To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its ...effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience.
Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience.
Seventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience.
Clinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health outcomes. While few studies found a direct effect on patient health outcomes, when provided to mental health professionals clinical supervision may be associated with a reduction in psychological symptoms of patients diagnosed with a mental illness. There was no association found between clinical supervision and the patient experience.
CRD42015029643 .
Aims
To investigate the extent to which emotional labour and emotional intelligence are associated with well‐being and job‐stress among a group of Australian community nurses. The moderating role of ...emotional intelligence was evaluated as a key factor in the rescue of healthcare workers from job‐stress, thus increasing job retention.
Background
Although emotional labour has been broadly investigated in the literature, the contribution of emotional labour and emotional intelligence to the well‐being and experience of job‐stress in a community nursing setting requires further exploration.
Design
This study used a cross‐sectional quantitative research design with data collected from Australian community nurses.
Methods
Australian community nurses (n = 312) reported on their perceived emotional labour, emotional intelligence and their levels of well‐being and job‐stress using a paper and pencil survey in 2010.
Results/Findings
Results from structural equation modelling support the hypothesis that both emotional labour and emotional intelligence have significant effects on nurses' well‐being and perceived job‐stress. Emotional intelligence plays a moderating role in the experience of job‐stress.
Conclusion
These findings provide additional evidence for the important effects that emotional labour and emotional intelligence can have on well‐being and job‐stress among community nurses. The potential benefits of emotional intelligence in the nurses' emotional work have been explored.
Using government health datasets for secondary purposes is widespread; however, little is known on researchers' knowledge and reuse practices within Australia.
To explore researchers' knowledge and ...experience of governance processes, and their data reuse practices, when using Victorian government health datasets for research between 2008-2020.
A cross-sectional quantitative survey was conducted with authors who utilised selected Victorian, Australia, government health datasets for peer-reviewed research published between 2008-2020. Information was collected on researchers': data reuse practices; knowledge of government health information assets; perceptions of data trustworthiness for reuse; and demographic characteristics.
When researchers used government health datasets, 45% linked their data, 45% found the data access process easy and 27% found it difficult. Government-curated datasets were significantly more difficult to access compared to other-agency curated datasets (p = 0.009). Many respondents received their data in less than six months (58%), in aggregated or de-identified form (76%). Most reported performing their own data validation checks (70%). To assist in data reuse, almost 71% of researchers utilised (or created) contextual documentation, 69% a data dictionary, and 62% limitations documentation. Almost 20% of respondents were not aware if data quality information existed for the dataset they had accessed. Researchers reported data was managed by custodians with rigorous confidentiality/privacy processes (94%) and good data quality processes (76%), yet half lacked knowledge of what these processes entailed. Many respondents (78%) were unaware if dataset owners had obtained consent from the dataset subjects for research applications of the data.
Confidentiality/privacy processes and quality control activities undertaken by data custodians were well-regarded. Many respondents included data linkage to additional government datasets in their research. Ease of data access was variable. Some documentation types were well provided and used, but improvement is required for the provision of data quality statements and limitations documentation. Provision of information on participants' informed consent in a dataset is required.
Governments, funders and hospital managers around the world are looking for ways to address the continual growth in expenditure by reducing the level of waste in the healthcare delivery system and ...improving the value of care provided to patients. Process improvement methods are applied to increase high value care, reduce low value care and remove waste from care processes. The purpose of this study is to review the literature to identify the methods used by hospitals to measure and capture financial benefits from PI initiatives to identify best practice. The review also pursues the way hospitals collate these benefits at the enterprise level to achieve improved financial performance.
A systematic review was undertaken in line with the PRISMA process and employed qualitative research methods. Databases searched were Medline, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINHAL), Web of Science and SCOPUS. The initial search was conducted in in July 2021 with a follow up search conducted in February 2023 using the same search terms and databases to identify additional studies published in the intervening period. The search terms were identified through the PICO (Participants, Interventions, Comparisons and Outcomes) method.
