Administrative Personnel

行政人员
  • 文章类型: Journal Article
    背景:沟通是一个多方面的过程,范围从线性,单向方法,比如发送一条简单的信息,利益相关者之间的持续交流和反馈循环。特别是COVID-19大流行强调了及时、有效和可信的证据沟通,以提高认识,信任水平,以及政策和实践中的证据吸收。然而,无论是改善危机中的政策应对还是应对更常见的社会挑战,在卫生政策和系统中向决策者提供证据的全面指导仍然有限。我们的目标是识别和系统化框架的全球证据,指导和工具,支持有效交流研究证据,以促进知识翻译和循证决策过程,同时也解决了障碍和促进者。
    方法:我们按照JoannaBriggs手册进行了快速范围审查。文献检索在八个索引数据库和两个灰色文献来源中进行,没有语言或时间限制。对纳入研究的方法学质量进行了评估,并应用了叙事-解释性综合来呈现研究结果。
    结果:我们确定了16个文档,这些文档展示了完整的框架或框架组件,包括指导和工具,旨在支持政策制定的证据沟通。这些框架概述了战略,理论模型,障碍和促进者,以及对决策者观点的见解,沟通需要,和偏好。三种主要的证据沟通策略,包括11个子策略,出现:“健康信息包装”,“向观众定位和定制信息”,和“综合沟通策略”。根据微型文件中记录的障碍和促进者,中观和宏观层面,确定了成功向决策者传达证据的关键因素。
    结论:有效的沟通对于促进知识翻译和循证决策是必不可少的。尽管如此,旨在加强与决策者的研究交流的框架仍然存在差距,特别是关于多种沟通策略的有效性。为了在这个领域取得进展,有必要制定纳入实施战略的全面框架。此外,必须承认和解决实施有效沟通的障碍和促进者,同时考虑到不同的背景。注册https://zenodo.org/record/5578550。
    BACKGROUND: Communication is a multifaceted process, ranging from linear, one-way approaches, such as transmitting a simple message, to continuous exchanges and feedback loops among stakeholders. In particular the COVID-19 pandemic underscored the critical need for timely, effective and credible evidence communication to increase awareness, levels of trust, and evidence uptake in policy and practice. However, whether to improve policy responses in crises or address more commonplace societal challenges, comprehensive guidance on evidence communication to decision-makers in health policies and systems remains limited. Our objective was to identify and systematize the global evidence on frameworks, guidance and tools supporting effective communication of research evidence to facilitate knowledge translation and evidence-informed policy-making processes, while also addressing barriers and facilitators.
    METHODS: We conducted a rapid scoping review following the Joanna Briggs Manual. Literature searches were performed across eight indexed databases and two sources of grey literature, without language or time restrictions. The methodological quality of included studies was assessed, and a narrative-interpretative synthesis was applied to present the findings.
    RESULTS: We identified 16 documents presenting either complete frameworks or framework components, including guidance and tools, aimed at supporting evidence communication for policy development. These frameworks outlined strategies, theoretical models, barriers and facilitators, as well as insights into policy-makers\' perspectives, communication needs, and preferences. Three primary evidence communication strategies, comprising eleven sub-strategies, emerged: \"Health information packaging\", \"Targeting and tailoring messages to the audience\", and \"Combined communication strategies\". Based on the documented barriers and facilitators at micro, meso and macro levels, critical factors for successful communication of evidence to policy-makers were identified.
    CONCLUSIONS: Effective communication is indispensable for facilitating knowledge translation and evidence-informed policy-making. Nonetheless gaps persist in frameworks designed to enhance research communication to policy-makers, particularly regarding the effectiveness of multiple communication strategies. To advance in this field, the development of comprehensive frameworks incorporating implementation strategies is warranted. Additionally, barriers and facilitators to implementing effective communication must be recognized and addressed taking diverse contexts into consideration. Registration https://zenodo.org/record/5578550.
