The development of closed cultures in healthcare is not a new phenomenon. Closed cultures can occur in any industry, profession, or team because closed cultures are the product of several conditions that have been established.
Mental Health _ Monthly Developments MagazineAlicia Tamstorf
The passage discusses changes in approaches to humanitarian aid worker mental health. It notes a shift from crisis response models to preventative care and an increased focus on staff well-being. Factors like unpredictable work environments, threats of violence, organizational changes and loss of team structures impact mental health. Recent research highlights the importance of resilience-building and understanding brain health. Going forward, opportunities include increased training, practical resilience strategies, and improved global mental health standards and access to care.
This paper will discuss the definition, roles and evolution of
the family caregiver, before delving into the topic of caregiver fear – including the sources, consequences and mechanisms for alleviation.
The Emergentologist - Burnout & the Specialty Myiesha Taylor
This document discusses physician burnout, focusing on factors that contribute to burnout among emergency physicians. It notes that emergency medicine is a highly stressful field dealing with sick and dying patients. Contributing factors include high administrative burdens, lack of autonomy, disrespect, and regulations. Women physicians tend to experience higher rates of burnout due to larger household duties and responsibilities. The document provides burnout rates among various medical specialties, with emergency medicine having the 4th highest rate at 45%. It emphasizes the importance of self-care, spending time with loved ones, connecting with one's purpose, and maintaining work-life balance to prevent and address burnout.
This document discusses the importance of a positive work culture for employee well-being and performance. It notes that managers sometimes unwittingly contribute to employee psychological distress through their actions. While occupational health services aim to support individuals, they often do not address the root causes within the work culture or manager behaviors. A positive work culture is essential and is built on cultural foundations of virtuous intent that promote well-being and performance. However, subtle signals from managers must also reflect these foundations, otherwise employee distress can still occur. The document outlines other factors like professional and leadership subcultures that can influence work culture positively or negatively.
Nursing Leadership and Management Response 1 This writer is currently.docx4934bk
The writer is satisfied working at their non-profit, magnet recognized hospital. The hospital's values of innovation, collaboration, accountability, respect and empathy guide its work to continually improve care. As a magnet hospital,
This case study examines communication issues between a physician and medical staff at a large hospital. The nurse, Nancy, must decide whether to bring her negative experiences with the difficult physician to the hospital's Pulse Team. The Pulse Team was created to encourage two-way communication and feedback to improve teamwork and patient safety. Bringing the issue to the Pulse Team would allow Nancy to protect patients while getting input from the team on how to approach the physician. Proper communication is important for patient care, staff satisfaction, and hospital culture and addressing the physician's behavior through the Pulse Team could help resolve the long-standing problem.
This document discusses mental health issues among physicians and rehabilitation doctors. It notes that physicians have higher rates of stress, anxiety, depression and suicidal thoughts than the general population due to risk factors like perfectionism, heavy workloads and lack of communication skills training. While medical schools have tried to improve communication skills, many doctors remain reluctant to seek help due to stigma around mental illness. The document argues that rehabilitation doctors in particular need strong communication skills to manage teams and patients, and that doctors should work to improve self-care and identify issues in themselves and their colleagues.
Creating adaptable communities summary from Empowering Adaptable Communities ...Innovations2Solutions
Sodexo was honored to be a featured presenter at the 2nd Annual Atlantic Center for Population Health Sciences Empowering Adaptable Communities Summit. The Summit was held on October 21 and 22, 2015, in Morristown, New Jersey, at the College of Saint Elizabeth. The event was devoted to providing new insights, information, inspiration, and personal connections in our united efforts to empower communities to be more adaptable.
Mental Health _ Monthly Developments MagazineAlicia Tamstorf
The passage discusses changes in approaches to humanitarian aid worker mental health. It notes a shift from crisis response models to preventative care and an increased focus on staff well-being. Factors like unpredictable work environments, threats of violence, organizational changes and loss of team structures impact mental health. Recent research highlights the importance of resilience-building and understanding brain health. Going forward, opportunities include increased training, practical resilience strategies, and improved global mental health standards and access to care.
This paper will discuss the definition, roles and evolution of
the family caregiver, before delving into the topic of caregiver fear – including the sources, consequences and mechanisms for alleviation.
The Emergentologist - Burnout & the Specialty Myiesha Taylor
This document discusses physician burnout, focusing on factors that contribute to burnout among emergency physicians. It notes that emergency medicine is a highly stressful field dealing with sick and dying patients. Contributing factors include high administrative burdens, lack of autonomy, disrespect, and regulations. Women physicians tend to experience higher rates of burnout due to larger household duties and responsibilities. The document provides burnout rates among various medical specialties, with emergency medicine having the 4th highest rate at 45%. It emphasizes the importance of self-care, spending time with loved ones, connecting with one's purpose, and maintaining work-life balance to prevent and address burnout.
This document discusses the importance of a positive work culture for employee well-being and performance. It notes that managers sometimes unwittingly contribute to employee psychological distress through their actions. While occupational health services aim to support individuals, they often do not address the root causes within the work culture or manager behaviors. A positive work culture is essential and is built on cultural foundations of virtuous intent that promote well-being and performance. However, subtle signals from managers must also reflect these foundations, otherwise employee distress can still occur. The document outlines other factors like professional and leadership subcultures that can influence work culture positively or negatively.
