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The purpose of this article is to assess the reliability of an in‐depth analysis on causation, preventability, and disability by two separate review teams on five selected adverse events in acute hospitals: pressure ulcer, postoperative pulmonary embolism or deep vein thrombosis, postoperative sepsis, ventilator‐associated pneumonia and postoperative wound infection.

The analysis uses a retrospective medical record review of 1,515 patient records by two independent teams in eight acute Belgian hospitals for the year 2005. The Mann‐Whitney U‐test is used to identify significant differences between the two review teams regarding occurrence of adverse events as well as regarding the degree of causation, preventability, and disability of found adverse events.

Team 1 stated a high probability for health care management causation in 95.5 per cent of adverse events in contrast to 38.9 per cent by Team 2. Likewise, high preventability was considered in 83.1 per cent of cases by Team 1 versus 51.7 per cent by Team 2. Significant differences in degree of disability between the two teams were also found for pressure ulcers, postoperative pulmonary embolism or deep vein thrombosis and postoperative wound infection, but not for postoperative sepsis and ventilator‐associated pneumonia.

New insight on the degree of and reasons for the huge differences in adverse event evaluation is provided.

A clinical pathway for patients with acute ischemic stroke was implemented in 2014 by one Italian teaching hospital multidisciplinary team. The purpose of this paper is to determine whether this clinical pathway had a positive effect on patient management by comparing performance data.

Volume, process and outcome indicators were analyzed in a pre-post retrospective observational study. Patients’ (admitted in 2013 and 2015) medical records with International Classification of Diseases, ICD-9 code 433.x (precerebral artery occlusion and stenosis), 434.x (cerebral artery occlusion) and 435.x (transient cerebral ischemia) and registered correctly according to hospital guidelines were included.

An increase context-sensitive in-patient numbers with more severe cerebrovascular events and an increase in patient transfers from the Stroke to Neurology Unit within three days (70 percent, p=0.25) were noted. Clinical pathway implementation led to an increase in patient flow from the Emergency Department to dedicated specialized wards such as the Stroke and Neurology Unit (23.7 percent, p<0.001). Results revealed no statistically significant decrease in readmission rates within 30 days (5.7 percent, p=0.85) and no statistically significant differences in 30-day mortality.

The pre-post retrospective observational study design was considered suitable to evaluate likely changes in patient flow after clinical pathway implementation, even though this design comes with limitations, describing only associations between exposure and outcome.

Clinical pathway implementation showed an overall positive effect on patient management and service efficiency owing to the standardized application in time-dependent protocols and multidisciplinary/integrated care implementation, which improved all phases in acute ischemic stroke care.

The purpose of this paper is to explore the literature regarding work intensification that is being experienced by nurses, to examine the effects this is having on their capacity to complete care. The authors contend that nurses’ inability to provide all the care patients require, has negative implications on their professional responsibility.

The authors used institutional ethnography to review the discourse in the literature. This approach supports inquiry through the review of text in order to uncover activities that remain institutionally accepted but unquestioned and hidden.

What the authors found was that the quality and risk management forms an important part of lean thinking, with the organisational culture influencing outcomes; however, the professional cost to nurses has not been fully explored.

The text uncovered inconsistency between what organisations accepted as successful cost savings, and what nurses were experiencing in their attempts to achieve the care in the face of reduced time and human resources. Nurses’ attempts at completing care were done at the risk of their own professional accountability.

Nurses are working in lean and stressful environments and are struggling to complete care within reduced resource allocations. This leads to care rationing, which negatively impacts on nurses’ professional practice, and quality of care provision.

This approach is a departure from the standard qualitative review because the focus is on the textual relationships between what is being advocated by organisations directing cost reduction and what is actioned by the nurses working at the coalface. The discordant standpoints between these two juxtapositions are identified.

The study aims to explore how healthcare workers (HCWs) navigate and experience time when caring for older cancer patients living with other illnesses.

This paper presents findings from a qualitative study of how HCWs conceptualise and navigate the temporal aspects of delivering personalised care to older people living with multimorbidity. Building on research from organisation studies and the sociology of time, we interviewed 19 UK HCWs about their experiences of delivering care to this patient group.

Our findings illustrate how the delivery of personalised care contradicts contemporary models for healthcare delivery defined by efficiency and standardisation. We found that HCWs engage with time as both a valuable commodity to be rationed and prioritised within a constrained context and as a malleable resource for managing workload and overcoming “turbulence” in the system. However, participants in this study also shared how the simultaneous multiplicity and lack of time had a profoundly personal impact on them through the emotional toll associated with “time debt” and “lost” time.

