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Article

Ina Fourie and Retha Claasen‐Veldsman

The potential of current awareness services (CAS) for oncology nurses is considered with special reference to the spectrum of WWW CAS that are available, their benefits…

Abstract

Purpose

The potential of current awareness services (CAS) for oncology nurses is considered with special reference to the spectrum of WWW CAS that are available, their benefits and problems, and how these can be linked to the dynamic health environments in which oncology nurses may find themselves. The intention with the article is to show the need for exploring the value of WWW CAS for dynamic professional fields such as oncology nursing, and to offer a point of departure for research on their information behaviour. The WWW CAS that were identified might be used to get oncology nurses interested in using such services, as well as in participating in research on their information behaviour.

Design/methodology/approach

A literature study on the nature and value of CAS is combined with a cursory analysis of the literature of oncology nursing to provide insight into the professional demands that oncology nurses need to cope with, and the potential value of CAS for oncology nurses. Based on this a selection of WWW CAS suitable for oncology nurses is identified. Insight into the potential of WWW CAS for oncology nurses and the CAS that are available are combined with what can be learned from studies on information‐seeking behaviour to offer some suggestions on how the need for oncology nurses to use CAS available via the WWW can be further explored. In general the suggestions to explore the use of CAS would also apply to other professional fields.

Findings

It seems as if oncology nurses can benefit substantially from WWW CAS. To successfully implement such CAS, extensive research on the information‐seeking behaviour, information use and information communication of oncology nurses is, however, necessary. The article could be used as an instrument to gain oncology nurses' interest in WWW CAS, and willingness to participate in further research on their information needs and information behaviour.

Practical implications

Oncology nurses' interest in CAS can be stimulated, and the article can be used as point of departure for further research. The article can also offer new opportunities for library and information (LIS) professionals to offer CAS in the health and other professional sectors, by reconsidering how one can use CAS available via the WWW.

Originality/value

No reports on CAS for oncology nurses could be traced, and there are also very few reports on the information needs and information behaviour of oncology nurses. The article hopes to pave the way for renewed interest in using CAS in demanding professional environments, and especially the health sciences, as well as to stimulate interest in research in information‐seeking behaviour in the health sciences.

Details

The Electronic Library, vol. 25 no. 1
Type: Research Article
ISSN: 0264-0473

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Article

Eileen O'Donnell, Paul D'Alton, Conor O'Malley, Finola Gill and Áine Canny

The psycho-oncology and social work services recognised that a cancer diagnosis and treatment can result in considerable emotional consequences for patients, yet the…

Abstract

Purpose

The psycho-oncology and social work services recognised that a cancer diagnosis and treatment can result in considerable emotional consequences for patients, yet the referral rate to both services was extremely low. Only very visibly distressed patients were being referred to the service. The “Distress Thermometer” (DT), a distress screening tool, was introduced as a pilot project with day care and inpatient oncology patients of St Vincent ' s University Hospital, Dublin, in an effort to improve the identification, management and treatment of psychological distress in oncology patients. The purpose of this paper is to evaluate the effectiveness of this new intervention.

Design/methodology/approach

The Psycho-oncology service in conjunction with the Medical Social Work Department and Nursing Management at St Vincent ' s University Hospital, Dublin, initiated a Distress Education Management and Training Programme (DEMP). The initiative involved providing a training programme for oncology nursing staff and the introduction of a distress-screening tool for patients. In 1998, the DT was developed and validated for evaluation of distress (and depression) in cancer. It was adopted into recommendations made by the US National Comprehensive Cancer Network. The DT is a simple, self-report, pencil and paper measure consisting of a line with a 0-10 scale anchored at the zero point with “No distress” and at scale point ten with “Extreme distress”. Patients are given the instruction, “How distressed have you been during the past week on a scale of 0-10”? Patients indicated their level of distress with a mark on the scale. Patients scoring 4 or above were regarded as requiring intervention. The DT includes a problem checklist. The patient is asked to identify those problems from the checklist which are contributing to their score. The use of the DT was evaluated through interviews with patients and professionals.

