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1.
J Nurs Adm ; 50(2): 63-65, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977943

RESUMO

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US states, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Equidade em Saúde/organização & administração , Invenções , Enfermeiras Administradoras/organização & administração , Recursos Humanos de Enfermagem/organização & administração , Inovação Organizacional , Brasil , Canadá , China , Humanos , Liderança , Estados Unidos
3.
Metas enferm ; 22(10): 22-27, dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185328

RESUMO

Objetivo: determinar el grado de satisfacción de los usuarios del servicio de hemodiálisis tras una innovación organizacional. Método: estudio descriptivo transversal realizado en usuarios del servicio de hemodiálisis del Hospital de la Santa Creu (Tarragona). Se administró el cuestionario SERVQHOS modificado para hemodiálisis y se comparó la satisfacción reportada previa y posterior al cambio. La comparación de medias se analizó mediante la t de Student para muestras relacionadas. Resultados: de 80 usuarios que cumplían los criterios de inclusión se obtuvieron 43 encuestas válidas. El perfil mayoritario del usuario que contestó fue el de un varón (76,2%), de 71,7 años, sin estudios o con estudios primarios (85,7%), pensionista o jubilado (90,5%). Aunque en la satisfacción global la opción "muy satisfecho" disminuyó un 7,5% después del cambio, el resultado no fue estadísticamente significativo, como tampoco fueron las diferencias de los 20 ítems del cuestionario. Conclusiones: el mantenimiento de la satisfacción obtenido refuerza el aumento de eficiencia alcanzado con el cambio organizativo y confirma factores de éxito en innovación, animando en la búsqueda de estrategias para reducir costes sin comprometer buenos resultados


Objective: to determine the level of satisfaction of the users of the Hemodialysis Unit after an organizational innovation. Method: a descriptive cross-sectional study conducted in users of the Hemodialysis Unit of the Hospital de la Santa Creu (Tarragona). The SERVQHOS questionnaire modified for hemodialysis was administered, and the satisfaction previously reported was compared with the satisfaction after the change. The comparison of means was analyzed through Student's t test for paired samples. Results: out of those 80 users who met the inclusion criteria, 43 valid surveys were obtained. The predominant profile of the user who answered the survey was: male (76.2%), 71.7-year-old, no formal education or primary school completed (85.7%), pensioner or retired (90.5%). Even though in Overall Satisfaction, there was a 7.5% reduction in the "Very Satisfied" option after the change, this result and the differences in the 20 questionnaire items were not statistically significant. Conclusions: the sustained satisfaction achieved reinforces the increase in efficiency reached with the organizational change, and confirms factors of success in innovation, encouraging the search for strategies in order to reduce costs without compromising good results


Assuntos
Humanos , Masculino , Feminino , Idoso , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Satisfação do Paciente , Unidades Hospitalares de Hemodiálise/organização & administração , Inovação Organizacional , Estudos Transversais , Inquéritos e Questionários , Benchmarking
6.
J Nurs Adm ; 49(12): 575-576, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31725514

RESUMO

The pace of change in today's healthcare environment is unprecedented. What used to happen every few months now seems to happen every day. From rapidly shifting technology to evolving models of care to new payment systems, nursing leaders must navigate constant change to stay relevant. How well they manage it has a direct bearing on everything from patient safety and outcomes to nursing cohesion and satisfaction. In this month's Magnet Perspectives column, we explore the essential elements that contribute to successful change management and the strategies leaders can employ to keep their nurses, and their organizations, forward-focused. In addition, we take a deep dive into the Magnet Model component of transformational leadership and examine its impact on creating and sustaining an environment where change flourishes and nurses thrive.


Assuntos
Atitude do Pessoal de Saúde , Liderança , Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Inovação Organizacional , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Nurs Educ Perspect ; 40(6): E25-E27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644461

RESUMO

This funded project assisted veteran students to obtain a baccalaureate in nursing by aligning the skills learned through military training with concepts and skills valued by professional nursing and taught to nursing students. Nine concepts or skills were identified by nursing faculty that validated for course credit. The identified concepts and skills were incorporated into four simulation scenarios. Veteran students' skills were validated through simulation experiences in place of taking a three-credit nursing course. Anecdotal data from the debriefing process were rich with students' experiences and gratitude for being recognized for their military knowledge and service.


