Search

Increased waste in health care is a widespread problem. Currently, modern clinical practices favour single-use products and pre-packaged supply kits. Many of these consist of various types of plastics. By weight, up to 25 per cent of total hospital waste is plastics. Common plastics used are polyethylene terephthalate, polypropylene, polyethylene, polyvinylchloride and polyurethane. Polyethylene terephthalate represents the highest volume, and accounts for 40 per cent of the plastics used in operating rooms. Health care has an enormous ecological footprint. Around the world, health care waste management strategies and clinician activities are starting to address how health care affects our planet and public health. Recovery of valuable waste, or product stewardship, is one of these strategies. In many countries, product stewardship in health care is still non-existent or unregulated. Clinicians and health service organisations must make product stewardship in health care an integral part of sustainable procurement and health care business activities. In addition, sustainable solutions require the engagement of suppliers of plastic packaging who can contribute to reducing waste in health care and minimising the impact of plastics on the environment and public health. [ABSTRACT FROM AUTHOR]

Background: Value-based healthcare provider reimbursement models have been proposed as an alternative to traditional fee-for-service arrangements that can align financial reimbursement more closely to the outcomes of value to patients and society. This study aimed to investigate stakeholder perceptions and experiences of different reimbursement systems for healthcare providers in high-performance sport, with a focus on fee-for-service versus salaried provider models. Methods: Three in-depth semi-structured focus group discussions and one individual interview were conducted with key stakeholders across the Australian high-performance sport system. Participants included healthcare providers, health managers, sports managers and executive personnel. An interview guide was developed using the Exploration, Preparation, Implementation, Sustainment framework, with key themes deductively mapped to the innovation, inner context and outer context domains. A total of 16 stakeholders participated in a focus group discussion or interview. Results: Participants identified several key advantages of salaried provider models over fee-for-service arrangements, including: the potential for more proactive and preventive models of care; enhanced inter-disciplinary collaboration; and the ability for providers to have a deeper understanding of context and how their role aligns with a broader set of priorities for an athlete and the organisation. Noted challenges of salaried provider models included the potential for providers to revert to reactive care delivery when not afforded adequate capacity to provide services, and difficulties for providers in demonstrating and quantifying the value of their work. Conclusions: Our findings suggest that high-performance sporting organisations seeking to improve primary prevention and multidisciplinary care should consider salaried provider arrangements. Further research to confirm these findings using prospective, experimental study designs remains a priority. [ABSTRACT FROM AUTHOR]

Interest in values work – the purposeful effort of actors to create, maintain and disrupt the values of organizations, professions and other institutions – is growing among scholars. We ask: How do frontline professionals engage in values work while enacting managerialist practices inside organizations? We investigate this question using a case study of nurses enacting managerialist practices associated with time-efficient work flow in a hospital emergency department in Australia. Our findings show that professionals engage in values work by categorizing the values of the profession and taking actions within the managerialist practice to (1) defend a superordinate value category, (2) contain erosion of a subordinate value category, and (3) integrate a basic value category. Our study brings attention to how multiple values complicate the processes of values work when particular values become implicated in organizational practices. Frontline professionals become motivated and take actions to accomplish values within a relational system of multiple values according to relative importance and relevance to the local context. Our study offers a way forward for understanding the performance of values work within the 'new normal' for professions in contemporary organizational contexts. [ABSTRACT FROM AUTHOR]