Delayering Research Articles

The Conceptual Framework for 360 Degree Feedback: Objectives, Requirements, and Conditions for Success

360-degree feedback is the process of collecting and measuring co-worker feedback from multiple sources. The descriptive objectives of this study to discussed the conceptual framework of the 360-degree feedback method, which is part of an extensive study conducted by the researcher. Objectives: presenting the concept of the feedback method, defining the objectives of the method, discussing the reasons for use, the advantages and disadvantages of the method, application requirements, and finally the conditions for the success of the feedback (360) degrees. The study adopted the descriptive analytical approach, and the method of collecting quantitative. The results showed that the objectives of the method are useful for work and career development, including self-development, leadership development, management and implementation development, identifying the training needs of employees, reducing traditional performance appraisal errors, and introducing the individual to his or her level of performance. As for the reasons that led to the use of the method, they are: the transformation of companies from hierarchical organization to horizontal organization, widening the scope of supervision, obtaining broader points of view, improving the school climate based on justice. Among the advantages are for revealing the gap between the individual's perspective in evaluating his or her performance, and the perspective of others for this performance, building training programs for employees, enhancing the orientation towards teamwork and exchanging experiences, helping to make decisions related to promotion and wage increase. As for the defects, they included: the possibility of being affected by various biases, such as the halo effect, the recency bias, the indulgence bias, in addition to the employees' reluctance to provide negative feedback even if it was honest, the delay in the feedback process, and low participation rates. The errors were limited to (13) errors that may occur when using this method. As for the requirements, they included: defining objectives, defining target individuals. Determine the method of analyzing the information, carrying out an awareness and communication campaign, and following up the implementation accurately. Among the conditions for the success of the assessment: that the feedback is done honestly in the light of specific objectives, adopt impartiality, objectivity, scientific and professional properly. Focus on the performance, not the person. Taking into account the feelings of workers when providing negative feedback. It should be comprehensive and provide positive and negative feedback. Share external sources.

Sustainable employability of long-term care staff in self-managing teams: A qualitative study.

To discover what long-term care (LTC) staff working in self-managing teams consider necessary to remain sustainably employable. Qualitative study with semi-structured interviews. In 2020, semi-structured interviews were conducted one-on-one with 25 LTC workers from a medium-large Dutch organization providing long-term care. All interviews were audio-recorded, anonymously transcribed verbatim and analysed with thematic content analysis in the software program Atlas.ti. LTC workers indicated a need for autonomy. They wanted their control and involvement in decisions to be strengthened. Furthermore, LTC workers indicated a need for relatedness, by experiencing support, a feeling of togetherness and more time to have attention for the residents. Lastly, LTC workers expressed a need for (assistance in) further developing their competence. In order to remain willing and able to work, LTC workers in self-managing teams want their needs for autonomy, relatedness and competence to be addressed. Working conditions are important to these LTC workers' sustainable employability since they can hinder or promote the satisfaction of their needs. It is important that management in LTC is aware of the importance of LTC workers' needs for sustainable employability. We recommend that management critically reflect on and invest in addressing these needs by enhancing indicators and limiting inhibitors of the needs. A robust LTC workforce is necessary to provide care to the aging population. In the context of the increasing implementation of self-managing teams in LTC organizations, understanding what workers in self-managing teams need in order to remain sustainably employable is crucial. For sustainable employability (i.e. to remain willing and able to work), interviewees indicated a need for autonomy, relatedness, and competence. Nearly all participants stressed the importance of belonging and feeling connected. Working conditions seemed to relate not only directly to the sustainable employability of LTC staff but also indirectly through their lack of contribution to the satisfaction of workers' psychological needs. The outcomes of this study primarily impact workers and management within LTC organizations with self-managing teams. They benefit from recognizing the significance of addressing workers' needs to ensure their essential and sustainable employability in the sector. The Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative (COREQ) research were used. Two LTC workers provided advice and feedback regarding the materials and set up of the interviews. These two ambassadors additionally helped in reaching our population, by disseminating information about the study.

