Departmental Factors Research Articles

Factors Affecting the Response Time of Radiology Result Reading

Respond time is a common issue in healthcare practice. This problem also occurs in radiology services concerning the reading of radiology results to the expert interpretation process by radiologists. This study analyzes departmental and personal factors influencing the response time of radiology result readings at Murni Teguh General Hospital in Medan in 2021. This quantitative research study has a cross-sectional design and an analytical observational approach. The population includes all radiologists in the Radiology Department. Data is collected through questionnaires and documentation. Logistic regression is used for data analysis. The majority of radiology result readings have a poor response time (56.9%). Multivariate analysis reveals that departmental factors (image results and network) and personal factors (work schedule) significantly influence the response time of radiology result readings. However, there is no significant influence from departmental factors (teaching obligations) and personal factors (educational level and employment status) on the response time of radiology result readings. It is recommended that hospital management cultivate a collaborative and supportive environment among the technology and human resources working in the Radiology Department to improve the response time by the standards set by the ministry.

Understanding Healthcare Providers’ Care for Patients with Medications Treating Opioid Use Disorder in the Emergency Department: A Scoping Review

Background There is limited research exploring the changing clinical practices among healthcare providers (HPs) care for patients with Emergency Department (ED)-initiated Medication for Opioid Use Disorder (MOUD). Methods This scoping review followed the methodological framework of Arksey and O’Malley to map relevant evidence and synthesize the findings. We searched PubMed, EMBASE, CINAHL, Web of Science, and Scopus for related studies from inception through October 12, 2022. Following the application of inclusion and exclusion criteria, 16 studies were included. Subsequently, they were charted and analyzed thematically based on ecological systems theory. Results The main determinants in the four ecological systems were generated as follows: (1) microsystem: willingness and attitude, professional competence, readiness, and preference; (2) mesosystem: ED clinical practices, departmental factors; (3) exosystem: multidisciplinary approaches, discharge planning, and (4) macrosystem: stigma, health insurance, policy. The findings have implications for HPs and researchers, as insufficient adoption, implementation, and retention of MOUD in the ED affect clinical practices. Conclusions Across the four ecological systems, ED-initiated MOUD is shaped by multifaceted determinants. The microsystem underscores pivotal patient-HP trust dynamics, while the mesosystem emphasizes interdepartmental synergies. Exosystemically, resource allocation and standardized training remain paramount. The macrosystem reveals profound effects of stigma, insurance disparities, and evolving policies on treatment access and efficacy. Addressing these interconnected barriers is crucial for optimizing patient outcomes in the context of MOUD.

Theorizing Decision-Making in International Bureaucracies: UN Peacekeeping Operations and Responses to Norm Violations

Abstract Many international organizations (IOs) provide assistance to governments through country offices or peacekeeping operations. Sometimes, government authorities in countries receiving IO services violate norms that underpin the IO’s engagement. IO officials must then choose between confrontational and conciliatory responses. These responses are located on a spectrum that ranges from a firm and public response to silence and downplaying. How do IO officials decide on their response? Based on over 200 interviews with UN peacekeeping officials, we argue that the factors that shape their decision-making are found across three categories: individual, departmental, and positional. In terms of individual characteristics, previous experience, career security, and the length of service at a particular duty station matter. Regarding departmental factors, politicization of work, professional composition, and the type of interlocutors predispose departments to be supporters or critics of authorities in recipient countries. In terms of positional considerations, the place of a post or department in the IO hierarchy, relations with other IO entities, and the distance from the field play a role. While important in its own right, decision-making by civilian UN peacekeeping officials is informative about similar processes in other complex international bureaucracies that employ individuals from diverse backgrounds.

Timing of antibiotics in febrile children meeting sepsis criteria at a paediatric emergency department.

