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1 – 10 of over 5000
Article
Publication date: 16 November 2015

Ann Dadich, Penny Abbott and Hassan Hosseinzadeh

Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many…

Abstract

Purpose

Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare systems, it is important to identify strategies that bolster clinician-capacity to promote evidence-based care. The purpose of this paper is to identify strategies to increase Practice Nurse capacity to promote evidence-based sexual healthcare within general practice.

Design/methodology/approach

A survey of 217 Practice Nurses in an Australian state and ten respondent-interviews regarding two resources to promote evidence-based sexual healthcare – namely, a clinical aide and online training.

Findings

The perceived impact of both resources was determined by views on relevance and design – particularly for the clinical aide. Resource-use was influenced by role and responsibilities within the workplace, accessibility, and support from patients and colleagues.

Research limitations/implications

This is the first Australian study to reveal strategies to promote evidence-based sexual healthcare among Practice Nurses. The findings provide a platform for future research on knowledge translation processes, particularly among clinicians who might be disengaged from sexual healthcare.

Practical implications

Given the benefits of evidence-based practices, it is important that managers recognize their role, and the role of their services, in promoting these. Without explicit support for evidence-based care and recognition of the Practice Nurse role in such care, knowledge translation is likely to be limited.

Originality/value

Knowledge translation among Practice Nurses can be facilitated by: resources-deemed informative, relevant, and user-friendly, as well as support from patients, colleagues, and their workplace.

Details

Journal of Health Organization and Management, vol. 29 no. 7
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 3 July 2017

Ruiling Guo, Steven D. Berkshire, Lawrence V. Fulton and Patrick M. Hermanson

The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare

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Abstract

Purpose

The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics.

Design/methodology/approach

A cross-sectional study was conducted among US healthcare leaders. Spearman’s correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0.

Findings

One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders’ values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous “use of EBMgt” response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman’s correlation indicated statistically significant relationships between healthcare leaders’ use of EBMgt and healthcare organization bed size (rs = 0.217, n = 152, p < 0.01), attitude towards EBMgt (rs = 0.517, n = 152, p < 0.01), and the number of organization employees (rs = 0.195, n = 152, p = 0.016).

Originality/value

This study generated new research findings on the practice of EBMgt in US healthcare administration decision-making.

Details

Leadership in Health Services, vol. 30 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 1 July 2006

Andrew Booth

The paper seeks to provide an overview and update of thinking in relation to the theory and practice of formulation of answerable research questions within evidence based

20869

Abstract

Purpose

The paper seeks to provide an overview and update of thinking in relation to the theory and practice of formulation of answerable research questions within evidence based information practice.

Design/methodology/approach

The paper reviews the healthcare and information literature on question formulation, augmented by structured and purposive internet searches.

Findings

Although a few key authors have published extensively on all aspects of the evidence‐based information practice process, including question formulation, there is little in the way of empirical research.

Research limitations/implications

In the absence of an empirical research base from within the specific domain of information practice, this conceptual paper extrapolates findings from healthcare research to general librarianship.

Practical implications

This article models the process of question formulation using a proposed conceptual framework (SPICE) and encourages practitioners to identify their own practice‐based questions.

Originality/value

This is the first article specifically to address question formulation for a general (i.e. non‐health) library audience.

Details

Library Hi Tech, vol. 24 no. 3
Type: Research Article
ISSN: 0737-8831

Keywords

Book part
Publication date: 12 August 2014

Abraham B. (Rami) Shani and Susan Albers Mohrman

This chapter provides a reflective synopsis of six cases focused on making healthcare sustainable. The nature and value of an ecosystem perspective is explored. The intent…

Abstract

Purpose

This chapter provides a reflective synopsis of six cases focused on making healthcare sustainable. The nature and value of an ecosystem perspective is explored. The intent is to apply and generate organizational knowledge to understand and guide purposeful design and learning.