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  • 文章类型: Journal Article
    工作人群中的心理健康问题越来越受到关注,对个人产生巨大影响,组织,赔偿当局,和社会福利制度。工作场所既存在社会心理风险,也存在独特的干预机会。尽管近几十年来工作场所心理健康干预措施迅速扩大,周围方向明确适当,基于证据的行动仍然有限。虽然已经提出了许多工作场所心理健康模型来指导干预,一般模型通常不能充分考虑证据基础和仅最佳实践原则为行动提供信息的地方。Further,随着新发现的出现,建议需要更新。我们寻求根据干预有效性的新证据更新心理健康工作场所框架,同时纳入循证原则。更新后的模型还整合了现有替代模型的概念,以全面概述旨在增强福祉的策略,尽量减少伤害,促进恢复。讨论了现有证据和实施障碍的示例。该框架旨在支持雇主和管理人员确定应用哪些战略并指导未来的研究途径。
    Mental health problems among the working population represent a growing concern with huge impacts on individuals, organizations, compensation authorities, and social welfare systems. The workplace presents both psychosocial risks and unique opportunities for intervention. Although there has been rapid expansion of workplace mental health interventions over recent decades, clear direction around appropriate, evidence-based action remains limited. While numerous workplace mental health models have been proposed to guide intervention, general models often fail to adequately consider both the evidence base and where best-practice principles alone inform action. Further, recommendations need to be updated as new discoveries occur. We seek to update the Framework for Mentally Healthy Workplaces based on new evidence of intervention effectiveness while also incorporating evidence-based principles. The updated model also integrates concepts from existing alternate models to present a comprehensive overview of strategies designed to enhance wellbeing, minimize harm, and facilitate recovery. Examples of available evidence and obstacles to implementation are discussed. The Framework is designed to support employers and managers in determining which strategies to apply and to guide future avenues of research.
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  • 文章类型: Journal Article
    背景:社区参与是制定预防和控制COVID-19的本地和特定环境策略的关键。然而,大流行早期的快速研究设计和批准可能限制了社区成员影响大流行相关研究的机会。在这项研究中,我们试图了解社区参与小组(CEG)如何影响大型纵向COVID-19研究项目(优化),仅涉及研究的口译和知识翻译阶段。
    方法:为CEG招募了7名社区成员,代表了各种各样的群体。每个月,主题重要性的优化数据已汇编成报告草案。CEG在每月会议上讨论了报告草案,成员的贡献被纳入最终报告,分发给决策者。在这项研究中,对2021年2月至11月连续编写的十份报告进行了文件分析。每份报告在纳入CEG捐款之前和之后进行了比较,然后使用专题分析进行分析。
    结果:社区参与Optimise的口译和知识翻译阶段对决策者的报告产生了积极影响,包括在更广泛的社区视角下建立经验发现,确定影响不同群体的政策问题,并在实证结果之外提供独特的见解。总的来说,CEG的贡献证明了在经验数据之下的生活经验的复杂性。
    结论:社区参与“优化”研究结果的翻译,导致向决策者提交了反映更广泛社区观点的研究报告,这为与COVID-19相关的新出现的政策问题提供了潜在的解决方案。这项研究增加了有关社区参与在以后的研究解释和知识翻译阶段的影响的证据基础,特别是在公共卫生紧急情况下向政策制定者报告的背景下。
    BACKGROUND: Community engagement is key to developing local and context-specific strategies for the prevention and control of COVID-19. However, expedited research design and approval in the early days of the pandemic may have limited the opportunities for community members to influence pandemic-related research. In this study, we sought to understand how a Community Engagement Group (CEG) could impact a large longitudinal COVID-19 research project (Optimise), when involved solely in the interpretation and knowledge translation phases of the research.
    METHODS: Seven community members were recruited for the CEG, representing a diverse range of groups. Each month, Optimise data of topical importance were compiled into a draft report. The CEG discussed the draft report at their monthly meeting and members\' contributions were incorporated into the final report for distribution to policy-makers. In this study, a document analysis was undertaken of ten consecutive reports produced between February and November 2021. Each report was compared pre- and post- the inclusion of CEG contributions, which were then analysed using thematic analysis.
    RESULTS: Community engagement in the interpretation and knowledge translation phases of Optimise had positive impacts on reports for policy-makers, including grounding the empirical findings in broader community perspectives, identifying policy issues affecting different groups and contributing unique insights beyond the empirical findings. Overall, the CEG contributions demonstrated the complexity of lived experience lying beneath the empirical data.
    CONCLUSIONS: Community engagement in the translation of the Optimise findings resulted in research reports to policy-makers that were reflective of a broader range of community perspectives, and that provided potential solutions to emerging policy issues related to COVID-19. This study adds to the evidence base about the impact of community engagement in the later interpretation and knowledge translation phases of research, particularly in the context of reporting to policy-makers during a public health emergency.
