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This exploratory study aims to examine female Muslim immigrant patients’ expectations of physicians’ religious competence during clinical interactions.

In total, 101 female Muslim immigrants in Ottawa, Canada, completed an eight-item survey measuring patients’ expectations of physicians’ religious competence during clinical communication.

Results from the independent samples t-tests and one-way ANOVA suggested that female Muslim immigrant patients in this study expected their doctors to be aware of Islam as a religion and be sensitive to their religious needs, especially food/dietary practices during clinical communication. Although the participants did not differ in their expectations of physicians’ religious competence based on age, educational level, employment status and income level, they differed based on their frequencies of visiting doctors and their ethnic/cultural origin.

This study fills a gap in the literature by advancing understanding of religious competence during clinical interactions from female Muslim immigrant patients’ perspective. The findings can contribute to developing religiously competent and accessible health-care services for religiously diverse populations.

This study illuminates the experiences of adults diagnosed with autism spectrum disorders (ASDs) and intellectual disabilities (IDs) and their challenges and successes in receiving quality healthcare services. Individuals with developmental disabilities often experience health issues associated with aging at earlier ages and at higher rates than the general population. This population has a higher incidence of chronic health conditions that require regular medical attention.

The intent of this project was to learn directly from adults and their caregivers how well healthcare providers understand autism, explore their experience with how well their care is coordinated between primary healthcare and other specialty services, and identify factors which could impact access to care and to discover what other barriers which may potentially influence health outcomes for ASD adult.

A qualitative study conducted with semi-structured interviews with 12 adults diagnosed with ASD and/or their guardians/caregivers.

Some of the adults interviewed experienced negative health outcomes and suboptimal relationships with healthcare providers; others seemed to have positive relationships. Clinical and communications accommodations were necessary to make healthcare provision more comfortable. Barriers to accessing healthcare services existed in many forms.

The healthcare needs of the growing population adults diagnosed with ASD/ID are anticipated to be significant. This challenge is further exacerbated given there are few trained healthcare providers who are prepared or dedicated to serve this population. Continuing to build awareness of the health needs of the ASD/ID adult population is critical.

This project is highly innovative as it is the first attempt to understand how the adult autism population accesses care and perceives their healthcare interactions. This study serves as a starting point to suggest new opportunities for further research for this growing population.

Robotic coronary artery bypass (rCABG) is a relatively novel and less invasive form of surgery. A yearlong direct-to-consumer advertising (DTCA) campaign was initiated to provide the community with information regarding rCABG, increase awareness and recruit patients. To optimize information content and ensure appropriate messaging for future campaigns, this study aims to analyze the campaign effectiveness and compared service quality perceptions and clinical outcomes, following surgery across DTCA-responder and control groups.

The institution initiated an rCABG program and one-year DTCA campaign. The authors prospectively documented all rCABG referrals prompted by these ads (DTCA-responder group) and concurrent referrals from medical providers (controls). Groups were compared according to baseline characteristics, perioperative outcomes, patient satisfaction (HCAHPS survey) and functional capacity at three weeks (Duke Activity Status Index). At six months, both groups were surveyed for patient satisfaction and unmet expectations.

There were 103 DTCA responders and 77 controls. The subset of responders that underwent rCABG (n = 54) had similar characteristics to controls, except they were younger, less likely to have lung disease or to be scheduled as an urgent case. Both groups had similar 30-day clinical outcomes, functional capacity recovery and overall satisfaction at three weeks. Follow-up interviews at six months and four years revealed that the DTCA group reported more unmet expectations regarding the “size of the skin incisions” and “recovery time” but no concern about “expertise of their surgeon”.

The DTCA campaign was effective at recruiting patients. The specific focus of the ads and narrow timeframe for decision-making about CABG lends confidence that the incremental cases seen during the campaign were prompted primarily by DTCA. However, differences in unmet expectations underscore the need to better understand the impact of message content on patients recruited via DTCA campaigns.

