Nurse Usage of HIS to Coordinate Work across Shifts.

To provide continuous patient care, nurses rely on various forms of Health Information Systems (HIS) to coordinate work across shifts. While these technologies are critical for the quality of patient care, we know little about the practical challenges nurses face in making use of them when distributed across shifts. Against this backdrop, we used a social-technical design perspective grounded in organization theory to investigate how nurses used a HIS to support coordination across work shifts. We collected data by interviewing and observing nurses in their everyday work. Our analysis reveals interesting differences in how technology supported coordination, partly because of the specific coordination challenges nurses faced and because of nurses’ perception of the HIS as an enabler of coordination. We contribute to the literature on nursing in the context of work shifts with empirical insights into and a conceptual framework for studying nurses’ use of HIS across work shifts

Organisationsdesigns betydning for kvaliteten af patientbehandling

Med udgangspunkt i de danske akutafdelinger belyses, hvordan organisationers design har betydning for organisationens målopfyldelse, herunder den kvalitet, organisationen leverer. Grundet få og ikke specifikke nationale retningslinjer er akutafdelingerne organiseret meget forskelligt. Nogle afdelinger ændrer også organisering i løbet af døgnet og ugen. Vi belyser, hvordan disse organisationsforskelle har betydning for kvaliteten af patientbehandlingen og risikoen for at dø efter en indlæggelse. Dødelighed er en hyppig anvendt parameter for kvalitet af patientbehandling. En patients risiko for at dø efter en indlæggelse bestemmes ud fra kliniske parametre. Risikoen er ligeledes afhængig af den behandlingskvalitet, hospitalet kan levere. Hospitalets ressourcer, organisering af ressourcerne, samt kommunikation og beslutningsprocesser spiller en væsentlig rolle. Vi giver i artiklen et overblik over de organisationsdesignelementer, der er væsentlige: den grundlæggende organisering, brug af IT-systemer og organisering på forskellige tidspunkter, herunder natte- og weekendskift. Vi præsenterer ligeledes et værktøj, der kan vurdere organisationsdesignet – et værktøj, alle kan anvende

Digital transformation leadership competencies:A contingency approach

Practitioners and researchers are increasingly engaged and interested in digital transformation leadership. However, the existing literature is fragmented and we lack knowledge of the competencies required by business leaders to facilitate digital transformation. In response, we rely on a literature study and draw inspiration from the Competing Values Framework to identify digital transformation leadership competencies. We theorize four archetypical competency portfolios, which are labeled according to the types of leaders who personify the constituent competencies: the challenger, the bricoleur, the organizer, and the competitor. We draw inspiration from the Competing Values Framework in advancing a contingency perspective on archetypical these portfolios. By theorizing competency portfolios, we contribute new insights into the role of leadership in digital transformation, which requires different competencies depending on the transformation drivers and goals. Our proposed competency portfolio framework serves as a valuable tool for identifying the required competencies and making decisions on whether to upskill existing leaders or hire new ones to drive transformation efforts.</p

Predictors of health-related quality of life in children with chronic heart disease

Objective: Chronic paediatric heart disease is often associated with residual symptoms, persisting functional restrictions, and late sequelae for psychosocial development. It is, therefore, increasingly important to evaluate the health-related quality of life of children and adolescents with chronic heart disease. The aim of this study was to determine medical and socio-demographic variables affecting health-related quality of life in school-aged children and adolescents with chronic heart disease. Patients and methods: The Pediatric Cardiac Quality of Life Inventory was administered to 375 children and adolescents and 386 parental caregivers. Medical information was obtained from the charts. The socio-demographic information was provided by the patients and caregivers. Results: Greater disease severity, low school attendance, current cardiac medication, current parental employment, uncertain or limited prognosis, history of connection to a heart-lung machine, number of nights spent in a hospital, and need for treatment in a paediatric aftercare clinic independently contributed to lower health-related quality of life (self-report: R-2 = 0.41; proxy-report: R-2 = 0.46). High correlations between self-reports and parent-proxy reports indicated concordance regarding the evaluation of a child's health-related quality of life. Conclusions: Beyond medical treatment, integration into school is important to increase health-related quality of life in children and adolescents surviving with chronic heart disease. Regular screening of health-related quality of life is recommended to identify patients with special needs