Staff Recognition Research Articles

Technicians as teachers: the emerging role of technical staff within higher education teaching and learning environments

ABSTRACT Technicians and technical staff are making increasingly significant contributions to the teaching and learning of undergraduate and postgraduate students in the UK. This paper reports on a survey of 1766 technical staff regarding their roles within teaching and learning environments, and a series of follow-up focus groups with 44 technical staff further exploring the roles, visibility, and recognition of technical staff. Analysis suggests many technicians’ roles have transitioned to such an extent that traditional lines between academic and technical teaching responsibilities, expertise, and contributions are becoming increasingly blurred. This trend is particularly noticeable for disciplines within creative arts but is also found in other discipline areas. This is likely accelerated by a competitive higher education environment and global graduate job market which incentivise skills-based learning and graduate employability, with a general transition towards increased value of ‘know-how’ as well as ‘know-what’. Although this can greatly enhance students’ skills-based learning at the hands of experienced practitioners, there is a danger that under-valued ‘cheap labour’ could be used to replace under-resourced academic teaching communities, or that technical staff find expansion of their teaching responsibilities are not being matched with adjustments in value, recognition, or reward. Specific examples are explored, and the impact of COVID-19 related disruption is further used to highlight these overall themes. The authors advocate for common understanding and recognition of teaching roles throughout the higher education sector, regardless of job family.

“Improved access, delayed accreditation, low recognition”: perspectives of mental health educators, preceptors and students on the Kintampo Project in Ghana

PurposeThe purpose of this study explores the perspective of key informants (educators, preceptors and former students) of the Kintampo Project, on the perceived effectiveness, gains and challenges in delivering this large-scale training innovation in Ghana. The problem of mental health care neglect in Ghana is gradually improving. The Kintampo Project which trained mental health workers in Ghana has played a critical role in increasing access to mental health care.Design/methodology/approachThis qualitative study explored participants' perspectives on the Kintampo Project in three broad areas: perceived effectiveness, gains and challenges. In all, 17 interviews were conducted with former students, preceptors and educators from the project. The interviews were digitally audio-recorded, transcribed, coded and analysed using deductive and thematic methods.FindingsThe participants perceived the project to have been successful in increasing the number of mental health workers in Ghana. The project provided a route for career progression for those involved. However, the Kintampo Project faced accreditation issues, low recognition, improper integration and remuneration of trained staff in the Ghana Health Service. This study points to the fact that the sustainability of mental health training in Ghana can be obstructed, because of this career path being less attractive. Further research is needed to explore how best to achieve sustainability of similar mental health innovations.Originality/valueThis paper shares the views of participants in the Kintampo Project.

NCCN Highlights Best Practices for Challenges in Oncology

NCCN Highlights Best Practices for Challenges in Oncology

Evolution of the Chief Medical Officer Role in Teaching Hospitals and Health Systems.

Clinical physician leaders have become an increasingly important asset to hospitals and hospital systems in a changing healthcare environment. Specifically, the role of the chief medical officer (CMO) has expanded and evolved amid the shift to value-based payment models and sharpened focus on patient safety, quality, community engagement, and equity in healthcare, as well as a global pandemic. In light of these changes, this study examined the transformation of CMOs and similar roles and evaluated the current needs, challenges, and responsibilities of clinical leaders today. The primary data source used in this analysis was a survey fielded to 391 clinical leaders in 290 Association of American Medical Colleges-member hospitals and health systems in 2020. In addition, this study compared responses to the 2020 survey with findings from two prior iterations of the survey from 2005 and 2016. The surveys collected information regarding demographics, compensation, administrative titles, qualifications for the position, and the scope of the role, among other questions. All surveys consisted of multiple-choice, free response, and rating questions. The analysis was conducted using frequency counts and percentage distributions. Thirty percent of eligible clinical leaders responded to the 2020 survey. Twenty-six percent of the clinical leader respondents identified as female. Ninety-one percent of the CMOs were members of the senior management team in their hospital or health system. CMOs reported that they were responsible for five hospitals, on average, with 67% indicating they were responsible for more than 500 physicians. This analysis provides hospital and health systems with insight into the expanding scope and complexity of CMOs as they take on greater leadership responsibilities within their institutions amidst a shifting healthcare landscape. In reflecting on our results, hospital leaders can understand the current needs, barriers, and responsibilities of today's clinical leaders.