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  • 文章类型: Journal Article
    背景:可持续发展目标(SDG)的相互依存和交叉性质需要政府部门之间的合作。过去很少互动的部门很可能会发现自己参与了可持续发展目标项目的联合任务。部门间行动(IA)正在成为不同部门共同努力的共同框架。了解制定IA的政策团队外部的环境因素对于在可持续发展目标方面取得进展至关重要。
    方法:对加拿大联邦政府9个部门领导可持续发展目标工作的高级公务员进行了访谈[n=17],以获取有关影响部门如何参与可持续发展目标IA的问题的信息。成绩单是根据与加拿大在可持续发展目标方面的进展有关的20份文件的背景审查中确定的一组因素进行编码的。作者的迭代小组主题分析阐明了影响可持续发展目标IA流程的一系列国内和全球背景因素。
    结果:成功的IA机制被确定为促进治理,由中央协调办公室领导,支持人员,灵活清晰的报告结构,充足的资源,和有针对性的技能发展侧重于协作和跨部门学习。积极影响IA的因素包括可持续发展目标议程与国内和全球政治优先事项的一致性。土著权利和性别平等等社会问题的共同出现,这些问题提高了对相关可持续发展目标的认识和支持。对IA产生负面影响的因素包括竞争概念框架,以接近共同的优先事项,官僚员工缺乏“大局”思维的能力,和全球破坏使国家优先事项从可持续发展目标转移。
    结论:IA正在成为解决与政府问责制不同的问题的正常方法。这些合作的成功可能受到任何一个部门无法控制的背景因素的影响。
    BACKGROUND: The interdependent and intersecting nature of the Sustainable Development Goals (SDGs) require collaboration across government sectors, and it is likely that departments with few past interactions will find themselves engaged in joint missions on SDG projects. Intersectoral action (IA) is becoming a common framework for different sectors to work together. Understanding the factors in the environment external to policy teams enacting IA is crucial for making progress on the SDGs.
    METHODS: Interviews [n=17] with senior public servants leading SDG work in nine departments in the federal government of Canada were conducted to elicit information about issues affecting how departments engage in IA for the SDGs. Transcripts were coded based on a set of factors identified in a background review of 20 documents related to Canada\'s progress on SDGs. Iterative group thematic analysis by the authors illuminated a set of domestic and global contextual factors affecting IA processes for the SDGs.
    RESULTS: The mechanisms for successful IA were identified as facilitative governance, leadership by a central coordinating office, supportive staff, flexible and clear reporting structures, adequate resources, and targeted skills development focused on collaboration and cross-sector learning. Factors that affect IA positively include alignment of the SDG agenda with domestic and global political priorities, and the co-occurrence of social issues such as Indigenous rights and gender equity that raise awareness of and support for related SDGs. Factors that affect IA negatively include competing conceptual frameworks for approaching shared priorities, lack of capacity for \"big picture\" thinking among bureaucratic staff, and global disruptions that shift national priorities away from the SDGs.
    CONCLUSIONS: IA is becoming a normal way of working on problems that cross otherwise separate government accountabilities. The success of these collaborations can be impacted by contextual factors beyond any one department\'s control.
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  • 文章类型: Journal Article
    目标:鉴于管理者的幸福对其领导行为的重要性,员工健康,以及业务效率和生存,更好地了解管理者的福祉和工作条件对于创建健康和可持续的企业非常重要。以前的研究大多提供了一个静态的情况下,经理的福利和工作在小企业的背景下,错过了这种背景下的可变性和动态性。因此,这项研究的目的是探讨如何在小公司的管理者认为他们的工作条件和福利在业务增长的背景下。
    方法:该研究基于对来自12家小型公司的20名经理的定性半结构化访谈。采用内容和主题分析。
    结果:调查结果表明,经理的工作环境从其初始阶段演变到公司的成长,随着时间的推移,导致经理对幸福和工作与生活平衡的体验以及工作需求和资源的变化。当工作量和工作时间减少并实现更好的工作与生活平衡时,经理的工作环境变得不那么苛刻,更易于管理。感知到的改进与组织因素(如公司资源)的变化有关,但也有个人因素(例如,管理者对可持续工作环境重要性的认识提高)。然而,随着时间的推移,工作条件和福利如何变化,以及组织和个人资源如何影响被研究的管理者的福利,存在差异。
    结论:这项研究表明,在小企业的背景下,管理者的工作条件和福利是动态的,并且与从组织活动开始和成长期间发生的与增长相关的变化有关。此外,研究结果表明,由于组织和个人因素之间的相互作用,随着时间的推移,管理者的工作条件和福利的变化遵循不同的轨迹。
    OBJECTIVE: In view of the importance of managers\' wellbeing for their leadership behaviour, employee health, and business effectiveness and survival, a better understanding of managers\' wellbeing and working conditions is important for creating healthy and sustainable businesses. Previous research has mostly provided a static picture of managers\' wellbeing and work in the context of small businesses, missing the variability and dynamism that is characteristic of this context. Therefore, the purpose of this study is to explore how managers in small companies perceive their working conditions and wellbeing in the context of business growth.
