Change Management and Digital Innovations in Hospitals of Five European Countries.
Ontology highlight
ABSTRACT:
SUBMITTER: Hospodkova P
PROVIDER: S-EPMC8625074 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
Publications
Change Management and Digital Innovations in Hospitals of Five European Countries.
Hospodková Petra P Berežná Jana J Barták Miroslav M Rogalewicz Vladimír V Severová Lucie L Svoboda Roman R
Healthcare (Basel, Switzerland) 20211105 11
The objective of the paper is to evaluate the quality of systemic change management (CHM) and readiness for change in five Central European countries. The secondary goal is to identify trends and upcoming changes in the field of digital innovations in healthcare. The results show that all compared countries (regardless of their historical context) deal with similar CHM challenges with a rather similar degree of success. A questionnaire distributed to hospitals clearly showed that there is still ...[more]
Similar Datasets
Project description:Digital maturity assessments can inform strategic decision-making. However, national approaches to assessing the digital maturity of health systems are in their infancy, and there is limited insight into the context and processes associated with such assessments. This viewpoint article describes and compares national approaches to assessing the digital maturity of hospitals. We reviewed 5 national approaches to assessing the digital maturity of hospitals in Queensland (Australia), Germany, the Netherlands, Norway, and Scotland, exploring context, drivers, and approaches to measure digital maturity in each country. We observed a common focus on interoperability, and assessment findings were used to shape national digital health strategies. Indicators were broadly aligned, but 4 of 5 countries developed their own tailored indicator sets. Key topic areas across countries included interoperability, capabilities, leadership, governance, and infrastructure. Analysis of indicators was centralized, but data were shared with participating organizations. Only 1 setting conducted an academic evaluation. Major challenges of digital maturity assessment included the high cost and time required for data collection, questions about measurement accuracy, difficulties in consistent long-term tracking of indicators, and potential biases due to self-reporting. We also observed tensions between the practical feasibility of the process with the depth and breadth required by the complexity of the topic and tensions between national and local data needs. There are several key challenges in assessing digital maturity in hospitals nationally that influence the validity and reliability of output. These need to be explicitly acknowledged when making decisions informed by assessments and monitored over time.
| S-EPMC11926443 | biostudies-literature
Project description:BackgroundLong-term management of chronic conditions, such as atrial fibrillation (AF), require frequent interactions with the healthcare systems. The multinational EUropean Patient Survey in Atrial Fibrillation (EUPS-AF) was conducted to investigate patient satisfaction with AF management in different of five European healthcare systems at a time of changing treatment paradigms for stroke prophylaxis, prior to the advent of newer oral anticoagulants.MethodsAdults (>18 years) were recruited at random from the total populations of France, Germany, Italy, Spain and the UK using a randomized telephone dialling system. At least 300 respondents per country reporting to have a diagnosis of AF or receiving oral anticoagulation therapy for suspected AF or to have a heart rhythm disturbance completed a structured telephone interview.ResultsMost respondents were satisfied with their treatment for AF over the previous 12 months, with 85.5% (n?=?1289) rating their care as good or better. Suboptimal clinical practices, however, were identified in several key areas. Coordination of primary and secondary care and a lack of patient engagement and support were particular issues, especially for those patients likely to have extensive contact with their healthcare system.ConclusionsIn the context of Europe-wide guidelines for management of AF, most patients with AF were satisfied with their care, but for a greater proportion of patients, some aspects are unsatisfactory. Patient-centred surveys, such as the EUPS-AF, are crucial for understanding the factors that contribute to patient satisfaction and compliance with long-term treatment for chronic conditions.
| S-EPMC4219387 | biostudies-literature
Project description:BackgroundMultimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained.MethodsChange management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases.ResultsPolypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation.ConclusionWithin the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives.
| S-EPMC5905890 | biostudies-literature
Project description:PURPOSE:Long lengths of stay (LoS) in psychiatric hospitals or repeated admission may affect the social integration of patients with psychiatric disorders. So far, however, studies have been inconclusive. This study aimed to analyse whether long LoS or repeated admissions in psychiatric wards were associated in different ways with changes in the social integration of patients. METHODS:Within a prospective cohort study, data were collected on 2181 patients with a main ICD-10 diagnosis of psychotic, affective, or anxiety disorder, hospitalised in the UK, Italy, Germany, Poland, and Belgium in 2015. Social integration was measured at baseline and 1 year after admission using the SIX index, which includes four dimensions: employment, housing, family situation, and friendship. Regression models were performed to test the association between LoS, the number of admissions, and the change in social integration over the study period, controlling for patients' characteristics (trial registration ISRCTN40256812). RESULTS:A longer LoS was significantly associated with a decrease in social integration (β = - 0.23, 95%CI - 0.32 to - 0.14, p = 0.03), particularly regarding employment (OR = 2.21, 95%CI 1.18-3.24, p = 0.02), housing (OR = 3.45, 95%CI 1.74-5.16, p < 0.001), and family situation (OR = 1.94, 95%CI 1.10-2.78, p = 0.04). In contrast, repeated admissions were only associated with a decrease in friendship contacts (OR = 1.15, 95CI% 1.08-1.22, p = 0.03). CONCLUSIONS:Results suggest that a longer hospital LoS is more strongly associated with a decrease in patients' social integration than repeated admissions. Special attention should be paid to helping patients to find and retain housing and employment while hospitalised for long periods.