From professional support to academic pathway – negotiating professional identity in a time of organisational change (case study of two middle managers at a UK university language centre)

In the past five years some UK Universities have introduced the Academic Education Pathway contracts (AEP), incorporating the elements of leadership, teaching and scholarship for recognition and promotion of professional services staff with teaching responsibilities. While colleagues have been encouraged to apply for the new contracts at the departmental level, the University policy guidelines have been conflicting and ambiguous. Many newly AEP transferred departmental middle managers have reported stress related to the application process, uncertainty about career progression, increased workload, and professional identity regulation largely due to the element of research added to the new role. The novelty of the AEP contract and the anecdotal evidence of the burden placed upon the individuals experiencing role incongruity has identified the gap in the knowledge of professional identity construction of UK University middle managers at a time of contractual organisational change. This study will investigate the previously unresearched area of University Language Centre managers with teaching responsibilities. Despite similarities in experiencing organisational change, the participants of the study make different identity claims aligning or resisting the dominant societal and organisational discourses, such as the discourse of New Managerialism, thus highlighting the nuanced and culturally specific approach to professional identity negotiation. The study is framed by the concepts of Educational Leadership, Middle Management and Organisational Change. While the findings may not be generalized beyond the context of this study, the implications can be significant for UK Higher Education policy makers.

대학 교직원의 조직비전 인식, 집단효능감, 직무열의 간 관계

The purpose of this paper is to understand the organizational vision recognition, job engagement, group efficacy of university faculty and staff. For this purpose, a structural model was established that assumed the mediating effect of group efficacy in the relationship between the organizational vision recognition and job engagement. And the model's goodness of fit and the variables was analyzed. Samples include 8,882 faculty and staff working at 73 universities. The data was collected using the University Innovation Capacity Assessment(UICA). The results showed that the estimation model explained the data well. In addition, it was found that the organizational vision recognition of faculty and staff had an effect on group efficacy and job engagement, respectively, and it was confirmed that group efficacy had a significant effect on job engagement. Organizational vision recognition was also statistically significant in the mediating model that influences job engagement through group efficacy. As a result, it was revealed that an organization clearly presenting its vision to its members and continuously sharing it can affect positive beliefs about the organization and individual job-related motivation. Based on the findings, future plans for university operation were suggested.

Investing in our human capital: Sharing the experience of implementing a retention strategy at a large academic hospital from a leadership lens

The impact of the COVID-19 pandemic on healthcare providers is well documented and has resulted in significant pressures from a health human resources perspective with many point-of-care providers taking extended leave or moreover, leaving the healthcare sector altogether. As part of a larger Health Human Resources (HHR) strategy at Sunnybrook Health Sciences Centre (Sunnybrook) in Toronto, Canada, a time-limited interprofessional working group titled Supporting Team Sunnybrook (STS) was created. The working group was created to focus on staff retention to respond to ongoing concerns by leaders with regard to staff leaving the organization at an increased rate as documented by our organization's decision support team. Anecdotally, many staff cited their decision to leave the organization as a consequence of the pandemic. As no staff retention committee had been formally created at our organization, STS was established to engage all staff members while addressing and resolving current feedback, concerns, suggestions and issues. The objective of our working group was to review published literature, establish themes from this review, and align these themes to priority themes brought forward by staff through a number of data capture activities. Data capture activities included reviewing existing survey data, new survey data and meetings with staff members. Analysis of the data resulted in the identification of five key consensus areas (priority themes): Staff recognition, wellbeing, grow at Sunnybrook, leaderful leaders, and communication. Our team created five corresponding working groups with the aim to create short- and long-term goals, as well as time sensitive and sustainable operational activities that would contribute to improved staff retention at our organization. Outcomes from our work provided two key learnings to leaders on their ongoing work to retain staff which were the importance of: (1) engagement across all roles, professions including non-clinical team members and support staff and (2) broad communication on the outcomes of our working group to demonstrate that that their feedback was taken seriously and acted upon.