Delay in antibiotic administration in paediatric sepsis is associated with increased mortality and prolonged organ dysfunction. This pre-intervention study evaluated performance in paediatric sepsis management. Retrospective cohort study of febrile children admitted through the ED at The Children's Hospital at Westmead, Sydney, between 1 May and 31 July 2017. Participants were children aged 29 days to 60 months excluding children with simple febrile seizures, neonates and children who had received intravenous antibiotics elsewhere. We assessed the timing of antibiotic administration in children meeting local sepsis guidelines. We conducted a survey of clinicians in ED in 2018 to describe contributing factors. There were 160 febrile children admitted and 144 presentations were included in the analysis. Male 53% (n = 76); median age 20.1 months (interquartile range [IQR] 3.9-37 months). Thirty-seven (26%) febrile children met local sepsis criteria. The median time from triage to first dose of intravenous antibiotic was 109 min (IQR 62-183 min). Delay (>60 min) occurred in 26 (76%) children. Reported reasons contributing to delay included high patient load, long waiting times, difficult intravenous access, delayed prescribing, inadequate staffing and difficulty distinguishing between a viral infection and serious bacterial infection. There was frequent delay in administering antibiotics in children meeting local sepsis criteria, more commonly in young infants. Reasons contributing to delay were specific to young children along with departmental factors that will require addressing through targeted quality improvement interventions.

Giving It the Old College Try: Academic Departments and Undergraduate Curriculum Change in Political Science, 2009–2019

Thirty years after the last APSA-sponsored recommendations on the structure of the undergraduate political science major, new efforts at curriculum reform are under way. As a prelude to how the profession might respond, this article examines how political science departments made undergraduate curriculum changes during the 2010s. Based on a survey of department chairs in 2019–2020 (prior to the onset of the COVID-19 pandemic in the U.S.), one-half of political science programs changed major requirements in the previous five years and 70% made revisions during the decade. Most changes involved adding courses or tracks and modifying course sequences within the prevailing model of subfield distribution. Assuming departments are rational actors seeking to improve student learning and respond effectively to the educational marketplace, various explanations of curriculum change were tested. Structural variables (institutional type and departmental factors) had no significant effects. Nevertheless, the survey revealed learning-based (acquiring disciplinary knowledge, developing intellectual skills) and market-based (concern about enrollments) motivations for change, as well as institutional constraints. Among curricular alternatives to the distribution model, evidence indicated greater support for promoting liberal learning outcomes. Moreover, the civic engagement movement influenced departmental decision-making. However, few programs made curriculum changes related to diversity, equity, or social justice, notable concerns among students and within the discipline.

Challenges in Implementing Competency-Based Management in the Brazilian Public Sector: An Integrated Model

Studies have identified the interference of contextual factors that inhibit the effective implementation of Competency-based Management (CM) under the National Personnel Development Policy (NPDP) in the Brazilian public sector, though organizations have overcome these factors through various initiatives. This article proposes an integrated model that relates the factors that interfere with CM implementation with the initiatives adopted by public organizations to circumvent and overcome them. This qualitative study through documental research and interviews with those responsible for implementing CM in six organizations within the Brazilian public sector. Pre and post-categorical analysis have enabled the establishment of a relationship between the 20 categories identified and divided into four kinds of interfering factors and the 20 adopted initiatives identified in seven categories. It was identified that the organizational and departmental factors are the ones that most interfere with the implementation of CM in the public sector. The strategic role of the HR unit, capable of carrying out structural changes, was identified as the most important initiative to induce the implementation of CM. This study provides a model that integrates strategic, political, and instrumental thematics, showing how these aspects impact the effective implementation of CM, which helps HR managers to recognize the factors that are under their control and how to face them.