Seven papers were identified that reported reduction in care process waste or improvement of the value of care using an evidence-based PI approach and included financial benefits analysis. Positive financial impact was measured for the PI initiatives but none of the studies reported how these financial benefits were captured or applied at the enterprise level. Three of the studies suggested that sophisticated cost accounting systems were required to enable this.
The study demonstrates the paucity of literature in the field of PI and financial benefits measurement in healthcare. Where financial benefits are documented, they vary in terms of cost inclusions and the 'level' at which the costs were measured. Further research on best practice financial measurement methods is needed to enable other hospitals to measure and capture financial benefits arising from their PI programs.
bartram t., casimir g., djurkovic n., leggat s.g. & stanton p. (2012) Do perceived high performance work systems influence the relationship between emotional labour, burnout and intention to leave? A ...study of Australian nurses. Journal of Advanced Nursing68(7), 1567–1578.
Aims. The purpose of this article was to explore the relationships between perceived high performance work systems, emotional labour, burnout and intention to leave among nurses in Australia.
Background. Previous studies show that emotional labour and burnout are associated with an increase in intention to leave of nurses. There is evidence that high performance work systems are in association with a decrease in turnover. There are no previous studies that examine the relationship between high performance work systems and emotional labour.
Design. A cross‐sectional, correlational survey.
Methods. The study was conducted in Australia in 2008 with 183 nurses. Three hypotheses were tested with validated measures of emotional labour, burnout, intention to leave, and perceived high performance work systems. Principal component analysis was used to examine the structure of the measures. The mediation hypothesis was tested using Baron and Kenny’s procedure and the moderation hypothesis was tested using hierarchical regression and the product‐term.
Results. Emotional labour is positively associated with both burnout and intention to leave. Burnout mediates the relationship between emotional labour and intention to leave. Perceived high performance work systems negatively moderates the relationship between emotional labour and burnout. Perceived high performance work systems not only reduces the strength of the negative effect of emotional labour on burnout but also has a unique negative effect on intention to leave.
Conclusion. Ensuring effective human resource management practice through the implementation of high performance work systems may reduce the burnout associated with emotional labour. This may assist healthcare organizations to reduce nurse turnover.
This study assessed the link of patient care outcome to occupational differences in response to human resource management. A cross-sectional survey was conducted in three large regional hospitals in ...China. A total of 700 questionnaires were distributed to doctors, nurses, allied health workers, and managers and 499 (71%) were completed. Data were analyzed using a final sample of 193 doctors and 180 nurses. Quality of patient care was rated by the participants using a modified version of the Victorian Patient Satisfaction Questionnaire. Human resource management was measured on seven aspects: job security, recruitment, training, transformational leadership, information sharing, job quality, and teams. The differences between doctors and nurses in response to the human resource management practices and their associations with quality of care were compared through independent samples t-tests, correlational analyses, and moderator regressions. Doctors gave a higher rating on quality of patient care than their nurse counterparts. ‘Training’, ‘transformational leadership’, and ‘information sharing’ were more likely to be associated with higher ratings on quality of patient care in nurses. By contrast, a greater association between ‘teams’ and quality of patient care was found in doctors. Although doctors and nurses in China are exposed to the same hospital management environment, professional differences may have led them to respond to management practices in different ways.
Objective The objective of this research is to appraise current practice in hospitals against the 'Framework to achieve value in healthcare' (the Framework) and to identify additional contributory ...factors that support or hinder its application. Methods A multi-site case study was undertaken with five hospitals in Australia, the USA and UK using purposeful sampling to identify hospitals to participate. Data collection took place between September and November 2022. The hospitals included in the study had Process Improvement (PI) programs of more than 5 years duration, with strong executive engagement and broad outcomes measurement, including financial benefits. All hospitals were acute public hospitals or private, not for profit. Results All hospitals indicated current practice according to Steps 1-5 for some part of their PI programs. All hospitals indicated that they were more likely to include financial benefits measurement for activities aimed specifically at improving cost rather than reducing non-value adding activities or improving the value of clinical care. Step 5 (reinvestment of cost savings) of the Framework is dependent on the accomplishment of Step 4 (measurement and realisation of financial benefits) and the contributory elements are important in supporting hospitals to utilise the Framework. Conclusions The 'Framework to achieve value in healthcare' provides a practical guide for hospitals to reduce non-value adding activities, improve the value of clinical care and reduce costs. Further research is indicated to establish its reliability in hospitals in other countries and hospitals that do not have an established PI program.
