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Pramila-Savukoski S, Jarva E, Kuivila HM, Juntunen J, Koskenranta M, Kääriäinen M, Mikkonen K. Generic competence among health sciences students in higher education - A cross-sectional study. Nurse Educ Today 2024; 133:106036. [PMID: 37992578 DOI: 10.1016/j.nedt.2023.106036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Highly competent health care experts are needed for the development of the social and health care sectors. More knowledge is needed on the levels of generic competencies that health sciences experts possess, particularly in the context of complex decision-making. OBJECTIVES To describe self-evaluated generic competence of health sciences students and its associated factors. DESIGN A cross-sectional observational study design. PARTICIPANTS A total of 291 health science students in five universities in Finland participated in this study during the spring of 2022. METHODS The data was collected by using the HealthGenericCom instrument with 88 items and 8 sum dimensions using a five-point Likert scale (1-poor to 5-excellent): 1) competence in leadership, administration, and finance; 2) people-centred guiding competence; 3) competence of health promotion; 4) competence of evidence-based practice; 5) digital competence; 6) competence in work well-being and self-management; 7) competence in collaboration and problem-solving, and 8) competence in societal interaction. The K-means cluster algorithm was used to classify generic competence profiles to identify the profiles of health sciences students. RESULTS Four generic health sciences competence profiles (A = 18 %, B = 23 %, C = 33 %, D = 26 %) were identified. Profile A demonstrated the lowest level of most generic competencies in health sciences. Digital competence was shown to be at the lowest level among the participants, whereas competence in collaboration, problem-solving, and health promotion was evaluated as the highest competence level. The students evaluated their competence as being higher when they were older, were currently engaged in master's degree programmes, had completed work-based practical training in social and health care, and had varied work experiences or held leading positions. CONCLUSIONS Students need to improve their generic competencies in health sciences, with a particular focus on developing their digital competence. More focus should be given to work-based practical training.
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Affiliation(s)
| | - Erika Jarva
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
| | - Heli-Maria Kuivila
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
| | - Jonna Juntunen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
| | - Miro Koskenranta
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland.
| | - Maria Kääriäinen
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
| | - Kristina Mikkonen
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
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Allan J, Olcon K, Everingham R, Fox M, Pai P, Mackay M, Keevers L. Leading wellness in healthcare: A qualitative study of leadership practices for wellness in hospital settings. PLoS One 2023; 18:e0285103. [PMID: 37467299 DOI: 10.1371/journal.pone.0285103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/14/2023] [Indexed: 07/21/2023] Open
Abstract
Ways of dealing with workplace stress and enhancing healthcare workers wellness are sought globally. The aim of this study was to explore healthcare leaders' practice in relation to the implementation of a workplace wellness program called SEED in the context of multiple crises (bushfires and COVID-19) affecting a local health district in New South Wales, Australia. Practice theory informed interviews (n = 23), focus groups (n = 2) and co-analysis reflexive discussions (n = 2) that were conducted with thirteen leaders and twenty healthcare workers. A pragmatic approach to program implementation for healthcare workers' wellness explored the process and actions that resulted from leadership practice in an inductive thematic analysis. Preliminary themes were presented in the co-analysis sessions to ensure the lived experiences of the SEED program were reflected and co-interpretation of the data was included in the analysis. Three key themes were identified. 1) Leading change-implementing a wellness program required leaders to try something new and be determined to make change happen. 2) Permission for wellness-implicit and explicit permission from leaders to engage in wellness activities during worktime was required. 3) Role-modelling wellness-leaders viewed SEED as a way to demonstrate leadership in supporting and caring for healthcare workers. SEED provided a platform for leaders who participated to demonstrate their leadership practices in supporting wellness activities. Leadership practices are critical to the implementation of healthcare wellness programs. The implementation of SEED at a time of unprecedented crisis gave leaders and healthcare workers opportunities to experience something new including leadership that was courageous, responsive and authentic. The study highlighted the need for workplace wellness programs to intentionally include leaders rather than only expect them to implement them. The practices documented in this study provide guidance to others developing, implementing and researching workplace wellness programs.