Findings

Patients who scored four or above (38 per cent of patients), were seen by the Oncology Social Worker for psychosocial assessment and mental health triage. Patients who scored above a certain level (usually above 12/20) in the clinical range on the Hospital Anxiety and Depression scale (3 per cent) were referred to Psycho-oncology. That 38 per cent of oncology patients required intervention from a specialist service accurately reflects international findings on the rate of distress among cancer patients.

Practical implications

Assessment of cancer patients ' distress levels in a structured and planned manner with a Distress Thermometer, as recommended by best international practice, works very effectively and should be considered for all cancer out-patients This will have implications in terms of staff that will be required to manage such a service.

Originality/value

This was the first time that this internationally recognised tool was used to such an extent and to positive effect in an Irish context.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article

Christian Gadolin, Erik Eriksson and Patrik Alexandersson

The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by…

Abstract

Purpose

The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved.

Design/methodology/approach

A qualitative case study primarily consisting of interviews.

Findings

The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination.

Originality/value

The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability.

Details

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

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Article

Fariba Taleghani, Elaheh Ashouri, Mehrdad Memarzadeh and Mortaza Saburi

The purpose of this paper is to explore oncology nurses’ barriers to empathy-based care perceptions.

Abstract

Purpose

The purpose of this paper is to explore oncology nurses’ barriers to empathy-based care perceptions.

Design/methodology/approach

The authors used a descriptive qualitative method. In total, 18 oncology nurses were selected via purposive sampling. Data were collected through in-depth interviews and qualitative content analysis using an inductive approach.

Findings

Three main categories emerged from the data analysis: barriers related to nursing including: lacking compassion; disinterest in oncology nursing and self-criticism; psychological distress; barriers related to healthcare: job strain; task-centeredness; no formal training; poor manager support; nurse-patient gender imbalance; and barriers related to cancer care including: difficulty maintaining empathy with cancer patients; and inappropriate cancer patient

Practical implications

Oncology nurses provided insights into barriers to empathy-based care and the challenges they encountered while caring for cancer patients. Understanding these barriers is the first step to overcoming obstacles and creating an open and caring environment to provide an empathic care culture.

Originality/value

Given that oncology nurses experience several emotions, positive coping strategies for these distresses should be adopted. Healthcare systems should change cancer-caring culture from task-centered to patient-centered care. Compassion and empathy should become patient care values.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 3
Type: Research Article
ISSN: 0952-6862

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Article

Ellen Belitzky, Christian Bach and Erika Belitzky

This study aims to understand how healthcare social media offer nonmedical psycho-social support for pediatric oncology patients and their care community and how social…

Abstract

Purpose

This study aims to understand how healthcare social media offer nonmedical psycho-social support for pediatric oncology patients and their care community and how social media can be exploited for healthcare knowledge management.

Design/methodology/approach

Social media capabilities were identified and categorized based on psycho-social support services for pediatric oncology patients, caregivers and their community of care. Data were collected from 187 service sites representing more than 100 organizations. These broadly defined capabilities in trusted care organizations were analyzed to understand use of social media in providing psycho-social support.

Findings

Analysis revealed resource guides, stories and in-person support at clinics as the most prevalent forms of technology-guided psycho-social support. Privacy, security and information integrity rose as technical challenges for interactive social media platforms. Medical community trust is inconsistent, leading to immature adoption of critical psycho-social support as a knowledge management source. Findings further indicate the not-for-profit support sector provides robust social media capabilities compared to the healthcare sector.

Research limitations/implications

Future research may extend to maturing healthcare and not-for-profit sector services and to private sector products such as mobile applications and other technologies.

Practical implications

Survivor and caregiver quality of life depend on psycho-social support communities and services delivered via social media.

Social implications

Child protection social implications require significant attention due to sensitivity of security, privacy concerns and longevity of digital footprints for pediatric patients.

Originality/value

Research demonstrates opportunity for medical provider, healthcare organization, not-for-profit sector, patient and caregiver cooperation using social media. Data indicate healthcare technology systems leveraging social media can extend knowledge management capability beyond organization boundaries.

