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1 – 10 of 654This article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU…
Abstract
Purpose
This article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU. While both systems are driven by the same goal of providing high-quality healthcare services and achieving optimal patient outcomes, they operate under different national approaches and resources.
Design/methodology/approach
Two recent crises are presented as examples that highlight the necessity of cooperation between civilian and military medical systems. The Covid-19 Pandemic and the Ukrainian Conflict are described based on the experience gathered by the author as a member of the NATO Centre of Excellence for Military Medicine and form the base to shape a broader perspective on the future of civil-military interaction in healthcare at the European Union level.
Findings
The ability to deliver coordinated responses during crises depend on the level of interoperability, preparation and mutual understanding. To improve synergies, a structured partnership should be established, prioritizing common standards of care and shared best practices. Integrating military and civilian healthcare pathways can be especially beneficial in situations where patients are moved from the point of injury or sickness across different military and civilian structures to receive the most appropriate treatment and rehabilitation for their conditions.
Originality/value
The relationship between military and civilian healthcare systems is often discussed at multinational level, but a clear focus is lacking concerning their shared mission, distinct functions and potential for cross-border collaboration.
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Áine Carroll, Jane McKenzie and Claire Collins
The aim of this study was to explore and understand the leadership experiences of medical consultants prior to a major hospital move. Health and care is becoming increasingly…
Abstract
Purpose
The aim of this study was to explore and understand the leadership experiences of medical consultants prior to a major hospital move. Health and care is becoming increasingly complex and there is no greater challenge than the move to a new hospital. Effective leadership has been identified as being essential for successful transition. However, there is very little evidence of how medical consultants experience effective leadership.
Design/methodology/approach
A qualitative methodology was utilized with one-to-one semi-structured interviews conducted with ten medical consultants. These were transcribed verbatim and analyzed using inductive thematic analysis. The research complied with the consolidated criteria for reporting qualitative research (COREQ).
Findings
Four themes were found to influence medical consultants’ experience of leadership: collaboration, patient centredness, governance and knowledge mobilization. Various factors were identified that negatively influenced their leadership effectiveness. The findings suggest that there are a number of factors that influence complexity leadership effectiveness. Addressing these areas may enhance leadership effectiveness and the experience of leadership in medical consultants.
Research limitations/implications
This study provides a rich exploration of medical consultants’ experience of collective leadership prior to a transition to a new hospital and provides new understandings of the way collective leadership is experienced in the lead up to a major transition and makes recommendations for future leadership research and practice.
Practical implications
The findings suggest that there are a number of factors that influence complexity leadership effectiveness. Addressing these areas may enhance leadership effectiveness and the experience of leadership in medical consultants.
Social implications
Clinical leadership is associated with better outcomes for patients therefore any interventions that enhance leadership capability will improve outcomes for patients and therefore benefit society.
Originality/value
This is the first research to explore medical consultants’ experience of collective leadership prior to a transition to a new hospital.
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Katherine Brown and Laura Jenkinson
A notable number of young people self-harm, with only a minority receiving professional support. Evidence suggests that therapy can help recovery from self-harm, but little is…
Abstract
Purpose
A notable number of young people self-harm, with only a minority receiving professional support. Evidence suggests that therapy can help recovery from self-harm, but little is known about the experiences of those who self-harm and participate in therapy delivered via videoconferencing.
Design/methodology/approach
Risk assessments were examined for evidence of self-harm and used to identify two groups for analysis: young people who had self-harmed in the past six months and those who had not. A mixed methods analysis was then conducted to examine process and outcome data for these two groups. Data included a number of sessions attended, late-cancelled and missed without notice; and patient-reported outcome measure scores (Young Person-Clinical Outcomes in Routine Evaluation and Revised Children’s Anxiety and Depression Scale). End-of-treatment reports were subsequently analysed using thematic analysis.
Findings
Those with current self-harm risk appeared to start therapy with lower well-being. No notable differences in progress were found between groups on quantitative outcomes. There was greater reporting of poorer clinical outcomes in the reports of those with current self-harm risk, including two unique types of barriers to effective therapy: “general difficulties” (e.g. poor well-being limiting engagement, specific components of therapy being challenging) and “CBT was not preferred”.
Originality/value
Lower baseline well-being could explain the greater ongoing care needs and lower well-being post-therapy among those with current self-harm risk, despite both groups appearing to make similar levels of therapeutic progress quantitatively. Recent self-harm does not appear to reduce the utility of videoconferencing cognitive behavioural therapy; however, clients’ individual needs should be carefully considered.
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Marc Griffiths, Kaz Monaghan, Mke Monaghan and Verna Tompkins
The creation of new practice learning environments for healthcare students promotes the development of professional judgement skills and decision-making. Through the modelling of…
Abstract
Purpose
The creation of new practice learning environments for healthcare students promotes the development of professional judgement skills and decision-making. Through the modelling of established practices across other subject disciplines, Healthcare Technicians designed and created the Clinical Skills Lounge to support student learning outside of scheduled classes.
Design/methodology/approach
The design and development of a new learning and simulation space for healthcare students was created following feedback from students. Using a model of learning support for students across the creative subject disciplines, the creation of the Clinical Skills Lounge provided an opportunity to create a space where practical techniques could be practiced and support provided by Technicians.
Findings
Student feedback highlights the importance and flexibility of the Clinical Skills Lounge design and opportunities to learn and practice key skills outside of timetabled sessions. Greater confidence and opportunities to further develop decision-making skills were reported by students who use this space.
