Subjective unmet needs for school health services among adolescents with different disabilities:a population-based study in Finland

Abstract Background: Subjective perceptions of unmet needs for health services among adolescents with different disabilities remain largely unstudied, even though various international conventions on the rights of people with disabilities oblige signatory governments to improve the equality of access to services. Aims: The aim the study was to examine the need for, and accessibility to, support and help from school health services among adolescents with different disabilities. A second aim was to determine whether these unmet needs are related to certain sociodemographic factors. Methodology: A nationwide, population-based cross-sectional study design was used. The data were collected from the 2017 School Health Promotion study in Finland. The study population consisted of 72,994 8th and 9thgrade adolescents (aged 14–16) who responded to a web survey, reflecting a response rate of 63%. The data were analyzed by cross-tabulation, chi-square tests and logistic regression. Results: The most common self-reported disabilities among adolescents were difficulties in remembering and learning (6–7%). However, a troubling 18–29% of adolescents with major difficulties reported that they had needed support from a school health nurse but had not received it. Moreover, 26–36% of adolescents with difficulties who had needed support from a physician had not received it. Adolescents with disabilities have approximately two- or three-fold higher risks of unmet needs than adolescents without disabilities. Adolescents with difficulties concentrating showed an over three-fold higher risk for unmet needs than other adolescents. The identified differences were evident even after sociodemographic factors were controlled for. Conclusions: Disabled adolescents may well have more health needs than other adolescents, and some of these needs may be unidentified. Thus, disabled adolescents may not receive the support and help they require. In this respect, there are challenging differences between adolescents with and without disabilities

Hand-hygiene compliance by hospital staff and incidence of health-care-associated infections, Finland

Abstract Objective: To determine changes in hand-hygiene compliance after the introduction of direct observation of hand-hygiene practice for doctors and nurses, and evaluate the relationship between the changes and the incidence of health-care-associated infections. Methods: We conducted an internal audit survey in a tertiary-care hospital in Finland from 2013 to 2018. Infection-control link nurses observed hand-hygiene practices based on the World Health Organization’s strategy for hand hygiene. We calculated hand-hygiene compliance as the number of observations where necessary hand-hygiene was practised divided by the total number of observations where hand hygiene was needed. We determined the incidence of health-care-associated infections using a semi-automated electronic incidence surveillance programme. We calculated the Pearson correlation coefficient (r) to evaluate the relationship between the incidence of health-care-associated infections and compliance with hand hygiene. Findings: The link nurses made 52 115 hand-hygiene observations between 2013 and 2018. Annual hand-hygiene compliance increased significantly from 76.4% (2762/3617) in 2013 to 88.5% (9034/10 211) in 2018 (P < 0.0001). Over the same time, the number of health-care-associated infections decreased from 2012 to 1831, and their incidence per 1000 patient-days fell from 14.0 to 11.7 (P < 0.0001). We found a weak but statistically significant negative correlation between the monthly incidence of health-care-associated infections and hand-hygiene compliance (r = −0.48; P < 0.001). Conclusion: The compliance of doctors and nurses with hand-hygiene practices improved with direct observation and feedback, and this change was associated with a decrease in the incidence of health-care-associated infections. Further studies are needed to evaluate the contribution of hand hygiene to reducing health-care-associated infections

Primary healthcare managers’ perceptions of management competencies at different management levels in digital health services:secondary analysis

Abstract Purpose: The purpose of this study is to describe primary health-care managers’ perceptions of management competencies at different management levels in digital health services using the management competency assessment program as a framework. Design/methodology/approach: A secondary analysis study involving 21 semi-structured individual interviews was conducted among Finnish primary health-care managers at different management levels (frontline, middle and senior). The deductive framework method was used to analyze the data. Findings: Similarities and differences were found in management competencies between different levels of management. Competencies related to the use of digitalization were highlighted by managers at all management levels. Managers at all management levels were involved in developing digital solutions and supporting employees in using digital solutions in their work. Frontline and middle managers emphasized more issues related to day-to-day management and communication with employees, whereas senior managers highlighted the management of large entities. Research limitations/implications: In the secondary analysis, data were used for purposes other than originally intended. Therefore, the data are subject to limitations of the methodology applied and should be transferred to other contexts with caution. Practical implications: Identifying the management competencies needed to manage digital health services is important to target managers’ training according to needs in the future. Social implications: The results could be used to develop the management of digital health services, as well as improve digital health services and their deployment. Originality/value: Previous literature mostly examined managers’ informatics competencies and paid little attention to other management competencies. This study discusses more broadly the management competencies that digital health services require from managers at different levels of management