Details

Measuring Business Excellence, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1368-3047

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Article

Esther Uña Cidón, Fernando Cuadrillero Martín, Milagros Hijas Villaizán and Francisco López Lara

Although “satisfaction” is not easy to define, excellence in health care is impossible without professional/patient satisfaction, so this paper aims to report on a pilot…

Abstract

Purpose

Although “satisfaction” is not easy to define, excellence in health care is impossible without professional/patient satisfaction, so this paper aims to report on a pilot study designed in order to evaluate the degree of nursing staff satisfaction with the implementation of measures to improve quality of care.

Design/methodology/approach

The project consisted of several phases: writing protocols of care; training of nursing staff in their management; and a cross‐sectional study to evaluate nursing staff satisfaction with them. The design of the survey consisted of a 16‐item Likert scale, which had to be auto filled. A factorial analysis to simplify and validate the tools was used, using statistical analyses with SPSS software 8.0.

Practical implications

The results are applicable to young small oncological units with high degree of variability in patient care. The study showed that nursing staff satisfaction with new improvement measures taken improves safety and finally quality of care.

Findings

The study obtained four dimensions (D) explaining 100 percent of variance. Each dimension with several items: D1: “Nursing job quality” explaining 48.4 percent of variance; D2: “Satisfaction with the knowledge”; D3: “Nursing job feelings/perceptions”; D4: “Nursing communication with doctors/patients”. It provided a direct point of view of each nurse, knowledge about problems encountered daily and demonstration of how a simple/convenient method is useful to engage the staff in decision‐making‐process and implementation of new strategies or to promote the integration of basic aspects of health management in daily clinical practice.

Originality/value

This is the first study evaluating nursing staff satisfaction with new improvement measures taken in a small medical unit, aiming at quality of care benefits. Very promising results were obtained although the sample size was small.

Details

International Journal of Health Care Quality Assurance, vol. 25 no. 2
Type: Research Article
ISSN: 0952-6862

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Article

Katariina Silander, Paulus Torkki, Paul Lillrank, Antti Peltokorpi, Saara A. Brax and Minna Kaila

Modularity promises to relieve problems of complexity in service systems. However, limited evidence exists of its application in specialized hospital services. The purpose…

Abstract

Purpose

Modularity promises to relieve problems of complexity in service systems. However, limited evidence exists of its application in specialized hospital services. The purpose of this paper is to identify enablers, constraints, and outcomes of modularization in specialized hospital services.

Design/methodology/approach

A qualitative comparative study of a hematology unit with modular service architecture and an oncology unit with integral service architecture in a university hospital is performed to analyze the service architectures, enablers and constraints of modularization, and outcomes.

Findings

A framework and five propositions combining the characteristics of specialized hospital services, enabling activities, and outcomes of modularization were developed. Modular service architecture was developed through limiting the number of treatment components, reorganizing production of standardized components into a separate service unit, and standardizing communication and scheduling in interfaces. Modularization increased service efficiency but diluted ownership of services, decreased customization, and diminished informal communication. This is explained by the specific characteristics of the services: fragmented service delivery, professional autonomy, hierarchy, information asymmetry, and requirement to treat all.

Research limitations/implications

Modularization can increase efficiency in specialized hospital services. However, specific characteristics of specialized care may challenge its application and limit its outcomes.

Practical implications

The study identifies enabling activities and constraints that hospital managers should take into account when developing modular service systems.

Originality/value

This is the first empirical study exploring the enablers, constraints, and outcomes of modularization in specialized hospital services. The study complements literature on service modularity with reference to specialized hospital services.

Details

International Journal of Operations & Production Management, vol. 37 no. 6
Type: Research Article
ISSN: 0144-3577

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Article

Risha Fayyaz, Fasih Ali Ahmed, Adeel Abid, Afshan Akhtar, Rabail Jarwar, Anila Jasmine, Sameer Ahmad Khan, Shahira Shahid, Iraj Khan, Aneeq Muhammad Yousuf and Imtiaz Jehan

This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and…

Abstract

Purpose

This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to identify domains where improvement is needed.

