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1.
J Nurs Adm ; 50(7-8): 369-371, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32701640

RESUMO

In today's dynamic healthcare environment, it is more important than ever that the chief nursing officer (CNO) possesses transformational leadership skills. This includes the cultivation of leaders whom the CNO can partner with to advance strategic priorities that benefit patients, families, clinical nurses, and others within a strong, supportive practice environment. A collaborative partnership not only ensures the advancement of an agenda for change but also enhances communication and visibility and provides an opportunity for development of key individuals on the executive team. By supporting partnerships, the CNO has the opportunity to keep talented leaders in the pipeline and to identify those who should be a part of the succession planning process. This is a critically important concept that can lead to a smooth leadership transition.


Assuntos
Liderança , Tutoria , Enfermeiras Administradoras , Inovação Organizacional , Humanos , Seleção de Pessoal , Técnicas de Planejamento , Desenvolvimento de Pessoal
2.
Prehosp Disaster Med ; 35(4): 451-453, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32507122

RESUMO

Coronavirus Disease 2019 (COVID-19), a new respiratory disease, is spreading globally. In France, Emergency Medical Service (EMS) teams are mobile medicalized resuscitation teams composed of emergency physician, nurse or anesthesiologist nurse, ambulance driver, and resident. Four types of clinical cases are presented here because they have led these EMS teams to change practices in their management of patients suspected of COVID-19 infection: cardiac arrest, hypoxia on an acute pneumonia, acute chronic obstructive pulmonary disease (COPD) exacerbation with respiratory and hemodynamic disorders, and upper function disorders in a patient in a long-term care facility. The last case raised the question of COVID-19 cases with atypical forms in elderly subjects. Providers were contaminated during the management of these patients. These cases highlighted the need to review the way these EMS teams are responding to the COVID-19 pandemic, in view of heightening potential for early identification of suspicious cases, and of reinforcing the application of staff protection equipment to limit risk of contamination.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Serviços Médicos de Emergência/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Idoso , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Planejamento em Desastres , Serviços Médicos de Emergência/normas , Tratamento de Emergência/normas , Feminino , França/epidemiologia , Humanos , Masculino , Pandemias , Equipamento de Proteção Individual , Técnicas de Planejamento , Pneumonia Viral/epidemiologia
9.
Waste Manag ; 104: 262-269, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31991267

RESUMO

Anaerobic digestion (AD) reduces GHG emission and facilitates renewable energy generation. The slow rate of adoption of this technology is often attributed to economic and technical considerations. Collaboration of two or more dairy farms into a centralized AD system can improve the process economics through economies of scale. However, uncertainties related to the process parameters and the scope/scale of the collaborative implementation impede its adoption. This study presents techno-economic optimization model as a design aid to determine ideal location, capacity, and participation level (cluster size) that maximize economic return on a cooperative digester. This study employs a probabilistic approach to overcome uncertainty regarding project parameters such as manure biomethane potential (BMP), project capital, and electricity sale price. Two case studies based on dairy production regions in Wisconsin were developed to test the model and demonstrate its capabilities. Herd sizes and spatial distribution in a given region were found to be critical factors in determining the viability of digestion projects in general, and collaborative digestion systems in particular. The number of simulation runs needed to capture the probability of profitable AD facility establishment was less than 1000 for both case studies assessed. Electricity sale price and biomethane potential of feedstock utilized were found to be the most restrictive to the feasibility of AD adoption. Changing the optimization objective function, to adopting maximization, favored the formation of collaborative AD facilities for both case studies evaluated.


Assuntos
Biocombustíveis , Esterco , Anaerobiose , Animais , Metano , Técnicas de Planejamento , Incerteza , Wisconsin
10.
Cogitare enferm ; 25: e72659, 2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1094872

RESUMO

OBJETIVO: frente à divulgação do guia COVID-19 - Operational Planning Guidelines to Support Country Preparedness and Response, pela Organização Mundial da Saúde, esta comunicação buscou comparar o conteúdo do Plano de Contingência Nacional às orientações da Organização Mundial da Saúde. DESENVOLVIMENTO: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov2), causador da COVID-19, apresenta transmissão comunitária sustentada no Brasil desde março de 2020. O país lançou seu Plano de Contingência Nacional para Infecção Humana pelo novo Coronavírus COVID-19, em fevereiro de 2020, no intuito de orientar a resposta nacional de combate à doença. CONCLUSÃO: o documento brasileiro atende parcialmente às recomendações do guia internacional e concentra suas principais lacunas nos pilares sobre pontos de entrada, prevenção e controle da infecção por SARS-CoV-2 COVID-19 em equipamentos de saúde e espaços comunitários, manejo de casos suspeitos e confirmados e suporte operacional e logístico.


