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2.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34636213

RESUMO

PURPOSE: Health systems function in an ecosystem that is turbulent and competitive because of demographic, economic, political, technological and lifestyle changes and sociopolitical influences, requiring hospitals to adopt comprehensive business strategies. Failure to do so may result in duplication, waste and deficits. This original article uses the prism of agency theory to examine differences in approach at two levels of hospital management and the consequent problems in the incorporation of necessary changes. Agency theory posits an inherent conflict of interest in organizations, including health organizations: the managers (agents) always aim to maximize their profit or personal interest instead of that of the owner or organization (principal), potentially causing difficulty in managing the organization. The aim is to generate recommendations for policymakers. DESIGN/METHODOLOGY/APPROACH: The study is based on 30 semi-structured, in-depth interviews with key figures in the health system and on two levels of hospital management: senior managers and heads of selected departments. The analysis used a categorical qualitative methodology. FINDINGS: The main findings are five key themes: views of business behavior, asymmetry of interests, asymmetry of information, transparency and cooperation between various levels of management and ambivalence toward business in hospitals. The two levels of management are clearly divided in terms of interests, information and activity, leading to difficulty in cooperation, efficiency and achievement of organizational goals. ORIGINALITY/VALUE: Using agency theory, this study provides a systemic and organizational view of hospitals' management and environmental adaptation. Understanding the processes and increasing cooperation at various managerial levels can help make the system more efficient and ensure its survival in a dynamic market.


Assuntos
Conflito de Interesses , Administração Hospitalar , Ecossistema , Hospitais , Objetivos Organizacionais
7.
Ann Intern Med ; 174(10): 1466-1467, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34487453
8.
Br J Radiol ; 94(1126): 20210547, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34433005

RESUMO

The Internal Dosimetry User Group (IDUG) is an independent, non-profit group of medical professionals dedicated to the promotion of dosimetry in molecular radiotherapy (www.IDUG.org.uk). The Ionising Radiation (Medical Exposure) Regulations 2017, IR(ME)R, stipulate a requirement for optimisation and verification of molecular radiotherapy treatments, ensuring doses to non-target organs are as low as reasonably practicable. For many molecular radiotherapy treatments currently undertaken within the UK, this requirement is not being fully met. The growth of this field is such that we risk digressing further from IR(ME)R compliance potentially delivering suboptimal therapies that are not in the best interest of our patients. For this purpose, IDUG proposes ten points of action to aid in the successful implementation of this legislation. We urge stakeholders to support these proposals and ensure national provision is sufficient to meet the criteria necessary for compliance, and for the future advancement of molecular radiotherapy within the UK.


Assuntos
Monitoramento de Radiação/legislação & jurisprudência , Monitoramento de Radiação/normas , Radioterapia (Especialidade)/normas , Proteção Radiológica/legislação & jurisprudência , Proteção Radiológica/normas , Humanos , Objetivos Organizacionais , Órgãos em Risco , Radiação Ionizante , Dosagem Radioterapêutica , Sociedades Médicas , Reino Unido
11.
Front Health Serv Manage ; 38(1): 4-13, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431813

RESUMO

SUMMARY: Across the healthcare landscape, the COVID-19 pandemic has been incredibly challenging. It also has been a catalyst for change. It has ignited a redesign of the US health system and presented opportunities in areas such as caregiver and patient communication, digital practice, telehealth and virtual care, and more. Notably, the pandemic also has shined a new light on caregiver well-being. As executive leaders of Cleveland Clinic's Caregiver Office, our top priority throughout the pandemic has been to support our caregivers professionally and personally-to help them be their best for themselves and for their fellow caregivers, our patients, our organization, and our communities. Today, Cleveland Clinic is realizing the profound impact of many of the strategies put in place during the pandemic and seeing how COVID-19 accelerated our organization's unified vision for caregiver well-being. This article offers insight into Cleveland Clinic's commitment to caregiver well-being, highlights actions we undertook during the pandemic, shares the resulting lessons we learned, and showcases how those lessons are shaping our future caregiver well-being strategy.