A Socio-Emotional Framework to Understand Engagement in Engineering Student Project-Teams

Project-based design courses typically involve self-managed teams whose goal is to develop solutions to open-ended engineering problems. Due to their collaborative nature, team-based design courses are largely effective only if students participate and are engaged with both individual and team level learning and tasks. Despite efforts to improve team effectiveness, low engagement persists as a critical issue in engineering student project-teams. In this work, we present a socio-emotional conceptual framework to better understand how team member interactions affect the engagement of team members within engineering-student project-teams over time. It is proposed that this framework will be used to investigate previously overlooked characteristics of a team's social climate (including task interdependence, intra-team trust, and psychological safety) which may affect student engagement in the engineering project-team context. It is anticipated that this framework will provide novel insight into the social climate of the team environment and its effects on student engagement. Through better understanding these phenomena, we will be able to design curriculum to leverage this understanding and improve student engagement at a course-wide level.

Emergent leadership in agile software development teams: leader identification through network analysis and aggregation approaches

PurposeAgile project teams are self-managing and self-organizing teams, and these two characteristics are pivotal attributes of emergent leadership. Emergent leadership is thus common in agile teams – however, how these (informal) emergent leaders can be identified in teams remains far from understood. The purpose of this research is to uncover techniques that enable top management to identify emergent agile leaders.Methodology/designWe approached six agile teams from four organizations. We employ social network analysis (SNA) and aggregation approaches to identify emergent agile leaders.Design/methodology/approachWe approached six agile teams from four organizations. We employ SNA and aggregation approaches to identify emergent agile leaders.FindingsSeven emergent leaders are identified using the SNA and aggregation approaches. The same leaders are also identified using the KeyPlayer algorithms. One emergent leader is identified from each of the five teams, for a total of five emergent leaders from the five teams. However, two emergent leaders are identified for the remaining sixth team.Originality/valueEmergent leadership is a relatively new phenomenon where leaders emerge from within teams without having a formal leadership assigned role. A challenge remains as to how such leaders can be identified without any formal leadership status. We contribute by showing how network analysis and aggregation approaches are suitable for the identification of emergent leadership talent within teams. In addition, we help advance leadership research by describing the network behaviors of emergent leaders and offering a way forward to identify more than one emergent leader in a team. We also show some limitations of the approaches used and offer some useful insights.

The mediating role of employee performance in the relationship between human resource management (HRM) practices and police service effectiveness

PurposeThe efficiency of each of an organization’s individual workers determines its effectiveness. The study aims to explore the relationship between human resource management (HRM) practices and organizational effectiveness with employee performance as a mediating variable.Design/methodology/approachData were collected from 800 police officers in the Greater Accra and Tema regions. The data were supported by the hypothesized relationship. Construct reliability and validity was established through confirmatory factor analysis. The proposed model and hypotheses were evaluated using structural equation modeling.FindingsThe results show that career planning and employee performance were significantly related. Self-managed teams and employee performance were shown to be nonsignificantly related. Similarly, performance management and employee performance were shown to be nonsignificantly related. Employee performance significantly influenced organizational effectiveness. The results further indicate that employee performance mediates the relationship between HRM practices and organizational effectiveness.Research limitations/implicationsThe generalizability of the findings will be constrained due to the research’s police service focus and cross-sectional data.Practical implicationsThe study’s findings will serve as valuable pointers for the police administration in the adoption, design and implementation of well-articulated and proactive HRM practices to improve the abilities, skills, knowledge and motivation of officer’s to inordinately enhance the effectiveness of the service.Originality/valueBy evidencing empirically that employee performance mediates the relationship between HRM practice and organizational effectiveness, the study extends the literature.

Tactics and team development: study reveals positive and negative impacts of six tactics at early and later group stages

PurposeThis paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies.Design/methodology/approachThis briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.FindingsResearchers based in Israel analyzed the use of six different tactics to get the most out of 75 self-managed teams. The results showed that at early stages of team development, it was detrimental when a high proportion of team members used “assertiveness”. But, at advanced stages of team development, it was more detrimental when a high proportion of team members used “ingratiation”Originality/valueThe briefing saves busy executives, strategists and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

(258) Trends in Prevalence, Incidence and Pharmacological Prescriptions for Premature and Delayed Ejaculation – A Claims Database Analysis

