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Purpose: Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager's job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers' perceptions of, prerequisites for and experiences from the implementation of changes in their manager's work conditions. Design/methodology/approach: A grounded theory–based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis. Findings: Three thematic areas were identified: engagement, facilitation and achievement. The second-line managers' descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process. Originality/value: This study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up. [ABSTRACT FROM AUTHOR]

Aim(s): To ascertain nurses' perceptions about, and suggestions for, management solutions to workplace violence perpetrated by patients. Background: Violence towards nurses from patients in the workplace is high in Australia. There is a need for good management responses, and experienced nurses can provide logistical suggestions about effective strategies. Method(s): This study uses an exploratory qualitative design. Focus group interviews were undertaken with 23 nurses working in a regional public hospital in Queensland, Australia. The COREQ research reporting checklist was followed, and the qualitative data were transcribed and thematically analysed manually and by NVivo. Results: Policy implementation, training, staff movement, seclusion, debriefing and a full reporting cycle were identified as central themes. Workplace violence management happens before, during and after a violent event. Conclusion(s): Weak processes undermine management; staff training on de‐escalation is needed. Affected staff need freedom to move from the ward. Better medical orders should be in place before an event. A full debriefing and feedback cycle are required, along with easier reporting processes. Implications for Nursing Management: Nursing management can reduce violence by ensuring better institutional support, consistent follow‐up and complete feedback procedures. Legal support, follow‐up mechanisms and staff training in de‐escalation are key points. [ABSTRACT FROM AUTHOR]

Aims: To identify the organisational changes faced by front‐line nurses working with COVID‐19 patients during the first wave and describe how they responded to these changes. Background: The COVID‐19 pandemic has altered the provision of care and the management of health care around the world. Evolving information about SARS‐CoV‐2 meant that health care facilities had to be reorganised continually, causing stress and anxiety for nurses. Methods: Qualitative study based on Rapid Research Evaluation and Appraisal (RREAL). The research took place in hospital and community health settings of the Spanish national health system with a purposive sampling of 23 front‐line nurses. Semi‐structured interviews were conducted between May and June 2020. The duration was 30–45 min per interview. We used the Dedoose® data analysis software to perform a thematic analysis. Results: Nurses responded to organisational changes using the following strategies: improvisation, adaptation and learning. Conclusion: Our rapid approach allowed us to record how nurses responded to changing organisation, information that is easily lost in a disaster such as the COVID‐19. Implications for nursing management: Knowing about their strategies can help planning for future health disasters, including subsequent waves of the COVID‐19. [ABSTRACT FROM AUTHOR]

Objective: To study reasons for job satisfaction and dissatisfaction among interns. Design: Using a qualitative methodology, one‐to‐one interviews were conducted with interns. Setting: The study was based at a Victorian Rural Intern Training program. Participants: Twelve interns from the program were interviewed during their final rotation. Main outcome measures: Reasons for job satisfaction and dissatisfaction among rural interns. Results: Reasons for job satisfaction included feeling supported in the workplace as well as getting quality supervision, teaching and clinical exposure. Reasons for job dissatisfaction included poor access to administration, unduly stressful working situations, lack of support for mental health and well‐being, and poorly organised teaching sessions. Conclusion: The internship experience, together with the people they are influenced by, can determine a doctor's future career pathway. It is therefore vital for internship coordinators and hospital managers to facilitate a positive internship experience. The findings have implications for human resource management policy and practice in rural hospitals. [ABSTRACT FROM AUTHOR]

Background: Health information technology (IT) solutions can aid healthcare reform efforts, but without proper information management, these efforts are futile. In this study, we used Kuwait as an example of a high per-capita gross domestic product country that faces information management challenges to draw insights that can be generalised to other developed countries. Objective: (i) to uncover the status quo of information management practices in public hospitals and (ii) to offer recommendations to improve them. Method: This study analysed qualitative and quantitative accreditation-related data pertaining to the compliance with the information management standard at all secondary care public hospitals over two accreditation cycles. Results: Overall, public hospitals had made positive progress in their compliance with the information management standard. However, issues still existed with (i) developing and implementing an information management plan, (ii) involving the appropriate stakeholders in selecting health IT solutions and (iii) access to the Internet by staff and patients. Conclusion: Evidence underscored the importance of proper information management driven by clear centralised strategic plans. Implications: With the rapid adoption of digital health systems, the role of health information management leaders should not be undervalued. Embracing health IT solutions with strong information management practices can aid healthcare reform efforts. [ABSTRACT FROM AUTHOR]