| S-EPMC7578147 | biostudies-literature
Project description:IntroductionHospitals remain the cornerstone of health systems in European countries. Therefore, the financial sustainability of hospitals constitutes an important determinant of healthcare provision security. The fragmentary data available indicate that hospitals in many European countries are continuously facing financial deficits and/or insolvency problems. Yet a comparative analysis of hospital financial performance across European countries has been lacking. The proposed review will, therefore, fill in an important research gap and build a knowledge base on the topic of assessing and monitoring the financial sustainability of hospitals in Europe. The general objective is to identify, synthetise and map existing evidence on hospital financial performance across European countries.Methods and analysisThis scoping review will follow six stages: (1) defining the research question, (2) identifying relevant literature, (3) studies selection, (4) data extraction, (5) collating, summarising and reporting of results and (6) consultation process and involvement of knowledge users. The following databases will be searched:(1) Medline via PubMed, (2) Web of Science Core Collection, (3) Scopus and (4) ProQuest Central. In addition, a Google Engine search will also be performed. Furthermore, reference lists of relevant papers will be visually scanned to identify further studies of interest. The review will include both quantitative and qualitative empirical studies as well as theoretical papers and technical reports. The PRISMA extension for a Scoping Review checklist will be used for reporting.Ethics and disseminationFormal ethical approval is not required because no primary data will be collected in this study. Results will be published in a peer-reviewed journal. The findings will also be disseminated through conference presentations and summaries to key stakeholders.
| S-EPMC10773386 | biostudies-literature
Project description:AimsThe purpose was to compare the frequency of needs of patients with schizophrenia in forensic services across five European countries as assessed by both the patients and their care staff.MethodsPatients with schizophrenia and a history of significant interpersonal violence were recruited from forensic psychiatric services in Austria, Germany, Italy, Poland and England. Participants' needs were assessed using the Camberwell Assessment of Needs-Forensic Version (CANFOR). Multiple linear regression analyses were used to identify predictors of numbers of needs.ResultsIn this sample, (n = 221) the most commonly reported need according to patients (71.0%) and staff (82.8%) was the management of psychotic symptoms. A need for information was mentioned by about 45% of staff and patients. Staff members reported a significantly higher number of total needs than patients (mean 6.9 vs. 6.2). In contrast, staff members reported a significantly lower number of unmet needs than patients (mean 2.0 vs. 2.5). Numbers of total needs and met needs differed between countries. Unmet needs as reported by patients showed positive associations with the absence of comorbid personality disorder, with higher positive symptom scores and lifetime suicide or self-harm history. Significant predictors of unmet needs according to staff were absence of comorbid personality disorder and higher positive as well as negative symptom scores according to PANSS.ConclusionsStaff rated a significantly higher number of total needs than patients, while patients rated more unmet needs. This indicates that patients' self-assessments of needs yield important information for providing sufficient help and support.
| S-EPMC9284498 | biostudies-literature
Project description:Building on the active aging framework, the aim of this study, carried out between 2016 and 2018, is to analyze concrete experiences of older individuals acting as key players of social change in six local communities of five European countries (Bulgaria, Denmark, England, France, Spain). The 19 seniors involved in the study, according to social contexts, individual past experiences, knowledge, and motivations, acted as senior social entrepreneurs, trying to build a pathway towards social solutions for unmet social problems they detected in local communities. Data were collected via templates and questionnaires and analyzed using the thematic analysis. The results highlighted that the 16 local initiatives created by seniors concerned social problems such as food waste, social isolation, multicultural integration, etc. The social solutions implemented by seniors seemed to have the potential to produce social value and, to different degrees, encouraging results and impact. Since this "social experiment" provided evidence that senior social entrepreneuring could be a driver to solve societal problems, policy makers should sustain the spread of both social entrepreneurial mindset and practices at the European level, for catalyzing the active potential of older people for the benefit of European local communities.