Overcoming Bar Code Medication Administration Scanning Challenges in the Emergency Department

Background: Bar Code Medication Administration (BCMA) scanning is a globally accepted technology. However, many clinicians do not understand the requirements as a metric for nursing quality and safety behind the BCMA process. Objective: The aim of this Quality Improvement (Q.I.) project is to improve the BCMA scanning compliance, to identify the percentage of noncompliance, along with the numbers representing the percentage and to raise awareness of the challenges of using BCMA in the Emergency Department setting. Methodology: The Institute of Healthcare Improvement’s Plan-Do-Study-Act (PDSA) cycle was used to plan, test, and observe the results of this Q.I. project. This report followed the Standards for Quality Improvement Reporting Excellence (SQUIRE V.2.0) publication guidelines. Results: Following a series of PDSA cycle implementations over an 18-month period, BCMA scanning rates for patients were increased to 93%, and medication scanning was increased to 94%, with an overall increase of 33% and 34%, respectively. Timely documentation improved by 18%, which accounted for a total of 96% compliance. Conclusion and Recommendations: Leadership involvement, nursing workflow monitoring of BCMA safety, as well as staff accountability and recognition, were crucial factors in improving the overall compliance rate. Suggestions to improve scanning safety include modifying the dashboard and highlighting the noncompliance scanning percentage along with actual numbers to raise awareness among clinicians. Organizations need to implement ongoing monitoring, continued training, and education, along with improvements and modifications.

The Power of a Team Huddle During the COVID-19 Pandemic

Background InformationDebriefing is a structured process designed to continuously evolve in rapidly changing situations that originated in the military as a way to learn quickly and address concerns or changes. In a leading oncology organization, a new offsite ambulatory procedure unit was established. Leading a new clinical team during a pandemic can be challenging. The focus of daily team huddles was to mitigate fear related to COVID- 19 healthcare challenges, promote team work, address patient safety concerns, establish workflows, and identify challenges.Objectives of ProjectEstablish a daily team huddle to promote • Problem solving • Communication forum during COVID-19 Crisis • Create healthy work environment standards • Identify risk management concerns • Promote teamwork • Provides a venue for feedback • Develop leadership skills for charge nurses • Safe environment for discussion • Discuss strategic directionProcess of ImplementationImplementation of the team huddle was established by the leadership team which included the nurse manager, assistant nurse manager, and clinical development specialist. Daily team huddles were conducted at the same designated time and location. Guidelines for the team huddle were developed including: check in with the team, daily institutional COVID-19 updates, patient census and review staffing, potential patient safety concerns, anticipated needs for the next day, positive outcomes, recommended improvements, workflow concerns, open forum with no topic off limits, staff recognition (end with a win) and thank everyone for attending the huddle.Statement of Successful PracticeNinety five percent of staff members surveyed indicated that conducting a daily debrief was an effective way to communicate institutional updates. Eighty nine percent of team members indicated that the daily team huddle improved their communication with leadership and team members. Ninety nine percent of team members surveyed felt safe speaking up in the daily debrief. All team members surveyed indicated daily debriefs can improve the patient experience.Implications for Advancing the Practice of Perianesthesia NursingConducting daily team huddles improved team communication by creating a safe venue where team members felt empowered to address workflow concerns and identify safety issues. Implementation of this daily communication tool could help improve staff retention, patient safety and the patient experience.

Identifying Factors Affecting the Sustainability of the STAR-VA Program in the Veterans Health Administration.