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Affiliation(s)
- Julaine Allan
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Katarzyna Olcon
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Ruth Everingham
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Shoalhaven Local Health District, Warrawong, New South Wales, Australia
| | - Mim Fox
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Padmini Pai
- Illawarra Shoalhaven Local Health District, Warrawong, New South Wales, Australia
| | - Maria Mackay
- Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lynne Keevers
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
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Varela T, Zamorano P, Muñoz P, Rain C, Irazoqui E, Sapag JC, Tellez A. Evaluation of the implementation progress through key performance indicators in a new multimorbidity patient-centered care model in Chile. BMC Health Serv Res 2023; 23:439. [PMID: 37143071 PMCID: PMC10159678 DOI: 10.1186/s12913-023-09412-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Complex health interventions involve deep organizational, structural, and cultural changes that challenge health teams and decision-makers. The explosion of chronic diseases has made the multimorbidity approach a global priority. The Centro de Innovación en Salud ANCORA UC implemented a Multimorbidity Patient-Centered Care Model in the Chilean public health system. OBJECTIVE This study aims to evaluate the progress of the implementation of the Multimorbidity Patient-Centered Care Model in seven primary care centers through key performance indicators. METHODS a set of indicators was designed to evaluate change management, operations, installation of new roles, and services and activities of the intervention strategy of the model. Key performance indicators were identified to monitor the implementation progress on minimal components for the model's sustainability. Each item was assigned against an expected minimum score of 67% of progress from the overall score. They were monitored twice in seven primary health centers in 2019 and 2020, which intervened 22,642 patients with the intervention. RESULTS The results showed that six of the seven primary care centers reached the minimum implementation threshold. The main advances were in operational conditions, and those with minor progress in implementation were the clinical services. Population size, organization, coordination of the health care teams, additional training, and decision-makers support were key factors that determined the degree of progress in a complex intervention. CONCLUSION It was possible to measure the progression of the implementation of a complex intervention through key performance indicators delivering relevant information for decision-makers that pursue a successful and faithful implementation. This study provides a valuable tool for the national scale-up of a similar model started in Chile by the Ministry of Health and other countries.
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Affiliation(s)
- Teresita Varela
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula Zamorano
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Health Technology Assessment Unit, Center of Clinical Research, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Current Address: Diagonal Paraguay, Santiago, 362, Chile.
| | - Paulina Muñoz
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Rain
- Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Esteban Irazoqui
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime C Sapag
- Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Public health, Pontificia Universidad Católica de Chile, Santiago, Chile
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Alvaro Tellez
- Centro de Innovación en Salud ANCORA UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Wiggins D, Downie A, Engel RM, Brown BT. Factors that influence scope of practice of the five largest health care professions in Australia: a scoping review. Hum Resour Health 2022; 20:87. [PMID: 36564798 PMCID: PMC9786531 DOI: 10.1186/s12960-022-00783-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION A well-functioning health system delivers quality services to all people when and where they need them. To help navigate the complex realm of patient care, it is essential that health care professions have a thorough understanding of their scope of practice. However, a lack of uniformity regarding scope of practice across the regulated health professions in Australia currently exists. This has led to ambiguity about what comprises scope of practice in some health care professions in the region. OBJECTIVE The objective of this review was to explore the literature on the factors that influence scope of practice of the five largest health care professions in Australia. METHODS This study employed scoping review methodology to document the current state of the literature on factors that influence scope of practice of the five largest health care professions in Australia. The search was conducted using the following databases: AMED (Allied and Complementary Medicine Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, EMBASE (Excerpta Medica Database), MANTIS (Manual, Alternative and Natural Therapy Index System), MEDLINE, PubMed, and SCOPUS. Additional data sources were searched from Google and ProQuest. RESULTS A total of 12 771 publications were identified from the literature search. Twenty-three documents fulfilled the inclusion criteria and were included in the final analysis. Eight factors were identified across three professions (nursing & midwifery, pharmacy and physiotherapy) that influenced scope of practice: education, competency, professional identity, role confusion, legislation and regulatory policies, organisational structures, financial factors, and professional and personal factors. CONCLUSION The results of this study will inform a range of stakeholders including the private and public arms of the healthcare system, educators, employers, funding bodies, policymakers and practitioners about the factors that influence scope of practice of health professions in Australia.