Nursing Leadership and Management Response 1 This writer is currently.docx4934bk
The writer is satisfied working at their non-profit, magnet recognized hospital. The hospital's values of innovation, collaboration, accountability, respect and empathy guide its work to continually improve care. As a magnet hospital,
This case study examines communication issues between a physician and medical staff at a large hospital. The nurse, Nancy, must decide whether to bring her negative experiences with the difficult physician to the hospital's Pulse Team. The Pulse Team was created to encourage two-way communication and feedback to improve teamwork and patient safety. Bringing the issue to the Pulse Team would allow Nancy to protect patients while getting input from the team on how to approach the physician. Proper communication is important for patient care, staff satisfaction, and hospital culture and addressing the physician's behavior through the Pulse Team could help resolve the long-standing problem.
This document discusses mental health issues among physicians and rehabilitation doctors. It notes that physicians have higher rates of stress, anxiety, depression and suicidal thoughts than the general population due to risk factors like perfectionism, heavy workloads and lack of communication skills training. While medical schools have tried to improve communication skills, many doctors remain reluctant to seek help due to stigma around mental illness. The document argues that rehabilitation doctors in particular need strong communication skills to manage teams and patients, and that doctors should work to improve self-care and identify issues in themselves and their colleagues.
Creating adaptable communities summary from Empowering Adaptable Communities ...Innovations2Solutions
Sodexo was honored to be a featured presenter at the 2nd Annual Atlantic Center for Population Health Sciences Empowering Adaptable Communities Summit. The Summit was held on October 21 and 22, 2015, in Morristown, New Jersey, at the College of Saint Elizabeth. The event was devoted to providing new insights, information, inspiration, and personal connections in our united efforts to empower communities to be more adaptable.
Lateral violence in nursing exists on a spectrum from gossiping and criticism to physical intimidation. It is connected to nurses feeling oppressed in their work environments where they have little control but high accountability. To address lateral violence, initiatives must be taken to empower nurses, improve communication, develop clear anti-bullying policies, and foster a culture of respect rather than one based on fear. Confronting problematic behaviors respectfully and taking personal responsibility can help enact positive change.
The X Factor In Wellbeing And Performancederekmowbray
The document discusses the relationship between wellbeing and performance in organizations. It introduces the XABC formula, which emphasizes the importance of context (X) in how individuals respond to adverse events (A) at work. The context refers to an organization's culture (X), which influences thoughts, emotions and behaviors (B) in response to events, and ultimately impacts consequences (C). Rather than focusing only on supporting individuals, the document argues organizations should implement a "Positive Work Culture" that promotes wellbeing and engagement as part of their overall strategy. This approach, known as the X-Factor, can help eliminate issues like presenteeism that undermine performance.
This document discusses the need for a new approach to supervision for therapists working with trauma survivors. It notes the paradox that relationship is key to healing trauma, but supervision often focuses on productivity over relationships. It proposes adapting the Sanctuary Model, which redefines therapists, supervisors, and supervision to provide better support for trauma therapists. The model aims to address the "gaping hole" left by evidence-based practices that fail to consider meaning, purpose and social context in healing complex trauma.
Understanding Personality Disorders By Tom BurnsAnsel Group Ltd
Article for the Insight Supplement of Mental Health Today Magazine July/August 2010. Tom Burns, CEO of the Ansel Group, provides an insight into this patient group and provides some messages around organising services to best meet their needs.
Tips for your health care : FAMILY ORIENTED NURSINGRachel Masih
Family-oriented nursing aims to meet the health needs of the family as a whole. It involves assessing the family structure, lifestyle, medical history, and developing a nursing care plan. The care plan may utilize different approaches like problem-oriented nursing, progressive patient care, and team nursing. Problem-oriented nursing addresses specific health issues, progressive patient care matches nursing needs to care levels, and team nursing assigns nurses and aids to collaborate on patient care. Overall, family-oriented nursing takes a holistic approach to promote family health and well-being through open communication and collaboration between nurses, patients, and family members.
A great culture change movement and a rigorously researched, whole new paradigm in understanding cognitive and behavioral disorder together offer a potent, dramatic new approach to addressing elder care and both the prevention of and recovery from cognitive decline, dementia and other neurobehavioral sequelae that particularly affect elders, especially so those residing in a long-term care facility. The culture-change movement embraces the concept of person-centered care (PCC), while the innovative cognitive and behavioral intervention model, referred to as Cognitive Neuroeducation (CNE), fuses a neuroscience-informed base with a human-values orientation, both PCC and CNE rejecting the distorted medical model.
This paper outlines the affinity of the philosophy and objectives of the PCC and CNE paradigms, elucidates the misdirection of the medical model, and suggests that CNE and PCC, in a fully integrated approach, can give a whole new lease on life for the elder, redefining elderhood as a meaningful, rich, and rewarding stage of life, even in physical decline and when living in a long-term care facility.
This document discusses culture and leadership in healthcare between the Middle East and Western world. It notes key differences in Middle Eastern culture, such as a stronger emphasis on family and developing personal relationships. Middle Easterners also have different views of time, personal space, and personal privacy. Western medical professionals need to understand these cultural differences to effectively serve Middle Eastern patients and work with their families. The document concludes that culture and leadership are important to healthcare everywhere, and leaders must address cultural issues to provide quality care.
