Faiza Aljarameez, Chandni Saha, Mohammed Sinan, Loveson Rajan, G. Ahmed, A. A. Mutair
Improving retention of critical care nurses requires a better understanding of the perceptions and attitudes of this staff group towards structural empowerment and organisational commitment. This study aimed to assess the relationships between structural empowerment, organisational commitment and sociodemographic factors among critical care nurses. The study used a descriptive, cross-sectional, correlational research design. A convenience sample of 198 critical care nurses working in Saudi Arabia responded to a questionnaire, comprising the Conditions of Work Effectiveness Questionnaire-II, the Three-Component Commitment Model and a sociodemographic survey. Descriptive statistics and correlational analyses were conducted using the Statistical Package for the Social Sciences version 25, with a P value equal to or less than 0.05 considered statistically significant. Structural empowerment was significantly associated with organisational commitment. Employment in a private healthcare organisation, non-Saudi Arabian nationality, greater length of experience in nursing, more time spent in current working unit and average weekly working hours were significantly associated with higher organisational commitment and structural empowerment. Respondents in the higher salary bracket (over 15000 Saudi riyals per month) had significantly lower levels of organisational commitment and structural empowerment. Structural empowerment is a key predictor of organisational commitment and must be considered by managers and leaders seeking to improve retention. Further exploration of how factors such as nationality, salary and experience on empowerment and commitment is needed, so that policies can be developed accordingly.
提高重症护理护士的保留率需要更好地了解这一工作人员群体对结构授权和组织承诺的看法和态度。本研究旨在评估危重病护理护士结构授权、组织承诺与社会人口因素之间的关系。本研究采用描述性、横断面、相关性研究设计。在沙特阿拉伯工作的198名重症护理护士的方便样本回答了一份问卷，包括工作效率条件问卷- ii，三成分承诺模型和社会人口调查。描述性统计和相关分析使用Statistical Package for the Social Sciences version 25进行，P值等于或小于0.05认为具有统计学意义。结构授权与组织承诺显著相关。在私营医疗机构工作、非沙特阿拉伯国籍、护理经验较长、在当前工作单位工作时间较长和平均每周工作时间与较高的组织承诺和结构授权显著相关。高工资阶层(每月超过15000沙特里亚尔)的受访者在组织承诺和结构授权方面的水平明显较低。结构性授权是组织承诺的关键预测指标，寻求提高员工留存率的管理者和领导者必须考虑这一点。进一步探讨如何需要国籍、薪金和有关授权和承诺的经验等因素，以便制定相应的政策。
{"title":"Sociodemographic determinants of structural empowerment and organisational commitment among critical care nurses in Saudi Arabia: a comparative cross-sectional study","authors":"Faiza Aljarameez, Chandni Saha, Mohammed Sinan, Loveson Rajan, G. Ahmed, A. A. Mutair","doi":"10.12968/bjhc.2021.0167","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0167","url":null,"abstract":"Improving retention of critical care nurses requires a better understanding of the perceptions and attitudes of this staff group towards structural empowerment and organisational commitment. This study aimed to assess the relationships between structural empowerment, organisational commitment and sociodemographic factors among critical care nurses. The study used a descriptive, cross-sectional, correlational research design. A convenience sample of 198 critical care nurses working in Saudi Arabia responded to a questionnaire, comprising the Conditions of Work Effectiveness Questionnaire-II, the Three-Component Commitment Model and a sociodemographic survey. Descriptive statistics and correlational analyses were conducted using the Statistical Package for the Social Sciences version 25, with a P value equal to or less than 0.05 considered statistically significant. Structural empowerment was significantly associated with organisational commitment. Employment in a private healthcare organisation, non-Saudi Arabian nationality, greater length of experience in nursing, more time spent in current working unit and average weekly working hours were significantly associated with higher organisational commitment and structural empowerment. Respondents in the higher salary bracket (over 15000 Saudi riyals per month) had significantly lower levels of organisational commitment and structural empowerment. Structural empowerment is a key predictor of organisational commitment and must be considered by managers and leaders seeking to improve retention. Further exploration of how factors such as nationality, salary and experience on empowerment and commitment is needed, so that policies can be developed accordingly.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45050425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Promoting a shift from smoking tobacco to reduced-risk products—such as vapes and heat-not-burn tobacco—has the potential to ease the burden on healthcare resources, particularly health expenditure, if empirical evidence shows that reduced-risk products are an effective smoking cessation tool or can help to mitigate the risk of disease. However, there are notable variations in needs and provision of healthcare services between different regions. This article will explore this heterogeneity with the aim of understanding the different health impacts of switching from smoking to reduced-risk products across England, assessing the potential savings for the NHS and potential progress towards the goal of the country becoming smoke-free. This exploratory analysis of different sources of variation across regions offers policy insights to motivate further research.