Design/methodology/approach

This is a cross-sectional study carried out at two tertiary care hospitals of Karachi, Pakistan, belonging to private and public sector, respectively, between February and April 2018. Face-to-face interviews were conducted using a modified questionnaire having five-point Likert scale questions regarding satisfaction of patients with doctors, nursing staff, information provided and the hospital standards. SPSS 20 was used for statistical analysis, and the results were expressed using mean, frequencies, percentages and p-values.

Findings

The authors approached 415 patients, out of which 389 patients agreed to participate in the study. For both hospitals, the lowest mean scores were for sections pertaining to satisfaction with psychosocial support and information provided. The mean satisfaction score of patients from the private hospital were found to be significantly higher as compared to patients from the public hospital for all domains of patient care (p-value < 0.01 using t-test for two independent samples). The data showed an increasing trend of “satisfied” responses as the household income increased.

Research limitations/implications

A comparative study should be conducted with the aim of pinpointing the differences in areas in which there is a significant difference in positive satisfaction levels between private and public sectors. Similar research could also be expanded adding other variables that affect quality of care such as doctor's approach to their patients, time given during each consultation and patient's understanding of doctor's knowledge. Further studies can be done to bridge the gaps between what a doctor views as standard care and what the patient knows will help them receive a more holistic approach to care.

Practical implications

Assessing the quality of care helps determine gaps in care and allocating health resources accordingly. In clinical practice, emphasis needs to be given on increased duration and improved quality of patient counselling to improve the low satisfaction levels of patients regarding the psychosocial support. Addressing patients' concerns should be made part of clinical teaching from an undergraduate level. As far as patient access to doctors of the specific speciality is concerned, hospital managements should adopt systems to ensure continuum of care and come up with mechanisms to bridge the discrepancy between a patient's needs and doctor availability.

Social implications

After being identified as a major deficiency, training doctors in the sensitivities of the population and demographics, especially with respect to socio-economic statuses, can aid in enhancing patient satisfaction to the treatment. Implementation of patient-centred care leads to greater satisfaction with care, which, in turn, increases a patient's self efficacy in managing important aspects of their care and improves health care-related quality of life.

Originality/value

Cancer patients have long-term exposure to the hospital environment. A patient's satisfaction with the quality of care is an important determinant in patient compliance to the treatment protocol and required hospital visits. There is a dearth of research on the outpatient quality of care in the oncology departments in Karachi. This study provides an overview of the quality of care available to cancer patients in Karachi both in public and private sectors. The results of our study identify the gaps in the quality of care being provided to the patients in a developing country like Pakistan, which can be used to improve the quality of care, leading to better patient outcomes.

Details

International Journal of Health Care Quality Assurance, vol. 34 no. 1
Type: Research Article
ISSN: 0952-6862

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Article

Rowena Catipay Buyan, Jill Aylott and Duncan Carratt

Over half of adults under the age of 65 years will be diagnosed with cancer at some point in their lives (Ahmad et al., 2015). Demand for services is outstripping the…

Abstract

Purpose

Over half of adults under the age of 65 years will be diagnosed with cancer at some point in their lives (Ahmad et al., 2015). Demand for services is outstripping the capacity in the NHS, as 77% of NHS Trusts are unable to start treatment within 62 days (Baker, 2019; NHS England, 2019). Side effects of treatment can be life threatening (Tsai et al., 2010) with many patients attending ED; however, these can be managed through a hospital’s Acute Oncology Service (AOS). This paper aims to explore a collaborative leadership approach to improve services for patients [Rubin et al., 2015; Department of Health (DOH), 2012].

Design/methodology/approach

A case study of an AOS in an NHS Trust was the focus for the development of a strategy of ‘Collaborative’ leadership, with the aim to increase the engagement of a wide network of clinical and non-clinical stakeholders in a review of the AOS. The case study identified the level of effectiveness of the service since its inception in 2012. Using a quality improvement methodology (Deming 2000; Health Foundation, 2011; Aylott, 2019) resulted in learning and increased collaboration between clinical and non-clinical staff.