This document discusses trauma informed care and practice, with a focus on childhood trauma. It notes that while trauma is a core issue for many consumers, current mental health services seldom identify or address trauma. Childhood trauma can have widespread impacts and coping strategies adopted in childhood often persist into adulthood. The document calls for a trauma informed approach that recognizes a person's traumatic life experiences rather than just focusing on diagnoses. It outlines some key principles of trauma informed care including safety, choice, and empowerment.
This document discusses workplace violence and incivility experienced by nurses. It begins by defining bullying and providing statistics on nurses who have experienced threats or assaults. It then discusses the roles of nursing leaders, managers, and followers in addressing workplace violence and incivility. Specifically, leaders assess the problem and develop strategic plans, managers support initiatives and assure policies are followed, and followers provide input and feedback. The document also discusses the importance of effective communication and information technology in prevention, as well as nursing resource management in developing individualized violence prevention plans involving staff input.
END OF LIFE CARE (SUBSTANCE USE SPECIFIC)Kevin Jaffray
This document discusses end of life care for substance users and former substance users. It notes there are many challenges to providing quality end of life care for this group, including negative attitudes, fears of addiction, undertreatment of pain, lack of screening and training for healthcare providers, and risk of diversion of medications. It emphasizes the importance of person-centered care, understanding an individual's needs and background, effective communication, and addressing barriers through strategies like screening, education, and support networks.
The field of prevention is undergoing significant changes due to factors like new technologies, political climates, and decreased funding. Access to the field is expanding as universities offer new prevention-focused programs. There is increased collaboration between prevention specialists and other professionals, but also potential duplication of efforts. The language of prevention is also changing as specialists are asked to quantify outcomes and participate more in behavioral research. The scope of issues addressed by prevention is expanding beyond substances to include other social problems. Through it all, prevention specialists must continue sharing their knowledge and advocating for families and communities.
Managing lateral violence and its impact on the team la ronge november 2013griehl
Lateral violence is a reality for many people working in the health care field. This presentation looks at causes and looks at ways to addresses bullying behavior.
This document discusses compassion fatigue, which refers to the negative effects helping professionals can experience from exposure to traumatic stories and events through their work. It is comprised of secondary traumatic stress, burnout, and lack of compassion satisfaction. The document provides examples of codes of ethics from various professions addressing self-care. Risk and protective factors are discussed, as well as implications for individuals, clinical practice, and organizations. Suggestions are made for addressing compassion fatigue through education, support, and advocacy.
What do nurse leaders need to know working with Indigenous communitiesgriehl
This document provides information for nurse leaders working with Indigenous communities. It discusses the importance of recognizing different worldviews and Indigenous leadership structures. It also outlines principles for being an effective ally, including recognizing one's own privilege, focusing on action over identity, and allowing Indigenous communities to decide who is an ally. The document emphasizes collaboration, communication, respect, and being community-guided in one's work.
2018-04-18 المؤتمر العلمي الثاني للمعهد القومي لعلوم المسنين جامعة بني سويف بعنوان" التحديات والمستجدات العالمية في رعاية المسنين"
http://www.bsu.edu.eg/ShowConfDetails.aspx?conf_id=217
1EU HCM505 - 146Research Methodology in Health CriAnastaciaShadelb
1
EU HCM505 - 146
Research Methodology in Health
Critical Thinking Assignment: Research Paper_ Module 12
130 Points
/
Saami Comment by Dale Gooden: Hello Saleh,
Thank you for the hard work on this submission. I enjoyed reading it and have provided my feedback below.
Warmly,
Dr. Gooden
November 26, 2021
Patient Safety Culture in hospitals.
Introduction. Comment by Dale Gooden: You provided a solid introduction, background, and overview of the central theme of your research.
Patient safety is an issue of global public health concern. It refers to preventing patients from harm by implementing a care system that contains errors and learns from medical errors to build a safety culture involving healthcare workers, patients, and healthcare organizations. The safety of patients is critical in care quality. Many patients worldwide have suffered injuries, disabilities, and death due to medical errors or unsafe care. Patient safety culture can be defined as healthcare organizations' values about what is essential and how to operate to protect patients. To achieve a safety culture, organizations and their members need to understand the values, norms and beliefs about the essential attitudes and behaviors associated with patient safety (Ali et al., 2018).
To achieve a culture of safety, organizations should emphasize addressing disparities in the quality of care because the current challenges may worsen the efforts to narrow the gap. Quality and safety are key issues in establishing and delivering accessible, responsive and effective healthcare systems. Poor quality and unsafe patient care increase mortality and morbidity rates throughout the world. About 75% of the healthcare delivery gaps are preventable, and approximately 10% of inpatient admission result from preventable patient harm (Amiri et al., 2018).
Patient safety cultures with strong collaboration and leadership drive and prioritize safety (Wu et al., 2019). Strong leadership and commitment from manger are essential because their attitudes and actions influence the wider workforce's behaviors, perceptions, and attitudes. Other important aspects of the patient safety culture are; effective communication, mutual trust, shared views on the importance of patient safety, engaging the healthcare workforce, acknowledging mistakes, and having a system that recognizes, responds, and gives feedback on adverse events (Alquwez et al., 2018). Patient safety culture is influenced by burnouts, hospital characteristics, communication, position, work area, commitment to the patient safety program, leadership, and patient safety resources and management.
Thesis statement. Comment by Dale Gooden: Include a research question supported with peer-reviewed references to improve your grade.
Patient safety culture focuses on safety in health care by emphasizing the prevention, reporting, and investigation of medical errors that may cause patients' adverse effects, thus reducing harm by implementing n ...
