Search results

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

The purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients.

Guidance on leave was requested from National Health Service (NHS) mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis.

In total, 32 organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (Department of Health, 2016; Welsh Government, 2016). Definitions of important terms, for example, leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients from leaving hospital wards.

Research should be undertaken to explore the impact of local policies on the informal patient’s right to life and liberty.

All NHS organisations need to develop an evidence-based policy to facilitate the informal patient’s right to take leave. A set of national standards that organisations are required to comply with would help to standardise the content of leave policies.

To the best of the author’s knowledge, this is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital.

Research has suggested that employees interpret high-performance work systems (HPWSs) as targeting two distinct organizational objectives: enhancing performance and promoting employee well-being. These attributions often exert divergent effects on employee attitudes. Thus, this study aims to investigate this dynamic within the context of the Korean nursing occupation, clarifying how the HPWS can simultaneously evoke dual attributions: human resource (HR) well-being and HR performance attributions. Additionally, the authors examine the contrasting effects of these attributions and identify a moderating variable that could reconcile them. Drawing on the psychological experience of status theory, the authors conceptualize and test the moderating effect of employees' self-perceived status on the relationship between HR performance attribution and affective commitment.

Data were collected from 475 nurses in 82 work units in Korean hospitals. Hypotheses were tested in a multilevel moderated mediation model.

The findings revealed that an HPWS elicits HR well-being and HR performance attributions. While HR well-being attribution was positively associated with affective commitment, HR performance attribution was positively related to affective commitment when employees' self-perceived status was high. Moreover, the HPWS demonstrated an indirect relationship with affective commitment via increasing HR performance attribution when self-perceived status was high.

Although the personal meaning of HR attributions differs depending on the perceiver’s situation, this aspect has received little attention in the field of research. This study advances the understanding of HR attributions derived from the HPWS within the specific context of Korean nursing. Furthermore, the authors suggest that the two attributions may not conflict with each other, indicating that the impact of HR performance attribution is conditional on an individual’s self-perceived status.

The advent of online live streaming platforms (OLSPs) and online health communities (OHCs) has expedited the integration of traditional medical services with Internet new media technology. Since the practice of physicians conducting live streaming is a relatively new phenomenon, the potential cross-platform effects of such physicians’ live streaming have not received adequate attention.

This study collected data from 616 physicians specializing in cardiology, obstetrics and gynecology and neurology between April and November 2022 on Live.Baidu.com and WeDoctor.com. It constructed a panel data set comprising a total of 4,928 observations over an 8-month period and validated the model using empirical analysis with the fixed-effects method.

We find evidence of cross-platform influence in online healthcare. Physicians’ live streaming behavior (whether live or not and the heat of their streams) on OLSPs positively impacts both their consultation and reputation on OHCs. Additionally, physicians’ ability positively moderates the relationships between live streaming heat and their performance (in terms of consultation volume and reputation) on OHCs. However, ability does not moderate the relationship between physicians’ live streaming status (live or not) and their performance (in terms of consultation and reputation) on OHCs. Furthermore, the attractive appearance of the physicians also significantly moderates the impact in a positive way.

This is one of the pioneering studies on physicians’ live streaming. The study offers vital guidance for physicians and patients utilizing dual platforms and holds significant reference value for platform operators (such as OLSPs and OHCs) aiming to optimize platform operations and for the government in policy formulation and industry regulation.

Various health systems are challenged by a multifaceted crisis of increased service demand and workforce shortages. The effects are devastating and may end up in decreased access to care, poor quality of patient care and extreme demands on the workforce. The introduction of the physician assistant (PA) profession provided an avenue to address such challenges in several countries. In Germany, the integration of PAs has been proceeding slowly.

To understand the integration of the profession in Germany, we conducted 15 expert interviews to reveal how the PA profession is perceived among healthcare experts as well as the barriers and facilitators of integration in inpatient care.

Our results highlight a generally positive perception of PAs, particularly in terms of workload relief and bridging the gap between healthcare professionals. Nonetheless, barriers include resistance from healthcare workers unfamiliar with the PA role, while workforce shortages and collaborative teamwork facilitate integration.

These findings lay the groundwork for potential integration-enhancing strategies in Germany.

This paper aims to explore the roles of psychologists in seclusion in adult mental health services in Ireland, their perspectives on seclusion and its use in recovery-oriented practice and related professional practice issues.

A qualitative hermeneutic phenomenological study was conducted from a social constructivist perspective. Semi-structured interviews with 17 psychologists were analysed using reflexive thematic analysis.

Twenty-four themes were identified, which were clustered into four overarching themes. Participants viewed themselves and psychology in Ireland more broadly as peripheral to seclusion. They believed that seclusion possessed no inherent therapeutic value but viewed it as an uncomfortable and multi-faceted reality. Participants regarded seclusion and recovery as largely inconsistent and difficult to reconcile, and they perceived systemic factors, which had a pervasive negative impact on seclusion and recovery in practice.