Determinants and barriers to junior faculty well-being at a large quaternary academic medical center: A qualitative survey

BackgroundIncreasing levels of burnout among trainees and faculty members at all levels is a major problem in academic medicine. Junior faculty members may be at unique risk for burnout and have unique needs and barriers that contribute to attrition, job satisfaction, and overall workplace well-being. MethodsTwenty-seven faculty members at the assistant professor level at a large, quaternary referral academic medical institution were interviewed. A qualitative analyst with no reporting relationship to faculty was used as the proctor. Seven scripted questions targeting faculty well-being and institutional barriers to well-being were administered, and the responses were coded for common themes between respondents. ResultsRespondents most commonly identified clinical work (26%), research (19%), and teaching (19%) as the best aspects of their job. Among respondents, 3% stated they were not able to devote as much time as they would like to work they enjoyed and found most meaningful. Of these respondents, 44% cited “insufficient help” as the root cause. Also, 33% stated time spent writing and managing institutional review board requirements was a major contributor, and 22% cited both clinical volume/performance benchmarks and administrative responsibilities as significant barriers. The most common responses to departmental factors that can be improved included moving meetings to during the workday versus after hours, establishing a similar value system/metric for all faculty, and providing more opportunities to interact with faculty across divisions. The most common barriers to change identified were difficulty hiring research support, patient volume and clinical demands, and a pervasive culture of continuing to work after the workday has ended. At an institutional level, provision of childcare and promotion of basic science research were identified as areas for improvement. More actionable items were identified at the departmental rather than institutional level (53 vs 34). ConclusionsJunior faculty well-being is most affected at the department level. Qualitative data collection from junior faculty regarding barriers to well-being and academic/clinical productivity can be invaluable for departments and institutions seeking to make cultural or systemic improvements.

A novel perspective on doctoral supervision

While supervision is often characterised as a relatively private relationship, we would argue it is strongly influenced by departmental, institutional, national and global factors. It is also intertwined with other academic work and life experiences – with time playing an important role, not just as regards lifecourse but also changing institutional policies and practices. Using this embedded dynamic perspective in a longitudinal institutional case study, we examined how individual supervisory practices, embedded within life experiences and the evolving policy contexts of supervision and other academic activities, changed over time. We found that changed institutional supervision expectations and related structures influenced supervisory thinking and actions. Future research could further examine how this dynamic perspective opens horizons for understanding individual supervisor change in light of new institutional expectations.

Development of the German version of the patient safety climate inventory to the Austrian context

ObjectivesIn recent years, patient safety culture (PSC) in hospitals, including its development and measurement, has increasingly received attention in Europe. Even though several instruments have been developed for PSC measurement...

Departmental leadership and peer pressure on academic research performance at universities in emerging countries: An empirical study in Vietnam

Research performance of lecturers in higher education institutions has become an important topic but many variables are still largely unexplored in current literature. The main objective of this study is to examine the impact of four leadership behaviors of department heads and coworkers on the lecturers’ research performance and the moderating effects of achievement value. A survey was conducted with a sample of 408 Vietnamese lecturers at economics and business management focused universities. Our findings contribute to the literature of job performance in higher education from an organizational behavior perspective by explaining the mid-level impacts of departmental factors affecting research performance. We also discuss potential implications and make recommendations for future research.

Involuntary psychiatric admissions initiated by two US police departments: a descriptive analysis

Purpose Police officers are increasingly interacting with individuals with mental illnesses. Officers who encounter these persons have three choices: detain, arrest and transport to a correctional facility; resolve the situation informally; or initiate an involuntary psychiatric admission. The decision to place someone under an involuntary psychiatric admission is based on a variety of factors. This paper aims to collaborate with two metropolitan Police Departments in South Florida to explore individual and departmental factors that contribute to involuntary psychiatric admissions initiated by their officers. Design/methodology/approach This investigation examined 1,625 police reports of involuntary psychiatric admissions in 2013, 2014 and 2015. Descriptive statistics for the entire sample were computed, and percentages of Crisis Intervention Team (CIT)-trained officers for both departments in each year were determined. Findings Results highlighted differences in rates of involuntary commitments, CIT-trained officers and associated variables (e.g. mental health diagnoses, substance use) between the two cities. Practical implications Implications of the findings, and directions that future research in this area might take, are discussed. Originality/value There is a dearth of literature pertaining to involuntary psychiatric admissions in general and factors specific to involuntary psychiatric admissions initiated by police. This paper adds preliminary findings and implications to this body of research.

