Search results

In this chapter, we identify three distinct transformational performance improvement (TPI) approaches commonly used to redesign work processes in health care organizations. We describe the unique components or tools that each approach uses to improve the delivery of health services. We also summarize what is empirically known about the effectiveness of each TPI approach according to systematic reviews and recent studies published in the peer-reviewed literature. Based on examination of this research, we discuss what knowledge is still needed to strengthen the evidence for whole system transformation. This involves the use of conceptual frameworks to assess and guide implementation efforts, and facilitators and barriers to change as revealed in a recent evaluation of one major initiative, the Lean Enterprise Transformation (LET) at the Veterans Health Administration. The analysis suggests ways in which TPI facilitators can be developed and barriers reduced to improve the effectiveness and sustainability of quality initiatives. Finally, we discuss appropriate study designs to evaluate TPI interventions that may strengthen the evidence for their effectiveness in real world practice settings.

In this chapter, the authors describe collaborative efforts of three teacher leaders and a college professional development school (PDS) liaison to ensure that preservice candidates and practicing teachers can effectively meet the needs of English learners (ELs). The chapter includes an introduction to the PDS’s history and mission, an overview of research on effective practices that promote ELs’ learning, a description of teacher leadership in the PDS context, examples of professional learning opportunities to help preservice candidates and practicing teachers ensure that ELs are academically successful, and a discussion of how data are being used to evaluate the impact of this work on both teachers and students.

Assessing learners with extensive support needs has traditionally been rooted in deficit perspectives, in which student incapacities are highlighted. We start this chapter with an overview of this historical view and identify its shortcomings. Next, we identify alternate assessment and progress monitoring as key efforts for shifting the lens from deficit-oriented assessment toward more grade-aligned, inclusive-, and strengths-based strategies. We also identify strategies for comprehensive assessment that can continue this shift in approach. Finally, we conclude with ideas for future directions in assessing learners with extensive support needs.

The adoption of electronic health records (EHRs) and digitization of health data over the past decade is ushering in the next generation of digital health tools that leverage artificial intelligence (AI) to improve varied aspects of health system performance. The decade ahead is therefore shaping up to be one in which digital health becomes even more at the forefront of health care delivery – demanding the time, attention, and resources of health care leaders and frontline staff, and becoming inextricably linked with all dimensions of health care delivery. In this chapter, we look back and look ahead. There are substantive lessons learned from the first era of large-scale adoption of enterprise EHRs and ongoing challenges that organizations are wrestling with – particularly related to the tension between standardization and flexibility/customization of EHR systems and the processes they support. Managing this tension during efforts to implement and optimize enterprise systems is perhaps the core challenge of the past decade, and one that has impeded consistent realization of value from initial EHR investments. We describe these challenges, how they manifest, and organizational strategies to address them, with a specific focus on alignment with broader value-based care transformation. We then look ahead to the AI wave – the massive number of applications of AI to health care delivery, the expected benefits, the risks and challenges, and approaches that health systems can consider to realize the benefits while avoiding the risks.

To summarize and build on research that explores the influence of culture on team dynamics, particularly over time. Specifically, we explore culture and teams from a dynamic perspective by providing a framework for understanding both how culture influences team dynamics over time, and where interventions should be targeted at different points to maximize the potential benefits of cultural diversity.

Drawing from a prominent model of team development (Kozlowski, Gully, Nason, & Smith, 1999), we provide mechanisms through which culture exerts an influence, as well as the practical approaches that will be best suited for mitigating potential negative effects at different points in time.

We focus on the following phases: team formation, task compilation, role compilation, team compilation, as well as team maintenance. At first, surface-level characteristics and subgroup formation should be closely monitored along with interventions to develop a group identity when teams are being formed. Later on, emergent states (e.g., trust, conflict) can come to the forefront as team members can develop multiple memberships or yet be resistant to performing in an adaptive manner.

We identify key avenues for future research to serve as a foundation for those studying the cultural diversity within teams via temporal lens, including the role of context and going beyond Hofstede’s cultural dimensions.

Albeit research has started to accumulate regarding how culture influences teams through conflict, communication, trust, cohesion, and creativity, this chapter goes beyond current development to address when different cultural elements influence team dynamics.

Ambridge residents live with extended kin and non-family members much more often than the population of the United Kingdom as a whole. This chapter explores cultural norms, economic need, and family and health care to explain patterns of coresidence in the village of Ambridge. In landed families, filial obligation and inheritance norms bind multigenerational families to a common dwelling, while scarcity of affordable rural housing inhibits residential independence and forces reliance on access to social networks and chance to find a home among the landless. Across the socioeconomic spectrum, coresidence wards off loneliness among unpartnered adults. Finally, for Archers listeners, extended kin and non-kin coresidence creates a private space where dialogue gives added dimensionality and depth to characters who would otherwise be known only through their interactions in public spaces.

The field of behavioral business ethics has come a long way since its inception nearly five decades ago. Pioneered in part in response to a number of high-profile corporate scandals, the early field of business ethics was thought by many to be a fad that would recede along with the salience of the scandals of the day. Yet, this could not have been further from the truth. The need for behavioral business ethics research remains ever-present, as evidenced by the sustained number of scandals and unethical behavior within and by organizations. Moreover, research in this area has burgeoned. In the 1980s, only 54 articles had been published on this topic (Tenbrunsel & Smith-Crowe, 2008); today, a similar search yields over 3,000 “hits.” In light of the area’s growth, we suggest the need to take a look back at the seminal work that sparked social scientific work in the field. In particular, this chapter has two main objectives. First, we provide a review of select foundational work. In so doing, we identify some of the key trends that characterized early knowledge development in the field. Second, we draw on this historical context to consider how past trends relate to current work and speak to future research opportunities.

Increasingly, addressing healthcare's grand challenges requires complex system-level adaptations involving continuously evolving teams and leaders. Although leadership development strategies have been shown to improve individual leader effectiveness, much less is known about how organization-level leadership development affects organization-level outcomes. To begin building an evidence base as well as encouraging evidence-based practices, the US-based National Center for Healthcare Leadership developed a program capitalizing on leaders' demonstrated interest in organizational competitiveness: the biennial Best Organizations for Leadership Development (BOLD) program. In this chapter, we describe the philosophy behind this unique survey program and summarize research to date on relationships between survey dimensions and organizational outcomes such as patient experience and financial performance. We conclude with a description of promising areas for future study.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.