Care process quality (i.e. how care is enacted by a care worker toward a client at the interpersonal level) is a strong predictor of satisfaction in a wide range of health care services. The purpose of this paper is to describe the basic elements of care process quality as user-oriented care. Specifically, the questions of how and why quality in user-oriented care varies were investigated in the context of elderly care.
A new taxonomy for categorizing process quality variation, the Big Five of user-oriented care (task-focus, person-focus, affect, cooperation, and time-use), is proposed. In addition, the perceived reasons for process quality variation are reported in our own developed Quality Agents Model, suggesting that variations in care process evaluations may be explained from different perspectives at multiple levels (i.e., older person, care worker-, unit-, department-, and municipality level).
The proposed taxonomy and model are useful for describing user-oriented care quality and the reasons for its variations. These findings are of relevance for future quality developments of elderly care services, but also may be adapted to applications in any other enterprise employing a user-oriented approach.
BACKGROUND AND RATIONALE: The underlying assumption was that the aesthetics of the hospital surroundings are often neglected. AIMS: This article is the first part of a larger study into the aesthetics of general hospitals. The aim of the study is to throw light on the influence of aesthetics on the health and well-being of patients and the professional personnel, and to examine how aesthetic considerations are dealt with. We present a survey of how the aesthetic dimension is planned and it is considered important in the strategic plans of Norwegian general hospitals. METHODS: Data were sampled by analyzing the strategic plans of somatic hospitals. Sixty-four of 86 hospitals responded (74%). Concepts were categorized in a matrix of 11 main categories, each with subcategories. The method was quantitative, in that the analyzed material was amenable to counting. RESULTS: Very few concrete guidelines or directions for the aesthetic dimension have been included in written documents. This indicates that the aesthetic area is a neglected field in the directions for the daily management of hospitals. CONCLUSIONS: The research available today on the contribution of environmental aesthetics to health, rehabilitation, and well-being suggests that it is important to have concrete guidelines recorded in strategic plans. This field concerns the maintenance of high quality in the caring professions.
The first reengineering project undertaken by the Sunnybrook Health Science Centre after adopting a philosophy of patient-focused care was the introduction of a new category of worker: the multi-skilled service assistant. This article describes the experiences of the first two cohorts of service assistants and assesses the changes made to the work itself and the integration of the new workers into the work environment. It concludes by sharing recommendations for introducing a new work role.
The complex health profile of an older adult entering a hospital presents staff and administrators with a new challenge. This paper documents the Vancouver Island Health Authority's (VIHA) move towards an Elder-Friendly Hospital (EFH). A new approach to hospital care is described, one that takes account not only of an acute healthcare crisis, but also the developmental phenomena associated with aging, with the likelihood of chronic illnesses compounding both diagnosis and treatment. Customized strategies and suggestions for implementation that may be useful to other healthcare agencies are explained.
The concept of self-care is multidimensional, with many defining elements. This paper describes the origin of this comprehensive concept. It examines the response of the nursing discipline to citizen self-care initiatives and the subsequent effects this response has had on the development of nursing knowledge. The evolution of self-care as a core concept within Canadian health policy is presented; the potential readiness fo citizens to accept self-care as an aspect of healthcare delivery is explored, identifying potential benefits and obstacles. The paper concludes with a proposed self-care approach to healthcare reform in Canada and the subsequent influence this approach may have on the discipline of nursing. The congruency between a self-care healthcare delivery system and the theoretical foundations and perspective of healthcare delivery held by the nursing discipline is discussed. The role nurses might assume in shaping a self-care healthcare delivery system is delineated.
To delineate the role of the oncology patient navigator, drawing from the experiences and descriptions of younger women with breast cancer.
Interpretive, descriptive, qualitative research design.
Participants' homes, researcher's home, and via telephone, all in Winnipeg, Manitoba, Canada.
12 women aged 50 years or younger who were diagnosed with breast cancer within the last three years.
Face-to-face semistructured interviews explored patient experiences with the cancer care system, including problems encountered, unmet needs, and opinions about the functions of the patient navigator role. The audio-recorded interviews were transcribed and data were broken down and inductively coded into four categories. Constant comparative techniques also were used during analysis.
The role of the oncology patient navigator included two facets: "Processual facets," with the subthemes assigned to me at diagnosis, managing the connection, mapping the process, practical support, and quarterbacking my entire journey; and "Personal qualities: The essentials," with the subthemes empathetic care tenor, knowing the cancer system, and understanding the medical side of breast cancer.
Despite the tremendous effort directed toward enhancing care for younger women undergoing treatment for breast cancer, gaps continue to exist. Younger women with breast cancer require a care approach providing ongoing dialogue, teaching, and emotional support from the point of diagnosis through treatment, including transitions of care within the oncology setting and back to their primary care practitioner.
Oncology nurse navigators are well positioned to provide patients with anticipatory guidance from diagnosis to the end of treatment.
Comment In: Oncol Nurs Forum. 2014 Jan 1;41(1):89-9124368242
This paper describes an interprofessional capability framework which builds on the existing interprofessional competency and capability frameworks from the United Kingdom, Canada, and the United States of America. Existing published frameworks generally make reference to being client-centred and to the safety and quality of care, and locate interprofessional collaborative practice as the central theme or objective. In contrast, this framework interlinks all three elements: client-centred services, safety and quality of services, and interprofessional collaborative practice. The framework is clear and succinct with an accompanying visual representation that highlights all key features. The framework has informed curriculum which incorporates a common first-year, case-based educational workshops and practice placements within a large complex health sciences faculty of approximately 10,000 students from 22 disciplines. The articulation of these key elements of health practice has facilitated students, academic staff, and community health professionals to develop a shared understanding of interprofessional education and practice. The design, implementation, and evaluation of learning outcomes, learning experiences, and assessments have been transformed with the introduction of this framework, which is highly applicable to other contexts.