Characteristics of Magnet Nursing Work Environment that Promotes Patient Safety Culture at Mansoura University Oncology Center

The Magnet hospital concept and related criteria have drawn the consideration of researchers and nurses for more than twenty years. Nurses assume an essential part in forming health policy in any nation by observing the problems in the healthcare organizations and evaluating its effects. They understand where enhancements are required to shape care, rise access, enhance proficiency and quality of health services, and encourage prevention. Perfection in nursing care has been connected with constructive results for both nurses and patients. To accomplish magnet status, hospitals should provide confirmation of having band of attributes as exemplary professional practice; knowledge; structural empowerment, improvements, and innovation; and transformational leadership. These attributes act together to shape a positive workplace that ought to prompt better results. Magnet designation gives a helpful mechanism for assessing and changing nursing workplace to be more proficient. Many of the recent efforts concentrated on enhancing patient safety and quality. Less efforts has been focused on enhancing nursing care to improve patient safety. Hence, the present determine the relationship between magnetism dimensions and patient safety culture in inpatient units at Oncology Center Mansoura University (OCMU). A descriptive correlation design was used. Sample of the study consisted of all nurses (n=95 nurses) working in inpatient units in the Oncology Center Mansoura University. Two tools were used for data collection, namely; Magnetism Dimensions Scale and Patient Safety Culture Questionnaire. A major finding of the present study there was a statistically significant correlation between magnetism dimensions and patient safety culture in inpatient units. It was concluded that the nurse administrators play an important role in establishing conditions for magnet work environment  that support patient safety culture. It was recommended that additional researches are needed to correlate patient outcomes to magnet issues. Key words: nursing work environment, Magnet, Magnet Recognition Program, Forces of Magnetism professional practice environments, quality, patient safet

Patient-centered Coordination in Healthcare Service Networks - Measuring and Improving Inter-organizational Information Flow

This thesis investigates the idea of a coordination service that improves the information flow between independent stakeholders along the patient care pathway. Based on identified requirements regarding process, ICT-structure, and legal constraints, a stroke-specific coordination service was developed, validated, implemented, and evaluated. A randomized controlled trial showed improved patients\u27 HRQoL and competences, positive cost-benefit ratio, and acceptance by the involved stakeholders

Integration and Continuity of Primary Care: Polyclinics and Alternatives, a Patient-Centred Analysis of How Organisation Constrains Care Coordination

Background An ageing population, increasingly specialised of clinical services and diverse healthcare provider ownership make the coordination and continuity of complex care increasingly problematic. The way in which the provision of complex healthcare is coordinated produces – or fails to – six forms of continuity of care (cross-sectional, longitudinal, flexible, access, informational, relational). Care coordination is accomplished by a combination of activities by: patients themselves; provider organisations; care networks coordinating the separate provider organisations; and overall health system governance. This research examines how far organisational integration might promote care coordination at the clinical level. Objectives To examine: 1. What differences the organisational integration of primary care makes, compared with network governance, to horizontal and vertical coordination of care. 2. What difference provider ownership (corporate, partnership, public) makes. 3. How much scope either structure allows for managerial discretion and ‘performance’. 4. Differences between networked and hierarchical governance regarding the continuity and integration of primary care. 5. The implications of the above for managerial practice in primary care. Methods Multiple-methods design combining: 1. Assembly of an analytic framework by non-systematic review. 2. Framework analysis of patients’ experiences of the continuities of care. 3. Systematic comparison of organisational case studies made in the same study sites. 4. A cross-country comparison of care coordination mechanisms found in our NHS study sites with those in publicly owned and managed Swedish polyclinics. 5. Analysis and synthesis of data using an ‘inside-out’ analytic strategy. Study sites included professional partnership, corporate and publicly owned and managed primary care providers, and different configurations of organisational integration or separation of community health services, mental health services, social services and acute in-patient care. Results Starting from data about patients' experiences of the coordination or under-coordination of care we identified: 1. Five care coordination mechanisms present in both the integrated organisations and the care networks. 2. Four main obstacles to care coordination within the integrated organisations, of which two were also present in the care networks. 3. Seven main obstacles to care coordination that were specific to the care networks. 4. Nine care coordination mechanisms present in the integrated organisations. Taking everything into consideration, integrated organisations appeared more favourable to producing continuities of care than were care networks. Network structures demonstrated more flexibility in adding services for small care groups temporarily, but the expansion of integrated organisations had advantages when adding new services on a longer term and larger scale. Ownership differences affected the range of services to which patients had direct access; primary care doctors’ managerial responsibilities (relevant to care coordination because of its impact on GP workload); and the scope for doctors to develop special interests. We found little difference between integrated organisations and care networks in terms of managerial discretion and performance. Conclusions On balance, an integrated organisation seems more likely to favour the development of care coordination, and therefore continuities of care, than a system of care networks. At least four different variants of ownership and management of organisationally integrated primary care providers are practicable in NHS-like settings