This is one of the first studies to provide real-world direct empirical evidence of patients’ clinical and attitudinal outcomes for DTCA campaigns. Furthermore, the findings contradict prevailing beliefs that DTCA is ineffective for prompting surgical referrals.

The purpose of this paper is to investigate the clinical communication using Tamale Teaching Hospital as a case.

The paper is based on the Reassure, Explain, Listen, Answer, Take Action and Express Appreciation (RELATE) model and the Four Habits models of Clinical Communication.

The results of the study indicate that leadership conducted staff meetings with some of the components of the RELATE model. These include staff meetings, employee rounding and communication/notice boards. The results of the study also suggest that much as some parts of the Four Habits model was used in provider–patient communication, certain aspects of the model were absent. The study identified some communication challenges including poor dissemination, lack of unity among some health workers, poor attendance in meetings and, with respect to patients, language barrier, patients’ reluctance to disclose their actual health problems to health providers, lack of privacy and lack of a friendly environment.

Providers, especially physicians, should be given training on the local languages in areas where they perform their services. Health service providers should receive as part of their learning in-depth training on the Four Habits model of Clinical Communication, especially the Medical Officers.

It is imperative to embrace evidence-based practices/models aimed at securing proper communication in all hospitals but most especially teaching hospitals.

This paper aims to extend the consideration of distributed leadership in health-care settings. Leadership is typically studied from the classical notion of the place of single leaders and continues to examine distributed leadership within small teams or horizontally. The purpose is to develop a practical understanding of how distributed leadership may occur vertically, between different layers of the health-care leadership hierarchy, examining its influence on health-care outcomes across two hospitals.

Using semi-structured interviews, data were collected from 107 hospital employees (including executive leadership, clinical management and clinicians) from two hospitals in Australia and the USA. Using thematic content analysis, an iterative process was adopted characterized by alternating between social identity and distributed leadership literature and empirical themes to answer the question of how the practice of distributed leadership influences performance outcomes in hospitals?

The perceived social identities of leadership groups shaped communication and performance both positively and negatively. In one hospital a moderating structure emerged as a leadership dyad, where leadership was distributed vertically between hospital hierarchal layers, observed to overcome communication limitations. Findings suggest dyad creation is an effective mechanism to overcome hospital hierarchy-based communication issues and ameliorate health-care outcomes.

The study demonstrates how current leadership development practices that focus on leadership relational and social competencies can benefit from a structural approach to include leadership dyads that can foster these same competencies. This approach could help develop future hospital leaders and in doing so, improve hospital outcomes.

Mental health simulation is the educational practice of recreating clinical situations in safe environments using actors, followed by structured debriefing, to foster professional development and improve care. Although evidence outlines the benefits of simulation, few studies have examined the impact of interprofessional mental health simulation on healthcare trainees, which is more reflective of clinical care. The purpose of this paper is to evaluate the impact of mental health simulation training on students’ confidence, attitudes, knowledge and perceived professional development and anticipated clinical practice.

Participants (n=56) were medical (41 per cent) and mental health nursing students (41 per cent), and clinical psychology trainees (18 per cent). Six simulated scenarios, involving one to three trainees, were followed by structured debriefs with trained facilitators. Scenarios, using actors, reflected patient journeys through emergency, medical and psychiatric settings. Participants’ confidence, knowledge and attitudes were measured quantitatively using pre- and post-course self-report questionnaires. Perceptions of impact on professional development and clinical practice were assessed using thematic analysis of post-course questionnaire responses.

Knowledge, confidence and attitudes scores showed statistically significant increases, with large effect sizes. Thematic analyses highlighted themes of: interprofessionalism, communication skills, reflective practice, personal resilience, clinical skills and confidence.

Further research should clarify the impact of interprofessional simulation training on mental health practice in the context of other training received.

Simulation training may begin to influence participants’ professional development and future clinical practice and subsequently care delivered, supporting its increased use in mental health.

This study adds to nascent understandings of the use and potential of interprofessional mental health simulation, outlining innovative training, its positive outcomes and implications.

