Search results

The complex challenges facing the healthcare sector call for a revision of the ways it can provide high-quality services with economic sustainability. Revision can proceed along different pathways. Among the new paradigms of healthcare is the shift from a silo approach by hospitals towards an integrated, multidisciplinary approach. This entails restructuring hospitals in disease centres and exploring how AI can aid in the integration of hospital services and community care. Reorganization is vital to the development of patient-centred healthcare and the holistic approach. To achieve these goals, healthcare and policy decision-makers need to consider both the administrative and the clinical aspects of everyday issues. AI can play a key role in helping balance this duality. The overarching objective is to create interdisciplinary therapeutic and diagnostic pathways within care networks shared between the hospital and the community. This involves the analysis of huge amounts of data and interdisciplinary knowledge beyond the grasp of an individual. Therefore, knowing how AI can help in the development and reorganization of community healthcare is essential for clinical leaders to take advantage of this enormous opportunity in larger settings.

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators’ perspectives on implementing a transition program for newly graduated nurses.

An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.

The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.

This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.

This study aims to examine the unique lived experiences of international graduate students in light of COVID-19 and the recent sociopolitical climate in the USA (e.g. Black Lives Matter movement, protests against anti-Asian hate crimes and gun violence).

The authors used an exploratory qualitative design embedded within a constructivist/interpretivist paradigm. A total of 31 international health service psychology graduate students completed an online survey, 17 of whom participated in a 60-min one-on-one semi-structured interview.

Participants reported facing a range of difficulties (e.g. travel ban/inability to spend time with family, visa-related concerns, racism, decreased support) during the global pandemic and the recent sociopolitical climate in the USA. A total of 48 themes were identified and organized into six domains: COVID-19-related stress and worry, experiences of racism/discrimination, coping mechanisms, support received, recommendations for programs and higher learning institutions and advice for other international graduate students.

The recent sociopolitical climate in the US exacerbated some of the preexisting inequities for international graduate students due to their international student status and the global pandemic. Although few in number, students also spoke about some positive changes as a result of these major historical and political events. Implications for graduate education, clinical practice and policymaking are discussed.

Hospital governance accountability structures in Iran, similar to other countries, have undergone various reforms with different goals. The current study aimed to identify the rules and regulations of the hospital governance structure in Iran and how they pay attention to accountability.

This qualitative document content analysis study was conducted using hospital governance structure documents in Iran using the Ready materials, Extract data, Analyze data and Distil (READ) document analysis framework. 2,921 documents were extracted from the official government websites of Iran. After screening, seven documents related to the hospital governance structure were selected. A directed content analysis approach was used. The findings were finally future purification matched with the original documents.

The findings showed that documents had not addressed the inclusive governance structure of the hospital comprehensively. The medical staff organization structure is not considered in the documents, and its duties are assigned to a technical or a clinical director. Most documents addressed financial accountability. The documents did not require the hospital’s governance to have an inclusive accountability structure. However, they paid more attention to the administrative and financial autonomy of hospitals.

Accountability is one of the most essential components in the hospital's governance structure. It can increase the success of hospital efficiency, effectiveness, vision and mission fulfillment. The study result can help health services policymakers and managers formulate better organization structure rules and regulations for hospital governance accountability.

This study is the first qualitative analysis of accountable governance structure documents in Iranian hospitals. We used the READ method as a comprehensive approach for document analysis.

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.

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.

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.

This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.

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.

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.

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.

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.

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”.

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.

In educational settings, intersectional factors such as neurodiversity, structural inequalities and social isolation have resulted in additional complexity in meeting young people’s mental health needs. The specific phenomenon of voice-hearing can be linked to these complexities and stigma has been shown to further marginalise young people following disclosure. Educational staff report a lack of confidence and specialist training in this area. This chapter outlines the current understanding around the experience of voice-hearing and identifies examples of good practice by considering the lived experiences of individuals that have made a disclosure of this nature in school. Barriers to disclosure and what was helpful about the experience are discussed. Developing a trauma-informed ethos and compassion-focussed principles are highlighted as whole-setting approaches to support and benefit both young people with these presentations and education staff. Recommendations of relevant organisations and training initiatives in schools are provided with guidance on developing and implementing best practices.

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.

The authors conducted an online international cross-sectional survey of 178 participants.

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.

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.

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.

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.

The therapeutic community (TC) is an environmental intervention where principles of working together democratically can enhance self-agency. While availability of inpatient TCs within the UK National Health Service (NHS) has declined, shorter or alternative interventions using core TC approaches have shown promise in enacting change. The purpose of this paper is to report and reflect on the development and running of a pilot nano-TC.

Foundations Group was a 2-h TC group intervention set up and run within the NHS for 18 months in 2021–2022, and taking place on City Farm premises. The group was convened as part of the complex emotional needs service in a mental health NHS Trust in the South West of England. Over the study period, the group comprised 11 members, one peer member and three staff members.

The authors reflected on the TC stance of working democratically with a fluid hierarchy, taking a non-expert approach, and using support and challenge to enhance self-agency and belongingness. The authors have detailed the structure of the group session including use of community meetings, psychoeducation, creative sessions and reviews. Members took on roles within the group including chairing sessions.

This group was a novel service within the NHS Trust where it was conducted and may represent a standalone therapeutic group. The authors hope it will show that core TC principles can be applied in shorter interventions than have previously been used.

Implementing artificial intelligence (AI) in healthcare organizations involves the entire organization. This groundbreaking technology is becoming central to achieve the goals of the new healthcare through the ongoing commitment to sustainability despite the severe lack of resources. Decision-makers in healthcare need knowledge and skills to prepare for the changes in many professional activities in the years ahead. Furthermore, chief medical officers and clinical leaders need to act on the opportunities that AI can bring, starting from its integration into the reality of healthcare settings while working with those responsible for managing and implementing AI in compliance with current legislation in Europe and the United States. Finally, stakeholders need to know how to leverage AI capabilities and how to recognize its limitations and its opportunities in administrative applications (admin AI) to optimize day-to-day operations and clinical applications (non-admin AI). In this view, clinical leaders and health care decision-makers may appreciate AI as a new way to provide sustainable social and healthcare services.