ERP implementation methodologies and frameworks: a literature review

Enterprise Resource Planning (ERP) implementation is a complex and vibrant process, one that involves a combination of technological and organizational interactions. Often an ERP implementation project is the single largest IT project that an organization has ever launched and requires a mutual fit of system and organization. Also the concept of an ERP implementation supporting business processes across many different departments is not a generic, rigid and uniform concept and depends on variety of factors. As a result, the issues addressing the ERP implementation process have been one of the major concerns in industry. Therefore ERP implementation receives attention from practitioners and scholars and both, business as well as academic literature is abundant and not always very conclusive or coherent. However, research on ERP systems so far has been mainly focused on diffusion, use and impact issues. Less attention has been given to the methods used during the configuration and the implementation of ERP systems, even though they are commonly used in practice, they still remain largely unexplored and undocumented in Information Systems research. So, the academic relevance of this research is the contribution to the existing body of scientific knowledge. An annotated brief literature review is done in order to evaluate the current state of the existing academic literature. The purpose is to present a systematic overview of relevant ERP implementation methodologies and frameworks as a desire for achieving a better taxonomy of ERP implementation methodologies. This paper is useful to researchers who are interested in ERP implementation methodologies and frameworks. Results will serve as an input for a classification of the existing ERP implementation methodologies and frameworks. Also, this paper aims also at the professional ERP community involved in the process of ERP implementation by promoting a better understanding of ERP implementation methodologies and frameworks, its variety and history

Volume, benefits and factors that influence inter-municipal ICT cooperation in relation to ICT-related social services and healthcare services

Information and communication technology (ICT) has become an integral part of the daily municipal administration, production and development of municipal services. Social services and health care account for ≥ 50% of municipal ICT expenditure. Municipalities operate and develop their ICT activities with limited ICT resources. This is an incentive for inter-municipal ICT cooperation. Four sets of secondary data are analysed in this article to evaluate how ICT cooperation is carried out in 20 Finnish municipal regions. Transaction cost economics (TCE), resource-based view (RBV), resource dependency theory (RDT) and the concepts of Granovetter’s social network theory are reviewed. The data are used to describe the expected and perceived economic and social benefits of inter-municipal ICT cooperation, and to understand the social connections that influence the execution of inter-municipal ICT cooperation. The data analysis revealed distinctive differences in the amount and forms of ICT cooperation, and regarding its governance. The results suggest that public organisations were able to benefit substantially from well-organised ICT cooperation. The characteristics of social networks were also found to relate to variations in the degree to which ICT cooperation was performed

The Relationship between Nurse Manager Leadership Style and the Enculturation of Shared Governance

Shared governance, a participative model of governance, implemented by healthcare organizations for more than 30 years has been associated with empowerment, job satisfaction, and retention of registered nurses. Recent studies document a lack of participation in shared governance by registered nurses; the reason for the change is unknown. The nurse managers\u27 role in this change is unknown. The purpose of this non-experimental, cross-sectional survey design study was to test Bass\u27 theory of transformational leadership that examines the relationship between the leadership style of the manager and the enculturation of shared governance in acute care hospitals in the United States. A random sample of 111 nurse managers, who were members of the American Organization of Nurse Executives, were surveyed on leadership style using the Multi-factor Leadership Questionnaire and unit governance, using the Index of Professional Nursing Governance. Data was analyzed using Pearson\u27s Product Moment Correlation and a statistically significant positive relationship was found between transformational leadership style and shared governance. No relationship was found between other leadership styles and shared governance. There was no relationship between the achievement of a shared governance score on the participation subscale of the Index of Professional Nursing Governance and transformational leadership style. The study contributes to social change through the identification of the manager\u27s use of a transformational leadership style to foster the autonomy and empowerment of nurses to cultivate a positive the work environment using a shared governance model, which results in registered nurse retention and decreased organizational turnover costs

Leveraging System Context to Understand Collaborative Systems in Modern Public Management