Assuntos
Bacharelado em Enfermagem/organização & administração , Inovação Organizacional , Estudantes de Enfermagem , Veteranos , Docentes de Enfermagem , Humanos
8.
Harefuah ; 158(10): 669-673, 2019 Oct.
Artigo em Hebraico | MEDLINE | ID: mdl-31576715

RESUMO

INTRODUCTION: Competency-based medical education (CBME) is a model aimed to address certain challenges and shortcomings attributed to the contemporary models of medical education and the medical profession in general. The CBME model has been used mainly in the education of undergraduate medical students with no continuation to residency, fellowship, or independent practice. In this review, we present a program based on the CBME model for the design and implementation of a new fellowship program in neonatology in Israel. As part of the program, we propose a mentorship program as a means to facilitate the implementation and acceptance of the program in the different wards. We designed assessment tools that can help the mentor track the fellow's development over time as well as to examine the impact of the proposed program on performance and on all stakeholders' satisfaction over time. We aim to evaluate the benefits and effectiveness of this CBME training not only on the fellows' abilities and performance outcomes, but also on the accompanying general organizational changes that can lead to general improvement in the neonatal profession in Israel.


Assuntos
Bolsas de Estudo , Neonatologia , Inovação Organizacional , Profissionalismo , Humanos , Israel
12.
Fam Med ; 51(8): 664-669, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31509217

RESUMO

BACKGROUND AND OBJECTIVES: Facilitation is common in the era of practice transformation. Much of the literature on practice facilitators focuses on the role of external facilitators who come into a practice to aid in practice transformation efforts. Our study sought to better understand the attributes of exemplary facilitators. METHODS: We conducted 10 structured interviews in four family medicine residencies. RESULTS: Program directors easily identified internal staff who serve informally as exemplary facilitators. Despite varying jobs, they possess seven identifiable attributes within three broad domains: task orientation, relational skills, and emotional intelligence. CONCLUSIONS: Given the increasing cost of practice transformation and the finite resources in many clinics, this study can help leaders identify current employees best suited for facilitation.


Assuntos
Comportamento Cooperativo , Medicina de Família e Comunidade/educação , Medicina de Família e Comunidade/organização & administração , Ciência da Implementação , Internato e Residência , Inovação Organizacional , Inteligência Emocional , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Melhoria de Qualidade
14.
J Nurs Adm ; 49(10): 457-459, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31517752

RESUMO

During the 1st half of 2019 the AONL Foundation for Nursing Leadership Research and Education underwent an identity and brand change and adopted a new strategic plan, complete with a new mission and vision, to guide the foundation's work forward toward creating a sustainable research for nursing leadership research and education. This article describes the strategic planning activities and process the AONL Foundation recently undertook and highlights future goals.


Assuntos
Liderança , Cuidados de Enfermagem/organização & administração , Inovação Organizacional , Objetivos Organizacionais , Sociedades de Enfermagem/organização & administração , Humanos , Estados Unidos
15.
BMC Health Serv Res ; 19(1): 634, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488149

RESUMO

BACKGROUND: The involvement of doctors in managerial roles seems to be the solution to reducing the friction between traditional professionalism and modern organizational paradigms. However, these "hybrid" professionals responded in different ways to these conflicting demands, and we need to better understand the contextual factors that explain such variation. METHODS: The paper studies hybrid professionals in a hospital characterized by numerous organizational changes. The site is located in Italy, a country in which healthcare organizations have been exposed to managerial reforms for years but where the degree to which professionals embraced management varies. A longitudinal case study was performed that involved gathering data through multiple sources of evidence to understand the complex organizational dynamics that take place in the hospital. RESULTS: The analysis shows that the taking up of hybrid managerial roles is enabled by a number of interrelated features of the social/organizational context. Professionals willing to become hybrids were favored by the support provided by the organization. While for those doctors initially more reluctant towards medical management, distinctive contextual factors, in particular, the presence of space for interaction with colleagues within the professional domains but beyond disciplinary boundaries, was of key importance. This second group also proved capable of interiorizing organizational values and practices in a reconfigured way. CONCLUSIONS: In order to understand hybridization, it is necessary to look beyond hybrids at the context surrounding them. This study provides evidence for scholars and practitioners willing to understand how medical management is evolving and how this transition can be supported, and it contributes to the literature on hybrid managers by showing how contexts facilitating social interactions enable professionals' hybridization. TRIAL REGISTRATION: The article does not report the results of a health care intervention on human participants, and material used in the research did not need ethical approval according to Italian law.


Assuntos
Corpo Clínico Hospitalar/organização & administração , Médicos , Profissionalismo , Reforma dos Serviços de Saúde , Hospitais/estatística & dados numéricos , Humanos , Itália , Inovação Organizacional , Administração da Prática Médica/organização & administração
17.
Transplant Proc ; 51(6): 1661-1666, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31399157

