Suchergebnisse

Under the progress of network environment, the interaction between employees and an organization might result in great effects on the organization and directly affect the relationship between the organization and customers. Employees receiving good trust, selfless devotion, and kind care from the leader would show feedback and voluntary act to the organization to indirectly or directly affect organizational employees' work attitude and performance. Taking supervisors and employees in healthcare industry in Fujian Province as the questionnaire objects, total 500 copies of questionnaire are distributed. After removing invalid and incomplete copies, 416 copies are valid, with the retrieval rate 83%. The research results reveal 1.significantly positive effects of servant leadership on employees' collective strategic vision, 2.remarkably positive effects of employees' collective strategic vision on organizational innovation performance, and 3.notably positive effects of servant leadership on organizational innovation performance. According to the results to propose suggestions, it is expected to have organizational employees and stakeholders in healthcare industry, under the leading of servant leaders and resource distribution, perceive fair treatment so that employees present identity on organizational vision and further form positive, shared, and innovative climate to effectively promote organizational innovation performance.

AbstractSystems‐theoretic process analysis (STPA) is a prospective safety assessment tool increasingly applied in healthcare. A problem hampering STPA proliferation is the difficulty of modeling systems for analysis by creating control structures. In this work, a method is proposed to use existing process maps—commonly available in healthcare—when creating a control structure. The proposed method entails (1) extract information from the process map, (2) determine the modeling boundary of the control structure, (3) transfer the extracted information to the control structure, (4) add additional information to complete the control structure. Two case studies were conducted: (1) ambulance patient offloading in the emergency department and (2) ischemic stroke care with intravenous thrombolysis. The amount of process map‐derived information in the control structures was quantified. On average, 68% of the information in the final control structures was derived from the process map. Additional control actions and feedback were added from nonprocess map sources for management and frontline controllers. Despite the differences between process maps and control structures, much of the information in a process map can be used when creating a control structure. The method enables the creation of a control structure from a process map to be done in a structured fashion.

Objectives: Real-world evidence (RWE) is increasingly used to inform health technology assessments (HTAs) for resource allocation, which are valuable tools for emerging economies such as in America. However, the characteristics and uses in South America are unknown. This study aims to identify sources, characteristics and uses of RWE in Argentina, Brazil, Colombia and Chile, and evaluate the context-specific challenges. The implications for future regulation and responsible management of RWE in the region are also considered. Methods: A systematic literature review, database mapping, and targeted grey literature search were conducted to identify the sources and characteristics of RWE. Findings were validated by key opinion leaders attending workshops in four South American countries. Results: A database mapping exercise revealed 407 unique databases. Geographic scope, database type, population and outcomes captured were reported. Characteristics of National Health Information Systems show efforts to collect interoperable data from service providers, insurers and government agencies, but that initiatives are hampered by fragmentation, lack of stewardship and resources. RWE is mainly used in South America for pharmacovigilance and as pure academic research, but less so for HTA decision-making or pricing negotiations and not at all to inform early access schemes. Conclusions: The quality of data collected in real-world in the case-study countries varies and RWE is not consistently used in healthcare decision-making. Authors recommend that future studies monitor the impact of digitalisation, and the potential effects of access to RWE on the quality of patient care.

BackgroundPeople living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran.MethodsIn‐depth, semi‐structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach.Results and discussionNearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value‐based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub‐optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare‐seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress.ConclusionsWhile previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma‐reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational intervention programmes targeting healthcare providers. Finally, further studies are needed to investigate the role of the physician and religion in the local context.

A potential solution for an economic challenge – increasing needed foreign direct investment (FDI) – is proposed using a human resource development perspective: equally investing in the development of men and women to serve in public leadership. This cross-sectional, nonexperimental study addressed a void in the literature by examining the impact of women in public leadership on FDI through lowered perceived corruption and increased national investment in healthcare. Structural equation modeling using a simple path model was used to test relationships between observable variables. Results included statistically significant relationships between the number of women in public leadership and lower levels of perceived corruption, between lower levels of perceived corruption and greater national investment in healthcare, and between greater national investment in healthcare and increased FDI countries received. Additionally, a fully mediated, indirect relationship between the number of women in public leadership and FDI countries received was statistically significant. That is, as the number of women increased within governments, levels of perceived corruption decreased, national investment in healthcare increased, and FDI increased.  Ultimately, this study provides empirical results professionals and institutions can use to advocate for gender equitable vertically integrated human resource development, particularly within developing countries, to promote FDI and its related benefits. Keywords: women, public leadership, corruption, foreign direct investment, healthcareÂ

This case describes the process and experience with conducting a large-scale multi-hospital survey study. It draws upon the example of New Zealand's largest ever health professional workforce survey, conducted across 19 multi-hospital sites, which the author led the design and conduct of. The aim of the study was to gauge progress with implementing clinical governance and respondent perceptions of aspects of healthcare quality and safety. Key challenges of the survey study included managing the processes of organizing such a study and interacting with multiple agencies. The case notes that large survey studies can provide useful data and, for the researcher, can be particularly rewarding.