Complex and boundary-spanning problems like overpopulation, hunger, pandemics, homelessness, and environmental degradation occur more frequently now than ever (Bynander & Nohrstedt, 2019; Criado & Guevara-Gómez, 2021; Huang, 2020; Kapucu, 2015; Getha-Taylor, 2007; Jayasinghe et al., 2022). Policymakers increasingly address these challenges through interorganizational collaboration (Isett et al., 2011). Countries worldwide now use collaborative governance to respond to such wicked problems (Jayasinghe et al., 2022; Huang, 2020; Megawati et al., 2020). Despite growing in popularity, gaps remain in understanding collaborative governance at scale. In this dissertation, I present research on the interconnected nature of collaborative governance initiatives in the United States by studying the units that carry out collaborative governance in modern public management: collaborative governance regimes (CGRs). A CGR is “a particular mode of, or system for, public decision-making in which cross-boundary collaboration represents the prevailing pattern of behavior and activity” (Emerson et al., 2015, p. 18). Collaborative systems occur when multiple CGRs operate within or across policy arenas in a defined geography or jurisdiction (Annis et al., 2020). I explore the contexts that collaborative systems operate within. System context refers to “the broad and dynamic set of surrounding conditions that create opportunities and constraints for initiating and sustaining CGRs (Emerson & Nabatchi, 2015a, p. 232). Studying the system context is essential because collaboration does not occur in a vacuum. System context factors can create opportunities for or constraints on CGRs that influence their processes and performance. I show the existence of collaborative systems in the U.S. and ask, what leverage can be gained by exploring the broader system contexts of collaborative systems? I present studies of collaborative systems consisting of hundreds of interconnected CGRs in practice today to uncover lessons about collaborative governance at scale. In Chapter One, I detail a collaborative system operating in Oregon in a facilitative system context for collaborative governance. Oregon’s system context features state support and legislation that supports the CGRs there (Cochran et al., 2019). In Chapter Two, I examine the context of the COVID-19 pandemic to understand collaborative governance when an unexpected crisis occurs. I analyze adaptation in two community referral networks whose system context is unstable due to the pandemic’s onset. In Chapter Three, I do not examine the characteristics of a collaborative system; instead, I study the association between states’ broader system contexts and formal CGR registration to that state. I find that collaborative systems exist and can be measured. Chapter One explores representation in a collaborative system in Oregon. The results reveal a high amount of membership overlap among CGRs, even across sectors. This high level of membership overlap has resulted in a tightly interconnected collaborative system in Oregon. It should alert leaders to probe whether a diverse set of actors are substantively represented across the system because the same actors appear in CGRs repeatedly. In Chapter Two, I examine what leverage analysts can gain from looking at collaborative systems in a system context impacted by a crisis. I do this by studying two community referral networks in a U.S. state where the system context was unstable due to the onset of the COVID-19 pandemic. I document that community referral networks adapted to changes in supply and demand for services during the pandemic’s emergence. I find organizational tenure and resource munificence contributed to CGR\u27s adaptability during the crisis. Rather than going through the lead organization governance model with the coordination center directing ties, organizations saw greater returns to modifying the governance structure for faster service delivery to locate and serve clients directly and more quickly during the early days of the pandemic. I find flexible governance structures can buffer CGR member exit during crises. In Chapter Three, I analyze collaborative governance in Medicare to show how researchers can understand CGRs’ broader system context. Chapter Three demonstrates how leaders and managers can use data analytics to understand CGRs, system context factors, and outcomes. I draw four conclusions from the three essays. First, I conclude that researchers and practitioners can gain leverage by examining the system context of collaborative systems, including public management insights on steering collaborative systems for large-scale policy implementation. Second, my results indicate that studying collaborative systems and their contexts allows scholars to contribute to a concise theory of collaborative governance that transcends disciplines. Third, I find that managers can enhance the success of CGRs by focusing on their governance structures and the entities that support them. Fourth, my results show that scholars can gain leverage in understanding collaborative systems and broader system contexts using various data types and methodologies, including qualitative methods, network analysis, and econometrics. The broad range of data types and methodologies available to understand collaborative governance is good for scholarship and practice. When leaders know system context conditions, they become better equipped to manage the current and changing conditions that influence their work (Emerson & Nabatchi, 2015a)

Integrating policy and practice in healthcare

There are national and local concerns about a policy-practice gap in healthcare services which bring into question the effectiveness of traditional mechanisms for policy implementation. Using clinical governance as a focus, this report describes the rationale, development and evaluation of an alternative approach designed to integrate health policy with practice within a Mental Health and Learning Disability NHS Trust through a programme of social opportunities. A number of methodological compromises were made due to the pragmatic nature of the project and limited availability of resources to undertake the evaluation. Not all disciplines and services were involved in the approach so different methods may be needed to engage these groups. However, the potential impact of the process for local policy, practice and aspects of practice culture has been critically evaluated using a framework for policy analysis and mixed methods for implementation, data collection and analysis. The findings suggest that the intervention was successful in providing an opportunity for practitioners to meet, network and discuss policy and practice issues and virtually all attendees valued the opportunity to participate. Contextually, the key focus was on meeting the needs of different client groups, i.e. working age adults, older people, children and people with a learning disability. Generally, all practitioners value the principles of user-centred, safe and effective practice that underpin national policy although some are valued more than others and practice in all areas can be improved. Personal responsibility is accepted and satisfactory levels of support are available and accessed. However, culturally there is evidence of conflict created by perceived differences between practitioner and organisational values, increased workload without added value and a need for improved interdisciplinary working and better service integration. This is particularly evident in the adult community mental health services. A theoretical model and process to integrate policy and practice is presented that needs embedding within an organisational approach to learning that provides supportive structures, processes and cultures requiring time, leadership and management commitment. Recommendations are made for the dissemination of findings, further development and testing of the theoretical model and process