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Book part
Publication date: 29 July 2009

Patrick A. Palmieri and Lori T. Peterson

The Institute of Medicine's seminal report, To err is human: Building a safer health system, established the national patient safety framework and initiated interest in…

Abstract

The Institute of Medicine's seminal report, To err is human: Building a safer health system, established the national patient safety framework and initiated interest in changing the traditionally punitive healthcare culture. This paper reviews a multidisciplinary literature and offers an attribution framework to explicate the organizational processes that contribute to an industry-wide culture where clinicians are routinely blamed for adverse patient events. Attribution theory is concerned with the manner in which people explain the behaviors of others or themselves by assigning causality for events. To date, attribution theory, though well established in the management literature, has yet to be translated to healthcare. In this paper, we first describe the historical evolution of attribution theory in relation to human behavior in clinical practice and healthcare management and then discuss the work environments in contemporary healthcare organizations. Next, we demonstrate the applicability of attribution theory to healthcare by providing two adverse event exemplar cases. Then, the Healthcare Attribution Error Model is offered to demonstrate how concepts from attribution theory serve as antecedents to the employee cynicism, learned helplessness, organizational inertia, and the emerging Just Culture perspective. We conclude by suggesting attribution theory offers an important theoretical framework that warrants further conceptual development and empirical research. In the quest to produce exceptional healthcare environments where safety and quality are fundamental employee concerns, healthcare managers and clinical professionals need theoretically supported knowledge and evidence-based insights.

Details

Biennial Review of Health Care Management: Meso Perspective
Type: Book
ISBN: 978-1-84855-673-7

Book part
Publication date: 26 August 2010

Patrick A. Palmieri, Lori T. Peterson, Bryan J. Pesta, Michel A. Flit and David M. Saettone

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system…

Abstract

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established through modification in employee safety perspective and work behavior, human resource (HR) professionals need to contribute to this developing organizational domain. The IOM indicates individual employee behaviors cumulatively provide the primary antecedent for organizational safety and quality outcomes. Yet, many safety culture scholars indicate the concept is neither theoretically defined nor consistently applied and researched as the terms safety culture, safety climate, and safety attitude are interchangeably used to represent the same concept. As such, this paper examines the intersection of organizational culture and healthcare safety by analyzing the theoretical underpinnings of safety culture, exploring the constructs for measurement, and assessing the current state of safety culture research. Safety culture draws from the theoretical perspectives of sociology (represented by normal accident theory), organizational psychology (represented by high reliability theory), and human factors (represented by the aviation framework). By understanding not only the origins but also the empirical safety culture research and the associated intervention initiatives, healthcare professionals can design appropriate HR strategies to address the system characteristics that adversely affect patient outcomes. Increased emphasis on human resource management research is particularly important to the development of safety cultures. This paper contributes to the existing healthcare literature by providing the first comprehensive critical analysis of the theory, research, and practice that comprise contemporary safety culture science.

Details

Strategic Human Resource Management in Health Care
Type: Book
ISBN: 978-1-84950-948-0

Book part
Publication date: 25 July 2008

Patrick A. Palmieri, Patricia R. DeLucia, Lori T. Peterson, Tammy E. Ott and Alexia Green

Recent reports by the Institute of Medicine (IOM) signal a substantial yet unrealized deficit in patient safety innovation and improvement. With the aim of reducing this…

Abstract

Recent reports by the Institute of Medicine (IOM) signal a substantial yet unrealized deficit in patient safety innovation and improvement. With the aim of reducing this dilemma, we provide an introductory account of clinical error resulting from poorly designed systems by reviewing the relevant health care, management, psychology, and organizational accident sciences literature. First, we discuss the concept of health care error and describe two approaches to analyze error proliferation and causation. Next, by applying transdisciplinary evidence and knowledge to health care, we detail the attributes fundamental to constructing safer health care systems as embedded components within the complex adaptive environment. Then, the Health Care Error Proliferation Model explains the sequence of events typically leading to adverse outcomes, emphasizing the role that organizational and external cultures contribute to error identification, prevention, mitigation, and defense construction. Subsequently, we discuss the critical contribution health care leaders can make to address error as they strive to position their institution as a high reliability organization (HRO). Finally, we conclude that the future of patient safety depends on health care leaders adopting a system philosophy of error management, investigation, mitigation, and prevention. This change is accomplished when leaders apply the basic organizational accident and health care safety principles within their respective organizations.

Details

Patient Safety and Health Care Management
Type: Book
ISBN: 978-1-84663-955-5

Book part
Publication date: 6 July 2011

Eric W. Ford and Nir Menachemi

In 2009, the Health Information Technology for Economic and Clinical Health Act (HITECH) was signed into law. This Act, part of the broader “stimulus” legislation…

Abstract

In 2009, the Health Information Technology for Economic and Clinical Health Act (HITECH) was signed into law. This Act, part of the broader “stimulus” legislation, represents the U.S.'s largest investment in health information technology (HIT) to date. More importantly, it sets a vision and provides a plan intended to transform the U.S. health care system to a safer, more efficient place to receive care. To that end, the Act seeks to fundamentally change the path HIT applications' adoption and implementation was taking to ensure that “meaningful use” and interoperability are achieved. However, such bold and sweeping changes will not come without unintended consequences, and their broad scope makes measuring the new public policy's success a challenge.