The effects of leader expectation and coworker pressure on research engagement in higher education: the moderating role of achievement value

PurposeWhile being largely studied in organizational research, job engagement has rarely been empirically investigated in the context of higher education. In this study, this paper aim to examine the effects of leader performance expectation and coworker pressure on research engagement of lecturers and the moderation of achievement value.Design/methodology/approachThe authors based the survey on the data collected from public higher educational institutions in Vietnam.FindingsThe findings contribute to the literature of job engagement in higher education from an organizational behavior perspective by explaining the mid-level impacts of departmental factors affecting research engagement.Originality/valueThe authors develop an organizational behavior perspective related to middle-level factors to understand factors influencing one specific research job of lecturers in higher education in a non-Western developing nation.

The reasons women choose and stay in a geology major: a qualitative multi-case analysis

Despite earning half of all science and engineering undergraduate degrees between 2007 and 2016 in the USA, women were awarded only 39% of earth science degrees in the same time period. In order to better understand why women are both choosing and staying in geology programs, we conducted a multi-case study of nine current female undergraduate geology majors at a large public university in the USA within a department that is at gender parity among its undergraduate majors. The main data source was audio-recorded critical incident interviews of each participant. Data from the interviews were analyzed through an iterative coding process using codes adapted from previous studies that focused on factors both internal and external to the department. The students said that personal interests, influence by others outside of the department, and introductory classes attracted them to the geology program, but once declared, departmental factors such as relationship with faculty caused them to stay. We also found an emphasis on female role models, especially those teaching introductory courses. We believe this study offers important insights into the ways in which factors leading to recruitment and retention play out in the lived experiences of female geology majors.

Factors in Successful Humanities Integration: A Case Study of One Physical Therapist Education Program

Introduction. Humanities have been recognized as an effective pedagogical tool for developing professional behaviors and a patient-centered approach. Physical therapy education programs may aspire to add humanities to their curricula but lack knowledge of how to do it successfully. The purpose of this study was to examine methods of humanities integration and supporting factors contributing to success in one physical therapist education program. Methods. This research used a qualitative single case study approach. Seventeen participants from one physical therapist education program were interviewed, including faculty, students, and alumni. An onsite visit to campus also included review of artifacts and observations of campus events. Interviews were transcribed, coded, and analyzed for themes. Results. Four main themes emerged: learning about the human experience through real patient encounters, including narrative writing, guest speakers, and experiential learning; pedagogical approaches can increase successful use of humanities, including repeated exposure, explicitness about the benefits, and sensitivity to time constraints; strong support systems help with success of humanities integration, including culture, leadership, mentorship, and resources; and challenges remain in humanities integration, including lack of buy-in and comfort, time constraints, difficulty with assessment, and devaluing of the humanities by the profession. Discussion. Successful humanities integration may be cultivated by informed pedagogical approaches and attention to the institutional and departmental factors which support humanities. Conclusion. This study helps to guide programs looking to increase presence of humanities by providing an example of how the humanities are integrated throughout the curriculum at one physical therapist education program and the factors that have affected the success of the integration.

Turnover Intentions in the STEM Fields: The Role of Departmental Factors

The underrepresentation of women faculty in the STEM fields (Science, Technology, Engineering, and Mathematics) remains a persistent feature of academia, with turnover being a contributing factor. The departmental context is likely implicated in the decision to stay or leave, as it is one of the key defining features of faculty members’ work experiences. Using the job-demands resources theoretical approach, this study examines how four facets of university departments – department climate, department chair support, perceived injustice, and scholarly isolation – are related to turnover intentions among STEM tenure-system faculty, along with whether these relationships differ by gender. Data are from STEM tenure-system faculty at a mid-sized university located in the upper Midwest (N = 117 faculty members). The findings indicate each facet of the department is related to STEM faculty members’ turnover intentions, regardless of gender. Taken together, these findings suggest that improving the department atmosphere may enhance retention of men and women STEM faculty members alike.