Whether implicit or explicit, professional judgement is a central component of the many nurse staffing systems implemented in high-income countries to inform workforce planning and staff deployment. Whilst a substantial body of research has evaluated the technical and operational elements of nurse staffing systems, no studies have systematically examined the role of professional judgement and its contribution to decision-making. To explore nurses' use of professional judgement in nurse staffing systems in England and Wales. A cross-case comparative design centred on adult in-patient services in three University Health Boards in Wales and three National Health Service Trusts in England. Data generation was undertaken between January 2021 and March 2023 through stakeholder interviews, observations of staffing meetings, and analysis of documents and artefacts. Observations were undertaken in clinical areas but limited to three cases by COVID-19 restrictions. Analysis was informed by translational mobilisation theory. Two kinds of professional judgement were deployed in the nurse staffing systems: the judgement of clinical nurses and the judgement of senior nurse managers. The research highlighted the reflexive relationship between professional judgement and data, and the circumstances in which organisations placed trust in people and when they placed trust in numbers. Nurses' professional judgement was central to the generation of data, its interpretation and contextualisation. Healthcare organisations relied on the professional judgements of clinical nurses and senior nurse managers in making operational decisions to mitigate risk, where real-world understanding of the status of the organisation was privileged over formal data. Professional judgement had attenuated authority for the purposes of workforce planning, where data was a master actor. Nurses expressed concerns that strategic decision-making prioritised safety and efficiency, and formal measurement systems did not capture important aspects of care quality or staff wellbeing, which made it difficult to articulate their professional judgement. The implementation of staffing systems is resource intensive. Given limited evidence on which to recommend any specific methodology, the priority for future research is to optimise existing systems. If nurses are to deploy their professional judgement to proactively influence the conditions for care, as well as responding to the challenges of risk mitigation, there is a need for robust systems of nursing measurement aligned with agreed standards of care and a vocabulary through which these judgements can be articulated. Health systems depend on nurses' professional judgement for operational staffing decisions, but data is privileged over professional judgement for workforce planning. [ABSTRACT FROM AUTHOR]

Heart failure is a complex disease with poor outcome. This complexity may prevent care providers from covering all aspects of care. This could not only be relevant for individual patient care, but also for care organisation. Disease management programmes applying a multidisciplinary approach are recommended to improve heart failure care. However, there is a scarcity of research considering how disease management programme perform, in what form they should be offered, and what care and support patients and care providers would benefit most. Therefore, the Improving kNowledge Transfer to Efficaciously Raise the level of Contemporary Treatment in Heart Failure (INTERACT-in-HF) study aims to explore the current processes of heart failure care and to identify factors that may facilitate and factors that may hamper heart failure care and guideline adherence. Within a cross-sectional mixed method design in three regions of the North-West part of Europe, patients (n = 88) and their care providers (n = 59) were interviewed. Prior to the in-depth interviews, patients were asked to complete three questionnaires: The Dutch Heart Failure Knowledge scale, The European Heart Failure Self-care Behaviour Scale and The global health status and social economic status. In parallel, retrospective data based on records from these (n = 88) and additional patients (n = 82) are reviewed. All interviews were audiotaped and transcribed verbatim for analysis. [ABSTRACT FROM AUTHOR]

Background: Henri Fayol’s Classical Management Theory was based on an administrative vision marked by predictability, organisation, command, coordination, and control. To implement this administrative paradigm, fourteen general principles of management were defined. Objectives: To identify nurses’ representations of the current health administrative practices and analyse the extent to which these representations are in line with the principles of the Classical Management Theory. Methodology: Qualitative descriptive exploratory study. Data were collected using semi-structured interviews, with previously defined categories corresponding to the fourteen general principles of management. These interviews were conducted to eight nurses, with heterogeneous professional features and chosen by rational selection. Results: Interviewed nurses’ representations show that for them the current health administration is relatively close to the principles advocated by Fayol. Conclusion: The present study highlights that the discussion with nurses about changing the health work organisation is major when developing the best management strategies for the organisation of these professionals’ work. [ABSTRACT FROM AUTHOR]

Background: Job satisfaction has been shown to affect levels of staff retention and productivity, but few studies have been conducted on the work of occupational therapy managers and their job satisfaction. This study explores the roles and responsibilities of occupational therapy managers who are clinician-managers or manager-administrators, and sources of their work satisfaction. Methods: A collective case study involved telephone interviews with 16 occupational therapy managers. Semistructured interview questions were based on an earlier discussion with a separate group of occupational therapy managers. Interview transcripts were analysed for emerging themes. Results: There were no clear differences in the roles and responsibilities of the two types of managers (manager-administrators and clinician-managers); however, manager-administrators tended to be responsible for larger numbers of staff. Managers reported that taking a clinical caseload is often at their own discretion. A common challenge for managers is the balancing of priorities as a clinician and a manager. Managing people was a common source of joy and sometimes a source of frustration. Mediating between staff and senior management and the need for budget control and efficiencies was an important aspect of managers’ work, as was their autonomy to make decisions. Conclusions: Occupational therapy managers assume responsibilities consistent with clinician managers across disciplines. The main sources of work satisfaction related to people management particularly when staff were working effectively as a team and there was respect from senior management. Further research will confirm whether there are no obvious differences between clinician-manager and manager-administrators, and whether there are clear differences in work-related frustration across sectors. [ABSTRACT FROM AUTHOR]