Integrating Key Nursing Measures into a Comprehensive Healthcare Performance Management System: A Tuscan Experience

This paper addresses the evaluation of nursing quality and safety beyond nursing tasks in specific healthcare settings and sets it in a context that conveys the sense of complexity and multifaceted nature of the contribution that nursing makes to the whole system. The paper describes research conducted in Tuscany during 2019 involving regional managers and heads of nursing departments. This research has led to the development of an integrated evaluation framework through focus groups and consensus process with the latter, which includes Performance Organizational climate data, Patient-Reported Experience Measures (PREMs), and Patient-Reported Outcome Measures (PROMs). This integrated framework aims at both making sense of extant measures as key performance indicators shared among different professionals while recognizing the important role of nursing care by adding specific measures and can be seen as a tool that boosts the sense of “teamness” in healthcare

The relationship between healthcare service provision models and patient experience

Purpose User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery. Design/methodology/approach 65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables. Findings Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services. Research limitations/implications Different features referring to different nursing models make the difference in producing an excellent user experience with the service. Practical implications These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations. Originality/value This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations. Highlights This is one of the first studies on the relationship between provision models of nursing care and patient experience. Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse. Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience. Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations

Use of the Parents Preference Test in Child Custody Evaluations: Preliminary Development of Conforming Parenting Index

The Parents Preference Test (PPT) is a graphical test comprised of 24 easy to understand images of daily family life, which is widely used in forensic assessments of parenting skills. Nevertheless, the PPT lacks validity scales to detect participants’ attitudes toward the test; this is an important oversight, as the tendency to demonstrate faking-good parenting behaviors is common in child custody litigants. Study 1 aimed at identifying the differences in PPT responses between a normative/control group (N = 110) and a sample of parents undergoing a psychological evaluation of parenting ability (N = 99). Chi-square goodness of fit tests showed significant differences in answer preferences between groups in 11 vignettes (almost half of the total PPT items). Study 2 aimed at developing an index to detect faking-good behaviors. On the 11 vignettes in which significant differences in answer preferences were found in Study 1, the alternatives chosen with the highest frequency by the forensic group were added to an index called the “Conforming Parenting Index” (CPI). The area under the curve (AUC) of a receiver operating characteristic (ROC) curve for a sample of 58 participants who completed the PPT under both standard and faking-good instructions demonstrated good classification accuracy (AUC= .813)

Psychological Health Status of Psychiatric Patients Living in Treatment Communities before and during the COVID-19 Lockdown: A Brief Report

Many studies investigated the psychological impact of lockdown measures on the general population, while few studies focused on the psychiatric population. This study aimed to investigate the role of therapeutic communities in the management and containment of symptoms of patients with psychosis living in psychiatric residential facilities. Data were collected at two different points: November 2019 (Coronavirus disease 19 had not yet spread) and April 2020 (during the lockdown in Italy). Twenty-two study participants were recruited from three residential accredited psychiatric facilities. During lockdown, the patients showed a small increase in symptomatology in terms of emotional isolation. In addition, it was been observed significant differences in certain functional areas of the behavior, measured as lower inclination towards violent behaviors during lockdown, and higher scores in substance abuse and medical impairment. The lockdown condition could represent a form of containment; daily routines, along with adequate social support, are important aspects of the stability and the level of behavioral functioning of psychiatric patients. Social support and continuity of care offered by psychiatric communities can be an effective safeguard against the psychological impact of the COVID-19 epidemic