Originality/value
This particular type of learning environment promotes greater reflection, provides the opportunity for students to learn alongside their peers and encourages inter-professional learning. The opportunities for greater decision-making, confidence building and preparation for clinical placements.
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Suzana Sukovic, Jamaica Eisner and Kerith Duncanson
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Practical implications
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.
Originality/value
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.
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Märt Vesinurm, Inka Sylgren, Annika Bengts, Paulus Torkki and Paul Lillrank
This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and…
Abstract
Purpose
This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.
Design/methodology/approach
The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.
Findings
PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.
Research limitations/implications
This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.
Practical implications
We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.
Originality/value
Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.
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Armando Calabrese, Antonio D'Uffizi, Nathan Levialdi Ghiron, Luca Berloco, Elaheh Pourabbas and Nathan Proudlove
The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.
Abstract
Purpose
The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.
Design/methodology/approach
The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.
Findings
The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.
Originality/value
The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.
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Iván Manuel De la Vega Hernández, Juan Díaz Amorin and Rodolfo Fernández-Gomez
The purpose of this study focused on a global longitudinal bibliometric mapping of research in the field of health biotechnology between 1990 and 2023 to determine who is leading…
Abstract
Purpose
The purpose of this study focused on a global longitudinal bibliometric mapping of research in the field of health biotechnology between 1990 and 2023 to determine who is leading this field of knowledge and to estimate the sub-disciplines that are emerging and project those that will prevail in the future.
Design/methodology/approach
The study identified the most relevant countries, institutions and researchers, as well as the type of scientific collaborations. The applied steps applied in the study were the following: identification and selection of keyword terms by a panel of experts; design and application of an algorithm to identify these selected keywords in titles, abstracts and keywords using Web of Science terms to contrast them; performance of JCR data processing during 2023 using R, Python and VOSviewer.
Findings
Among the most relevant conclusions of the study are the following exponential growth has been observed in the study period; new branches of knowledge have emerged in which the subjects have been acquiring their own autonomous capabilities; and R&D in this field is still concentrated in a small group of core countries, and the trend is for it to remain so due to the capacity needs required.
Originality/value
This contribution seeks to systematize the existing scientific knowledge in the field of biotechnology, specifically in the area of health, using the technique of scientific mapping based on a logical model of indicators that aims to determine potential thematic ramifications.
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Tinna Dögg Sigurdardóttir, Adrian West and Gisli Hannes Gudjonsson
This study aims to examine the scope and contribution of Forensic Clinical Psychology (FCP) advice from the National Crime Agency (NCA) to criminal investigations in the UK to…
Abstract
Purpose
This study aims to examine the scope and contribution of Forensic Clinical Psychology (FCP) advice from the National Crime Agency (NCA) to criminal investigations in the UK to address the gap in current knowledge and research.
Design/methodology/approach
The 36 FCP reports reviewed were written between 2017 and 2021. They were analysed using Toulmin’s (1958) application of pertinent arguments to the evaluation process. The potential utility of the reports was analysed in terms of the advice provided.
Findings
Most of the reports involved murder and equivocal death. The reports focused primarily on understanding the offender’s psychopathology, actions, motivation and risk to self and others using a practitioner model of case study methodology. Out of the 539 claims, grounds were provided for 99% of the claims, 91% had designated modality, 62% of the claims were potentially verifiable and 57% of the claims were supported by a warrant and/or backing. Most of the reports provided either moderate or high insight into the offence/offender (92%) and potential for new leads (64%).
Practical implications
The advice provided relied heavily on extensive forensic clinical and investigative experience of offenders, guided by theory and research and was often performed under considerable time pressure. Flexibility, impartiality, rigour and resilience are essential prerequisites for this type of work.
Originality/value
To the best of the authors’ knowledge, this study is the first to systematically evaluate forensic clinical psychology reports from the NCA. It shows the pragmatic, dynamic and varied nature of FCP contributions to investigations and its potential utility.
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Marc Gilbey, Shea Palmer, Louise Moody, Christopher Newton, Natasha Taylor and Ksenija Maravic da Silva
This study, which is a cross-sectional survey, aims to investigate health-care academics, clinicians and students’ perspectives of health-care simulation-based learning (SBL) and…
Abstract
Purpose
This study, which is a cross-sectional survey, aims to investigate health-care academics, clinicians and students’ perspectives of health-care simulation-based learning (SBL) and extended reality (XR) haptics use within health-care education. Participants’ views regarding the application, barriers and facilitators of SBL and XR haptics were explored.
Design/methodology/approach
The authors conducted an online international cross-sectional survey of 178 participants.
Findings
The survey found high health-care SBL use (n = 97, 55.1%) but low awareness (n = 48, 27.3%) or prior use of XR haptics (n = 14, 7.9%). Participants expressed interest in XR haptic technology emphasising its potential in SBL, particularly for understanding anatomy and physiology, enhancing clinical reasoning and consultation and practical skills.
Research limitations/implications
Whilst there was interest in XR haptics, few participants described previous experience of using this technology in SBL. A large percentage of the participants were UK-based. Most participants were from a nurse or physiotherapy professional background.
Practical implications
XR haptics is a developing technology for SBL in health-care education. Whilst there was clear interest from survey participants, further research is now required to develop and evaluate the feasibility of using this technology in health-care education.
Originality/value
Health-care students, educators and clinicians views on XR haptics have not previously been explored in the development and application of this technology. The findings of this survey will inform the development of XR learning scenarios that will be evaluated for feasibility in health-care SBL.
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