{"title":"Does switching from tobacco to reduced-risk products free up hospital resources?","authors":"F. Moscone","doi":"10.12968/bjhc.2023.0046","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0046","url":null,"abstract":"Promoting a shift from smoking tobacco to reduced-risk products—such as vapes and heat-not-burn tobacco—has the potential to ease the burden on healthcare resources, particularly health expenditure, if empirical evidence shows that reduced-risk products are an effective smoking cessation tool or can help to mitigate the risk of disease. However, there are notable variations in needs and provision of healthcare services between different regions. This article will explore this heterogeneity with the aim of understanding the different health impacts of switching from smoking to reduced-risk products across England, assessing the potential savings for the NHS and potential progress towards the goal of the country becoming smoke-free. This exploratory analysis of different sources of variation across regions offers policy insights to motivate further research.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42597108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Value-based pricing of new medicines, when defined as pricing or reimbursement based on economic evaluation, requires the use of a threshold incremental cost-effectiveness ratio. Value-based pricing can leave little room for setting a price above zero for manufacturers of new life-extending add-on medicines that are used in combination regimens. This study aimed to present and explore different methodological approaches for pricing life-extending add-on medicines in this value-based pricing framework. The analysis demonstrated that excluding the costs of background therapy will create opportunity costs. A proportional division of the price can avoid opportunity costs. In the absence of information on relative health benefits, a counterfactual scenario of a head-to-head trial has suggested halving the price of background therapy in the relevant patient subgroups. Overall, the most plausible approach appears to be a proportional division of the total price of the combination therapy, in proportion to the health benefits of the add-on medicine and the background therapy.
{"title":"Value-based pricing of add-on life-extending medicines based on economic evaluation","authors":"A. Gandjour","doi":"10.12968/bjhc.2022.0031","DOIUrl":"https://doi.org/10.12968/bjhc.2022.0031","url":null,"abstract":"Value-based pricing of new medicines, when defined as pricing or reimbursement based on economic evaluation, requires the use of a threshold incremental cost-effectiveness ratio. Value-based pricing can leave little room for setting a price above zero for manufacturers of new life-extending add-on medicines that are used in combination regimens. This study aimed to present and explore different methodological approaches for pricing life-extending add-on medicines in this value-based pricing framework. The analysis demonstrated that excluding the costs of background therapy will create opportunity costs. A proportional division of the price can avoid opportunity costs. In the absence of information on relative health benefits, a counterfactual scenario of a head-to-head trial has suggested halving the price of background therapy in the relevant patient subgroups. Overall, the most plausible approach appears to be a proportional division of the total price of the combination therapy, in proportion to the health benefits of the add-on medicine and the background therapy.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44861249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Aurelio, Rita Araujo, Janeke Zoetmann, J. Moody, Amar J. Shah
Asthma in children and young people represents a substantial burden to the healthcare system, with these patients requiring frequent emergency care and having poorer health outcomes, leading to high system costs and poor patient experiences. This study used quality improvement methodology to achieve the triple aim of improved outcomes, better experience and reduced costs for those aged 0–16 years with asthma in north east London. A multidisciplinary project team used quality improvement methods to implement and assess two interventions: a community high-risk asthma clinic and educational asthma-friendly school groups, both of which were delivered by a specialist asthma nurse. Population-level outcomes included asthma control test scores, accident and emergency department admissions and costs. Intervention-specific outcomes included number of clinic consultations delivered, did-not-attend rates and participant confidence ratings following the school sessions. Accident and emergency admissions for asthma reduced by 52%, with a 50% reduction in average monthly acute care costs. Asthma control test scores improved significantly, from an average of 18.56 to 22.34 out of a maximum score of 25 (P=0.000) following the interventions. Participants in the asthma-friendly school groups reported increased confidence in both day-to-day and emergency asthma management at the end of their sessions. Having dedicated specialist asthma nurse input in the community and using school-based interventions can help to improve asthma care for children and young people, reducing the burden of frequent accident and emergency department admissions. Using quality improvement methods in pursuit of triple aim outcomes can help teams to work towards a shared goal.
