Bmc Health Serv Res
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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.
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Bmc Health Serv Res · Jul 2019
Impacts of working environment and benefits packages on the health professionals' job satisfaction in selected public health facilities in eastern Ethiopia: using principal component analysis.
World Health Organization (WHO) predicted that there will be a shortfall of skilled healthcare by 2035 with the greatest shortfall in Africa and Southeast Asia due to satisfaction with payment and incentives. Low job satisfaction of health workers can result in increased staff turnover and absenteeism, which affects the efficiency of health services. Ethiopia has been affected by a shortage of health professionals due to a brain drain of health professionals. Our study, therefore, aimed at assessing the impact of the working environment and benefits packages on the level of satisfaction among health professionals working in selected public Health facilities in Eastern Ethiopia. ⋯ level of job satisfaction of health professionals was found to be low. Level of job satisfaction was influenced by the age of the health professionals, type of health facility in which they were working, years of service they had in the health sectors, their working environment, professional allowance and benefits like financial rewards and benefits of being employed. Hence, policy makers and health managers need to pay special attention to increase the satisfaction of the health workforce at all levels in the health system. Moreover, special emphasis should be given for the benefits packages of health workers at different levels.
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Bmc Health Serv Res · Jul 2019
Optimal care at the end of life (OPAL): study protocol of a prospective interventional mixed-methods study with pretest-posttest-design in a primary health care setting considering the view of general practitioners, relatives of deceased patients and health care stakeholders.
At the end of life, about 85-90% of patients can be treated within primary palliative care (PC) provided by general practitioners (GPs). In Germany, there is no structured approach for the provision of PC by GPs including a systematic as well as timely identification of patients who might benefit from PC, yet. The project "Optimal care at the end of life" (OPAL) focusses on an improvement of primary PC for patients with both oncological and non-oncological chronic progressive diseases in their last phase of life provided by GPs and health care services. ⋯ The project OPAL is the first study to implement the SPICT-DE regionwide in general practices in Germany. The project OPAL may contribute to an overall optimisation of primary PC for patients in Germany by reducing GPs' uncertainty in initiating PC, by consolidating their skills and competencies in identifying patients who might benefit from PC, and by improving the cooperation between GPs and different health care stakeholders.