This document discusses workplace bullying, including industries where it is more prevalent such as healthcare, education, and public service. Bullying often stems from stressful work environments, rigid hierarchies, and a culture of perfectionism. While some bullies may not realize their own behavior, confronting them respectfully can help curb bullying. Overall, HR professionals should be sensitive to complaints, address unfair workplace dynamics, and protect victims who come forward.
1. The document discusses key concepts in nursing including person, environment, health, and nursing. It emphasizes that these concepts must work together to achieve quality healthcare and improved patient outcomes.
2. The response discusses that there can be multiple right answers to healthcare situations that achieve the same goal but at different rates. It also stresses the importance of valuing the whole individual by addressing their spiritual, emotional, and physical needs.
3. Barriers like financial challenges, lack of transportation, and lack of health education can prevent responding to patients' contextual needs but these barriers can be reduced through combined efforts of different stakeholders.
Professional practice level 4 assignment finalDave Manriquez
This document discusses ethical decision making and cultural considerations in healthcare using the case of a Korean patient, Mr. K.S. It notes that in Korean culture, the family does not want the patient to know their diagnosis due to beliefs that it could negatively impact their health. It analyzes this case using the CLPNBC Professional Standards and identifies both issues like lack of informed consent and potential solutions like providing interpreter services to overcome language and cultural barriers in patient care.
The document introduces the consulting team and key associates at Niche Consulting Team. It lists the names, qualifications, and areas of expertise for 16 individuals on the consulting team with experience in areas like safeguarding, mental health investigations, social work, finance, data science, and project management. It also lists 4 key project associates and provides brief biographies for each. Finally, it introduces the Employee Owned Trust Chairman, Nigel Gloudon, and outlines his qualifications and experience in accountancy and the NHS.
This document introduces the team at Niche including the Partner Team, Director Team, and Business Team. The Partner Team consists of 4 partners with various backgrounds in healthcare governance, service evaluation, investigations, and health economics. The Director Team includes 6 directors with experience in clinical practice reviews, investigations, governance, healthcare analytics, and healthcare finance. The Business Team supports the day-to-day operations and project work.
More Related Content
Similar to Closed cultures… and how to prevent them
Lateral violence in nursing exists on a spectrum from gossiping and criticism to physical intimidation. It is connected to nurses feeling oppressed in their work environments where they have little control but high accountability. To address lateral violence, initiatives must be taken to empower nurses, improve communication, develop clear anti-bullying policies, and foster a culture of respect rather than one based on fear. Confronting problematic behaviors respectfully and taking personal responsibility can help enact positive change.
The X Factor In Wellbeing And Performancederekmowbray
The document discusses the relationship between wellbeing and performance in organizations. It introduces the XABC formula, which emphasizes the importance of context (X) in how individuals respond to adverse events (A) at work. The context refers to an organization's culture (X), which influences thoughts, emotions and behaviors (B) in response to events, and ultimately impacts consequences (C). Rather than focusing only on supporting individuals, the document argues organizations should implement a "Positive Work Culture" that promotes wellbeing and engagement as part of their overall strategy. This approach, known as the X-Factor, can help eliminate issues like presenteeism that undermine performance.
This document discusses the need for a new approach to supervision for therapists working with trauma survivors. It notes the paradox that relationship is key to healing trauma, but supervision often focuses on productivity over relationships. It proposes adapting the Sanctuary Model, which redefines therapists, supervisors, and supervision to provide better support for trauma therapists. The model aims to address the "gaping hole" left by evidence-based practices that fail to consider meaning, purpose and social context in healing complex trauma.
Understanding Personality Disorders By Tom BurnsAnsel Group Ltd
Article for the Insight Supplement of Mental Health Today Magazine July/August 2010. Tom Burns, CEO of the Ansel Group, provides an insight into this patient group and provides some messages around organising services to best meet their needs.
Tips for your health care : FAMILY ORIENTED NURSINGRachel Masih
Family-oriented nursing aims to meet the health needs of the family as a whole. It involves assessing the family structure, lifestyle, medical history, and developing a nursing care plan. The care plan may utilize different approaches like problem-oriented nursing, progressive patient care, and team nursing. Problem-oriented nursing addresses specific health issues, progressive patient care matches nursing needs to care levels, and team nursing assigns nurses and aids to collaborate on patient care. Overall, family-oriented nursing takes a holistic approach to promote family health and well-being through open communication and collaboration between nurses, patients, and family members.
A great culture change movement and a rigorously researched, whole new paradigm in understanding cognitive and behavioral disorder together offer a potent, dramatic new approach to addressing elder care and both the prevention of and recovery from cognitive decline, dementia and other neurobehavioral sequelae that particularly affect elders, especially so those residing in a long-term care facility. The culture-change movement embraces the concept of person-centered care (PCC), while the innovative cognitive and behavioral intervention model, referred to as Cognitive Neuroeducation (CNE), fuses a neuroscience-informed base with a human-values orientation, both PCC and CNE rejecting the distorted medical model.
This paper outlines the affinity of the philosophy and objectives of the PCC and CNE paradigms, elucidates the misdirection of the medical model, and suggests that CNE and PCC, in a fully integrated approach, can give a whole new lease on life for the elder, redefining elderhood as a meaningful, rich, and rewarding stage of life, even in physical decline and when living in a long-term care facility.
