either not appointing nurses to governing boards or are not appointing nurses in numbers that are commensurate with the size and vital contributions of the profession. As a result, competent nursing professionals with an intimate understanding of quality care and patient safety are not in decision-making roles that may redesign health care and improve patient care. The purpose of this qualitative study was to describe experiences of nurse board members who hold governing board appointments in HCOs, and to describe the facilitators of and barriers to holding governing board appointments, as experienced by those nurse board members. This novel research employed naturalistic inquiry to explore the experiences of 12 nurse board members who held appointments with voting privileges in HCOs. From the interview data emerged four distinct themes: leveraging relationships and networking, valuing the mission of the board, feeling respected for my participation, and committing to board work. Facilitators of and barriers to governing board appointments were suggested. Findings validated the few previous research studies found in the literature and have implications for nursing leadership and governance.


Assuntos
Conselho Diretor/normas , Liderança , Papel do Profissional de Enfermagem/psicologia , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Conselho Diretor/tendências , Humanos , Segurança do Paciente/normas , Pesquisa Qualitativa
16.
J Health Organ Manag ; 33(4): 426-442, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31282818

RESUMO

PURPOSE: A key question in the provision of public health concerns how that provision is governed. The purpose of this paper is to examine the governance structure of a public health board and its perceived impact on the efficacy of clinical operations. DESIGN/METHODOLOGY/APPROACH: Structural issues examined the level of centralisation and public participation, and whether governance should occur through elected boards or appointed managers. These issues were examined through multiple lenses. First was the intention of the structure, examining the issues identified by parliament when the new structure was created. Second, the activities of the board were examined through an analysis of board meetings. Finally, hospital clinicians were surveyed through semi-structured interviews with both quantitative and qualitative questioning. FINDINGS: A contradiction was revealed between intention, perception and actual activities. This raises concerns over whether the public are significantly informed to elect the best-skilled appointees to governance positions. PRACTICAL IMPLICATIONS: This research holds implications for selecting governance structures of public health providers. ORIGINALITY/VALUE: Few studies have looked at the role of a publicly elected healthcare governance structure from the perspective of the clinicians. Hence, this study contributes to the literature on healthcare structure and its impact on clinical operations, by including a clinician's perspective. However, this paper goes beyond the survey and also considers the intention of the structure as proposed by parliament, and board activities or what the board actually does. This enables a comparison of intention with outcomes and perception of those outcomes.


Assuntos
Administração em Saúde Pública , Participação da Comunidade , Conselho Diretor/organização & administração , Processos Grupais , Humanos , Entrevistas como Assunto , Nova Zelândia
17.
Am J Orthod Dentofacial Orthop ; 155(6): 749-751, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31153483
18.
Indian J Med Ethics ; 4(3): 254-255, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31213416

RESUMO

The Government has superseded the Medical Council of India (MCI) with an interim board of governors that has assumed the powers and functions of the Council, pending passage of the National Medical Commission Bill. While a systemic revamp of medical education is intended, uncertainty prevails on whether medical academia will now be more inclusive.


Assuntos
Educação Médica/legislação & jurisprudência , Educação Médica/normas , Discriminação Social/ética , Discriminação Social/prevenção & controle , Conselho Diretor , Regulamentação Governamental , Humanos , Índia , Metáfora
19.
Nurs Res ; 68(5): 405-412, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31045866

RESUMO

BACKGROUND: Healthy People 2020 has made achieving health equity one of its overarching goals; another goal is increasing the number of accredited local agencies that have Community Health Improvement Plans (CHIPs). Community Health Improvement Plans are meant to serve agencies as guiding documents for multiple years. OBJECTIVES: This study investigates the prevalence with which health disparities are addressed within CHIPs and the specific health disparities targeted by these objectives. METHODS: Researchers analyzed 4,094 objectives from CHIPs of 280 local Public Health Accreditation Board (PHAB)-accredited and nonaccredited public health agencies in the United States. RESULTS: Despite the PHAB's focus on addressing health equity, not all PHAB-accredited agencies addressed health disparities (85.4% of CHIPs analyzed). However, more accredited than nonaccredited agencies (73.9%) contained at least one objective focused on health disparities. DISCUSSION: Findings indicate that if health equity is truly a goal of national initiatives, agencies' planning documents (e.g., CHIPs) can do a better job addressing commonly ignored populations.


Assuntos
Planejamento em Saúde Comunitária , Equidade em Saúde/organização & administração , Disparidades nos Níveis de Saúde , Acreditação/estatística & dados numéricos , Feminino , Objetivos , Conselho Diretor , Programas Gente Saudável , Humanos , Masculino , Administração em Saúde Pública , Estados Unidos
20.
Creat Nurs ; 25(2): 82-86, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31085660

RESUMO

Nurses across the nation are stepping forward as leaders in response to the rapid and continuous change in health care and the acute needs of vulnerable populations. Caring for vulnerable populations is inherent in the nurse's role. However, caring for those in vulnerable states goes beyond the bedside. Nurses are in a unique position to bring their experiences and knowledge in patient care, quality, safety, cost containment, and wellness, as members of boards, elected officials, and nonprofit directors. Their impact is significant, as they balance critical thinking skills, financial knowledge, and compassion in order to influence executive decision-making. This article describes the importance of nurses serving on boards from evidence-based as well as personal perspectives, and presents specific examples of nurses' impact on vulnerable populations and those on the brink of vulnerability, in schools, communities, health-care institutions, and beyond. Will you also rise to the call to serve?


Assuntos
Empatia , Conselho Diretor , Papel do Profissional de Enfermagem/psicologia , Cuidados de Enfermagem/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Defesa do Paciente/psicologia , Populações Vulneráveis/psicologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estados Unidos
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