    METHODS: The study is based on qualitative semi-structured interviews with 20 managers from twelve small companies. Content and thematic analysis were applied.
    RESULTS: The findings indicate that a manager\'s working environment evolves from its initial stages and through the company\'s growth, leading to variations over time in the manager\'s experiences of wellbeing and work-life balance as well as changes in job demands and resources. Managers\' working situation becomes less demanding and more manageable when workloads and working hours are reduced and a better work-life balance is achieved. The perceived improvement is related to changes in organizational factors (e.g. company resources), but also to individual factors (e.g. managers\' increased awareness of the importance of a sustainable work situation). However, there were differences in how the working conditions and wellbeing changed over time and how organizational and individual resources affected the studied managers\' wellbeing.
    CONCLUSIONS: This study shows that, in the context of small business, managers\' working conditions and wellbeing are dynamic and are linked to growth-related changes that occur from the start of organizational activities and during periods of growth. In addition, the findings suggest that changes in managers\' working conditions and wellbeing follow different trajectories over time because of the interaction between organizational and personal factors.
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  • 文章类型: Journal Article
    目标:在2023年,澳大利亚政府紧急医疗服务(EMS)响应了超过400万消费者,其中超过56%的人没有被归类为“紧急情况”,耗资55亿澳元。我们探讨了政治家的观点,政策制定者,临床医生和消费者如何管理这些非紧急请求。
    方法:采用了现实主义框架;多学科团队(包括辅助医学,医学和护理)形成;数据是通过半结构化焦点小组或访谈收集的,并进行了专题分析。
    方法:有目的地并通过公开广告选择了56名参与者:国家和州议员(n=3);政府医疗保健学科负责人(n=3);政府决策者(n=5);急诊医学行业决策者,全科医学和辅助医学(n=6);EMS首席执行官,医疗主管和经理(n=7);学者(n=8),一线临床医生,护理和辅助医疗(n=8);和消费者(n=16)。
    结果:出现了三个主题:第一,EMS工作负载的现实(主题为“面对现实”);第二,对政策应该采取什么方向来管理这一点的看法(“没有银弹”),最后,EMS在社会中的未来角色应该是什么(“找到合适的空间”)。与会者提供了16条政策建议,其中10项得到广泛支持:提高公共卫生素养,移除医疗优先调度系统,支持多学科团队,增加24小时虚拟急诊部门,修改本科护理人员大学教育,以反映当代角色的现实,越来越多地为频繁的消费者使用管理计划,护理人员与医疗保健系统更好地整合,通过提供估计的等待时间来赋予呼叫者权力,减少无效的媒体活动,以“为紧急情况保存EMS”,并将EMS从医院转诊转向社区护理。
    结论:有必要就EMS在社会中的作用达成共识,特别是,关于范围是否应该继续扩大到紧急护理之外。这项研究报告了16种可能的想法,每一项都可能需要考虑,并将它们映射到标准的患者旅程上。
    OBJECTIVE: In 2023, Australian government emergency medical services (EMS) responded to over 4 million consumers, of which over 56% were not classified as an \'emergency\', at the cost of AU$5.5 billion. We explored the viewpoints of politicians, policymakers, clinicians and consumers on how these non-emergency requests should be managed.
    METHODS: A realist framework was adopted; a multidisciplinary team (including paramedicine, medicine and nursing) was formed; data were collected via semistructured focus groups or interviews, and thematic analysis was performed.