This document discusses culture and leadership in healthcare between the Middle East and Western world. It notes key differences in Middle Eastern culture, such as a stronger emphasis on family and developing personal relationships. Middle Easterners also have different views of time, personal space, and personal privacy. Western medical professionals need to understand these cultural differences to effectively serve Middle Eastern patients and work with their families. The document concludes that culture and leadership are important to healthcare everywhere, and leaders must address cultural issues to provide quality care.
This document discusses trauma informed care and practice, with a focus on childhood trauma. It notes that while trauma is a core issue for many consumers, current mental health services seldom identify or address trauma. Childhood trauma can have widespread impacts and coping strategies adopted in childhood often persist into adulthood. The document calls for a trauma informed approach that recognizes a person's traumatic life experiences rather than just focusing on diagnoses. It outlines some key principles of trauma informed care including safety, choice, and empowerment.
This document discusses workplace violence and incivility experienced by nurses. It begins by defining bullying and providing statistics on nurses who have experienced threats or assaults. It then discusses the roles of nursing leaders, managers, and followers in addressing workplace violence and incivility. Specifically, leaders assess the problem and develop strategic plans, managers support initiatives and assure policies are followed, and followers provide input and feedback. The document also discusses the importance of effective communication and information technology in prevention, as well as nursing resource management in developing individualized violence prevention plans involving staff input.
END OF LIFE CARE (SUBSTANCE USE SPECIFIC)Kevin Jaffray
This document discusses end of life care for substance users and former substance users. It notes there are many challenges to providing quality end of life care for this group, including negative attitudes, fears of addiction, undertreatment of pain, lack of screening and training for healthcare providers, and risk of diversion of medications. It emphasizes the importance of person-centered care, understanding an individual's needs and background, effective communication, and addressing barriers through strategies like screening, education, and support networks.
The field of prevention is undergoing significant changes due to factors like new technologies, political climates, and decreased funding. Access to the field is expanding as universities offer new prevention-focused programs. There is increased collaboration between prevention specialists and other professionals, but also potential duplication of efforts. The language of prevention is also changing as specialists are asked to quantify outcomes and participate more in behavioral research. The scope of issues addressed by prevention is expanding beyond substances to include other social problems. Through it all, prevention specialists must continue sharing their knowledge and advocating for families and communities.
Managing lateral violence and its impact on the team la ronge november 2013griehl
Lateral violence is a reality for many people working in the health care field. This presentation looks at causes and looks at ways to addresses bullying behavior.
This document discusses compassion fatigue, which refers to the negative effects helping professionals can experience from exposure to traumatic stories and events through their work. It is comprised of secondary traumatic stress, burnout, and lack of compassion satisfaction. The document provides examples of codes of ethics from various professions addressing self-care. Risk and protective factors are discussed, as well as implications for individuals, clinical practice, and organizations. Suggestions are made for addressing compassion fatigue through education, support, and advocacy.
What do nurse leaders need to know working with Indigenous communitiesgriehl
This document provides information for nurse leaders working with Indigenous communities. It discusses the importance of recognizing different worldviews and Indigenous leadership structures. It also outlines principles for being an effective ally, including recognizing one's own privilege, focusing on action over identity, and allowing Indigenous communities to decide who is an ally. The document emphasizes collaboration, communication, respect, and being community-guided in one's work.
2018-04-18 المؤتمر العلمي الثاني للمعهد القومي لعلوم المسنين جامعة بني سويف بعنوان" التحديات والمستجدات العالمية في رعاية المسنين"
http://www.bsu.edu.eg/ShowConfDetails.aspx?conf_id=217
1EU HCM505 - 146Research Methodology in Health CriAnastaciaShadelb
1
EU HCM505 - 146
Research Methodology in Health
Critical Thinking Assignment: Research Paper_ Module 12
130 Points
/
Saami Comment by Dale Gooden: Hello Saleh,
Thank you for the hard work on this submission. I enjoyed reading it and have provided my feedback below.
Warmly,
Dr. Gooden
November 26, 2021
Patient Safety Culture in hospitals.
Introduction. Comment by Dale Gooden: You provided a solid introduction, background, and overview of the central theme of your research.
Patient safety is an issue of global public health concern. It refers to preventing patients from harm by implementing a care system that contains errors and learns from medical errors to build a safety culture involving healthcare workers, patients, and healthcare organizations. The safety of patients is critical in care quality. Many patients worldwide have suffered injuries, disabilities, and death due to medical errors or unsafe care. Patient safety culture can be defined as healthcare organizations' values about what is essential and how to operate to protect patients. To achieve a safety culture, organizations and their members need to understand the values, norms and beliefs about the essential attitudes and behaviors associated with patient safety (Ali et al., 2018).
To achieve a culture of safety, organizations should emphasize addressing disparities in the quality of care because the current challenges may worsen the efforts to narrow the gap. Quality and safety are key issues in establishing and delivering accessible, responsive and effective healthcare systems. Poor quality and unsafe patient care increase mortality and morbidity rates throughout the world. About 75% of the healthcare delivery gaps are preventable, and approximately 10% of inpatient admission result from preventable patient harm (Amiri et al., 2018).