Remote leadership in health care:a scoping review

Abstract Purpose: The degree of remote working has increased in the health-care sector, but remote leadership in health-care contexts has not been systematically studied. Thus, the purpose of this review was to map existing literature and research themes of remote leadership in health care and identify potential research gaps to guide future studies. Design/methodology/approach: A scoping review with narrative synthesis was conducted, covering all published literature addressing remote, virtual, online or distance leadership practices. The ABI/INFORM Collection, CINALH, PsycArticles, Scopus and Web of Science, MedNar, Open Grey and PQDT Open databases were searched electronically, and Finnish Journal of eHealth and eWelfare was searched manually. Findings: In total 15 articles were included in the review. Most literature concerning remote leadership in health care has been published during the past three decades. The main themes discerned in this research stream are related to interactions, work environments, leadership in practice, use of technology and needs for more study of remote leadership and guidance for remote leaders. Research limitations/implications: Research on remote leadership in health care is limited, patchy and associated concepts vary substantially. More comprehensive research on the phenomenon is needed, with more systematic attention to, and coverage of, relevant populations, concepts, contexts and the identified themes. Originality/value: To the best of the authors’ knowledge, this appears to be the first review to map research on remote leadership in health care and identify research gaps, which is important as its prevalence has rapidly increased

GenZ white paper:strengthening human competences in the emerging digital era

Executive summary We are witnessing an emerging digital revolution. For the past 25–30 years, at an increasing pace, digital technologies—especially the internet, mobile phones and smartphones—have transformed the everyday lives of human beings. The pace of change will increase, and new digital technologies will become even more tightly entangled in human everyday lives. Artificial intelligence (AI), the Internet of Things (IoT), 6G wireless solutions, virtual reality (VR), augmented reality (AR), mixed reality (XR), robots and various platforms for remote and hybrid communication will become embedded in our lives at home, work and school. Digitalisation has been identified as a megatrend, for example, by the OECD (2016; 2019). While digitalisation processes permeate all aspects of life, special attention has been paid to its impact on the ageing population, everyday communication practices, education and learning and working life. For example, it has been argued that digital solutions and technologies have the potential to improve quality of life, speed up processes and increase efficiency. At the same time, digitalisation is likely to bring with it unexpected trends and challenges. For example, AI and robots will doubtlessly speed up or take over many routine-based work tasks from humans, leading to the disappearance of certain occupations and the need for re-education. This, in turn, will lead to an increased demand for skills that are unique to humans and that technologies are not able to master. Thus, developing human competences in the emerging digital era will require not only the mastering of new technical skills, but also the advancement of interpersonal, emotional, literacy and problem-solving skills. It is important to identify and describe the digitalisation phenomena—pertaining to individuals and societies—and seek human-centric answers and solutions that advance the benefits of and mitigate the possible adverse effects of digitalisation (e.g. inequality, divisions, vulnerability and unemployment). This requires directing the focus on strengthening the human skills and competences that will be needed for a sustainable digital future. Digital technologies should be seen as possibilities, not as necessities. There is a need to call attention to the co-evolutionary processes between humans and emerging digital technologies—that is, the ways in which humans grow up with and live their lives alongside digital technologies. It is imperative to gain in-depth knowledge about the natural ways in which digital technologies are embedded in human everyday lives—for example, how people learn, interact and communicate in remote and hybrid settings or with artificial intelligence; how new digital technologies could be used to support continuous learning and understand learning processes better and how health and well-being can be promoted with the help of new digital solutions. Another significant consideration revolves around the co-creation of our digital futures. Important questions to be asked are as follows: Who are the ones to co-create digital solutions for the future? How can humans and human sciences better contribute to digitalisation and define how emerging technologies shape society and the future? Although academic and business actors have recently fostered inclusion and diversity in their co-creation processes, more must be done. The empowerment of ordinary people to start acting as active makers and shapers of our digital futures is required, as is giving voice to those who have traditionally been silenced or marginalised in the development of digital technology. In the emerging co-creation processes, emphasis should be placed on social sustainability and contextual sensitivity. Such processes are always value-laden and political and intimately intertwined with ethical issues. Constant and accelerating change characterises contemporary human systems, our everyday lives and the environment. Resilience thinking has become one of the major conceptual tools for understanding and dealing with change. It is a multi-scalar idea referring to the capacity of individuals and human systems to absorb disturbances and reorganise their functionality while undergoing a change. Based on the evolving new digital technologies, there is a pressing need to understand how these technologies could be utilised for human well-being, sustainable lifestyles and a better environment. This calls for analysing different scales and types of resilience in order to develop better technology-based solutions for human-centred development in the new digital era. This white paper is a collaborative effort by researchers from six faculties and groups working on questions related to digitalisation at the University of Oulu, Finland. We have identified questions and challenges related to the emerging digital era and suggest directions that will make possible a human-centric digital future and strengthen the competences of humans and humanity in this era