Design/methodology

From five countries where healthcare is organized differently, these cases illuminate particular approaches to develop the capabilities for healthcare to deliver greater value to society. Each case is examined through the lens of an appropriate theoretical perspective. This chapter reports the themes that were common in the six case studies.

Findings

New approaches are changing the connections in the healthcare ecosystem, including the flows of: medical knowledge, clinical information, and resources. Common themes include: the importance of networks in the emerging healthcare ecosystem; the role of governance mechanisms and leadership to align the diverse ecosystem components; the engagement of dominant ecosystem actors; the need for adaptive change capabilities, and for multi-stakeholder research collaborations to generate actionable knowledge.

Practical implications

Taking an ecosystem perspective enables healthcare leaders to broaden their conceptualization of the changes that will be required to be sustainable in a changing society.

Social implications

Almost every man, woman and child is affected by the healthcare system. Increasing the sustainability of healthcare is integral to increasing societal sustainability overall.

Originality

Viewing the ecosystem as the appropriate focus of purposeful change departs from a traditional approach that focuses on the effectiveness of each element.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
ISBN: 978-1-78441-035-3

Keywords

Article
Publication date: 1 August 2018

Peter F. Martelli and Tuna Cem Hayirli

The debate on evidence-based management (EBMgt) has reached an impasse. The persistence of meaningful critiques highlights challenges embedded in the current frameworks…

1021

Abstract

Purpose

The debate on evidence-based management (EBMgt) has reached an impasse. The persistence of meaningful critiques highlights challenges embedded in the current frameworks. The field needs to consider new conceptual paths that appreciate these critiques, but move beyond them. The paper aims to discuss this issue.

Design/methodology/approach

This paper unpacks the concept of finding the “best available evidence,” which remains a central notion across definitions of EBMgt. For each element, it considers relevant theory and offers recommendations, concluding with a discussion of “bestness” as interpreted across three key dynamics – rank, fit, and variety.

Findings

The paper reinforces that EBMgt is a social technology, and draws on cybernetic theory to argue that the “best” evidence is produced not by rank or fit, but by variety. Through variety, EBMgt more readily captures the contextual, political, and relational aspects embedded in management decision making.

Research limitations/implications

While systematic reviews and empirical barriers remain important, more rigorous research evidence and larger catalogues of contingency factors are themselves insufficient to solve underlying sociopolitical concerns. Likewise, current critiques could benefit from theoretical bridges that not only reinforce learning and sensemaking in real organizations, but also build on the spirit of the project and progress made towards better managerial decision making.

Originality/value

The distinctive contribution of this paper is to offer a new lens on EBMgt drawing from cybernetic theory and science and technology studies. By proposing the theoretical frame of variety, it offers potential to resolve the impasse between those for and against EBMgt.

Details

Management Decision, vol. 56 no. 10
Type: Research Article
ISSN: 0025-1747

Keywords

Article
Publication date: 4 April 2016

Rana Sagha Zadeh, Xiaodong Xuan and Mardelle M. Shepley

Healthcare projects face multiple obstacles in achieving sustainability. This paper aims to provide information regarding the energy consumption of healthcare facilities…

2663

Abstract

Purpose

Healthcare projects face multiple obstacles in achieving sustainability. This paper aims to provide information regarding the energy consumption of healthcare facilities, to identify barriers to sustainability and to suggest methods to improve the effectiveness of these buildings.

Design/methodology/approach

This study investigates sustainability in healthcare buildings by examining national databases about energy use and energy savings. The authors then initiate a dialogue on this topic by interviewing experts in healthcare planning and design regarding the implications of this data, challenges to sustainability and potential solutions to these challenges.

Findings

An analysis of data from the Energy Information Administration revealed that healthcare facilities rank second among building types in the USA in energy use per square foot and rank fourth in total energy use. Data from the US Green Building Council showed that only 1 per cent of healthcare buildings are registered with the Leadership in Energy and Environmental Design rating system, and 0.4 per cent have achieved certification, which is low compared with other building types.