Assuntos
Instituições de Assistência Ambulatorial/organização & administração , COVID-19 , Cuidadores/normas , Atenção à Saúde/organização & administração , Pessoal de Saúde/normas , Saúde Holística , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ohio , Cultura Organizacional , Objetivos Organizacionais , Pandemias , SARS-CoV-2
12.
Front Health Serv Manage ; 38(1): 20-26, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431815

RESUMO

SUMMARY: At Texas Health Resources, the well-being of our patients, our workforce, and our communities has long been at the core of who we are and the driving force behind business decisions, employee interactions, programs, practices, and the patient care we deliver. It is in our DNA, from our vision "to partner with you for a lifetime of health and well-being" to Our Texas Health Promise: Individuals Caring for Individuals, Together. That solid foundation-always the basis of our business preparations-made it possible for us to weather the challenges brought by the COVID-19 pandemic and to prepare ourselves for what comes next, emerging stronger and with sustained energy to transform the enterprise on the other end.


Assuntos
COVID-19/psicologia , COVID-19/terapia , Cuidadores/psicologia , Atenção à Saúde/organização & administração , Pessoal de Saúde/psicologia , Objetivos Organizacionais , Apoio Social , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Texas
13.
Front Health Serv Manage ; 38(1): 27-31, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431816

RESUMO

SUMMARY: Critical access hospitals (CAHs) serve their rural communities as the main access points and communication centers for healthcare, typically with very limited financial, staffing, and support resources. Local residents rely on their CAHs as the only providers for many miles around. When the COVID-19 pandemic hit in early 2020, CAH leaders had to rethink operations and priorities, both internally with staffs and externally with community leaders and organizations. Few critical care beds were available when the need was greatest. Testing was problematic, and cultural barriers complicated care. Now, as virus variants strike where vaccination numbers are low, CAH leaders remain wary of financial hits to elective procedure income, limited resources, and added stress for their staffs. Working with community service organizations and larger regional healthcare centers is a crucial strategy for CAHs as they address care delivery issues and ensure that their caregivers can do their jobs now and in the future.


Assuntos
COVID-19/terapia , Cuidados Críticos/organização & administração , Atenção à Saúde/organização & administração , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Administradores Hospitalares/psicologia , Serviços de Saúde Rural/organização & administração , Adulto , Animais , Atitude do Pessoal de Saúde , Feminino , Administração Hospitalar , Humanos , Illinois , Liderança , Masculino , Pessoa de Meia-Idade , Objetivos Organizacionais , Pandemias , SARS-CoV-2
14.
Front Health Serv Manage ; 38(1): 32-38, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431817

RESUMO

SUMMARY: Fighting the global COVID-19 pandemic has shifted from immediate response efforts to recognition of the long-term effects on the mental health and well-being of the general population and healthcare workforce. Leaders need to understand the vital role of behavioral health services in a population-based, integrated healthcare framework and address the needs of the behavioral health workforce to successfully deploy services in their organizations and communities.During the ongoing national response to COVID-19, three major trends have emerged: (1) a shift to telehealth and digital care, (2) greater awareness of the impact on the workforce of the shift to digital care, and (3) an open dialogue to counteract the stigma and discrimination related to mental illness and to emphasize mental well-being instead. When they address stigma and discrimination, healthcare leaders embrace a more holistic approach that welcomes behavioral health professionals as equal, vital members of the care team. They help their organizations advance the mental well-being of all.


Assuntos
COVID-19/psicologia , COVID-19/terapia , Pessoal de Saúde/psicologia , Promoção da Saúde/organização & administração , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Estigma Social , Telemedicina/organização & administração , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Objetivos Organizacionais , Pandemias , SARS-CoV-2 , Estados Unidos
15.
Front Health Serv Manage ; 38(1): 39-44, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431818

RESUMO

SUMMARY: Well-being, engagement, and burnout among clinicians are interconnected, and the common denominator is energy. Decades of research show that employees' energy is a decisive factor in achieving organizational outcomes. Knowing this, healthcare leaders can create well-being programs with measurable outcomes that make a positive impact on the bottom line. Just as important, leaders can avoid wasting money on fruitless efforts. How can clinician well-being be incorporated in organizational culture and strategic and operational plans? What are the special challenges to achieving clinician well-being? What key leadership actions promote and protect the well-being of clinicians? Which approaches are most effective during a crisis such as the COVID-19 pandemic? This article addresses those questions by presenting the rationale and methodology behind well-being programs that also address engagement and burnout so that clinicians can succeed in times of crisis and beyond.