The findings highlight the perceived complexity of seclusion and its interface with recovery, and the need to conscientiously balance conflicting priorities that cannot be easily reconciled to ensure ethical practice. The findings suggest psychologists are well-suited to participate in local and national discussions on using seclusion in recovery-oriented practice.

This study offers a unique insight into psychologists’ perceptions of seclusion and considers the implications of these views. Participants’ nuanced views suggest that psychologists can make valuable contributions to local and national discussions on these topics.

The study investigates the relationship between hospital environmental factors and the well-being of geriatric in-patients. It aims to identify the impact of architectural design on comfort, safety, privacy and stress levels experienced by elderly patients during their hospital stays.

Employing a mixed-methods approach, the research assesses the experiences of 100 geriatric in-patients across various hospital types through surveys, observational checklists and state anxiety measurements. The methodology involves examining architectural features, patient perceptions and correlations among environmental variables and patient experiences. Statistical analyses, including correlations and chi-square tests, were employed to discern associations between environmental variables and patient experiences.

The research identified key architectural features significantly impacting geriatric patients' experiences. Factors such as sturdy beds, furniture quantity, lighting conditions, proximity to facilities and ward occupancy levels were found to influence spatial, sensory and social comfort. Notably, proximity to facilities and control over the immediate environment were crucial for self-control and safety perceptions. Privacy, highly valued by patients, correlated with the presence of curtains and ward occupancy. Moreover, patient stress levels exhibited correlations with autonomy, privacy and ward occupancy.

This research offers significant insights into the criticality of specific architectural elements in enhancing comfort and reducing stress for geriatric in-patients. These findings hold substantial value for healthcare facility design, emphasizing the need to prioritize certain design aspects to promote the well-being of elderly patients during hospitalization.

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

Institutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health conditions living within institutional settings. This study aims to provide a broad perspective of safeguarding practices within institutional care to inform practice and service development in this area.

A narrative overview was undertaken of a range of empirical evidence, discussion papers, enquiry reports, reports from regulatory bodies and professional guidance to explore safeguarding practices within institutional care for individuals with learning disabilities and/or mental health conditions.

A range of literature was identified that exposed and explored abuse in this context. Three key themes were identified: failings within institutional care; safeguarding issues and concerns; and good practice within institutional care. Whilst guidance is available, standards are explicit and protocols facilitate improvement potential in this area, a consistent message was that statutory recommendations for reform have not been effective.

This paper provides an important resource for practitioners and service providers involved in institutional care. An accessible overview of both the empirical evidence and grey literature on adult safeguarding within institutional settings is provided, along with a range of standards and resources that specify practice in these settings.

The most common reaction to an acute physical illness is anxiety, which may be followed by depression. In patients with chronic diseases, the prevalence of anxiety disorders and depression is almost twice as high as in other diseases. This study aims to extract prominent components in the design of treatment spaces on reducing hospitalized patients’ depression from both experts and patients/users’ point of views. A final model is also presented based on the findings.

This research used an exploratory mixed method. The effective components were extracted through the administration of two Likert-scale researcher-made questionnaires in two phases. Q factor analysis was conducted to reach the components. A total of 205 patients were admitted to Namazi Hospital in Shiraz, and 20 architecture and psychology experts participated in the survey. Final modeling of the data was done through path analysis.

Six factors were found to be effective by experts in reducing depression in therapeutic spaces: nature-oriented space, targeted social space, diverse space, visual comfort, logical process and safe space. On the part of patients, seven components were deemed to be effective: visual perception, naturalism, functionalism, physical security, logical process, psychological safety and diversity. Also, four main cycles were extracted from the final model with the direct effect of diversity and the other five cycles were mediated by naturalism.

A total of 15 interviews with architects and psychologists, who were available at the time of the study, were conducted in January 2018. The only general question during interviews was “In your opinion, what factors are effective in reducing the level of depression of patients in the design of treatment spaces?” This may have limited the range of factors that could be surveyed in the study. After collecting the effective factors from the aforementioned expert’s points of view, the questionnaire of experts was designed (Appendix). The expert questionnaires were distributed and edited in two stages in January 2019 among 20 architect experts who were available at the time of the study. The one-year interval between designing and administering the questionnaires occurred because of the limitations posed by the COVID-19 pandemic situation. However, the interval did not pose methodological obstacles for the study.

Evidence-based investigation of the effectiveness of proper design components of therapeutic spaces in reducing the symptoms of patients with chronic secondary depression has received little attention in the literature. Using a “conceptual model,” the present study brought the issue into its focus so as to find effective components in the design of treatment spaces that can alleviate depression symptoms in chronically hospitalized patients.