Patient safety cultures with strong collaboration and leadership drive and prioritize safety (Wu et al., 2019). Strong leadership and commitment from manger are essential because their attitudes and actions influence the wider workforce's behaviors, perceptions, and attitudes. Other important aspects of the patient safety culture are; effective communication, mutual trust, shared views on the importance of patient safety, engaging the healthcare workforce, acknowledging mistakes, and having a system that recognizes, responds, and gives feedback on adverse events (Alquwez et al., 2018). Patient safety culture is influenced by burnouts, hospital characteristics, communication, position, work area, commitment to the patient safety program, leadership, and patient safety resources and management.
Thesis statement. Comment by Dale Gooden: Include a research question supported with peer-reviewed references to improve your grade.
Patient safety culture focuses on safety in health care by emphasizing the prevention, reporting, and investigation of medical errors that may cause patients' adverse effects, thus reducing harm by implementing n ...
This document discusses workplace bullying, including industries where it is more prevalent such as healthcare, education, and public service. Bullying often stems from stressful work environments, rigid hierarchies, and a culture of perfectionism. While some bullies may not realize their own behavior, confronting them respectfully can help curb bullying. Overall, HR professionals should be sensitive to complaints, address unfair workplace dynamics, and protect victims who come forward.
1. The document discusses key concepts in nursing including person, environment, health, and nursing. It emphasizes that these concepts must work together to achieve quality healthcare and improved patient outcomes.
2. The response discusses that there can be multiple right answers to healthcare situations that achieve the same goal but at different rates. It also stresses the importance of valuing the whole individual by addressing their spiritual, emotional, and physical needs.
3. Barriers like financial challenges, lack of transportation, and lack of health education can prevent responding to patients' contextual needs but these barriers can be reduced through combined efforts of different stakeholders.
Professional practice level 4 assignment finalDave Manriquez
This document discusses ethical decision making and cultural considerations in healthcare using the case of a Korean patient, Mr. K.S. It notes that in Korean culture, the family does not want the patient to know their diagnosis due to beliefs that it could negatively impact their health. It analyzes this case using the CLPNBC Professional Standards and identifies both issues like lack of informed consent and potential solutions like providing interpreter services to overcome language and cultural barriers in patient care.
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The document introduces the consulting team and key associates at Niche Consulting Team. It lists the names, qualifications, and areas of expertise for 16 individuals on the consulting team with experience in areas like safeguarding, mental health investigations, social work, finance, data science, and project management. It also lists 4 key project associates and provides brief biographies for each. Finally, it introduces the Employee Owned Trust Chairman, Nigel Gloudon, and outlines his qualifications and experience in accountancy and the NHS.
This document introduces the team at Niche including the Partner Team, Director Team, and Business Team. The Partner Team consists of 4 partners with various backgrounds in healthcare governance, service evaluation, investigations, and health economics. The Director Team includes 6 directors with experience in clinical practice reviews, investigations, governance, healthcare analytics, and healthcare finance. The Business Team supports the day-to-day operations and project work.
Mental health awareness plays a critical role in promoting overall well-being and creating a supportive and inclusive society. It is essential to shed light on the importance of mental health and address the stigma surrounding it. In this blog post, we will explore in detail why mental health awareness matters.
Thematic review (or thematic analysis) is, strictly speaking, a scientific discipline which requires certain conditions to be in place to enable accurate (and useful) end-user insights.
The tool is based on a bespoke set of core indicators, carefully selected with significant input from senior operational and clinical mental health experts, to help concisely describe a particular situation relating to care at your Trust.
These are complicated organisations facing very complicated tasks – but articulating what they are for in a way which is simple and powerful. What should the mission of mental health services be? Not just your organisation, which may be very generalist or very specialist – but mental health services’ overall role and purpose in society. What should we be working together to achieve?
The first great wave of gains in public health arguably owed as much to plumbers as to any other profession. From the mid-19th century onwards, improvements in sanitation and access to clean water had a huge impact in reducing infectious diseases and improving both life expectancy and quality of life.
The concept of a Benefit Corporation – often simply referred to as a “BCorp” - goes beyond the traditional notion of enterprises being driven simply by profit. Whilst profits still matter, B Corps have a threefold mission – to make a positive impact for their workforce, for wider society and for the environment. This model also fits perfectly when business is done between the public and private sectors, as it allows social value to be built into procurement processes. In this summary, we will explore the significance of BCorp in the realm of purpose-driven businesses.
Independence is crucial to a successful review, but how well is the idea of “independence” actually understood? Independence is about many things - much more than money and relationships. It is vital to ensure that there are systems, processes, and controls, all of which act to protect the judgements made; just as important are honesty, integrity, and accountability in professional practice.
Independence is crucial to a successful review, but how well is the idea of “independence” actually understood? Independence is about many things - much more than money and relationships. It is vital to ensure that there are systems, processes, and controls, all of which act to protect the judgements made; just as important are honesty, integrity, and accountability in professional practice.
Whistleblowing remains an important mechanism in healthcare, but it is deeply problematic for whistleblowers themselves (many of whom feel they have no other option but to take this route) for organisations, and for the NHS generally. During our many years of experience in reviews and investigations, Niche has found that cases of whistleblowing can almost always be attributed to a failure of governance. However, there are:
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The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
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Closed cultures… and how to prevent them
1. Closed Cultures… And How To Prevent
Them
The development of closed cultures in healthcare is not a new phenomenon. Closed cultures
can occur in any industry, profession, or team because closed cultures are the product of
several conditions that have been established.
What is a closed culture? And why does it matter?