    METHODS: 56 participants were selected purposefully and via open advertisement: national and state parliamentarians (n=3); government heads of healthcare disciplines (n=3); government policymakers (n=5); industry policymakers in emergency medicine, general practice and paramedicine (n=6); EMS chief executive officers, medical directors and managers (n=7); academics (n=8), frontline clinicians in medicine, nursing and paramedicine (n=8); and consumers (n=16).
    RESULTS: Three themes emerged: first, the reality of the EMS workload (theme titled \'facing reality\'); second, perceptions of what direction policy should take to manage this (\'no silver bullet\') and finally, what the future role of EMS in society should be (\'finding the right space\'). Participants provided 16 policy suggestions, of which 10 were widely supported: increasing public health literacy, removing the Medical Priority Dispatch System, supporting multidisciplinary teams, increasing 24-hour virtual emergency departments, revising undergraduate paramedic university education to reflect the reality of the contemporary role, increasing use of management plans for frequent consumers, better paramedic integration with the healthcare system, empowering callers by providing estimated wait times, reducing ineffective media campaigns to \'save EMS for emergencies\' and EMS moving away from hospital referrals and towards community care.
    CONCLUSIONS: There is a need to establish consensus on the role of EMS within society and, particularly, on whether the scope should continue expanding beyond emergency care. This research reports 16 possible ideas, each of which may warrant consideration, and maps them onto the standard patient journey.
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  • 文章类型: Journal Article
    本研究考察了越南家族企业中投资者注意力和首席执行官(CEO)权力对企业社会责任(CSR)的影响。与过去的大多数文学不同,本研究进一步考察了CEO权力对投资者注意力与企业社会责任关系的潜在调节作用。利用动力系统广义矩量法(GMM),这项研究分析了2005年至2020年由116家越南家族企业组成的数据集。调查结果揭示了家族企业中CEO权力与企业社会责任之间的倒U型;同时,投资者的关注表明对企业社会责任有负面影响。此外,结果显示,CEO权力是投资者注意力与企业社会责任之间关系的调节因素。这些结果与各种理论框架一致,包括代理理论,过度投资,职业关注,职业视野,和冲突解决假设。最后,我们的研究提供了管理意义,以促进家族企业内部企业社会责任的可持续发展,特别是在新兴市场。
    This study examines the influence of investor attention and Chief Executive Officers (CEOs) power on Corporate Social Responsibility (CSR) within Vietnamese family businesses. Unlike most of the past literature, this study further investigates the potential moderating effects of CEOs\' power on the relationship between investor attention and CSR. Utilizing the dynamic system Generalized Method of Moments (GMM), this study analyzes a dataset comprising 116 Vietnamese family businesses from 2005 to 2020. The findings reveal an inverted U-shape between CEO power and CSR within family businesses; meanwhile, investor attention demonstrates a negative impact on CSR. Moreover, the results report that CEO power is a moderating factor in the relationship between investor attention and CSR. These results are consistent with various theoretical frameworks, including agency theory, overinvestment, career concern, career horizon, and conflict-resolution hypotheses. Finally, our study offers management implications to foster the sustainable development of CSR within family businesses, particularly within emerging markets.
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  • 文章类型: Journal Article
    背景:卫生政策制定是政府决策的一个关键方面,它塑造了民众的福祉。在中东和北非,特别是在科威特,对探索研究能力的关注有限,订婚,以及卫生政策制定者的利用。本研究旨在通过调查科威特卫生政策制定者如何将循证研究纳入卫生相关政策的制定中来弥合这一差距。
    方法:这项横断面研究针对科威特卫生部(MOH)领导职位的卫生政策制定者。使用寻求,参与和评估研究(SEER)问卷,参与者的能力,订婚,并对研究的使用进行了评估。目标样本是所有担任领导职务的卫生政策制定者,从部门负责人及以上开始。问卷包括四个领域,14节,和50个问题,并利用李克特和二元尺度,综合分数预测参与行动和研究使用。数据是在2023年3月至7月之间收集的。所有统计分析均使用SPSSv27进行,并使用适当的统计检验对数值变量和分类变量进行分析,包括t检验,方差分析,和皮尔森的相关性。
    结果:在205个决策者中,88人参加(42.9%的反应率):主要是男性(51.1%)和已婚(78.4%)。平均年龄49.84±7.28岁,卫生部的平均任期为24.39±6.80年。参与者表现出很高的研究价值(平均得分为4.29±0.55),并对研究利用表示信心。组织对研究使用的重视表现出细微差别的看法,确定卫生部可能缺乏支持的领域。强调了获得研究资源和政策制定指导程序的挑战。
    结论:这项研究为科威特卫生政策制定者的研究能力和参与提供了重要见解。它强调需要有针对性的干预措施,以使个人的看法与组织的期望保持一致,解决信心差异,加强合作。组织投资对于培育动态研究生态系统以改善科威特医疗保健领域基于证据的政策制定至关重要。
    BACKGROUND: Health policymaking is a critical aspect of governmental decision-making that shapes the well-being of populations. In the Middle East and North Africa, particularly in Kuwait, limited attention has been given to exploring the research capacities, engagement, and utilization among health policymakers. This study aims to bridge this gap by investigating how Kuwaiti health policymakers incorporate evidence-based research into the formulation of health-related policies.
