An evaluation of an action research nursing documentation project

AIMS AND OBJECTIVES: The aim of this study is to describe healthcare professionals' experiences and perceptions of an intervention implemented in an action research project conducted to improve nursing documentation practices in four municipalities in Norway.

BACKGROUND: Documentation of individualized patient care is a continuing concern in healthcare services and could impacts the quality and safety of healthcare. Use of electronic systems has made some aspects of documentation more comprehensive, but creation of an individualized care plan remains a pressing issue.

DESIGN: A qualitative descriptive design was used.

METHODS: An action research project was conducted between 2010 and 2012 to improve the content and quality of nursing documentation in community healthcare services in four municipalities. One year after the project was completed four focus group interviews were conducted with healthcare professionals, one for each involved municipality. Two unit managers were interviewed individually. Qualitative content analysis was used.

RESULTS: Three themes emerged: healthcare professionals perceived competing interest; they experienced that they had to manage complexity and changes; and they highlighted a clear and visible leader as important for success.

CONCLUSIONS: Quality improvement activities are essential. Healthcare professionals experience a complicated situation when electronic health record systems do not support workflow. Further research is recommended to focus on the functionality and user interface of EHR systems, and on the role of leadership when implementing changes in clinical practice. This article is protected by copyright. All rights reserved.

The role of IT governance in generating business value from IT investments in healthcare: lessons from an Australian experience

Digitizing the core processes of healthcare delivery is looked at as a solution to control the escalating costs without compromising quality or patient outcomes. However, to date the business value of such IT solutions remains elusive, especially in view of the high failure rate of many solutions coupled with the high user resistance. The uniqueness of the healthcare industry makes measuring the business value of IT a complex missions, yet it is the thesis of this research that such an activity is an essential first step if we are to realise the full potential of IT in healthcare. The role IT governance can play is of high importance to generate business value from IT investments in healthcare. This is investigated using an integrative model that is proffered to conceptualise the business value of IT in healthcare. This conceptual model is then used to guide an exploratory case study based at a leading private healthcare provider in Melbourne-Australia.

It is not that simple nor compelling! Comment on "Translating evidence into healthcare policy and practice: single versus multi-faceted implementation strategies - is there a simple answer to a complex question?"

Healthcare decisions are often made under pressure, with varying levels of information in a changing clinical context. With limited resources and a focus on improving patient outcomes, healthcare managers and health professionals strive to implement both clinical and cost-effective care. However, the gap between research evidence and health policy/clinical practice persists despite our best efforts. In an attempt to close the gap through behaviour change interventions, there has been a strong held belief that 'more is better,' without understanding the mechanisms and circumstances of knowledge translation (KT). We argue that even a single intervention or strategy in translating evidence into healthcare policy or practice is rarely simple to implement. Nor is the evidence compelling on the best approach. As Harvey and Kitson argued, designing and evaluating KT interventions requires flexibility and responsiveness. If we are to move forward in translation science then we need to use rigorous designs such as randomised controlled trials to test effectiveness of interventions or strategies with embedded process evaluations to understand the reason interventions do or do not work!

Collaboration and co-production of knowledge in healthcare: opportunities and challenges

Over time there has been a shift, at least in the rhetoric, from a pipeline conceptualisation of knowledge implementation, to one that recognises the potential of more collaboration, co-productive approaches to knowledge production and use. In this editorial, which is grounded in our research and collective experience, we highlight both the potential and challenge with collaboration and co-production. This includes issues about stakeholder engagement, governance arrangements, and capacity and capability for working in a co-productive way. Finally, we reflect on the fact that this approach is not a panacea, but is accompanied by some philosophical and practical challenges.

Investigating the use of IELTS in determining employment, migration and professional registration outcomes in healthcare and early chidlhood education in Australia

Focusing on two professional fields that are critical to Australia’s future – health and early childhood education – the study provides key insights into the many challenges facing overseas-trained professionals and international graduates transitioning into the Australian labour market.The study highlights the complex language requirements in the professions of medicine, nursing and early childhood education and explores the implications for stakeholders. Employers require graduates to have high-level English language skills, and universities are increasingly expected to ensure international students graduate with the required English language proficiency.Finally, the study highlights the many challenges facing overseas-trained/international graduates transitioning into the labour market. For participants in this study, the challenges of working in their profession in Australia are many and varied. These challenges include workplace discrimination, isolation and extreme frustration when unable to work in their area of qualification.