The CQC somewhat vaguely define a closed culture as “a poor culture that can lead to harm,
including human rights breaches such as abuse.” This is of limited practical use, as it focuses
on the consequences of a poor culture more than on its features.
A more helpful example defines the opposite, identifying 37 features of an open culture[1].
These focus on open communication, open-mindedness, and psychological safety, with
leadership, employee attitudes, and organisational processes all contributing to a positive
culture. Statements indicating an open culture include:
“We are open to views from a wide network, such as those of other departments, professions,
and institutions.”
“We trust each other’s intentions”
“Respect for colleagues and patients is one of our most important values.”
2. Therefore, a closed culture might be indicated by an absence of these features. In healthcare,
like aviation, closed cultures can have a direct and catastrophic impact on safety. Closed
cultures can occur in any healthcare sector, but we tend to see them more in mental health or
care home sectors. Closed cultures in these settings are more likely to be environments of
highly expressed emotion, with a greater cohort of vulnerable patients, alongside lower-paid
staff and stretched services.
Wards can go from exemplar environments to closed cultures on a rapid basis and yet this
subtle decline can be very difficult to detect; this gives rise to a very real fear amongst board
members. Indeed, it might take years for the impact of a closed culture to emerge; it is therefore
crucial to try to spot some of the conditions which are required for a closed culture to thrive.
Poor tone at the top
If a Board does not send out an unequivocal message about ‘patients first’ - care, quality and
safety - then they risk sending out a very mixed message about what matters. With the
conflicting priorities faced by healthcare provider boards, it is surprisingly easy for operational
and financial matters to headline and filter through the organisation as a priority message,
particularly when there is often an observable lack of resources (such as staff and new estate)
which are made available to support care quality.
Senior leadership behaviour is also a pivotal factor (although not the only one) in the
development of a closed culture. Senior leader conduct is a matter frequently mentioned when
staff are interviewed after a catastrophic care failure involving a closed culture.
Closed cultures can also develop as a reaction to poor leadership. Consistent leaders exhibiting
consistent leadership behaviours are vital. They should be emotionally intelligent, able to hold
the line on poor behaviour, treat everyone equally, and lead by example.
Trauma responses
Environments of highly expressed emotion, and internalised and externalised trauma are often
found in closed cultures. Particularly in healthcare environments where staff might be dealing
with aggression from patients (for example CAMHS and secure/forensic mental health services).
These staff are also often witnesses to traumatic incidents of serious (sometimes fatal)
self-harm and psychological distress, they witness or participate in acts of restraint and these
high-incident environments become normalised. What often isn’t recognised, is the consistent
psychological trauma caused by this, which can also become normalised.
When this happens, staff can adapt their behaviour to be self-protective or pre-emptive, which
reinforces the use of restraint and reduces positive behavioural management approaches.
When set within a complex patient cohort (for example in inpatient CAMHS units), where acuity
might be rising, a clear downward spiral can occur.
Post-traumatic stress responses in staff and patients cannot be discounted as a significant
factor in the development of a closed culture. Skilled and supportive responses are required to
interrupt this cumulative decline.
3. Power imbalances
We see the development of a power imbalance in three key ways in closed-cultures; (1)
Between staff and patients (2) Between staff and families and (3) Between staff themselves.
1: Between staff and patient:
Being a patient in receipt of healthcare services is a power imbalance by itself. However, some
services by their very nature increase the power imbalance. Controlled egress units, units where
there is restricted patient mobility, or units where there are cognitive or psychological care needs
can all set the scene for the development of abusive power-based behaviours if the conditions
are not well managed.
Staff who have developed overly familiar and unprofessional approaches with patients can
quickly introduce a sense of duress where patients will feel forced to adopt certain behaviours to
gain favourable responses from staff and to be ‘liked’. This is different to staff who
‘loco-in-parentis’ offer a comforting hug or hand on the shoulder to a person who might be
feeling isolated; it is important not to vilify or inhibit a truly caring approach.
However, there are occasions where staff use punitive approaches to address behaviour,
changes in their levels of kindness and attention, withholding leave or introducing stigmatising
care. Patients become particularly vulnerable when other protective factors are removed, for
example, the meaningful involvement of relatives and family members, the use of safeguarding
processes, or individualised care adjustments. Additionally, the direct implementation of the
power of staff over patients, through physical and chemical restraints and seclusion can in turn
increase iatrogenic harms and promote the development of a closed culture.
An open dialogue, with genuine kindness, empathy and non-judgemental curiosity goes a long
way in supporting recovery, both for patients and their families.
2: Between staff and families:
Families are an utterly vital component within the ‘triangle of care’ and yet so often their views
are not meaningfully involved in care planning. Staff forget how exceptionally difficult it is for a
family to gain a rounded understanding of the care their loved one is receiving as they are only
able to physically connect on such an infrequent basis. This is where devices such as
smartphones can become an enormous battleground between staff, patients and families
(particularly in CAMHS).
Families are a vital source of insight and information; yes indeed, they may sometimes be part
of the problem, however, they are more often than not a large part of the solution. In a closed
culture, staff can hold significant power over families through both withholding information and
the exercising of unfounded judgements against them. Both can cause irreparable damage.
The best type of therapy, arguably, supports the notion that the ‘power’ of the therapeutic
relationship is held equally by both the patient and the therapist, that knowledge and the
therapeutic process is passed on so that individuals can be a participant in their recovery. This
is also true of families who are often left floundering when it comes to knowing what to do to
support their relatives. Collaborative work such as psychoeducation for families, family therapy
4. and attendance at all key meetings is so important in levelling up the power imbalance, thereby
promoting recovery.