OBJECTIVE: In view of the publication of the COVID-19 guide ­ Operational Planning Guidelines to Support Country Preparedness and Response, by the World Health Organization, this paper attempts to compare the content of the Brazilian National Contingency Plan to the WHO guidelines. DEVELOPMENT: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov2), the virus that causes COVID-19, has a sustained community transmission in Brazil since March 2020. The country launched the National Contingency Plan for Human Infection with the new COVID-19 Coronavirus in February 2020, in order to guide the national response to fight the disease. CONCLUSION: The Brazilian document only partially meets the recommendations of the international guide, the main gaps being the points of entry, prevention, and control of the infection caused by SARS-CoV-2 in health equipment and community spaces, handling suspected and confirmed cases, and operational and logistical support.


RESUMEN: Objetivo: en vista de la divulgación de la guía COVID-19 - Operational Planning Guidelines to Support Country Preparedness and Response, por parte de la Organización Mundial de la Salud, este comunicado tuvo como objetivo comparar el contenido del Plan de Contingencia nacional con las pautas de la Organización Mundial de la Salud. DESARROLLO: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov2), que causa el COVID-19, presenta transmisión comunitaria en Brasil desde marzo de 2020. El país lanzó su Plan de Contingencia Nacional para la Infección Humana por el nuevo Coronavirus COVID-19 en febrero de 2020, con la intención de orientar la respuesta nacional de lucha contra la enfermedad. CONCLUSIÓN: el documento brasileño cumple parcialmente las recomendaciones de la guía internacional y concentra sus principales déficits en los pilares sobre puntos de entrada, prevención y control de la infección SARS-CoV-2 COVID-19 en equipamientos de salud y espacios comunitarios, manejo de casos sospechados y confirmados, y soporte operativo y logístico.


Assuntos
Humanos , Técnicas de Planejamento , Infecções por Coronavirus , Coronavirus , Planos de Contingência , Pandemias , Organização Mundial da Saúde
11.
PLoS One ; 14(11): e0225669, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31774862

RESUMO

Change Acceleration Process model (CAP) emerged in early 90's as a set of principles for accelerating change management efforts in organizations. Business Process Improvement (BPI) projects open avenues of opportunity and success for organizations in this highly competitive era. However, most of these projects fail due to lack of commitment, communication, scope creep and inadequate resources. This research attempts to study industry relevant factors most critical to success of a BPI Project in the highly competitive telecom sector. Modified Delphi technique employing a panel of telecom professionals was adopted in order to determine the critical success factors (CSFs) after a thorough review of the literature. Exploratory factor analysis was performed to map extracted factors to the five agents of change. Research outcome defines the relevant CSFs in terms of vision, skills, incentives, resources and action plan. A significant contribution of this research is an extended CAP model for implementation of BPI projects. Practical implications of this research are utilization of the proposed model for BPI project success.


Assuntos
Eficiência Organizacional/normas , Indústrias/normas , Sistemas de Informação/normas , Modelos Organizacionais , Técnicas de Planejamento , Melhoria de Qualidade/organização & administração , Gestão da Qualidade Total/organização & administração , Humanos , Objetivos Organizacionais , Projetos de Pesquisa , Análise e Desempenho de Tarefas
13.
Nurs Forum ; 54(4): 707-713, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31667848

RESUMO

A 2-year long, multisite research study that evaluated cardiopulmonary resuscitation skill decay among nursing students was conducted at 10 schools of nursing across the United States. The study was conducted in two phases and required carefully timed sessions for skill performance. Multisite studies in nursing education need to be carefully planned. Time delays should be anticipated with processes and Institutional Review Board protocols across sites. All team members were trained and consistently supported during the entire study. While challenges and obstacles were identified, innovative solutions were implemented that assisted the research team to successfully complete the study. The use of new and existing technology allowed the team to surmount many of the challenges encountered in this study. The purpose of this article is to describe the logistics, processes, challenges, and lessons learned related to conducting a complex multisite study.