4134 Report from the research trenches: A mixed-methods approach to investigation of how recruitment methods, culture and collaboration impact clinical trial accrual

OBJECTIVES/GOALS: The research project aimed to understand the perceived effectiveness of research recruitment methods, including informatics tool utilization, so that best practices can be established and outcomes measured longitudinally. METHODS/STUDY POPULATION: The mixed-methods study was conducted by the Oregon Clinical and Translational Science Institute, the CTSA at Oregon Health and Sciences University. A survey, clinical trial accrual data, and interviews were used to assess the study aims. The survey asked about utilization and value of specific recruitment tools and methods. Accrual data was obtained from the clinical trial management system and analyzed using parameters from the CTSA “Accrual Metric”. The metric was calculated for clinical trials enrolling during 2017. Interviews were conducted with researchers identified by the survey and over or under-enrolled accrual data, and inquired about recruitment facilitators and barriers. RESULTS/ANTICIPATED RESULTS: The most frequently mentioned facilitator of recruitment was direct patient contact, either in the healthcare setting (58.4% of survey respondents) or through patient outreach (32%). A lack of resources was considered a key barrier (21% of survey respondents) and a stated need (27%). Interview data expanded on these findings, as 23% of interviewees indicated a collaborative culture, which includes clinic integration, was key to recruitment success. Additionally, 20% of interviewees identified resources (i.e. funding, staff, time) as their greatest need. Notably, 13% of studies with an accrual ratio of “0” had frequent staff turnover. DISCUSSION/SIGNIFICANCE OF IMPACT: This approach allowed for a uniquely targeted analysis of accrual facilitators and barriers. Use of the CTSA accrual metric identified high-value interview respondents and will allow for investigation into additional accrual questions, such as the impact of funding sources and departmental factors.

Sociodemographic Factors Associated With Adherence to Referrals From the Pediatric Emergency Department.

Outpatient referrals constitute a critical component of emergency medical care. However, barriers to care after emergency department (ED) visits have not been investigated thoroughly. The purpose of this study was to determine the impact of sociodemographic variables on referral attendance after ED visits. A retrospective cohort study was designed. Patients aged 0-17years who visited the C.S. Mott Children's Hospital ED in 2016 and received a referral were included. Multiple referrals for 1 patient were counted as independent encounters for statistical analysis. Chart review was performed on 6120 pediatric ED encounters, producing a total of 822 referrals to University of Michigan Health System outpatient clinics. Referral attendance did not differ by race, ethnicity, language, or religion. Older age was associated with decreased attendance at referrals (p=0.043). Patients who were black and female (p=0.019), patients with public health insurance (p=0.004), and patients residing in areas with either high rates of unemployment (p=0.003), or lower high school education rates (p=0.006) demonstrated decreased attendance. Patients referred to pediatric neurology had lower attendance rates (p<0.001), and those referred to pediatric orthopedic surgery attended referrals more often (p=0.006). This study provides an overview of the impact of sociodemographic and departmental factors on attendance at outpatient follow-up referrals. Significant disparities exist with respect to referral attendance after emergency medical care. Informed resource allocation may be utilized to improve care for these at-risk patient populations.

Development of the Austrian version of the Hospital Survey on Patient Safety Culture