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Affiliation(s)
- Desmond Wiggins
- Department of Chiropractic, Macquarie University, Sydney, Australia.
| | - Aron Downie
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | - Roger M Engel
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | - Benjamin T Brown
- Department of Chiropractic, Macquarie University, Sydney, Australia
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Gardner MJ, McKinstry C, Perrin BM. Enhancing the quality of allied health clinical supervision in a regional setting: An action research study. Aust J Rural Health 2022; 31:308-321. [PMID: 36444637 DOI: 10.1111/ajr.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 11/06/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To explore and describe strategies to enhance the implementation of an organisational clinical supervision framework and subsequently inform the development of a model of implementation of clinical supervision for allied health professionals in a regional health care setting. SETTING A large regional health service in Victoria, providing hospital, rehabilitation, community, mental health and aged care services. PARTICIPANTS Allied health managers employed at the health service were members of an action research group. DESIGN This longitudinal study used an action research approach. The action research group informed the repeated cycles of planning, action and reflection. Data from recorded action research meetings were analysed using content analysis. RESULTS The action research group met 11 times over a 5-year period informing four action research cycles. Six main themes relating to factors that enhanced the quality of clinical supervision emerged from the analysis of the action research group data: purpose and value of clinical supervision; clinical supervision characteristics; differences between disciplines; framework development; training and support and implementation of clinical supervision. CONCLUSION The findings from this comprehensive longitudinal study provide evidence-based approaches to the implementation of allied health clinical supervision. The action research approach used ensures that the strategies described are realistic and sustainable. A model has been developed to inform the implementation of clinical supervision for allied health.
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Affiliation(s)
- Marcus J. Gardner
- La Trobe Rural Health School Bendigo Victoria Australia
- Bendigo Health Bendigo Victoria Australia
| | - Carol McKinstry
- Department of Rural Allied Health La Trobe Rural Health School Bendigo Victoria Australia
| | - Byron M. Perrin
- Department of Rural Health Sciences La Trobe Rural Health School Bendigo Victoria Australia
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Affiliation(s)
- Reema Harrison
- Macquarie University, Sydney, New South Wales 2109, Australia
| | | | - Deborah Debono
- University of Technology, Sydney, New South Wales, Australia
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Pai P, Olcoń K, Allan J, Knezevic A, Mackay M, Keevers L, Fox M, Hadley AM. The SEED Wellness Model: A Workplace Approach to Address Wellbeing Needs of Healthcare Staff During Crisis and Beyond. Front Health Serv 2022; 2:844305. [PMID: 36925812 PMCID: PMC10012715 DOI: 10.3389/frhs.2022.844305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022]
Abstract
Workplace wellness has gained new meaning and significance in the healthcare workforce in the face of the COVID-19 pandemic. Healthcare workers across the world have carried the burden of responding to the public health crisis by having to work under new pressures and constantly changing environments, take on additional shifts, risk their own health and lives, and cope with the ongoing psychological and emotional strain. The purpose of this paper is to articulate a workplace wellness model applied across hospitals in the Illawarra Shoalhaven Local Health District, a regional area in New South Wales, Australia. The description of the development, components, and lessons learned from the SEED Wellness Model illustrates one possible solution about how to provide better care for the staff thus not only preventing staff burnout and turnover, but also creating lasting organizational benefits. The detailed model description can assist in developing a larger and more rigorous evidence-base to improve staff wellness in healthcare settings, both within Australia and internationally.