Assuntos
Invenções/tendências , Estudos Multicêntricos como Assunto/métodos , Técnicas de Planejamento , Comportamento Cooperativo , Humanos , Estudos Multicêntricos como Assunto/psicologia , Estados Unidos
14.
Am J Ophthalmol ; 208: 342-346, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31472158

RESUMO

PURPOSE: There is no consensus on the surgical management of head position associated with infantile nystagmus syndrome (INS) when strabismus coexists, and few outcome data have been published. We propose classifying strabismus into concordant or discordant based on the relationship between head positioning and strabismus and then modifying surgery accordingly. Our objective is to describe this system and to review surgical outcomes. DESIGN: Retrospective observational case series. METHODS: Twenty-eight patients with INS and coexisting horizontal strabismus underwent surgery for horizontal head positioning and had ≥2 months of follow-up from 1995-2018 at the Vanderbilt Eye Institute. Outcome variables included head positioning (minimal, ≤10°; mild, 11-30°; moderate 31-44°; and severe ≥45°), strabismus (range 0-70 prism diopters [PDs]; minimal ≤10 PD), and reoperation rates. Nonparametric Wilcoxon signed rank, Fisher exact, and Mann-Whitney U tests were used for statistical analysis. RESULTS: Twenty-one cases were concordant and 7 were discordant; the mean follow-up was 4.1 years. Ninety-six percent of patients had moderate to severe head positioning at baseline. Correction rates (to minimal) were 100% at 2-5 months postoperatively and 86% at last follow-up (P < .0001 at both time points compared with preoperatively). The magnitude of strabismus decreased compared with preoperative strabismus (30.8 ± 10.8 PDs; n = 28), strabismus at 2-5 months (9.1 ± 11.9 PDs; P = .0001; n = 26), and last follow-up (12.0 ± 14.1 PDs; P = .0003; n = 28). The overall reoperation rate was 32%. CONCLUSIONS: Our classification system in patients with INS allows a systematic way to surgically improve head positioning and strabismus in cases of moderate to severe baseline head positioning.


Assuntos
Cabeça/fisiologia , Nistagmo Congênito/cirurgia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Postura/fisiologia , Estrabismo/cirurgia , Criança , Feminino , Seguimentos , Humanos , Masculino , Nistagmo Congênito/fisiopatologia , Músculos Oculomotores/fisiopatologia , Técnicas de Planejamento , Estudos Prospectivos , Reoperação , Estudos Retrospectivos , Estrabismo/fisiopatologia , Tenotomia , Resultado do Tratamento , Acuidade Visual/fisiologia
15.
Implement Sci ; 14(1): 78, 2019 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399105

RESUMO

BACKGROUND: Advanced physiotherapist-led services have been embedded in specialist orthopaedic and neurosurgical outpatient departments across Queensland, Australia, to ameliorate capacity constraints. Simulation modelling has been used to inform the optimal scale and professional mix of services required to match patient demand. The context and the value of simulation modelling in service planning remain unclear. We aimed to examine the adoption, context and costs of using simulation modelling recommendations to inform service planning. METHODS: Using an implementation science approach, we undertook a prospective, qualitative evaluation to assess the use of discrete event simulation modelling recommendations for service re-design and to explore stakeholder perspectives about the role of simulation modelling in service planning. Five orthopaedic and neurosurgical services in Queensland, Australia, were selected to maximise variation in implementation effectiveness. We used the consolidated framework for implementation research (CFIR) to guide the facilitation and analysis of the stakeholder focus group discussions. We conducted a prospective costing analysis in each service to estimate the costs associated with using simulation modelling to inform service planning. RESULTS: Four of the five services demonstrated adoption by inclusion of modelling recommendations into proposals for service re-design. Four CFIR constructs distinguished and two CFIR constructs did not distinguish between high versus mixed implementation effectiveness. We identified additional constructs that did not map onto CFIR. The mean cost of implementation was AU$34,553 per site (standard deviation = AU$737). CONCLUSIONS: To our knowledge, this is the first time the context of implementing simulation modelling recommendations in a health care setting, using a validated framework, has been examined. Our findings may provide valuable insights to increase the uptake of healthcare modelling recommendations in service planning.


