Search results

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

This study aims to assess the alignment of South Korea’s government-certified social enterprises (GCSEs) with prevailing social enterprise (SE) models, notably the entrepreneurial nonprofit, social cooperative and social business models delineated in the “Emergence of Social Enterprises in Europe” (Defourny and Nyssens, 2012, 2017a, 2017b) and the “principle of interest” frameworks (Defourny et al., 2021). Thereby, it seeks to situate these enterprises within recognized frameworks and elucidate their hybrid identities.

Analyzing panel data from 2016 to 2020 for 259 GCSEs, this study uses tslearn for k-means clustering with dynamic time warping to assess their developmental trajectories and alignment with established SE models, which echoes the approach of Defourny et al. (2021). We probe the “fluid” identities of semi-public sector SEs, integrating Gordon’s (2013) notion that they tend to blend various SE traditions as opposed to existing in isolation.

Results indicate that GCSEs do align with prevalent SE frameworks. Furthermore, they represent a spectrum of SE models, suggesting the versatility of the public sector in fostering diverse types of SEs.

The concept of a semi-public sector SE model has been relatively uncharted, even though it holds significance for research on SE typologies and public sector entrepreneurship literature. This study bridges this gap by presenting empirical evidence of semi-public SEs and delineating the potential paths these enterprises might take as they amalgamate various SE traditions.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.