Although it is widely acknowledged that health care delivery systems are complex adaptive systems, there are gaps in understanding the application of systems engineering approaches to systems analysis and redesign in the health care domain. Commonly employed methods, such as statistical analysis of risk factors and outcomes, are simply not adequate to robustly characterize all system requirements and facilitate reliable design of complex care delivery systems. This is especially apparent in institutional-level systems, such as patient safety programs that must mitigate the risk of infections and other complications that can occur in virtually any setting providing direct and indirect patient care. The case example presented here illustrates the application of various system engineering methods to identify requirements and intervention candidates for a critical patient safety problem known as failure to rescue. Detailed descriptions of the analysis methods and their application are presented along with specific analysis artifacts related to the failure to rescue case study. Given the prevalence of complex systems in health care, this practical and effective approach provides an important example of how systems engineering methods can effectively address the shortcomings in current health care analysis and design, where complex systems are increasingly prevalent.

Effective use of data across public health organisations (PHOs) is essential for the provision of health services. While health technology and data use in clinical practice have been investigated, interactions with data in non-clinical practice have been largely neglected. The purpose of this paper is to consider what constitutes data, and how people in non-clinical roles in a PHO interact with data in their practice.

This mixed methods study involved a qualitative exploration of how employees of a large PHO interact with data in their non-clinical work roles. A quantitative survey was administered to complement insights gained through qualitative investigation.

Organisational boundaries emerged as a defining issue in interactions with data. The results explain how data work happens through observing, spanning and shifting of boundaries. The paper identifies five key issues that shape data work in relation to boundaries. Boundary objects and processes are considered, as well as the roles of boundary spanners and shifters.

The study was conducted in a large Australian PHO, which is not completely representative of the unique contexts of similar organisations. The study has implications for research in information and organisational studies, opening fields of inquiry for further investigation.

Effective systems-wide data use can improve health service efficiencies and outcomes. There are also implications for the provision of services by other health and public sectors.

The study contributes to closing a significant research gap in understanding interactions with data in the workplace, particularly in non-clinical roles in health. Research analysis connects concepts of knowledge boundaries, boundary spanning and boundary objects with insights into information behaviours in the health workplace. Boundary processes emerge as an important concept to understand interactions with data. The result is a novel typology of interactions with data in relation to organisational boundaries.

Health profession education has evolved to incorporate didactic instruction and experiential learning opportunities over time. Constructivism and interprofessional education are essential theoretical concepts that have shaped modern health profession education. However, transformative active learning is an approach that is particularly well suited to the needs of healthcare professionals. By integrating theoretical knowledge with practical skills, transformative active learning helps prepare students for the complex challenges they will face in their future careers and encourages them to become agents of change committed to improving healthcare practice. Saudi National Institute of Health (Saudi NIH) is one of the Ministry of Health's initiatives in the National Transformation Program 2020 to achieve the Kingdom's Vision 2030, as it supports biomedical research in the health sector in Saudi Arabia. One of the mandates of Saudi NIH is to build the research capacity through well-designed educational and training programs through the directory of education and research skills adopting active learning strategies. This chapter aims to communicate the methodological framework of the Education and Research Skills Directory of the SNIH for integrating active learning in the various training programs and initiatives aiming to promote the core learning capabilities with excellence, diversity, diversity, uniqueness, competency, and efficiency values.

This chapter focusses on the contribution of health professionals' communication competences to patients. We propose a model of communication to be used in the therapeutic relationship, supported by a literature review. The methodology is qualitative. Four focus groups (FGs) composed of Portuguese health professionals (N = 25), such as medical doctors, nurses and professors in health fields, were conducted during 2017 and 2018. All the participants of FGs validated a three-factor aggregated and interdependent model, which is composed of assertiveness, clear language and positivity (ACP model). The factors reinforce the therapeutic relationship and improve health literacy, thus reinforcing the patient's health and well-being. The argument is that health is wealth, so if the communication can improve health, then this has positive social implications. The study is a response to the lack of consensus in the literature on what specific and operative communication competences the health professional should perform in clinical encounters with the patients, and how these competences can improve, in the final instance, their health and well-being.