Assuntos
Assistência Ambulatorial/normas , Assistência à Saúde/normas , Ciência da Implementação , Modelos Organizacionais , Neurocirurgia/normas , Ortopedia/normas , Pacientes Ambulatoriais , Técnicas de Planejamento , Melhoria de Qualidade , Grupos Focais , Necessidades e Demandas de Serviços de Saúde , Humanos , Pesquisa Qualitativa , Queensland
18.
Hum Resour Health ; 17(1): 52, 2019 07 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296235

RESUMO

BACKGROUND: Gender equity remains a challenge across various labor markets with the health market being no exception. Despite the increased influx of women into health professions, horizontal and vertical occupational gender inequities persist. MAIN BODY: The objective of this scoping review is to map the studies on gender equity in healthcare systems in terms of workforce planning, development, and management, as well as to identify the barriers and facilitators for integrating gender equity into healthcare systems. We reviewed the literature on the topic using nine electronic and two grey literature databases with the search strategy combining medical subheadings and keywords for each of the following four concepts of interest: "gender equity," "human resources for health," "healthcare setting," and "management processes." The scoping review included studies focusing on the examination of gender equity at the level of the health workforce. Out of 20,242 studies identified through the database search, the full text of 367 articles was assessed for eligibility and 110 were included in the qualitative analysis. The data of those studies was abstracted and analyzed into themes. Results do not only reveal a global dearth of studies focused on this important topic, but also the concentration of such studies in a few countries around the globe, mainly in North America and Europe. Four out of each five studies included in this review focused on physicians, followed by nurses (14%). In terms of design, an overwhelming majority of studies utilized quantitative designs (75%), followed by qualitative designs and database analyses. Studies were categorized into four pre-determined main themes: facilitators and barriers, workforce planning, HRH management, and HRH development. CONCLUSION: Future research is needed to better understand poorly covered sub-themes such as mentorship, professional development, and training, as well as recruitment and retention among others. It is also equally needed to fill in the gaps in professional groups, study type, methodology, and region. While the review unearthed a number of well-studied themes, significant aspects of the topic remain untapped especially in developing countries and at the level of health professionals other than physicians.


Assuntos
Mão de Obra em Saúde , Administração de Recursos Humanos , Sexismo , Justiça Social , Feminino , Humanos , Masculino , Seleção de Pessoal , Técnicas de Planejamento
19.
J Nurs Adm ; 49(7-8): 343-344, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31335514

RESUMO

Succession planning is an important business strategy in many industries, but healthcare has been slow to recognize its value. In this month's Magnet Perspectives column, learn why succession planning and mentoring are critical for nursing, how they affect key outcomes, and who benefits from preparing the next generation of nurses. Chief nursing officers discuss the importance of identifying and grooming top talent and share their personal stories of how succession planning and mentoring impacted their careers. The column includes tips to create a succession planning program and explores how the Magnet environment promotes a culture of mentoring and leadership continuity.


Assuntos
Liderança , Mentores , Enfermeiras Administradoras/organização & administração , Técnicas de Planejamento , Desenvolvimento de Pessoal/organização & administração , Humanos
20.
J Craniofac Surg ; 30(8): 2459-2463, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31306382

RESUMO

BACKGROUND: Virtual surgical planning (VSP) is increasingly described in craniofacial surgery literature. However, the quality of the literature that has been published is unknown. The objective of this systematic review was to determine the level of evidence of published articles on VSP. METHODS: In this systematic review, PubMed, Web of Science, and ScienceDirect databases were queried for key terms in craniofacial VSP. Inclusion and exclusion criteria concentrated on patient-specific surgical outcomes in studies that could be rated for level of evidence. The articles were ranked according to their level of evidence, with level I being the highest level of evidence (randomized-controlled trials) and level V being the lowest (eg, case reports). RESULTS: The initial keyword search yielded 1524 articles, 273 of which were ranked and included in the systematic review. The average level of evidence for an article published was 4.1 (between level IV and level V). Level IV was the most common level of evidence (65.6%), followed by level V (24.9%), level III (7.3%), level II (2.2%), respectively. There were not any level I articles. The most common study type was case series, accounting for 68.1% of the studies, followed by case reports (23.0%), case-control studies (4.7%), cohort studies (3.3%), and randomized controlled trials (1.1%), respectively. CONCLUSION: Although the quantity of craniofacial VSP studies has proliferated, the quality of the studies has not. In order for VSP literature to feature a higher level of evidence, future studies would require more sophisticated study design, such as prospective cohort or prospective randomized control trials.


Assuntos
Procedimentos Cirúrgicos Otorrinolaringológicos , Humanos , Técnicas de Planejamento , Ensaios Clínicos Controlados Aleatórios como Assunto
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