Sustained implementation of new programs in complex care systems like nursing homes is challenging. This prospective qualitative evaluation examined factors affecting the sustainability of the Staff Training in Assisted Living Residences in Veterans Health Administration (STAR-VA) program in Veterans Health Administration (VA) Community Living Centers (CLC, i.e., nursing homes). STAR-VA is an evidence-based interdisciplinary, resident-centered, behavioral approach for managing distress behaviors in dementia. In 2019, we conducted 39 semistructured phone interviews with STAR-VA key informants across 20 CLCs. We identified a priori themes based on the Organizational Memory Framework, which includes 7 Knowledge Reservoirs (KRs): people, routines, artifacts, relationships, organizational information space, culture, and structure. We conducted content-directed analysis of transcripts to identify factors to program sustainment. We identified 9 sustainment facilitators across KRs: engaged site leaders and champions, regular meetings and trainings, written documentation and resources, regular and open communication, available educational tools (e.g., handouts and posters), adequate spaces, leadership support on many levels, staff buy-in across disciplines, and staff competencies and recognition. Ten barriers across KRs included: staffing concerns, inconsistent/inefficient routines, inconsistent documentation, lack of written policies, communication gaps, nonstandardized use of tools, constraints with meeting spaces and regulations on posting information, limited leadership support, division among staff, and missing performance expectations. Findings inform tailored strategies for optimizing STAR-VA program sustainment in CLCs, including the development of a sustained implementation guide, implementation resources, regional communities of practice, and STAR-VA integration into national CLC quality improvement routines for team communication and problem-solving.

“Inside Out”: A Regional Inpatient Joy in Work Project

AimsInpatient admissions during the COVID-19 pandemic went up in the regional unit by 18%. This included a 50% increase in Eating Disorder Presentations and more complex SMI requiring admission to Beechcroft. Beechcroft is the regional inpatient unit for CAMHS in Northern Ireland. This project aimed to improve staff joy in work by 30% by June 2021, following what was one of the most difficult years to be a health professional with the COVID-19 pandemic.MethodsWe used the IHI Joy in Work methodology along with our own rating scales in the inpatient unit.Several PDSA cycles were carried out including focus groups, gathering baseline data from different wards, and our change ideas- Beechcroft stars nominations, Virtual Quizzes and Staff recognition certificates.ResultsBaseline data on our run chart demonstrated a bad day median in Beechcroft with 4.3 being the score.With the PSDA cycle we demonstrated a 33% improvement in good day scores with a median of 1.4.We have learnt that Joy in work comes from recognising the work already being done and rewarding the efforts our staff go to.Spread and scale with Beechcroft stars now part of fortnightly MDT meeting and management meeting. Also rolled out to a community mental health team.ConclusionJoy in Work comes from the team. Recognising the efforts of the team is central to this. In particular during a pandemic.

P03 Improving antimicrobial stewardship and sustainability by promoting oral metronidazole in eligible surgical patients at the Royal Alexandra Hospital

BackgroundAntimicrobial stewardship (AS) is essential to minimize the emergence and spread of antimicrobial resistance.1 Timely IV to oral antibiotic switch and promotion of the oral route are key AS initiatives in the acute hospital setting.1 Metronidazole is commonly prescribed IV in the surgical management of intra-abdominal sepsis; however, metronidazole has excellent oral bioavailability of 95%–100%. In addition to improved AS, the oral route provides advantages to patients, staff and the environment including reduced patient risk of line infections/complications; reduced staff workload and healthcare costs; improved patient comfort/mobility; earlier discharge; and improved sustainability.ObjectivesTo measure baseline proportion of surgical patients meeting the criteria for oral receiving oral metronidazole; introduce tests of change to promote use of oral metronidazole where appropriate; and measure changes in prescribing behaviour to determine if improvement has been achieved, with the aim of increasing the proportion of oral metronidazole prescribed to eligible Royal Alexandra Hospital (RAH) surgical patients to 50% by February 2022.MethodsBaseline metronidazole prescribing data were collected over 6 weeks in surgical wards at the RAH. Exclusions for oral metronidazole included compromised gut absorption, oral route unreliable or worsening clinical condition/sepsis. A quality improvement approach was used to engage and raise awareness of the multidisciplinary surgical team to the benefits of prescribing oral metronidazole where appropriate. A range of methods were used including prospective audit and feedback; departmental presentations to surgical and pharmacy teams; eye-catching posters in key areas; staff champions; staff recognition awards; WhatsApp© group messages; and West of Scotland Surgical Association presentation. To measure improvement the proportion of oral and IV metronidazole prescribed was measured weekly and oral and IV metronidazole usage data in RAH surgical wards was measured monthly. A questionnaire was used to assess the impact of the project on nursing staff.ResultsBaseline data (n = 90) highlighted that only 13.5% of patients meeting the criteria for oral metronidazole were prescribed oral in RAH surgical wards. Post-change: oral metronidazole prescribing increased from a baseline median of 7% to 51%; IV metronidazole usage data decreased by 45%; there were 320 fewer IV metronidazole administrations per month; and nursing staff reported benefits including reduced workload, improved patient comfort and reduced plastic waste.ConclusionsA quality improvement approach to engage and raise staff awareness of the benefits of oral metronidazole resulted in a change in prescribing behaviour and increased the proportion of oral metronidazole prescribed to eligible surgical patients to 50% by February 2022.