Assuntos
Atitude do Pessoal de Saúde , Esgotamento Profissional/psicologia , COVID-19/terapia , Atenção à Saúde/organização & administração , Pessoal de Saúde/psicologia , Promoção da Saúde/organização & administração , Engajamento no Trabalho , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Objetivos Organizacionais , Pandemias , SARS-CoV-2
17.
Am J Respir Crit Care Med ; 204(2): e3-e23, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-34283696

RESUMO

Background: In the past two decades, many advances have been made to our understanding of interstitial lung disease (ILD) and the way we approach its treatment. Despite this, many questions remain unanswered, particularly those related to how the disease and its therapies impact outcomes that are most important to patients. There is currently a lack of guidance on how to best define and incorporate these patient-centered outcomes in ILD research. Objectives: To summarize the current state of patient-centered outcomes research in ILD, identify gaps in knowledge and research, and highlight opportunities and methods for future patient-centered research agendas in ILD. Methods: An international interdisciplinary group of experts was assembled. The group identified top patient-centered outcomes in ILD, reviewed available literature for each outcome, highlighted important discoveries and knowledge gaps, and formulated research recommendations. Results: The committee identified seven themes around patient-centered outcomes as the focus of the statement. After a review of the literature and expert committee discussion, we developed 28 research recommendations. Conclusions: Patient-centered outcomes are key to ascertaining whether and how ILD and interventions used to treat it affect the way patients feel and function in their daily lives. Ample opportunities exist to conduct additional work dedicated to elevating and incorporating patient-centered outcomes in ILD research.


Assuntos
Doenças Pulmonares Intersticiais/enfermagem , Pesquisa em Enfermagem/organização & administração , Objetivos Organizacionais , Avaliação de Resultados da Assistência ao Paciente , Satisfação do Paciente , Assistência Centrada no Paciente/organização & administração , Qualidade de Vida/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
18.
J Child Adolesc Psychopharmacol ; 31(7): 457-463, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34283939

RESUMO

Objectives: Our goal was to develop an open access nationally disseminated online curriculum for use in graduate and continuing medical education on the topic of pediatric telepsychiatry to enhance the uptake of telepsychiatry among child psychiatry training programs and improve access to mental health care for youth and families. Methods: Following Kern's 6-stage model of curriculum development, we identified a core problem, conducted a needs assessment, developed broad goals and measurable objectives in a competency-based model, and developed educational content and methods. The curriculum was reviewed by experts and feedback incorporated. Given the urgent need for such a curriculum due to the COVID-19 pandemic, the curriculum was immediately posted on the American Academy of Child and Adolescent Psychiatry and American Association of Directors of Psychiatric Residency Training websites. Further evaluation will be conducted over the next year. Results: The curriculum covers the six areas of core competence adapted for pediatric telepsychiatry and includes teaching content and resources, evaluation tools, and information about other resources. Conclusion: This online curriculum is available online and provides an important resource and set of standards for pediatric telepsychiatry training. Its online format allows for ongoing revision as the telepsychiatry landscape changes.


Assuntos
Psiquiatria do Adolescente/educação , COVID-19 , Psiquiatria Infantil/educação , Currículo/tendências , Educação Médica Continuada , Educação de Pós-Graduação em Medicina , Acesso à Informação , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Educação/métodos , Educação/organização & administração , Educação Médica Continuada/métodos , Educação Médica Continuada/organização & administração , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/organização & administração , Acesso aos Serviços de Saúde , Humanos , Serviços de Saúde Mental/normas , Serviços de Saúde Mental/tendências , Inovação Organizacional , Objetivos Organizacionais , SARS-CoV-2 , Telemedicina/métodos
19.
NASN Sch Nurse ; 36(4): 188-190, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34137307

RESUMO

Annually, the National Association of School Nurses (NASN) sets advocacy goals. The goals include legislative and policy priorities. The COVID-19 pandemic brought attention to the need to heighten advocacy efforts, specifically to provide for additional school nurses and supplies necessary to meet the challenge of safely returning students to school. While advocating at the national level, NASN also encouraged advocacy at the state and local levels. This article provides a brief summary of NASN's advocacy efforts as well as providing examples from two different state associations demonstrating the importance of collaboration in advocacy efforts in areas related to the pandemic and in general areas related to school nursing.


Assuntos
COVID-19/epidemiologia , Papel do Profissional de Enfermagem , Gestão da Segurança/organização & administração , Serviços de Saúde Escolar/organização & administração , Serviços de Enfermagem Escolar/legislação & jurisprudência , Sociedades de Enfermagem/legislação & jurisprudência , Humanos , Liderança , Objetivos Organizacionais , Serviços de Enfermagem Escolar/organização & administração , Estados Unidos
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