Journal of evaluation in clinical practice
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The Patient-Centred Medical Home (PCMH) is a model of team-based care that is patient centred, coordinated, accessible, and focused on quality and safety. To learn how this model of healthcare works in an Indigenous primary health care setting in Australia, we explored the experiences of health staff in an urban Aboriginal Community Controlled Health Service (ACCHS) transitioning to an adapted model of a PCMH. Normalisation Process Theory (NPT) was applied to better understand factors enabling and inhibiting implementation of the PCMH, and the work required to deliver it. ⋯ Applying NPT revealed the characteristics and practice norms of Indigenous community controlled health care as key enablers of implementing a PCMH in an urban ACCHS. Less than optimal resourcing and workforce development emerged as barriers needing to be resolved to strengthen implementation and delivery of a PCMH in this setting.
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Today, hospital information systems (HISs) play an irreplaceable role in hospital management. At present, HIS construction projects in many hospitals have faced the setback of 'project quagmire' to varying degrees. The critical path method (CPM) mainly aims to find the critical path, thus managing project progress. ⋯ The CPM could effectively measure the completion and deviation of each stage of the registration system project, which provided an effective guarantee for the subsequent schedule compression to ensure that the project was completed as scheduled and was of sufficient quality. However, all conditions had to be considered comprehensively; doing otherwise would lead to increased risks and costs.
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To meet concerns about ethical and unethical behavior in their work environments and workplaces, organizations began establishing ethics programs that contain ethics committees (ECs). There is now a tradition and diverse use of ECs for ethical decision-making in many different organizational settings. In addition, ECs have been subject to many publications in books and articles in the scientific literature. Yet, until now no comparative analysis has been published that brings together ECs' practices in different sectors. ⋯ Based on the exploratory analysis in this study, we conclude that there are the following three distinct main requirements for the functionality of ECs: (1) a dialog between EC members and other stakeholders, (2) an approach that considers various possible modes (reactive, screening, moderating, and preventive) to enhance the quality of ECs' decision-making processes and (3) an outreach to all relevant EC stakeholders for the further validation of the main requirements found for ECs functionality.