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Article
Publication date: 11 November 2014

Dirk F. de Korne, Jeroen D.H. van Wijngaarden, Cathy van Dyck, U. Francis Hiddema and Niek S. Klazinga

The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing…

Abstract

Purpose

The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program’s content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient safety, but little is known about how it affects safety culture.

Design/methodology/approach

Pre- and post-assessments of the hospitals’ safety culture was based on interviews with ophthalmologists, anesthesiologists, residents, nurses, and support staff. Interim observations were made at training sessions and in daily hospital practice.

Findings

The program consisted of safety audits of processes and (team) activities, interactive classroom training sessions by aviation experts, a flight simulator session, and video recording of team activities with subsequent feedback. Medical professionals considered aviation experts inspiring role models and respected their non-hierarchical external perspective and focus on medical-technical issues. The post-assessment showed that ophthalmologists and other hospital staff had become increasingly aware of safety issues. The multidisciplinary approach promoted social (team) orientation that replaced the former functionally-oriented culture. The number of reported near-incidents greatly increased; the number of wrong-side surgeries stabilized to a minimum after an initial substantial reduction.

Research limitations/implications

The study was observational and the hospital’s variety of efforts to improve safety culture prevented us from establishing a causal relation between improvement and any one specific intervention.

Originality/value

Aviation-based TRM training can be a useful to stimulate safety culture in hospitals. Safety and quality improvements are not single treatment interventions but complex socio-technical interventions. A multidisciplinary system approach and focus on “team” instead of “profession” seems both necessary and difficult in hospital care.

Details

Journal of Health Organization and Management, vol. 28 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

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Book part
Publication date: 18 December 2003

John Michael Montias

Abstract

Details

Economics of Art and Culture Invited Papers at the 12th International Conference of the Association of Cultural Economics International
Type: Book
ISBN: 978-0-44450-995-6

Content available
Article
Publication date: 3 July 2017

Marlieke den Herder-van der Eerden, Benjamin Ewert, Farina Hodiamont, Michaela Hesse, Jeroen Hasselaar and Lukas Radbruch

Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing…

Abstract

Purpose

Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice.

Design/methodology/approach

A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis.

Findings

IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems.

Originality/value

Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.

Details

Journal of Integrated Care, vol. 25 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

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