Findings

Action learning processes revealed that AOS staff had been frustrated for some time about the dysfunction of the current process to manage the increased demand for the service. They reported their perceptions and frustrations with the current process of referral and patient discharge. Data revealed alerts from the Emergency Department (ED) to AOS resulted in 72% of patients inappropriately referred, with an over representation of patients who had a previous existing cancer condition. Clinical engagement with the data informatics manager (DC) revealed a need to improve data quality through improvements made to the database.

Research limitations/implications

Increasing demand for cancer services requires a continuous need for improvement to meet patient needs. Cancer waits for diagnostic tests are at their highest level since 2008, with 4% of patients waiting over 6 weeks to be tested compared to the tested target of 1% (Baker, 2019). This paper draws on data collected from 2017 to 2018, but a continuous review of data is required to measure the performance of the AOS against its service specification. Every AOS team across the NHS could benefit from a collaborative learning approach.

Practical implications

Clinical services need collaborative support from informatics to implement a Quality Improvement methodology such as the IHI Model for Improvement (IHI, 2003). Without collaboration the implementation of a quality improvement strategy for all NHS Trusts will not come to fruition (Kings Fund, 2016). Quality Improvement Strategies must be developed with a collaborative leadership implementation plan that includes patient collaboration strategies (Okpala, 2018), as this is the only way that services will be improved while also becoming cost effective (Okpala, 2018).

Social implications

In the UK, 20-25% of new cancer diagnoses are made following an initial presentation to the ED (Young et al., 2016). Cancer-related attendances at ED had a higher level of acuity, requiring longer management time and length of stay in ED. With cancer care contributing to 12% of all hospital admissions, an increase of 25% over the past two decades (Kuo et al., 2017) the AOS will need continued collaboration between clinical staff, informatic managers, patients and all stakeholder organisations to continuously improve its services to be “fit for purpose”.

Originality/value

This case study reports the innovative collaborative work between a Medical Oncologist, an NHS Trust Informatics manager and a QI academic facilitator. The Health Foundation and Kings Fund have identified the continued challenges presented to the NHS in the transformation of its services, with the Health Foundation (2011) reporting the need for more collaborative working between clinicians and non-clinicians to drive improvement. This model of collaboration creates a new way of working to drive improvement initiatives and sets out a rationale to develop this model further to involve patients. However, this will call for a new way of working for all.

Details

Leadership in Health Services, vol. 33 no. 3
Type: Research Article
ISSN: 1751-1879

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Article

Francesca Dal Mas, Helena Biancuzzi, Maurizio Massaro and Luca Miceli

The paper aims to contribute to the debate concerning the use of knowledge translation for implementing co-production processes in the healthcare sector. The study…

Abstract

Purpose

The paper aims to contribute to the debate concerning the use of knowledge translation for implementing co-production processes in the healthcare sector. The study investigates a case study, in which design was used to trigger knowledge translation and foster co-production.

Design/methodology/approach

The paper employs a case study methodology by analysing the experience of “Oncology in Motion”, a co-production program devoted to the recovery of breast cancer patients carried on by the IRCCS C.R.O. of Aviano, Italy.

Findings

Results show how design could help to translate knowledge from various stakeholders with different skills (e.g. scientists, physicians, nurses) and emotional engagement (e.g. patients and patients' associations) during all the phases of a co-production project to support breast cancer patients in a recovery path. Stewardship theory is used to show that oncology represents a specific research context.

Practical implications

The paper highlights the vast practical contribution that design can have in empowering knowledge translation at different levels and in a variety of co-production phases, among different stakeholders, facilitating their engagement and the achievement of the desired outcomes.

Originality/value

The paper contributes to the literature on knowledge translation in co-production projects in the healthcare sector showing how design can be effectively implemented.

Details

Management Decision, vol. 58 no. 9
Type: Research Article
ISSN: 0025-1747

Keywords

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