Abstract Introduction Premature (PE) and delayed (DE) ejaculation are common male sexual dysfunction disorders. Despite a community-reported prevalence of approximately 30% for PE and 5% for DE, the clinical prevalence, incidence, and rates of pharmacological prescriptions for both disorders remain under-investigated in the literature. Objective Our objective is to assess the trends in prevalence, incidence, and pharmacological treatment of PE and DE using a large claims database. Methods The TriNetX Research database, a large insurance claims database, was queried to identify all adult (≥18 years) males that were evaluated from January 2012 through December 2022. The number of men diagnosed with PE (ICD-10 F52.4) and DE (F52.32 and N53.11) was compared to the total number of men evaluated using six-month intervals (January-June, July-December) to calculate percent prevalence and incidence. A chi-squared test of linear trends was performed for prevalence and incidence. Rates of prescribed treatments were calculated comparing the number of men receiving the treatment to the total number of men with the assessed disorder using six-month intervals for PE and one-year intervals for DE. Results A total of 17,647 adult males with a diagnosis of PE and 6,304 adult males with a diagnosis of DE were identified from January 2012 to December 2022. The prevalence and incidence for both disorders are found in Figure 1. The chi-square test for trends showed a significant increasing trend in the prevalence of PE (χ2 = 303.44, p-value = <0.0001) and DE (χ2 = 314.14, p-value = <0.0001) and incidence of PE (χ2 = 6.40, p-value = 0.0114) and DE (χ2 = 187.43, p-value = <0.0001). In the final period, 63.5% males with PE and 33.4% males with DE received at least one medication of the investigated therapies. The most common medications prescribed to men with PE were phosphodiesterase-5 inhibitors (25.7%), paroxetine (17.4%), topical anesthetics (13.4%), and sertraline (12.2%). The most common medications prescribed to men with DE were testosterone (11.7%), bupropion (12.2%), and cabergoline (10.0%). The prescription rates of all of the investigated medications for PE and DE are shown in Figures 2 and 3, respectively. Conclusions In this large US claims database analysis, premature and delayed ejaculation are overall diagnosed at low but increasing rates. Furthermore, the rates of pharmacological prescriptions for PE remains relatively low, despite pharmacotherapy being recommended as first-line options under the current guidelines. Additional research is necessary to investigate the long-term efficacy of individual medications for both PE and DE. Disclosure No.

Psychological safety climate and self-managing team innovation process: The role of constructive controversy and authority differentiation.

Psychological safety climate and self-managing team innovation process: The role of constructive controversy and authority differentiation.

Supplemental Material for Psychological Safety Climate and Self-Managing Team Innovation Process: The Role of Constructive Controversy and Authority Differentiation

Supplemental Material for Psychological Safety Climate and Self-Managing Team Innovation Process: The Role of Constructive Controversy and Authority Differentiation

Beyond democratic degeneration, horizontal and liberated organization? The agonistic approach of a Belgian food co-op

This research focuses on democratic organizations and the risk of degeneration. The author studies how horizontal management may maintain a democratic organization’s stability through the examination of a Belgium food cooperative with democratic governance. The article reaches two main conclusions. First, it concludes with a simple empirical finding: horizontal organization does not necessarily prevent degeneration. However, it stresses that implementing horizontal management in democratic organizations allows for daily members’ politicization and then the organization’s pluralization. Second, it proposes a theoretical contribution for a better understanding of democratic degeneration. In a horizontally organized structure, the degeneration process differs from what is typically noted in the literature, as it is triggered by the politicization of the members. Therefore, an agonistic reinterpretation of the traditional degenerative stages is proposed: (1) fusion, (2) pluralization, (3) conflictualization, and (4) centralization.

Self-managed project teams consist of three key factors that influence their effectiveness: trust, understanding, and power

Self-managed project teams consist of three key factors that influence their effectiveness: trust, understanding, and power

Coaching Leadership in Small Scale Normalized Living

Our human resources policy not only seeks to anticipate current developments but also wishes to play a pioneering role. This starts with a strong vision in which employees are partners in the organization of care and not mere suppliers of care. Where giving and taking responsibility, open communication and autonomy in connection are realized (and not hollow concepts). This also means that we are a flat organization where there are few or no hierarchical structures. The demand from employees for more collaboration, a different model of leadership, the convergence of responsibilities and authority was a clear message for us to tackle the organization thoroughly. A good organization is crucial for a company to function well. This includes having competent employees, sufficient finances and adequate equipment.
 Innovative labor organization
 According to the IAO (Innovative Labor Organization) method, we want to examine in each of the four residential care centers how we can come to a team that has sufficient regulatory capacity to
 
 work autonomously with responsible employees;
 ensure the quality care that we use in our vision;
 have sufficient manageability and flexibility for this;
 create more innovative capacity;
 with sufficient participation;
 in mutual cooperation.
 