RESUMO

BACKGROUND: For many cornea disorders, transplantation can be the treatment of first choice. In Brazil, there is a disparity in the number of transplants between regions due to the lack of an oriented system for cornea procurement.The aim of this study was to analyze the implementation of a system exclusively oriented toward the improvement of cornea recovery in the Rio de Janeiro State Organ Procurement Organization (OPO) area. With this system, all cornea donation activities were coordinated by the OPO after telephone referrals following asystolic death. From the perspective of health care innovation, we will discuss the role of the main participants and their interactions following the implementation phase. METHODS: One hospital was chosen to host the project following the first 2 years of the implementation of the State Cornea Donation System. We retrospectively analyzed all deaths between January 1 and December 31, 2016, using the hospital death records and the OPO referrals record. The strategic plan, documents, and interviews were carried out for the analysis of the implementation of this innovation in our region. RESULTS: Of 1720 deaths in 2016, 1093 (63.5%) were referred to the OPO following asystolic death for assessment and screening, but 819 of these potential tissue donors (PTDs) were not eligible for donation due to medical contraindications. The remaining 274 (25.1%) fulfilled the PTD criteria. Less than half of the families (n = 128) of these PTDs could be contacted requesting donation, but 50% consented. Finally, corneas were procured from 58 patients. The interactions between in-house coordinators and top managers were mandatory for the success of program implementation. CONCLUSION: For the first time in our country, cornea recovery took place following asystolic death with OPO coordination at a central level. The PTD rate could be estimated, and an analysis of the role of stakeholders could be made for the implementation phase of this innovation in our system.


Assuntos
Transplante de Córnea , Implementação de Plano de Saúde/organização & administração , Inovação Organizacional , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/organização & administração , Brasil , Hospitais , Humanos , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Obtenção de Tecidos e Órgãos/métodos
18.
Stud Health Technol Inform ; 263: 171-190, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31411162

RESUMO

Successful implementation of health informatics systems depends not only on efficient performance of intended tasks, but also integration into existing working relationships and environments. Implementation is an understudied area in health informatics research, and relevant empirical evidence is often absent from strategic decision making. Implementation theories such as Normalization Process Theory (NPT) can help address this gap by providing explanations for relevant phenomena, proposing important research questions, and framing collection and analysis of data. NPT identifies, characterizes, and explains mechanisms that have been empirically demonstrated to affect implementation processes and outcomes. These explanations are generalizable and facilitate comparative investigations. The first section of this chapter introduces the four main constructs of NPT (coherence, cognitive participation, collective action, and reflexive monitoring) and their constituent components. Each component is discussed with reference to a real-world example, and relationships between the four constructs are explored. The second section explores how NPT has been applied in both prospective planning of interventions and their evaluation, as well as retrospective exploration of factors promoting or inhibiting successful implementation. We examine two examples from published literature: firstly, prospective planning of an evaluation study on implementation of a digital health intervention for Type-2 diabetes; and secondly an evaluation of implementation of a new electronic preoperative information system within a surgical pre-assessment clinic. The chapter concludes with reflections on some limitations of NPT as a theoretical framework.


Assuntos
Assistência à Saúde , Informática Médica , Inovação Organizacional , Estudos Prospectivos , Estudos Retrospectivos
20.
Surgery ; 166(4): 587-592, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31447104

RESUMO

BACKGROUND: Our regional trauma organization, which comprises 7 trauma centers, 30 acute care hospitals and free-standing emergency departments, and 42 emergency medical services agencies, conducted possibly the largest mass-casualty drill to date, totaling 445 victims at 3 sites involving 11 hospitals and 25 agencies and organizations. METHODS: The drill was preceded by a tabletop exercise 4 months beforehand called Operation Continued Care Full-Scale Exercise, which consisted of simulated terrorist events at 3 sites to wound 445 moulaged patients. Four law enforcement and 5 fire and emergency medical services departments and 16 supporting organizations and agencies were involved in transporting patients to 11 different hospitals. The 7 objectives for the event addressed coordinating emergency operations, sustaining adequate communications, updating regional bed status, processing resource requests, triaging patients, tracking patients, and patient identification. RESULTS: Of the 445 transported patients, 270 (60%) were entered correctly into the state patient tracking system; 68 (25.2%) upgrades and 34 (12.6%) downgrades from scene triage categories were noted. Multiple opportunities for improvement were identified, with major weaknesses noted in communication and coordination from event sites to the regional trauma organizations and hospitals. CONCLUSION: The size and complexity of the drill provided experience and knowledge to facilitate future disaster preparedness and highlighted weaknesses in communication and coordination. Large, multijurisdictional, multiagency exercises provide opportunities to stress, evaluate, and improve regional disaster preparedness.


Assuntos
Defesa Civil/organização & administração , Planejamento em Desastres/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Incidentes com Feridos em Massa/mortalidade , Transporte de Pacientes/organização & administração , Centros de Traumatologia/organização & administração , Feminino , Bombeiros/estatística & dados numéricos , Humanos , Comunicação Interdisciplinar , Masculino , Incidentes com Feridos em Massa/prevenção & controle , Inovação Organizacional , Controle de Qualidade , Triagem , Estados Unidos
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