Aims
This article examines the relationships among emotional labour, team climate, burnout, perceived quality of care and turnover intention among nurses in Australia, with the aim of addressing ...nurse retention and burnout.
Background
Emotional labour refers to the regulation of emotion during interpersonal transactions. It may involve faking unfelt emotions, hiding genuine emotions and deep acting whereby the individuals attempt to influence their inner feelings to induce the appropriate outward countenance. Currently, there is a dearth of literature that investigates the link between emotional labour and perceived quality of care and ultimately turnover intention. The contribution of team climate in the relationship between emotional labour and burnout is still uncertain.
Design
A cross‐sectional quantitative study conducted with self‐completed questionnaires.
Methods
The study was conducted in 2011 with 201 registered nurses. Validated measures were used to measure the aforementioned constructs. Confirmatory factor analyses were used to examine the factor structure of the measured variables and hypotheses were tested using structural equation modelling.
Results
The final model demonstrates that faking has a significant negative influence on perceived quality of care. Hiding predicts burnout, leading to an increase in turnover intention. Team climate moderates the relationship between hiding and burnout, which may subsequently influence turnover intention.
Conclusion
The establishment of a strong team climate may help nurses to manage the emotional demands of their role, promote their well‐being and retention.
Aims and objectives
To determine whether a formal mentoring programme assists nurse practitioner candidates to develop competence in the clinical leadership competencies required in their advanced ...practice roles.
Background
Nurse practitioner candidates are required to show evidence of defined clinical leadership competencies when they apply for endorsement within the Australian health care system. Aiming to assist the candidates with the development or enhancement of these leadership skills, 18 nurse practitioner candidates participated in a mentoring programme that matched them with senior nurse mentors.
Design
A pre‐postlongitudinal intervention study.
Method
Eighteen nurse practitioner candidates and 17 senior nurses participated in a voluntary mentoring programme that incorporated coaching and action learning over 18 months in 2012 and 2013. Participants completed a pen and paper questionnaire to document baseline measures of self‐reported leadership practices prior to commencement of the programme and again at the end of the programme.
Results
The mentors and the nurse practitioner candidates qualitatively evaluated the programme as successful and quantitative data illustrated significant improvement in self‐reported leadership practices among the nurse practitioner candidates. In particular, the nurse practitioner candidates reported greater competence in the transformational aspects of leadership, which is directly related to the nurse practitioner candidate clinical leadership standard.
Conclusions
A formal, structured mentoring programme based on principles of action learning was successful in assisting Australian advanced practice nurses enhance their clinical leadership skills in preparation for formal endorsement as a nurse practitioner and for success in their advanced practice role.
Relevance to clinical practice
Mentoring can assist nurses to transition to new roles and develop knowledge and skills in clinical leadership essential for advanced practice roles. Nurse managers should make greater use of mentoring programmes to support nurses in their transition to new roles.
Hospital staff are interested in information on patient satisfaction and patient experience that can help them improve quality of care. Staff perceptions of quality of care have been identified as ...useful proxies when patient data are not available. This study explores the organizational factors and staff attitudes that influence staff perceptions of the quality of the care they provide in relation to patient satisfaction and patient experience.
Cross sectional survey completed by 258 staff of a large multi-campus, integrated metropolitan hospital in Australia. Structured equation modelling was used to analyse the data.
Our data suggest that different perceived organizational factors and staff attitudes contribute to different pathways for patient satisfaction and patient experience indicators. Hospital staff in our sample were more likely to indicate they provided the care that would result in higher patient satisfaction if they felt empowered within a psychologically safe environment. Conversely their views on patient experience were related to their commitment towards their hospital. There was no relationship between the staff perceptions of patient satisfaction and the staff response to the friends and family test.
This study provides empirical evidence that staff perceptions of the quality of care they provide that is seen to be related to patient satisfaction and patient experience are enacted through different pathways that reflect differing perceptions of organizational factors and workplace psychological attitudes.
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