    METHODS: This cross-sectional study targeted health policymakers in leadership positions within the Kuwait Ministry of Health (MOH). Using the Seeking, Engaging with and Evaluating Research (SEER) questionnaire, participants\' capacities, engagement, and use of research were assessed. The targeted sample was all health policymakers in leadership positions, starting from the head of departments and above. The questionnaire comprises four domains, 14 sections, and 50 questions and utilizes Likert and binary scales, with aggregate scores predicting engagement actions and research use. The data were collected between March and July 2023. All the statistical analyses were performed using SPSS v27, and the numerical and categorical variables were analyzed using appropriate statistical tests, including t-tests, ANOVA, and Pearson\'s correlation.
    RESULTS: Out of 205 policymakers, 88 participated (42.9% response rate): predominantly male (51.1%) and married (78.4%). The mean age was 49.84 ± 7.28 years, with a mean MOH tenure of 24.39 ± 6.80 years. Participants demonstrated high value for research (mean score 4.29 ± 0.55) and expressed confidence in the research utilization. Organizational emphasis on research use exhibited nuanced perceptions, identifying areas where MOH support may be lacking. Access to research resources and processes for policy development guidance were highlighted as challenges.
    CONCLUSIONS: This study provides crucial insights into the research capacities and engagement of Kuwaiti health policymakers. It emphasizes the need for targeted interventions to align individual perceptions with organizational expectations, address confidence disparities, and enhance collaborative efforts. Organizational investments are crucial for fostering a dynamic research ecosystem to improve evidence-based policy development in Kuwait\'s healthcare landscape.
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  • 文章类型: Journal Article
    背景:不良的童年经历会影响整个生命周期的身心健康。支持经历逆境的家庭,改善儿童健康和发展公平,一个综合的,需要多部门响应。儿童和家庭中心(Hubs)是提供此类响应的可行且可接受的方法。在澳大利亚的背景下,一些联邦和新南威尔士州(NSW)的国家政策支持一体化,使用Hubs支持经历逆境的家庭的多部门反应。这项研究考察了新南威尔士州政策利益相关者和卫生服务经理对将政策转化为实施儿童和家庭中心的障碍和促成因素的看法。
    方法:对11名新南威尔士州政府政策利益相关者和13名从事儿童和家庭政策和规划或儿童和家庭社区服务的社区卫生服务管理人员进行了半结构化访谈。面试时间为30-60分钟,探索了利益相关者的知识,围绕童年逆境的观点和经验,以及实施支持集线器的政策的障碍和推动者。使用实施研究综合框架(CFIR)对实施中心护理模型的障碍和促进者进行了分析。
    结果:出现的主要障碍包括短期和不一致的资金,缺乏集线器协调员的资源,对评估的支持有限,计划集线器实施的时间不足。主要促成因素包括Hub模型的灵活性和适应性,以满足本地需求,正式的变更管理流程,强大的治理结构和集线器从业者之间的参与度。关键见解包括有针对性的战略以支持持续的个人实践变化的重要性,以及需要全组织承诺以成功采用和维护中心护理模式。
    结论:这项研究提供了有价值的见解,并提供了有关加强和支持Hub护理模式的可操作性和可扩展性所需的证据。对枢纽从业人员的主要建议包括正式变更管理流程和建立强大的治理结构的重要性,虽然政策制定者的主要建议包括需要可持续的枢纽资金和标准化,基于证据的框架,以支持Hub的实施和评估。
    BACKGROUND: Adverse childhood experiences can impact physical and mental health throughout the lifespan. To support families experiencing adversity and improve child health and developmental equity, an integrated, multi-sector response is required. Child and Family Hubs (Hubs) are a feasible and acceptable approach to providing such a response. In the Australian context, a number of federal and New South Wales (NSW) state policies support an integrated, multi-sector response using Hubs to support families experiencing adversity. This study examined NSW policy stakeholder and health service manager perspectives on the barriers and enablers to translating policy into practice in the implementation of Child and Family Hubs.