{"title":"Using quality improvement to tackle the triple aim for children and young people with asthma: improving outcomes, experience and costs","authors":"M. Aurelio, Rita Araujo, Janeke Zoetmann, J. Moody, Amar J. Shah","doi":"10.12968/bjhc.2022.0101","DOIUrl":"https://doi.org/10.12968/bjhc.2022.0101","url":null,"abstract":"Asthma in children and young people represents a substantial burden to the healthcare system, with these patients requiring frequent emergency care and having poorer health outcomes, leading to high system costs and poor patient experiences. This study used quality improvement methodology to achieve the triple aim of improved outcomes, better experience and reduced costs for those aged 0–16 years with asthma in north east London. A multidisciplinary project team used quality improvement methods to implement and assess two interventions: a community high-risk asthma clinic and educational asthma-friendly school groups, both of which were delivered by a specialist asthma nurse. Population-level outcomes included asthma control test scores, accident and emergency department admissions and costs. Intervention-specific outcomes included number of clinic consultations delivered, did-not-attend rates and participant confidence ratings following the school sessions. Accident and emergency admissions for asthma reduced by 52%, with a 50% reduction in average monthly acute care costs. Asthma control test scores improved significantly, from an average of 18.56 to 22.34 out of a maximum score of 25 (P=0.000) following the interventions. Participants in the asthma-friendly school groups reported increased confidence in both day-to-day and emergency asthma management at the end of their sessions. Having dedicated specialist asthma nurse input in the community and using school-based interventions can help to improve asthma care for children and young people, reducing the burden of frequent accident and emergency department admissions. Using quality improvement methods in pursuit of triple aim outcomes can help teams to work towards a shared goal.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48970575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Low- and middle-income countries have inadequate access to high-quality medical and surgical care; as a result, over 8 million lives are lost every year in these countries. Lack of high-quality surgical care not only leads to poor health outcomes, but also has significant economic implications. Therefore, increasing surgical capacity in low- and middle-income countries is one of the most important global surgical issues. The NHS can play a significant role in alleviating these issues. Among surgeons, there is a growing interest in volunteering for global surgery initiatives, and engagement in these programmes can have important benefits for both the NHS itself and its staff. A significant consideration for volunteers is whether they can obtain time off their usual role to participate in global surgery initiatives, while balancing NHS service provision needs. This article discusses practical options for facilitating surgeon engagement in international development.
{"title":"Innovative job planning to facilitate UK surgeon engagement with international development","authors":"T. Gana, S. Boyes, Lesley Hunt","doi":"10.12968/bjhc.2022.0045","DOIUrl":"https://doi.org/10.12968/bjhc.2022.0045","url":null,"abstract":"Low- and middle-income countries have inadequate access to high-quality medical and surgical care; as a result, over 8 million lives are lost every year in these countries. Lack of high-quality surgical care not only leads to poor health outcomes, but also has significant economic implications. Therefore, increasing surgical capacity in low- and middle-income countries is one of the most important global surgical issues. The NHS can play a significant role in alleviating these issues. Among surgeons, there is a growing interest in volunteering for global surgery initiatives, and engagement in these programmes can have important benefits for both the NHS itself and its staff. A significant consideration for volunteers is whether they can obtain time off their usual role to participate in global surgery initiatives, while balancing NHS service provision needs. This article discusses practical options for facilitating surgeon engagement in international development.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48005845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"One-fifth of adults in England will have a major illness by 2040: a reflection for healthcare managers","authors":"I. Clough","doi":"10.12968/bjhc.2023.0094","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0094","url":null,"abstract":"","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45211997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In memory of monica duncan, 1950–2023","authors":"I. Clough","doi":"10.12968/bjhc.2023.0086","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0086","url":null,"abstract":"","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42486423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Building a sustainable healthcare workforce through innovative social partnerships","authors":"N. Muir","doi":"10.12968/bjhc.2023.0050","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0050","url":null,"abstract":"","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49257907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wound care represents a significant cost burden for the NHS. Four experts from the University of Salford discuss the key principles of frugal innovation in wound care, and their practical implications for UK services.
{"title":"Frugal innovation in wound care: the five Rs","authors":"M. Stephens, M. Wynn, Sheba Pradeep, L. Ackers","doi":"10.12968/bjhc.2023.0061","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0061","url":null,"abstract":"Wound care represents a significant cost burden for the NHS. Four experts from the University of Salford discuss the key principles of frugal innovation in wound care, and their practical implications for UK services.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48509176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health writer Francesca Ramadan provides an overview of the implications of continuous glucose monitoring and ‘flash’ monitoring for patient care and costs, ahead of the upcoming National Institute for Health and Care Excellence guidelines.
{"title":"Continuous glucose monitoring: key points for healthcare managers","authors":"F. Ramadan","doi":"10.12968/bjhc.2023.0071","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0071","url":null,"abstract":"Health writer Francesca Ramadan provides an overview of the implications of continuous glucose monitoring and ‘flash’ monitoring for patient care and costs, ahead of the upcoming National Institute for Health and Care Excellence guidelines.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47920690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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