Orthopedist involvement in the management of clinical activities: a case study.
Care management
Orthopedic surgeries
Patient outcomes
Physician incentive
Quality of healthcare
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
01 Apr 2021
01 Apr 2021
Historique:
received:
16
06
2020
accepted:
21
03
2021
entrez:
2
4
2021
pubmed:
3
4
2021
medline:
15
5
2021
Statut:
epublish
Résumé
The rapid shift in hospital governance in the past few years suggests greater orthopedist involvement in management roles, would have wide-reaching benefits for the efficiency and effectiveness of healthcare delivery. This paper analyzes the dynamics of orthopedist involvement in the management of clinical activities for three orthopedic care pathways, by examining orthopedists' level of involvement, describing the implications of such involvement, and indicating the main responses of other healthcare workers to such orthopedist involvement. We selected four contrasting cases according to their level of governance in a Canadian university hospital center. We documented the institutional dynamics of orthopedist involvement in the management of clinical activities using semi-structured interviews until data saturation was reached at the 37th interview. Our findings show four levels (Inactive, Reactive, Contributory and Active) of orthopedist involvement in clinical activities. With the underlying nature of orthopedic surgeries, there are: (i) some activities for which decisions cannot be programmed in advance, and (ii) others for which decisions can be programmed. The management of unforeseen events requires a higher level of orthopedist involvement than the management of events that can be programmed. Beyond simply identifying the underlying dynamics of orthopedists' involvement in clinical activities, this study analyzed how such involvement impacts management activities and the quality-of-care results for patients.
Sections du résumé
BACKGROUND
BACKGROUND
The rapid shift in hospital governance in the past few years suggests greater orthopedist involvement in management roles, would have wide-reaching benefits for the efficiency and effectiveness of healthcare delivery. This paper analyzes the dynamics of orthopedist involvement in the management of clinical activities for three orthopedic care pathways, by examining orthopedists' level of involvement, describing the implications of such involvement, and indicating the main responses of other healthcare workers to such orthopedist involvement.
METHODS
METHODS
We selected four contrasting cases according to their level of governance in a Canadian university hospital center. We documented the institutional dynamics of orthopedist involvement in the management of clinical activities using semi-structured interviews until data saturation was reached at the 37th interview.
RESULTS
RESULTS
Our findings show four levels (Inactive, Reactive, Contributory and Active) of orthopedist involvement in clinical activities. With the underlying nature of orthopedic surgeries, there are: (i) some activities for which decisions cannot be programmed in advance, and (ii) others for which decisions can be programmed. The management of unforeseen events requires a higher level of orthopedist involvement than the management of events that can be programmed.
CONCLUSIONS
CONCLUSIONS
Beyond simply identifying the underlying dynamics of orthopedists' involvement in clinical activities, this study analyzed how such involvement impacts management activities and the quality-of-care results for patients.
Identifiants
pubmed: 33794873
doi: 10.1186/s12913-021-06299-2
pii: 10.1186/s12913-021-06299-2
pmc: PMC8017788
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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