3: Between staff:
A power imbalance amongst staff is not automatically driven by formal role hierarchy. Hierarchy
and omnipotence of personality can be more instrumental in a closed culture. A strong
personality can quickly become all-powerful within a unit, which can then quickly become
partisan and divided. An errant personality which thrives upon ‘playing people off’ against each
other can rapidly destroy team cohesion if left unchecked.
The worst of all cases is a unit where the errant personality happens to be in a leadership
position, say, for example, a ward manager or shift leader and that person thrives upon splitting.
New staff will often struggle to integrate into this culture; high turnover of newer staff is a key
indicator of a potentially closed culture. Very low turnover of staff, however, can also be
something to check out, as are all outliers on workforce statistics.
Lower-grade staff might be more vulnerable to the impact of partisan behaviours because of an
increased likelihood of the combination of low pay and less job security. Going with the flow and
not becoming too visible amongst the staff group can lead to compliant behaviours.
Influencing
Basic professionalism amongst staff often wanes in a closed culture. One member of staff
having a bad day can easily develop into an acceptance that it is OK to speak and even make
notes in permanent records in a detrimental manner about patients. Hostile views expressed
about patients can be so destructive, that even one unkind or frustrated comment about
someone could embed a sustained detrimental view of that patient, heavily influencing the care
and support they have the right to access.
Families can also be seen by staff as an impediment in a unit where there is a closed culture.
For every family which asks questions or applies scrutiny there are staff who judge them,
apportion blame towards them and deny them their rightful inclusion in the care and treatment of
their loved one; they are pathologised for expressing genuine views or asking questions.
Basic standards, basic care and basic kindness all contribute to ensuring professional
approaches in staff. Staff might feel that they are unable to deliver these responsibilities
because of poor staffing, poor estate, low pay, or lack of training, but the basic professionalism
and responsibility of care should be the concern of all staff. A lack of professionalism should be
treated on a strict disciplinary basis, at all times.
Operationalising a closed culture
In safety-intensive industries, such as aviation, shift patterns are closely monitored. Air traffic
control, for example, can work in shift patterns of between 5 to 8 hours with mandatory
total-stop breaks at every 120 minutes. It seems incongruous that on, for example, a high acuity
physical or mental health ward staff regularly work 12/13-hour shifts on consecutive days.
Planning an off-duty is not without difficulty, but the needs of staff and reducing the
administrative burden on managers should not override the needs of patients, who benefit from
a workforce who are rested and have resilience and the energy to cater to their needs.
5. We are often told that long shifts promote care continuity, and this may be so in some cases for
some patients. However, working long shifts in intense care environments, such as psychiatric
intensive care or CAMHS, can, over time, induce compassion fatigue amongst staff, a key
ingredient in a closed culture.
Ensuring good governance and adequate supervision of a unit is also key. However, if the chain
of command around a unit is equally implicated in the issue, what might the other indicators be?
· High number of complaints – a lot of complaints may well be the best indicator that
defects exist. A high number of complaints which are not upheld may well be a clear sign of
institutional defensiveness.
· Or… a low number of complaints – might indicate a culture which is ‘clamped’ where
complaints are dissuaded or not escalated. Vulnerable people might not want to speak out
for fear of retribution. Therefore, the extent of informal concerns or ‘sidebar’ conversations
should be very closely monitored,
· Incident reporting - low numbers of incidents reported, or significant variances in incident
reporting on different shift patterns or different days.
· General noise – where the culture of a unit is in question it is remarkable how easily this
spills into social media. This is a particular feature where patients and families have felt
powerless or feel their concerns have not been answered.
In services which might have been vulnerable to a closed culture, the Covid response may well
have helped to operationalise dysfunction. Not only were organisations forced to develop rapid
safety responses around lockdown, but staff and patients were also scared, working at
increased risk, and working differently. The impact of COVID-19 on trauma responses amongst
staff is not yet fully known and it seems unlikely that managing this trauma has been part of
standard processes in organisations.
Preventing closed cultures
Spotting a closed culture on a service visit or inspection is incredibly difficult. By their nature,
those units might have become adept at presenting a functional exterior. Equally, statistics alone
may not surface the issue. A mixture of hard and soft intelligence is required and the
development of a weighted trigger tool to spot such units is key.
Arguably, the single most important way of preventing the development of a closed culture is
through a good ward manager. A good ward (or unit) manager will exhibit role model behaviours
and will set the cultural standard. They will ensure that shift patterns are focused on effective
patient care and not convenience for staff (although we accept that this is not always possible).
Role model behaviours within the chain of command, all the way up to the board, are vital in
preventing, identifying and repairing closed cultures. Particularly in leadership positions, people
should be recruited partly on their values. They should be given specific training to enable them
to tackle difficult personalities and to lead with integrity and confidence.
When staff see a positive role model they want to emulate those behaviours. Staff gravitate to
the leader who feels ‘psychologically safe’. A closed culture develops when the leader who feels
6. ‘safe’ occupies that influential role without any of the values, skills, experience, and
self-discipline necessary to take people on the right journey.
Developed by Kate Jury, James Fitton and with Dr Nim Cave as guest editor.
[1] Malik RF et al. (2021) Open organisational culture: what does it entail?...BMJ Open vol 11,
issue 9