Abstract Background Patient safety culture in hospitals (PSC), as well as its measurement and development, have received plenty of attention in Europe in recent years. Several instruments have been developed for its measurement in European countries. As Austria does not have empirically reviewed questionnaires to measure PSC jet, the research question of this study was: Is the globally admitted American questionnaire “Hospital Survey on Patient Safety Culture (HSOPSC)” (Sorra &amp; Nieva, 2004) suitable for the healthcare system in Austria? Methods The HSOPSC contains 42 questions, which constituted twelve factors altogether. The pre-test was done with 101 health professionals. The online survey was conducted in ten public hospitals in 2017. Overall 1525 health professionals participated, which corresponded to a response rate of 23%. A new instrument, namely “Hospital Survey on Patient Safety Culture in Austria (HSPSC-AUT)”, was developed using the Exploratory Factor Analysis (EFA) and the Confirmatory Analysis (CFA). Results The factor structure of HSOPSC was not identical to the factor structure of HSPSC-AUT, developed in our study. The study showcased a new tool, HSPSC-AUT, with 30 items altogether, consisting of seven departmental factors, two hospital factors and one outcome factor. This new tool (HSPSC-AUT) showed pleasant results on the model, indicator, and construct level. The results of CFA for HSPSC-AUT (χ2 [360] = 1408.245, p = 0.0001) showed a better model compared to HSOPSC. The absolute and relative fit-indices showed excellent model adjustment (RMSEA = 0.049, SRMR = 0.041, GFI = 0.927, CFI = 0.941, TLI = 0.929). Conclusions The study presents a new instrument, HSPSC-AUT, for the measurement of PSC. According to the results, HSPSC-AUT (10-factor structure) has a better model fit than the original HSOPSC. This was confirmed by chi-square test, absolute and relative fit-indices, informational criteria, reliability, and construct validity. Key messages The development of an instrument for measuring safety culture is the first step leading to a better PSC. For this reason, HSPSC-AUT is recommended as an instrument to measure the PSC in Austria. Finally, it can be said that the development of a new questionnaire as well as the related measurements of validity and reliability have added value to science and practice.

Regional, institutional, and departmental factors associated with gender diversity among BS-level chemical and electrical engineering graduates.

Engineering remains the least gender diverse of the science, technology, engineering and mathematics fields. Chemical engineering (ChE) and electrical engineering (EE) are exemplars of relatively high and low gender diversity, respectively. Here, we investigate departmental, institutional, and regional factors associated with gender diversity among BS graduates within the US, 2010-2016. For both fields, gender diversity was significantly higher at private institutions (p < 1x10-6) and at historically black institutions (p < 1x10-5). No significant association was observed with gender diversity among tenure-track faculty, PhD-granting status, and variations in departmental name beyond the standard "chemical engineering" or "electrical engineering". Gender diversity among EE graduates was significantly decreased (p = 8x10-5) when a distinct degree in computer engineering was available; no such association was observed between ChE gender diversity and the presence of biology-associated degrees. States with a highly gender diverse ChE workforce had a significantly higher degree of gender diversity among BS graduates (p = 3x10-5), but a significant association was not observed for EE. State variation in funding of support services for K-12 pupils significantly impacted gender diversity of graduates in both fields (p < 1x10-3), particularly in regards to instructional staff support (p < 5x10-4). Nationwide, gender diversity could not be concluded to be either significantly increasing or significantly decreasing for either field.

A quantitative investigation of geoscience departmental factors associated with the recruitment and retention of female students

Women are underrepresented in many undergraduate geoscience programs. Some departments are more successful at recruiting and retaining female students than others. To understand why, we investigated potential differences between more and less successful geoscience departments in terms of social support, institutional supports, institutional barriers, perceived connection to instructors, and transformative experiences. We collected data from 2,041 undergraduate geoscience students enrolled in six geoscience departments at public, four-year institutions across the United States. We recruited two departments that were successful at graduating a high percentage of female students compared to the national average (high-success sites), two departments with a moderate percentage (medium-success sites), and two with a low percentage (low-success sites). Students at high-success sites reported greater institutional supports, greater perceived connection to instructors, and lower institutional barriers than did students at medium- and low-success sites. Nonmajors at high-success sites reported higher levels of transformative experience than nonmajors at low-success sites. No significant differences were found between medium- and low-success sites. Across all sites, female students perceived less of a connection to their instructors and endorsed a lower level of transformative experience than did male students. We did not find gender differences in terms of the other factors. We also did not find gender by site interactions, suggesting that the success of high-success sites in recruiting and retaining women was associated with supporting all students. These results suggest departments can increase effectiveness in recruiting and retaining female student by increasing institutional supports, reducing institutional barriers, connecting with students, and fostering transformative experiences.