 Step by step we discovered that the IAO fits seamlessly with the operating principles of Small Scale Normalized Living. From our strong belief in the power of the capacities and competencies of employees and the continuous will to invest in employees, the step to this new organizational model is a logical next step. An obvious choice that also led to confrontations: how do we distribute tasks and responsibilities in the organization today? Do we really give employees the necessary autonomy that they need? Do we let employees shine sufficiently in all their potential? Do we involve them in those processes in which they need to be involved? Which sub-processes run centrally or decentralized?
 With a critical eye and the constant desire to improve, we laid the foundation for the care model of the future.

“Respect my authority”: spiritual self-managed teams and holacracy

PurposeThis paper aims to introduce two draft concepts, spiritual self-managed teams and holacracy, as solutions for reducing the friction within neo-enterprises and the issues of hierarchical leadership dynamics and mindset present within orthodox organizations’ structures and communications and they help businesses to grow further, achieve their goals, and become self-sustainable.Design/methodology/approachTo counter the popular maxim, “management and leadership are what cause many problems for organizations and its people,” the authors argue for six novel propositions constructed around the two draft concepts following a critical review and meta-analysis of notable business/leadership cases, presented in a narrative-based descriptive style.FindingsThis article presents a list of novel propositions for entrepreneurs, managers and researchers who may investigate further and possibly test it in organizations. The findings merit opening new frontiers for perceiving leadership, group dynamics and decision-making in organizations using spiritual ideas.Originality/valueAdopting the paper’s content can benefit organizations’ management, efficiency and sustainability. Implementation of the two novel concepts – spiritual self-managed teams and holacracy – and their combination can significantly reduce friction within organizations’ structures and communications.

Developing a person-centred care environment aiming to enhance the autonomy of nursing home residents with physical impairments, a descriptive study

BackgroundEnhancing autonomy is important within the context of the care environment in nursing homes. A nursing home is a place for older adults with physical impairments, who need assistance, to live and where staff work who help them to exercise autonomy. Previous research shows that older adults and staff are influenced by the care environment to apply autonomy-enhancing activities. Therefore, organisational policies regarding the care environment seem promising for enhancing autonomy. The aim is to gain a deeper insight into the development and implementation of organisational policies aimed to enhance the autonomy of older adults with physical impairments.MethodsA qualitative descriptive design was chosen, using two methods. A document study was conducted on the policies, plans and proceedings in two care organisations. Moreover, interviews were conducted with 17 stakeholders involved in the policies, such as managers and members of the client council. The fragments of the 137 documents and 17 verbatim transcripts were coded and deductively categorised into the seven aspects (i.e., power-sharing, supportive organisational systems, appropriate skill mix, potential for innovation and risk-taking, the physical environment, effective staff relationships and shared decision-making systems) of the key domain care environment, as defined in the person-centred practice (PCP) framework developed by McCormack and McCance.ResultsThe aspect of power-sharing was used the most in the policies of the two participating organisations. The organisations expected much from the implementation of indirect interventions, such as access to the electronic care plan for residents and the development of staff towards self-managing teams. Less attention was paid to interventions in the physical environment, such as the interior of the building and privacy, and the collaboration processes between staff.ConclusionsThe PCP framework poses that all aspects of the key domain care environment are important to develop a person-centred practice. This is not yet the case in practice and the authors therefore recommend using all seven aspects of the care environment in a balanced combination with the other key domains of the PCP framework to achieve person-centred practice and as a result the enhancement of the autonomy of nursing home residents with physical impairments.

The Impact of Trust, Understanding and Power on Self-managed Teams

Local administrations and companies rely on committed and self-reliant employees to achieve their goals. However, there is limited research on how influencing factors such as trust, understanding, and power affect self-managed teams. This study investigates the modes of interaction of these factors on the team structure within self-managed teams in IT departments and service providers of different German public administrations. The research methodology was a quantitative online survey comprising validated items from standardised test procedures to measure the influence factors. A total of 246 data sets were analysed by regression and mediator analysis. The study found significant positive effects of trust and power on understanding and a mediator effect of power on the relationship between trust and understanding. In conclusion, investments in team member empowerment in low-trust environments can be recommended to improve understanding more significantly than in high-trust situations.