Approaches to Measuring Productivity in Audiology Clinics

Approaches to Measuring Productivity in Audiology Clinics

Measuring and Evaluating Clinical Context in Implementation Science Research.

Measuring and Evaluating Clinical Context in Implementation Science Research.

Improving Obstuctive Sleep Apnea Care in the Postanesthesia Care Unit

PurposeThe purpose of this quality improvement project was to improve care of obstructive sleep apnea (OSA) patients through increased staff recognition of OSA in the postanesthesia care unit (PACU). DesignRetrospective chart review with implementation of best practice guideline form to front of patient's chart. MethodsBaseline data were collected during June 2020. Staff education was provided on current hospital policy of OSA patients. Implementation of a care guideline sheet was added to the front of patient charts for patients meeting inclusion criteria; it consisted of continuous pulse oximetry, 30-degree head of bed elevation, continuous positive airway pressure (CPAP) therapy, 1 hour minimum postoperative observation, nonopioid analgesics, and referral to polysomnography. A retrospective chart review was performed following the OSA guideline intervention. FindingsBoth pre- (N = 413) and postintervention (N = 420) groups had statistically similar demographics. CPAP use increased from 16 to 22 (t = 0.890; P = .336). The number of patients experiencing dyspnea decreased from 10 to 8 (t = 0.263; P = .608). The number of patients experiencing acute respiratory events (AREs) decreased from 24 to 18 (t = 1.012; P = .314). ConclusionThere were no significant statistical findings. However, increased recognition of OSA patients by PACU staff can lead to improved care alterations.

Improving culture of care through maximising learning from observations and events: Addressing what is at fault.

The term ‘culture of care’ in the context of using animals for scientific purpose describes the culture in organisations that provides support to staff to strive for continuous improvement in:• animal care and welfare;• support and recognition of staff involved in the animal care and use programme;• scientific quality;• openness and transparency.We developed a systematic process for reporting observations and events that have the potential to help with continuous learning, improving animal welfare and supporting staff. The process took learning from the safety, health and environment arena on accident prevention. The two key aspects were (a) the systematic logging of observations and events; and (b) the learning approach to following up on observations. Underpinning our systematic process is the ‘Learning from Observations and Events Log’. Reported observations and events can relate to positive practices, general observations as well as near misses.We created an environment to promote continuous improvement for both animals and staff by recognising, rewarding and sharing good practice, as well as where near misses are openly reported and learnt from. Supporting animal welfare, staff welfare, improving scientific quality and transparency are the four key pillars of a positive culture of care.We recognised early on that using a system and learning approach to follow up on observations and events rather than a people and blame approach was key to developing open reporting and a positive culture. In the systems approach, errors are consequences rather than causes, having their origins in systemic factors.

Implementation challenges to patient safety in Guatemala: a mixed methods evaluation

BackgroundLittle is known about factors affecting implementation of patient safety programmes in low and middle-income countries. The goal of our study was to evaluate the implementation of a patient safety...

Staff Reports of Behavioral Expressions of Persons With Dementia in 250 Assisted Living Communities.

