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3 results

Workplace Conditions

Workplace Conditions
  • Jill Maben, Jane Ball, Amy C. Edmondson
  • Published online:
    11 January 2023
    Print publication:
    02 February 2023
    • Element
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  • This Element reviews the evidence for three workplace conditions that matter for improving quality and safety in healthcare: staffing; psychological safety, teamwork, and speaking up; and staff health and well-being at work. The authors propose that these are environmental prerequisites for improvement. They examine the relationship between staff numbers and skills in delivering care and the attainment of quality of care and the ability to improve it. They present evidence for the importance of psychological safety, teamwork, and speaking up, noting that these are interrelated and critical for healthcare improvement. They present evidence of associations between staff well-being at work and patient outcomes. Finally, they suggest healthcare improvement should be embedded into the day-to-day work of frontline staff; adequate time and resources must be provided, with quality as the mainstay of professionals' work. Every day at every level, the working context must support the question 'how could we do this better?' This title is also available as Open Access on Cambridge Core.

  • Experiences of security and continuity of care: Patients' and families' narratives about the work of specialized palliative home care teams

  • Anna Klarare, Birgit H Rasmussen, Bjöörn Fossum, Carl Johan Fürst, Johan Hansson, Carina Lundh Hagelin
  • Journal:
    Palliative & Supportive Care / Volume 15 / Issue 2 / April 2017
    Published online by Cambridge University Press:
    22 July 2016, pp. 181-189
  • Background:

    Those who are seriously ill and facing death are often living with physical, emotional, social, and spiritual suffering. Teamwork is considered to be necessary to holistically meet the diverse needs of patients in palliative care. Reviews of studies regarding palliative care team outcomes have concluded that teams provide benefits, especially regarding pain and symptom management. Much of the research concerning palliative care teams has been performed from the perspective of the service providers and has less often focused on patients' and families' experiences of care.

    Objective:

    Our aim was to investigate how the team's work is manifested in care episodes narrated by patients and families in specialized palliative home care (SPHC).

    Method:

    A total of 13 interviews were conducted with patients and families receiving specialized home care. Six patients and seven family members were recruited through SPHC team leaders. Interviews were transcribed verbatim and the transcripts qualitatively analyzed into themes.

    Results:

    Two themes were constructed through thematic analysis: (1) security (“They are always available,” “I get the help I need quickly”); and (2) continuity of care (“They know me/us, our whole situation and they really care”). Of the 74 care episodes, 50 were descriptions of regularly scheduled visits, while 24 related to acute care visits and/or interventions.

    Significance of results:

    Patients' and family members' descriptions of the work of SPHC teams are conceptualized through experiences of security and continuity of care. Experiences of security are fostered through the 24/7 availability of the team, sensitivity and flexibility in meeting patients' and families' needs, and practical adjustments to enable care at home. Experiences of continuity of care are fostered through the team's collective approach, where the individual team member knows the patients and family members, including their whole situation, and cares about the little things in life as well as caring for the family unit.

  • Chapter 16 - Leadership and professionalism

  • Edited by Dinesh Bhugra, Institute of Psychiatry, London, Amit Malik
  • Book:
    Professionalism in Mental Healthcare
    Published online:
    10 November 2010
    Print publication:
    28 October 2010, pp 175-187

  • Summary

    The challenges of professionalism are related to changing public and patient expectations, increased costs, conflicts of interest and consumerism. This chapter talks about teamwork. The essence of teamwork is the model used for crew resource management. Teams have been around for centuries, but healthcare teams are relatively new. They contrast with familiar congenial work groups that constitute the basic units of all hospitals. The integration of true medical teams into healthcare in several countries has occurred to varying degrees with different results. In the United States, the Accreditation Council for Graduate Medical Education (ACGME) has defined six competencies which form the basis of physician training. Two models that explain medical student cynicism include: the intergenerational model and the professional identity model. Teams serve the purpose of self-preservation by encouraging physicians to honour their ultimate fiduciary avowal, and to work co-operatively for the greater good of society.