Bmc Health Serv Res
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Bmc Health Serv Res · Jul 2019
French cross-cultural adaptation of the Organizational Readiness for Implementing Change (ORIC).
Organizational readiness is a factor known to influence the predisposition of individuals within an organization to change. Based on Weiner's organizational theory, the "Organizational Readiness for Implementing Change" (ORIC) questionnaire was developed and validated to measure organizational readiness in healthcare contexts. However, no such tools allow French-speaking organizations to measure this concept. The objectives of this study were to (1) conduct a French cultural adaptation of the ORIC questionnaire, and (2) initiate the study of its psychometric properties. ⋯ The ROIC is a new theory-based and translated questionnaire that can be used to rigorously document the organizational readiness of French organizations. The ROIC has the potential to support members of different organizations in the identification of subsequent efforts for the implementation of a change.
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Bmc Health Serv Res · Jul 2019
Randomized Controlled TrialEffectiveness of quality incentive payments in general practice (EQuIP-GP): a study protocol for a cluster-randomised trial of an outcomes-based funding model in Australian general practice to improve patient care.
There is international interest in whether improved primary care, in particular for patients with chronic or complex conditions, can lead to decreased use of health resources and whether financial incentives help achieve this goal. This trial (EQuIP-GP) will investigate whether a funding model based upon targeted, continuous quality incentive payments for Australian general practices increases relational continuity of care, and lessens health-service utilisation, for high-risk patients and children. ⋯ The trial will provide robust evidence on a novel approach to providing continuous incentives for improving quality of general practice care, which can be compared to block payment incentives awarded at target quality levels of pay-for-performance, both within Australia and also internationally.
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Bmc Health Serv Res · Jul 2019
Observational StudyCommunication and relationship dynamics in surgical teams in the operating room: an ethnographic study.
In surgical teams, health professionals are highly interdependent and work under time pressure. It is of particular importance that teamwork is well-functioning in order to achieve quality treatment and patient safety. Relational coordination, defined as "communicating and relating for the purpose of task integration," has been found to contribute to quality treatment and patient safety. Relational coordination has also been found to contribute to psychological safety and the ability to learn from mistakes. Although extensive research has been carried out regarding relational coordination in many contexts including surgery, no study has explored how relational coordination works at the micro level. The purpose of this study was to explore communication and relationship dynamics in interdisciplinary surgical teams at the micro level in contexts of variable complexity using the theory of relational coordination. ⋯ The findings complement previous research on interdisciplinary teamwork in surgical teams and contribute to the theory of relational coordination. The findings offer a new typology of teams that goes beyond weak or strong relational coordination to capture four distinct patterns of relational coordination. In particular, the study highlights the central role of mutual respect and presents proposals for improving relational coordination in surgical teams.
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Bmc Health Serv Res · Jul 2019
Supporting access to healthcare for refugees and migrants in European countries under particular migratory pressure.
In 2015 the increased migratory pressure in Europe posed additional challenges for healthcare providers. The aim of this study was to inform the development of a "Resource Package" to support European Union (EU) member states in improving access to healthcare for refugees, asylum seekers and other migrants. ⋯ The findings of this study show that solutions that are aimed only at responding to emergencies often lead to fragmented and chaotic interventions, devolving attention from the need to develop structural changes in the EU health systems.
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Bmc Health Serv Res · Jul 2019
Impact of pharmacy-led medication reconciliation on admission to internal medicine service: experience in two tertiary care teaching hospitals.
The Institute for Healthcare Improvement identifies medication reconciliation as the shared responsibility of nurses, pharmacists, and physicians, where each has a defined role. The study aims to assess the clinical impact of pharmacy-led medication reconciliation performed on day one of hospital admission to the internal medicine service. ⋯ Pharmacy-led medication reconciliation upon admission, along with student pharmacist involvement and physician communication can reduce unintended discrepancies and improve medication safety and patient outcomes.