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Affiliation(s)
- Padmini Pai
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Katarzyna Olcoń
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Julaine Allan
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Andrea Knezevic
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Maria Mackay
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Lynne Keevers
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Mim Fox
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
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Allan J, Webster E, Chambers B, Nott S. "This is streets ahead of what we used to do": staff perceptions of virtual clinical pharmacy services in rural and remote Australian hospitals. BMC Health Serv Res 2021; 21:1306. [PMID: 34863164 PMCID: PMC8645070 DOI: 10.1186/s12913-021-07328-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of medications is the most common intervention in healthcare. However, unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in healthcare systems across the world. A Virtual Clinical Pharmacy Service (VCPS) was introduced in rural and remote New South Wales public hospitals to support safe and effective use of medications. In this model clinical pharmacy services are delivered via a telehealth cart at the patient's bedside and through electronic medical and pharmaceutical record systems. The aim of this research was to understand healthcare staff perspectives of the VCPS and identify areas for improvement. METHODS A qualitative approach informed by Appreciative Inquiry was used to investigate healthcare staff perceptions of the VCPS. Focus group discussions (n = 15) with hospital staff and medical officers were conducted via videoconference at each study site. Focus groups explored issues, benefits and barriers 3 months after service implementation. Transcribed data were analysed using thematic analysis and team discussion to synthesise themes. RESULTS Focus group participants identified the value of the VCPS to patients, to the health service and to themselves. They also identified enhancements to increase value for each of these groups. Perceived benefits to patients included access to specialist medication advice and improved medication knowledge. Staff valued access to an additional, trusted workforce who provided back-up and guidance. Staff also reported confidence in improved patient safety and identification of medication errors. Enhanced compliance with antimicrobial stewardship and hospital accreditation standards were beneficial to the health service. Suggested improvements included extending virtual service hours and widening patient eligibility to include aged care patients. CONCLUSIONS The VCPS brought a positive, collegiate culture regarding medications. Healthcare staff perceived the VCPS was effective and an efficient way for the health service to supply pharmacy services to smaller hospitals. The ease of use, model of delivery, availability, local knowledge and responsiveness of highly skilled pharmacists was the key to user satisfaction. TRIAL REGISTRATION ANZCTR ACTRN12619001757101 , 11/12/2019.
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Affiliation(s)
- Julaine Allan
- School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Emma Webster
- School of Rural Health, University of Sydney, Dubbo, Australia
| | | | - Shannon Nott
- Western NSW Local Health District, Dubbo, Australia
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Harrison R, Fischer S, Walpola RL, Chauhan A, Babalola T, Mears S, Le-Dao H. Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare. J Healthc Leadersh 2021; 13:85-108. [PMID: 33737854 PMCID: PMC7966357 DOI: 10.2147/jhl.s289176] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/10/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The increasing prioritisation of healthcare quality across the six domains of efficiency, safety, patient-centredness, effectiveness, timeliness and accessibility has given rise to accelerated change both in the uptake of initiatives and the realisation of their outcomes to meet external targets. Whilst a multitude of change management methodologies exist, their application in complex healthcare contexts remains unclear. Our review sought to establish the methodologies applied, and the nature and effectiveness of their application in the context of healthcare. METHODS A systematic review and narrative synthesis was undertaken. Two reviewers independently screened the titles and abstracts followed by the full-text articles that were potentially relevant against the inclusion criteria. An appraisal of methodological and reporting quality of the included studies was also conducted by two further reviewers. RESULTS Thirty-eight studies were included that reported the use of 12 change management methodologies in healthcare contexts across 10 countries. The most commonly applied methodologies were Kotter's Model (19 studies) and Lewin's Model (11 studies). Change management methodologies were applied in projects at local ward or unit level (14), institutional level (12) and system or multi-system (6) levels. The remainder of the studies provided commentary on the success of change efforts that had not utilised a change methodology with reference to change management approaches. CONCLUSION Change management methodologies were often used as guiding principle to underpin a change in complex healthcare contexts. The lack of prescription application of the change management methodologies was identified. Change management methodologies were valued for providing guiding principles for change that are well suited to enable methodologies to be applied in the context of complex and unique healthcare contexts, and to be used in synergy with implementation and improvement methodologies.
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Affiliation(s)
- Reema Harrison
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Sarah Fischer
- Clinical Excellence Commission, New South Wales Health, Sydney, NSW, Australia
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Ramesh L Walpola
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Ashfaq Chauhan
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Temitope Babalola
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Stephen Mears
- Hunter New England Medical Library, New Lambton, NSW, Australia
| | - Huong Le-Dao
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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