This research presents a unique analysis of how time is conceptualised and navigated in contemporary healthcare, offering valuable insights for policy improvement. We conclude that personalised models of healthcare are incompatible with many current temporal structures of treatment trajectories and work-practices, by nature of being centred around the person and not the system of delivery.

The complexity and uncertainty of healthcare operations increasingly require agility to safeguard a high quality of care. Using a microfoundations of dynamic capabilities perspective, this study investigates the effects of nurses' implicit voice theories (IVTs) on the behaviors that influence their individual agility.

This research uses quantitative survey data collected from 2,552 Canadian nurses during the fourth wave of the Covid-19 pandemic in the fall of 2021. Structural equation modeling is used to test a conceptual model that hypothesizes the effects of three different IVTs on nurses' creativity, spontaneity, agility and the quality of care they deliver to patients.

The results reveal that voice-inhibiting cognitions (like “suggestions are criticisms for higher-ups”, “I first need a solution or solid data”, and “speaking up has negative repercussions”) negatively impact nurses' creativity and spontaneity in crafting solutions to problems they face daily. In turn, this affects nurses' individual agility as they attempt to adapt to changing circumstances and, ultimately, the quality of care they provide to their patients.

Even if organizations have little control over employees' pre-held beliefs regarding voice, they can still reverse them by developing and nurturing a voice-welcoming culture to boost their workers' agility.

This study combines two theoretical frameworks, voice theory and dynamic capabilities theory, to study how individual-level factors (cognitions and behaviors) contribute to nurses' individual agility and the quality of care they provide to their patients. It answers the recent calls of scholars to study the mechanisms through which healthcare operations can develop and sustain dynamic capabilities, such as agility, and better face the “new normal”.

This study aims to analyze the managerial levers previously considered in literature in the setting of the provision of primary care and community services (in particular for patients with long-term conditions being treated also at home) as well as those scarcely explored that could potentially be adopted in the future.

This study was a structured literature review. The authors retrieved papers, published from 2005–2020, from electronic databases (i.e. ABI/INFORM Complete, Jstor, PubMed and Scopus). Each selected paper was assigned to a framework category, and a thematic analysis was performed.

Topics scarcely explored in literature were related to logistics/supply chain, economic evaluations, performance management and customer satisfaction. Some papers embraced more than one management topic, confirming the multidisciplinary nature of territorial healthcare services. The majority of research, however, focused on only one aspect of primary care services, and a lack of an integrated view regarding the provision of those services emerged.

This study represents a first attempt to rationalize the fragmented body of knowledge on the topic of the provision of primary and community care services. This study enabled some light to be shed on the managerial levers already explored previously in literature and also identifies a number of trajectories for future research.

Preventing burnout and promoting psychological well-being in nurses are of great importance. In this study the effect of an online, stand-alone individualized preventive program for nurse burnout based on cognitive behavioral therapy (CBT) is described and explained.

A mixed method study with an explanatory sequential design was applied. Quantitative data were collected from September 2015 to March 2016 during an intervention study with a pretest-posttest wait-list control group design within a population of hospital nurses in the Dutch speaking part of Belgium. Consecutively, 13 nurses from the intervention group who fully completed the program were interviewed.

All interviewed participants experienced some sort of effect due to working with the program. Emotional exhaustion remained stable in the intervention group and increased in the control group. However, this difference was not significant. Personal accomplishment decreased significantly within the intervention group when compared to the control group. This might be explained by the self-awareness that was created through the program, which confronted participants with their weaknesses and problems.

This study adds to the understanding of online individual burnout prevention. The results suggest the feasibility of an online program to prevent nurse burnout. This could be optimized by complementing it with organizational interventions, introducing refresher courses, reminders and follow-up. Furthermore, additional attention should be devoted to preparing the implementation in order to minimize attrition rates.

The purpose of this paper is to assess and examine the impact of physicians-nurses performance on patient perceptions on safety, trust and satisfaction.

A cross-sectional study of 170 inpatients at 78 Chinese hospitals has been conducted. A structured questionnaire covering multiple constructs was used to collect the data. Methodology is described and results are discussed.

Multivariate regression results show that despite the variations in education and training of physicians and nurses, trust is statistically significant in the models with doctors performance and nurses performance as dependent variables. One surprise result is that patient safety is not statistically significant in the regression model with NP as dependent variable.

Doctor and nurses as well as other staff at any healthcare setting or ward should provide patients with high-quality and safe healthcare. Competences and performance of physicians and nurses are the primary source of patient safety.

The patient correlate their patients safety with doctors but not with nurses. On the other hand, they relate their satisfaction more to nurses performance than doctors performance.