This paper looks at contemporary developments and some of the social and political phenomena that have affected the status of the gap in compensation between women and men generally, and in the fields of law and healthcare specifically. It examines not only progress to date, but also how this progress has been obtained and, based on both domestic and international experiences, provides recommendations for the future.

Acute crises, such as a war or a pandemic, are the ultimate tests for health care systems' resilience (temporary response to stress with change and adaptation) and antifragility (permanent benefit from change in response to stress). In this Health Policy paper, we analyse and discuss how the healthcare systems of two European countries – Bosnia and Herzegovina and Croatia – adapted to war as a man-made disaster, and how they adapted to COVID-19 pandemic twenty-five years later. These countries experienced full scale wars in recent history, which significantly changed their political and healthcare systems. This experience prepared the countries for the response to the pandemic, which coincided with two earthquakes in Croatia. We argue that healthcare systems in Croatia and Bosnia and Herzegovina are not only resilient but antifragile, and that they benefited from stressors they were exposed to. The antifragility of the two systems were primarily based on human effort – the strength, adaptability and resilience of health care professionals. We will look at lessons from the wars that were applied to the pandemic and discuss newly recognized opportunities and improvements.

This investigation explores the relationships among information subsidies, news media coverage, and policymaking activities regarding healthcare reform during the first year of the Obama presidential administration. Specifically, a comparison of information subsidies (from the president, federal government offices, Congress, and healthcare-related stakeholder groups), news media content, and policymaking activity was completed from March 2009 to December 2009. Significant correlations were found for the salience of issues and stakeholder groups among information subsidies, news media coverage, and policymaking activity. Robust linkages were also found concerning issue attribute salience.

The purpose of this study was to assess the cultural beliefs influencing access to maternal healthcare in East Pokot Pastoral Communities, Baringo County, Kenya. The study was founded on the choice-making model and the theory of access. The research methodology was directed by the descriptive survey design. The target population was 5720 women of reproductive age between 15 and 49 years and their partners, community leaders, government health facilities administrators, traditional birth attendants and community health workers from the pastoralist communities in East Pokot in Baringo County, Kenya. A stratified purposive sampling technique included stratified and purposive sampling techniques were used to sample 146 participants. Data was collected using Focus Group Discussions and in-depth interviews. Using the Nvivo software, the data were coded and tracked and the findings were presented using narratives with quotations. The study found that the cultural beliefs that the community members held at times barred the women from accessing maternal healthcare services in the East Pokot sub-county.

Abstract

Objectives
Despite numerous initiatives, occupational exposure to blood-borne pathogens (BBP) caused by percutaneous injuries or mucosal contamination remain common among healthcare workers (HCWs). These exposures were decreasing at the American University of Beirut Medical Center (AUBMC) in the previous decades. Recently, the medical center activity has been increasing with higher number of interventions performed and shorter hospital stay. Our aim was to determine the trend of incidents resulting from BBP exposures at AUBMC from 2014 till 2018 and identify whether the increase in hospital activity affected the rate of these exposures. We also aimed to assess the risk factors associated with needle stick injuries (NSIs).


Methods
A retrospective observational descriptive study of all exposures to BBPs among HCWs reported to the Environmental Health, Safety, and Risk Management department at the AUBMC between 2014 and 2018 was performed.


Results
There were 967 exposures reported among which 84% were due to needlesticks. Residents (40%), followed by nurses (30%), and then by attending physicians (16%) were the top three most exposed occupational groups. Half of the participants injured themselves using either a syringe or a suture needle; and mostly during or after use. Occupation and incident location were associated with NSIs. The mean BBP exposure incidence rate was 5.4 per 100 full-time employees, 65.6 per 100 bed-years, and 0.48 admission-years. The BBP exposure rate per 100 occupied beds per year decreased between 2014 and 2017 then increased in 2018 (P < 0.001). The number of BBP exposures showed a strong, though non-significant negative correlation with the average length of hospital stay (Spearman correlation coefficient = −0.9, P = 0.083).


Conclusions
BBP exposure remains a serious occupational hazard. Our study shows that the BBP exposure rate per 100 occupied beds per year started decreasing during the study period before increasing again in 2018. Only the nursing department showed a consistent decrease of exposures. The occupation and incident location were found to be risk factors associated with NSIs. In addition to providing education and training, additional steps such as providing safety equipment and future interventions directed towards adjusting to higher workload should be all considered.

How We Got Here : A Brief History of Patient-Centered Care -- The Evolution of Patient-Centered Care and Medical Progress -- The Rise of the Healthcare Consumer -- Building a Consumer-Provider Relationship -- Organization, Culture, and Leadership -- Defining a Conceptual Framework : The Dimensions of Patient-Centered Care -- Best Practices : Case Studies of Dimensions in Action -- Consumer-Centric Leadership -- Internal Talent Needs -- Removing Barriers -- Nonpreferred and Preferred Future.

The power plant and the microgrid -- Staff : care led by community and frontline providers -- Stuff : palm-size design for off-grid, off-road, offline use -- Systems : decentralized, goal-directed, and technology enabled -- Space : the right place at the right time -- Bridging the great divide.