An ERP implementation on a beekeeping and honey value chain

Goal: This research represents a case study on the selection and implementation of ERP systems in the beekeeping and honey production sector, developing a decentralized and digital system accessible to every stakeholder in a cooperative based in the province of Buenos Aires, Argentina. Methodology: The work develops an in-depth analysis of the beekeeping activities and how farmers participate and interact with the cooperative. This enables to distinguish the main features and specifications that an ERP system must have to give proper support to the business functions within the cooperative. Results: This implementation made it possible to make the production process more flexible, improve the traceability of production batches, and reduce costs in the business operation. Limitations: To generalize the results, other experiences from similar organizations should be incorporated. In addition, it would be convenient to reassess the situation when the implementation is fully developed, since this article presents the implementation of essential and critic modules for the operation of the organization. Practical implications: A special feature of this study is that the organization is structured as a cooperative, then each producer is a stakeholder in the system meaning that the decision-making processes are decentralized and transparent to each stakeholder. Originality: This study represents a novel development in using cloud and digital technologies to leverage and foster horizontal organizations such as cooperatives. Digitalization enables to share the information and decisions made by each of the stakeholders, something that strengthens the main purpose of cooperatives. As far as we know, there are no previous studies on developing ERP systems for an agricultural cooperative.

Soil and Water Losses with Simulated Rainfall Considering Experimental Plots and Rainfall Patterns

Rainfall simulators are important pieces of equipment to investigate hydrological processes and soil erosion. Here, we investigated the operational characteristics, the rainfall characteristics, and the soil erosion process under collecting plots and rainfall patterns using the InfiAsper simulator. We evaluated the standard plot of the simulator in a rectangular shape (1.0 × 0.7 m), as well as a circular plot (0.8 m diameter), and four precipitation patterns, characterized as advanced (AV), intermediate (IN), delayed (DL), and constant (CT). In the laboratory, uniformity and water consumption tests were carried out for shutter-disk rotations from 138 to 804 rpm, and in the field, simulated rains were applied on a Dystric Acrisol. Rains with different patterns were simulated and presented a uniformity coefficient above 83% for the circular plot and 78.2% for the rectangular plot. The soil erosion varied as a function of the precipitation patterns and, to a lesser extent, according to the shape of the experimental plot. However, runoff and soil loss in AV were 2.1 and 3.5 times greater when using a circular plot. Concerning IN and DL, the length of the rectangular plot may have influenced the formation of small furrows throughout most of the simulated rainfall event, providing greater runoff (13.1 mm) and soil loss (13.6 g m−2). The results obtained are promising, but plots with different shapes associated with rainfall patterns simulated by InfiAsper must be evaluated in other classes and soil use and cover conditions.

Perceived contribution of a hybrid serious game to the development of collaborative problem solving among undergraduate nursing students: A mixed method design

BackgroundCommunity health nurses collaborate in teams to address client care, organise services, and conduct preventive activities. Hence, it is crucial for students in this work context, to practise and enhance their collaborative problem-solving (CPS) skills. To facilitate this, a hybrid serious game called "Carion" was developed, immersing second-year nursing students in a semester-long experience of working as district nurses in self-managed teams. The game challenges them to collectively tackle authentic and fictional problems. However, the extent and manner in which this hybrid serious game contributes to students' CPS skill development is unknown. AimThe aim of this study is to explore how students perceive the development of CPS by doing assignments carried out in the learning context of the hybrid serious game Carion. ParticipantsTwo teams each consisting of five second-year nursing students, were selected for the qualitative case study. Two lecturers acting as team coaches also participated in this study. 110 (response rate 61 %) second-year students participated in the quantitative survey at the beginning of the semester, 109 students at the end of the semester. MethodsThe study is a mixed method design. The qualitative component involves a case study while the quantitative component consists of an online survey. Qualitative and quantitative data regarding collaborative problem solving was collected at different time points using focus group interviews, one-on-one interviews, digital logbooks and an online self-assessment tool. ResultsQualitative analysis revealed insights into three key themes: (1) Collaboration, encompassing consulting with each other, and capitalising on each other’s qualities and strengths; (2) Problem solving, encompassing quicker and easier problem solving, allocating assignments, coming to a joint solution, and problem-solving method; and (3) Learning from each other, encompassing learning from each other’s knowledge and experience, and from each other’s ideas. No growth in collaborative problem-solving development was statistically shown in the group. ConclusionsThis study gives an ambiguous view on students' perception of their CPS development through involvement in various Carion assignments. Based on this exploratory investigation, prematurely labelling Carion as a potential educational environment for developing CPS among undergraduate nursing students in community healthcare would be unwarranted. Further research is needed, particularly in scrutinising the interplay between CPS and diverse learning activities, assignments and learning outcomes within this specific hybrid serious game context.