    METHODS: Semi-structured interviews were conducted with 11 NSW government policy stakeholders and 13 community health service managers working in child and family policy and planning or child and family community-based services. Interviews were of 30-60 min duration and explored stakeholder knowledge, perspectives and experiences around childhood adversity, and barriers and enablers to operationalizing policies supporting Hubs. Analysis of barriers and facilitators to implementation of Hub models of care was undertaken using the Consolidated Framework for Implementation Research (CFIR).
    RESULTS: Key barriers that emerged included short-term and inconsistent funding, lack of resourcing for a Hub co-ordinator, limited support for evaluation and insufficient time to plan for Hub implementation. Key enablers included flexibility and adaptability of Hub models to meet local needs, formal change management processes, strong governance structures and engagement among Hub practitioners. Key insights included the importance of targeted strategies to support sustained individual practice change and the need for organization-wide commitment to enable the successful adoption and maintenance of the Hub model of care.
    CONCLUSIONS: This study provides valuable insights and contributes evidence around what is needed to strengthen and support the operationalization and scalability of the Hub model of care. Key recommendations for Hub practitioners include the importance of formal change management processes and establishment of strong governance structures, while key recommendations for policymakers include the need for sustainable Hub funding and a standardized, evidence-based framework to support Hub implementation and evaluation.
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  • 文章类型: Journal Article
    总经理(GM)作为跨国制药公司的国家附属公司的企业领导人发挥着至关重要的作用,平衡需求,所有地方职能部门的目标和治理。一个这样的功能,医疗事务,已经经历了从支持职能到战略合作伙伴的重大演变,在一些组织中,战略领导者受到药物日益复杂和转向更专业药物的支持。虽然功能取得了显著进展,有机会将医疗事务提升到另一个水平,总经理和业务部门主管(BUD)建议提高商业敏锐度,战略方针,创新和项目管理作为可以进一步培养的能力。审视当前行业的发展趋势,包括创新药物和患者旅程的日益复杂,报销药品的证据负担更高,创新的数据生成机会,不断变化的利益相关者参与期望和对企业声誉的关注,医疗事务被定位为协助通过这些复杂性导航组织的关键。通用汽车可以帮助促进医疗事务的不断发展的作用,鼓励横向移动,以实现更广泛的企业心态,通过投资培训来利用上述趋势,并在现在和将来提供最佳的患者和组织成果,在各职能部门之间传授共同治理责任的文化,以鼓励创新思维并培养即将到来的领导者。
    General managers (GMs) play a crucial role as enterprise leaders of the country affiliate of multi-national pharmaceutical companies, balancing needs, objectives and governance across all local functions. One such function, Medical Affairs, has undergone a significant evolution from a support function into a strategic partner and in some organizations a strategic leader supported by the increasing complexity of medications and a shift to more specialized medicines. Although the function has progressed significantly, there is opportunity to elevate Medical Affairs to another level, with GMs and business unit directors (BUDs) recommending increased business acumen, strategic approach, innovation and project management as competencies that could be further cultivated. Examining the current trends in the industry, including the increasing complexity of innovative medicines and patient journeys, a higher burden of evidence for the reimbursement of medicines, innovative data generation opportunities, the changing stakeholder engagement expectations and the focus on corporate reputation, Medical Affairs is positioned as a key to assist in navigating the organization through these complexities. The GM can help to foster the evolving role of Medical Affairs, encouraging lateral moves for broader enterprise mindset, imparting a culture of shared governance responsibilities across functions to encourage innovative thinking and nurture upcoming leaders by investing in training to take advantage of the above trends and deliver best patient and organizational outcomes now and in the future.
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