Research limitations/implications

Research and discussion must continue engaging all stakeholders to interpret the data and identify transformative solutions to facilitate sustainable healthcare design construction and operation.

Practical implications

It is important to approach sustainability in healthcare from social, economic, environmental and health-related perspectives. The authors identify five major barriers to sustainable healthcare design and construction and discuss 12 practical solutions.

Originality/value

Given the energy demands of healthcare buildings, facilitating their sustainability has the potential to make a significant difference in national energy use. Empirical research and evidence-based design can potentially help to accelerate sustainability by clarifying impacts and documenting the economic and operational returns on investment.

Details

Facilities, vol. 34 no. 5/6
Type: Research Article
ISSN: 0263-2772

Keywords

Content available
Article
Publication date: 27 March 2007

138

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 20 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 14 November 2008

Marco Isetta

The evidence‐based practice (EBP) model appears to have established itself as the principal change driver and discourse for the healthcare sector. This study sets out to…

2418

Abstract

Purpose

The evidence‐based practice (EBP) model appears to have established itself as the principal change driver and discourse for the healthcare sector. This study sets out to identify the emergence of the term EBP in the professional literature to establish an empirical foundation for discussion. The understanding of and relevance to healthcare practitioners in a large South West London hospital are assessed and their views related to the perspective of library and information professionals to assess implications for practice.

Design/methodology/approach

An extensive literature search was carried out and the data generated used to produce a growth curve for the literature. A survey of health care professionals using e‐mail and follow‐up interviews was undertaken at the case hospital.

Findings

Between 1998 and 2004 the number of papers appearing to discuss the theme increased four‐fold. The first recorded reference was in 1991. The EBP model had strong official and political support in the field. On the user sample there is evidence of resistance to the orthodoxy.

Practical implications

The EBP model – variously adopted by several healthcare agencies – has placed information management at the centre of the care process. In spite of this, there are few definite implications for the role of library and information professionals, since the world of information and the UK NHS itself are continually in a state of flux, and the current EBP dominance may neither strengthen nor safeguard it.

Originality/value

The bibliometric study provides a baseline. The study of healthcare professionals is a case study to add to knowledge of practice.

Details

Aslib Proceedings, vol. 60 no. 6
Type: Research Article
ISSN: 0001-253X

Keywords

Book part
Publication date: 12 August 2014

Susan Albers Mohrman and Michael Kanter

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the…

Abstract

Purpose

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the knowledge management literature and network theory. The criticality of this issue to the establishment of sustainable healthcare relates to the lynchpin nature of embedding evidence-based knowledge in healthcare practice and the simultaneous challenge of combining this with clinical knowledge that derives from practice.

Methodology/approach

The case study is compiled from longitudinal interviews with over 40 physicians and other stakeholders and an examination of archival information including published articles generated by the learning system.

Findings

The socio-technical approach to building this learning system was critical given the expectations of physicians for autonomy in making clinical decisions with respect to their patients. This robust learning system builds on rich professional and organizational networks, is led by physicians, and builds on and extends the foundation of evidence relating to quality and value. The goals of the physician practice and a robust measurement and feedback system provide focus for the learning system.

Social/practical implications

Accelerating the incorporation of evidence-based practice and increasing the scope and reach of the learning system entails building physician networks, having a robust system for critically examining and extending evidence, and a clear linkage to valued outcomes.

Originality/value of paper

This detailed examination of the dynamics of knowledge absorption extends understanding of the capacity of medical care systems to absorb evidence-based knowledge.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
ISBN: 978-1-78441-035-3

Keywords

Article
Publication date: 11 June 2018

Ali Janati, Edris Hasanpoor, Sakineh Hajebrahimi and Homayoun Sadeghi-Bazargani

Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital…

2135

Abstract

Purpose

Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework.

Design/methodology/approach

A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines.

Findings

Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers’ professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers’ personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing).

Originality/value

Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

1 – 10 of over 5000