Assisted living (AL) residents with dementia commonly exhibit behavioral expressions (BEs), yet no study has examined how AL staff perceive and respond to BEs in terms of the "ABC" model of antecedents, behaviors, and consequences, or how perceptions relate to organizational characteristics. Understanding staff perceptions may inform interventions. A convergent, mixed methods design was used in a study of health care supervisors from 250 AL communities in 7 states who reported 366 cases of resident BEs (one successful and one unsuccessful case). Qualitative analysis identified antecedents, BEs, staff responses, resident outcomes, and disposition (aging in place or discharge). Content analysis identified themes and compared case types. Descriptive statistics examined organizational characteristics associated with identifying antecedents. One quarter of cases recognized antecedents; slightly more were identified in successful (28%) compared to unsuccessful cases (20%); staff in dementia-only and smaller communities identified antecedents more often. Combativeness and anxiety were the most frequently reported BEs. The majority of both types of cases reported staff responses. Medication management was enacted as a response in 40% of cases compared to psychiatric assessment in 33% of cases. Staff training is indicated to increase AL staff recognition of antecedents; doing so might reduce the use of antipsychotic medications. Psychiatric assessment plays an important role in dementia care in AL and warrants further examination. Results could be helpful for applied behavioral researchers interested in developing ways to improve the identification of antecedents of BEs of persons with dementia.

Pain Behaviors and Pharmacological Pain Management Among Newly Admitted Nursing Home Residents.

Clinicians may place more weight on vocal complaints of pain than the other pain behaviors when making decisions about pain management. We examined the association between documented pain behaviors and pharmacological pain management among nursing home residents. We included 447,684 residents unable to self-report pain, with staff-documented pain behaviors (vocal, nonverbal, facial expressions, protective behaviors) and pharmacological pain management documented on the 2010-2016 Minimum Data Set 3.0. The outcome was no pharmacological pain medications, as needed only (pro re nata [PRN]), as scheduled only, or as scheduled with PRN medications. We estimated adjusted odds ratios and 95% confidence intervals from multinomial logistic models. Relative to residents with vocal complaints only, those with one pain behavior documented (i.e., nonverbal, facial, or protective behavior) were more likely to lack pain medication versus scheduled and PRN medications. Residents with multiple pain behaviors documented were least likely to have no treatment relative to scheduled with PRN medications, PRN only, or scheduled only pain medication regimens. The type and number of pain behaviors observed are associated with pharmacological pain management regimen. Improving staff recognition of pain among residents unable to self-report is warranted in nursing homes.

Relationship of knowledge about and attitudes towards violence with recognition of violence against women among health staff in pre-hospital emergency medical services

BackgroundDomestic violence, specifically, violence against women, is prevalent in all segments of society regardless of social class, ethnicity, culture or country. In other words, domestic violence is a global concern. AimThe study aims to investigate the relationship between the attitude and knowledge of the health staff in pre-hospital emergency medical services about violence against women and their recognition of such form of violence. MethodsThis descriptive study was conducted on 1023 paramedics and emergency medicine technicians who work in the pre-hospital emergency health setting and are members of the Paramedic and Pre-hospital Emergency Medicine Association. The Attitudes towards Violence against Women Scale (ATVAWS) and Health Staff's Recognition of Signs of Violence against Women Scale (HPRSVAWS) were used for data collection. ResultsThe mean scores for the ATVAWS and HPRSVAWS were 46.68 ± 6.92 and 20.31 ± 3.23, respectively. Of the participants, 48.5% had been subjected to violence, 43.93% had been subjected to violence perpetrated by their mothers, 41.53% had been exposed to physical violence and 4.2% remain exposed to domestic violence. Participants who had been exposed and those who remain exposed to domestic violence produced high scores in ATVAWS, which indicates an improvement in the traditional approach (less opposing view) to violence. High scores in the ATVAWS for (a) those who were exposed to violence in their workplaces, (b) who had never attended to actual or suspected cases of violence against women in their professional life, (c) who had attended to seven or more cases of violence against women, (d) who were less competent in physically examining actual or suspected cases of violence and (e) who had not been trained on violence against women, which indicates an increase in the traditional approach to violence. ConclusionThe study found that health staff in emergency health stations better recognised the signs of violence against women as their attitudes towards violence were less similar to the traditional approach. That is, they mostly held non-violent views. The characteristics, attitudes, perceptions and values of health professionals were considered important factors in addressing violence.