Details

Organization Development in Healthcare: Conversations on Research and Strategies
Type: Book
ISBN: 978-0-85724-709-4

Content available
Book part
Publication date: 26 August 2010

Abstract

Details

Strategic Human Resource Management in Health Care
Type: Book
ISBN: 978-1-84950-948-0

Content available
Book part
Publication date: 29 July 2009

Abstract

Details

Biennial Review of Health Care Management: Meso Perspective
Type: Book
ISBN: 978-1-84855-673-7

Content available
Book part
Publication date: 25 July 2008

Abstract

Details

Patient Safety and Health Care Management
Type: Book
ISBN: 978-1-84663-955-5

Book part
Publication date: 6 July 2011

Patrick Albert Palmieri, Lori T. Peterson and Luciano Bedoya Corazzo

The Institute of Medicine (IOM) views Health Information Technology (HIT) as an essential organizational prerequisite for the delivery of safe, reliable, and…

Abstract

The Institute of Medicine (IOM) views Health Information Technology (HIT) as an essential organizational prerequisite for the delivery of safe, reliable, and cost-effective health services. However, HIT presents the proverbial double-edged sword in generating solutions to improve system performance while facilitating the genesis of novel iatrogenic problems. Incongruent organizational processes give rise to technological iatrogenesis or the unintended consequences to system integrity and the resulting organizational outcomes potentiated by incongruent organizational–technological interfaces. HIT is a disruptive innovation for health services organizations but remains an overlooked organizational development (OD) concern.

Recognizing the technology–organizational misalignments that result from HIT adoption is important for leaders seeking to eliminate sources of system instability. The Health Information Technology Iatrogenesis Model (HITIM) provides leaders with a conceptual framework from which to consider HIT as an instrument for organizational development. Complexity and Diffusion of Innovation theories support the framework that suggests each HIT adoption functions as a technological change agent. As such, leaders need to provide operational oversight to managers undertaking system change via HIT implementation. Traditional risk management tools, such as Failure Mode Effect Analysis and Root Cause Analysis, provide proactive pre- and post-implementation appraisals to verify system stability and to enhance system reliability. Reconsidering the use of these tools within the context of a new framework offers leaders guidance when adopting HIT to achieve performance improvement and better outcomes.

Article
Publication date: 31 January 2022

Patrick T.I. Lam and Kelvin S.H. Mok

This study aims to identify the challenges facing innovative startups in the construction environment, recommending possible self-help measures and society support.

Abstract

Purpose

This study aims to identify the challenges facing innovative startups in the construction environment, recommending possible self-help measures and society support.

Design/methodology/approach

A comprehensive literature survey informed a questionnaire survey on built environment startups in Hong Kong, followed by a statistical analysis and supplemented by written views of respondents. Validation by experts confirms the survey results.

Findings

Triangulated findings highlight the problems of conservative policies, investors’ preference on short payback periods, price competition, high operation cost and a lack of promotion channels. The firm’s size and its age differentiate its networking and fund-raising capabilities.

Research limitations/implications

While the survey samples cover the spread of startups in Hong Kong’s construction/real estate industries well, the number is still limited because the city is relatively compact. The barriers and solutions may be particularly relevant to the built environment there, but also worth noting elsewhere.

Practical implications

Built environment startups are emerging and their path of development is obscured by industry barriers. While the findings reflect the current situation in Hong Kong, which is a metropolitan city with a vibrant construction market, government policies may present a varying factor in different economies. Conservatism in the construction industry may also be a hindrance, but gradual signs of improvements are seen.

Originality/value

The recommendations provided may help mitigate the problems of startup growth. They also provide insights into the construction “startup eco-system” worth the attention of policy makers and project managers, who may make better use of the innovative technology and services of built environment startups if the difficulties are alleviated.

Details

International Journal of Innovation Science, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1757-2223

Keywords

Book part
Publication date: 29 July 2009

Grant T. Savage and Myron D. Fottler

Eric Williams and his colleagues review the literature on both physician burnout and physician–patient communication. A major contribution in this chapter is a model based…

Abstract

Eric Williams and his colleagues review the literature on both physician burnout and physician–patient communication. A major contribution in this chapter is a model based on these two literatures, which outlines the impact that physician burnout can have on the physician–patient interaction and, therefore, patient outcomes. When physicians become emotionally exhausted, they begin to depersonalize to cope and focus on biomedical issues rather than communicating with the patient. When the patient is approached with this communication style from their physicians, they become less satisfied, trusting, and compliant. Less compliance results in worsened clinical outcomes, especially for patients with chronic disease. The authors discuss both the implications of this model and future directions for research.

Details

Biennial Review of Health Care Management: Meso Perspective
Type: Book
ISBN: 978-1-84855-673-7

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