| S-EPMC7177232 | biostudies-literature
Project description:IntroductionEconomic evaluations of tobacco control policies targeting adolescents are scarce. Few take into account real-world, large-scale implementation costs; few compare cost-effectiveness of different policies across different countries. We assessed the cost-effectiveness of five tobacco control policies (nonschool bans, including bans on sales to minors, bans on smoking in public places, bans on advertising at points-of-sale, school smoke-free bans, and school education programs), implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal.MethodsCost-effectiveness estimates were calculated per country and per policy, from the State perspective. Costs were collected by combining quantitative questionnaires with semi-structured interviews on how policies were implemented in each setting, in real practice. Short-term effectiveness was based on the literature, and long-term effectiveness was modeled using the DYNAMO-HIA tool. Discount rates of 3.5% were used for costs and effectiveness. Sensitivity analyses considered 1%-50% short-term effectiveness estimates, highest cost estimates, and undiscounted effectiveness.FindingsNonschool bans cost up to €253.23 per healthy life year, school smoking bans up to €91.87 per healthy life year, and school education programs up to €481.35 per healthy life year. Cost-effectiveness depended on the costs of implementation, short-term effectiveness, initial smoking rates, dimension of the target population, and weight of smoking in overall mortality and morbidity.ConclusionsAll five policies were highly cost-effective in all countries according to the World Health Organization thresholds for public health interventions. Cost-effectiveness was preserved even when using the highest costs and most conservative effectiveness estimates.ImplicationsEconomic evaluations using real-world data on tobacco control policies implemented at a large scale are scarce, especially considering nonschool bans targeting adolescents. We assessed the cost-effectiveness of five tobacco control policies implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal. This study shows that all five policies were highly cost-effective considering the World Health Organization threshold, even when considering the highest costs and most conservative effectiveness estimates.
| S-EPMC7291799 | biostudies-literature
Project description:BackgroundDespite a concerted policy effort in Europe, social inequalities in health are a persistent problem. Developing a standardised measure of socioeconomic level across Europe will improve the understanding of the underlying mechanisms and causes of inequalities. This will facilitate developing, implementing and assessing new and more effective policies, and will improve the comparability and reproducibility of health inequality studies among countries. This paper presents the extension of the European Deprivation Index (EDI), a standardised measure first developed in France, to four other European countries-Italy, Portugal, Spain and England, using available 2001 and 1999 national census data.Methods and resultsThe method previously tested and validated to construct the French EDI was used: first, an individual indicator for relative deprivation was constructed, defined by the minimal number of unmet fundamental needs associated with both objective (income) poverty and subjective poverty. Second, variables available at both individual (European survey) and aggregate (census) levels were identified. Third, an ecological deprivation index was constructed by selecting the set of weighted variables from the second step that best correlated with the individual deprivation indicator.ConclusionsFor each country, the EDI is a weighted combination of aggregated variables from the national census that are most highly correlated with a country-specific individual deprivation indicator. This tool will improve both the historical and international comparability of studies, our understanding of the mechanisms underlying social inequalities in health and implementation of intervention to tackle social inequalities in health.
| S-EPMC4853548 | biostudies-literature
Project description:Hospital waste management in Ghana faces the risk of cross-contamination from the lack of thorough sorting of the waste at the points of generation, codisposal of hazardous and nonhazardous waste types, and use of open-fire pits and substandard incinerators for burning infectious waste. This has increased the potential for the spread of infections and chemical pollutants. A cross-sectional study was conducted in five hospitals in Ghana to assess behavioral patterns on waste sorting and the effectiveness of hospital waste management in Ghana. A total of 250 questionnaires were distributed purposively to some staff of the five hospitals to assess workers' perceptions on medical waste sorting and handling. Additionally, focused group discussions and transect walks were adopted to examine the current collection, storage, treatment, and disposal methods used in the health facilities. Chi-square analyses showed significant differences in waste-sorting behavior based only on occupation (p < 0.0001, n=180) and not on gender, education, or experience in the health sector. Even though contaminated sharps were separated into brown safety boxes, color coding for other infectious waste containers was inconsistent across the health facilities. The study revealed that incineration is still the modal method of treatment in Ghanaian hospitals and therefore new approaches such as an engineering approach were required to minimize its environmental effects. It is recommended that periodic in-service training workshops be held for healthcare staff on the right source-segregation of medical waste, in order to facilitate the effective and safe handling, transport, treatment, and disposal of waste from health facilities.
| S-EPMC7073495 | biostudies-literature