Sequencing the Genomes of the First Terrestrial Fungal Lineages: What Have We Learned?

The first genome sequenced of a eukaryotic organism was for Saccharomyces cerevisiae, as reported in 1996, but it was more than 10 years before any of the zygomycete fungi, which are the early-diverging terrestrial fungi currently placed in the phyla Mucoromycota and Zoopagomycota, were sequenced. The genome for Rhizopus delemar was completed in 2008; currently, more than 1000 zygomycete genomes have been sequenced. Genomic data from these early-diverging terrestrial fungi revealed deep phylogenetic separation of the two major clades-primarily plant-associated saprotrophic and mycorrhizal Mucoromycota versus the primarily mycoparasitic or animal-associated parasites and commensals in the Zoopagomycota. Genomic studies provide many valuable insights into how these fungi evolved in response to the challenges of living on land, including adaptations to sensing light and gravity, development of hyphal growth, and co-existence with the first terrestrial plants. Genome sequence data have facilitated studies of genome architecture, including a history of genome duplications and horizontal gene transfer events, distribution and organization of mating type loci, rDNA genes and transposable elements, methylation processes, and genes useful for various industrial applications. Pathogenicity genes and specialized secondary metabolites have also been detected in soil saprobes and pathogenic fungi. Novel endosymbiotic bacteria and viruses have been discovered during several zygomycete genome projects. Overall, genomic information has helped to resolve a plethora of research questions, from the placement of zygomycetes on the evolutionary tree of life and in natural ecosystems, to the applied biotechnological and medical questions.

Understanding pediatric palliative care within interdisciplinary palliative programs: a qualitative study

PurposeTo describe the process of delivery of pediatric palliative care from the perspective of a pediatric interdisciplinary team and the children’s parents.MethodsA qualitative descriptive case study was conducted. Purposeful sampling took place within a specialized pediatric palliative care Unit in Madrid (Spain), located at the Niño Jesus Hospital. The study participants included a specialized pediatric palliative care team from Madrid's pediatric palliative care program, other professional teams involved in interdisciplinary care and parents of children under pediatric palliative care. Data were collected via semi-structured interviews, focus groups and researchers’ field notes. A thematic analysis was performed.ResultsThis study included 28 participants (20 women, 8 men), of whom 18 were professionals who belonged to the pediatric palliative care interdisciplinary team, 4 professionals were from other units that collaborated with the pediatric palliative care, and 6 were parents (5 women, 1 man). The mean age of the pediatric palliative care members was 38.2 years (SD ± 7.9), that of the collaborating professionals was 40.5 (SD ± 6.8), and that of the parents was 44.2 (SD ± 5.4). Two main themes emerged: a) Pediatric palliative care has a distinct identity, associated with life. It represents the provision of special care in highly complex children, in the context of the home, far from the hospital environment; b) The team is key: its interdisciplinary organization provides a more comprehensive view of the child and their family, fosters communication among professionals, and improves coordination with other services involved in the care of children. The mindset shift experienced by ID-PPC professionals towards a palliative approach makes them more sensitive to the needs of their patients and leads them to develop specific skills in areas such as communication, decision-making, and adaptability that were identified as differentiating aspects of pediatric palliative care.ConclusionsDescribing pediatric palliative care from the professional and parental perspective helps to establish realistic and comprehensive goals for the care of children and their parents. The findings of this study may help with the establishment of a pediatric palliative care team, as a necessary organizational change in a health care system that cares for children with complex and life-threatening conditions. Promoting training in pediatric palliative care, prioritizing more horizontal organizations, providing tools and spaces for coordination and communication between professionals from different services, together with the creation of a position of case coordinator in the care process of children could enhance the understanding of pediatric palliative care services.