The Impact of Leader-Member Relationships on Team Effectiveness Through Speaking Up and Silence: A Cross-Sectional Study in Rural Chinese Hospitals.

Introduction: Although the importance of leader-member relationships in teamwork is acknowledged in literature, a deeper understanding of this relationship is lacking, especially in rural areas. The impact of leader-member relationships on team outcomes is especially important in rural Chinese hospitals as improving teamwork forms a national health reform priority in these hospitals. This study investigates how leader-member relationships (ie leader-member perceived similarity and power distance orientation) influence team outcomes (ie perceived quality of care and job satisfaction) via speaking up and silence.

Do generational diversity and perceived similarity improve team functioning in rural Chinese hospitals? A cross-sectional survey study.

Objectives: Generational diversity, increasingly prominent in the composition of the healthcare workforce in rapidly developing countries, has received much attention in practice and research recently. While research has revealed various positive and negative impacts of generational diversity on team functioning, the understanding of the mechanism explaining how generational diversity influences team functioning is still limited. This study in rural Chinese hospitals examines the relationship between (surface-level) generational diversity and (deep-level) perceived similarity and investigates how they influence three teamwork behaviours that importantly determine quality of care, namely speaking up, silence and knowledge sharing.

Multidisciplinary Collaboration in Hospitals via Patient- and Process-Oriented Units: A Longitudinal Study.

Introduction: The complexity of healthcare is increasing, mainly due to the prevalence of multimorbidity in an ageing population. Complex care for patients with multimorbidity requires a multidisciplinary approach. Traditional physician-centered hospital structures do not facilitate the necessary multidisciplinary collaboration.

Identifying Differences in Frames of Reference That Are Hard to Reconcile During the Process of Normative Integration to Deliver Care for People with Multiple Problems: A Mixed-Method Delphi Study in the Netherlands.

Background: Integrated care is enhanced by integration on system, organizational, professional, and clinical levels including functional and normative integration. Many studies have been done on functional integration on these different levels, less studies focus on how normative integration takes place. In this study, we focus on the question: what differences in frames of refence must be addressed to establish consensus on appropriate care for People with Multiple Problems?

Methods: A mixed-method Delphi study was carried out in which professionals and managers regularly involved in care for people with multiple problems (PWMPs) worked towards consensus on appropriate care delivery through the assessment of 15 vignettes representing real trajectories of PWMPs.

The Effect of Long-Term (Im)balance of Giving Versus Receiving Support With Nonrelatives on Subjective Well-Being Among Home-Dwelling Older People.

Objectives: Although many studies have explored the benefits of support giving or receiving for older people, little is known about how the balance between giving and receiving instrumental support in nonrelative relationships affects home-dwelling older people. This study examines the relationship between long-term support balance and subjective well-being in relationships with nonrelatives among older people across 11 European countries.

Methods: A total of 4,650 participants aged 60 years and older from 3 waves of the Survey of Health and Retirement in Europe were included.

Clinical leaders crossing boundaries: A study on the role of clinical leadership in crossing boundaries between specialties.

Background: Due to the growing number of complex (multimorbid) patients, integrating and coordinating care across medical specialties around patient needs is an urgent theme in current health care. Clinical leadership plays an important role in stimulating coordination both within and between specialty groups, which results in better outcomes in terms of job satisfaction and quality of care.

Purpose: In this light, this study aims to understand the relation between physicians' clinical leadership and outcomes, focusing on the sequential mediation of relationships and coordination with physicians within their own medical specialty group and from other specialties.

Factors and interventions determining the functioning of health care teams in county-level hospitals in less affluent areas of China: a qualitative study.

Background: Teamwork is essential for the quality and safety of care, and research on teamwork in health care has developed rapidly in many countries. However, evidence from less affluent, non-Western countries is scarce, while improving teamwork may be especially relevant to be able to increase the quality of care in these settings. This study aims to understand the main factors that influence, and interventions used to improve, the functioning of health care teams in the context of county-level hospitals in less affluent areas of China.

Towards Process-Oriented Hospital Structures; Drivers behind the Development of Hospital Designs.

Hospitals have been encouraged to develop more process-oriented designs, structured around patient needs, to better deal with patients suffering from multi-morbidity. However, most hospitals still have traditional designs built around medical specialties. We aimed to understand how hospital designs are currently developing and what the important drivers are.

Crisis Management Tasks in Dutch Nursing Homes During the COVID-19 Pandemic: A Longitudinal Interview Study.

The COVID-19 pandemic hit long-term care, and particularly nursing homes hard. We aimed to explore how crisis management goals and tasks evolve during such a prolonged crisis, using the crisis management tasks as identified by Boin and 't Hart as a starting point. This longitudinal, qualitative study comprises 47 interviews with seven Dutch nursing home directors and a focus group.

How do clients with multiple problems and (in)formal caretakers coproduce integrated care and support? A longitudinal study on integrated care trajectories of clients with multiple problems.

Introduction: Integrated care can create several advantages, such as better quality of care and better outcomes. These advantages apply especially to clients with multiple problems (CWMPs) who have multiple, interconnected needs that span health and social issues and require different health care (e.g.

Collaboration Between Physicians from Different Medical Specialties in Hospital Settings: A Systematic Review.

Health care today is characterized by an increasing number of patients with comorbidities for whom interphysician collaboration seems very important. We reviewed the literature to understand what factors affect interphysician collaboration, determine how interphysician collaboration is measured, and determine its effects. We systematically searched six major databases.

Effect of Receiving Financial Support from Adult Children on Depression among Older Persons and the Mediating Role of Social Participation.

Older persons are vulnerable to depression SFduring the ageing process. Financial resources and social participation are expected to have an impact on depressive symptoms. This study investigated the relationship between financial support from children and depression among Chinese older persons, as well as the mediating effect of social participation in this relationship.

China's Elder Care Policies 1994-2020: A Narrative Document Analysis.

Until the 1980s, institutional elder care was virtually unknown in China. In a few decades, China had to construct a universal social safety net and assure basic elderly care. China's government has been facing several challenges: the eroding traditional family care, the funding to assure care services for the older population, as well as the shortage of care delivery services and nursing staff.

Primary healthcare professionals' perspective on vertical integration of healthcare system in China: a qualitative study.

Objective: This study aims to present the perspectives of primary healthcare professionals (PHPs) on the impacts of implementation of vertical integration and on the underlying interprofessional collaboration process on achievement of the policy goals in China.

Design: A qualitative study involving individual interview and group interview was conducted between 2017 and 2018.

Setting: Primary healthcare institutions (PHIs) in five counties/districts of China.

What Do We Know About Teamwork in Chinese Hospitals? A Systematic Review.

Improving quality of care is one of the primary goals in current Chinese hospital reforms. Teamwork can play an essential role. Characteristics of teamwork and interventions for improving teamwork in hospitals have been widely studied.

Factors Influencing the Implementation of Foreign Innovations in Organization and Management of Health Service Delivery in China: A Systematic Review.

China has been encouraged to learn from international innovations in the organization and management of health service delivery to achieve the national health reform objectives. However, the success and effectiveness of implementing innovations is affected by the interactions of innovations with the Chinese context. Our aim is to synthesize evidence on factors influencing the implementation of non-Chinese innovations in organization and management of health service delivery in mainland China.

Patients as team members: Factors affecting involvement in treatment decisions from the perspective of patients with a chronic condition.

Background: Active patient involvement in treatment decisions is seen as a feature of patient-centred care that will ultimately lead to better healthcare services and patient outcomes. Although many factors have been identified that influence patient involvement in treatment decisions, little is known about the different views that patients have on which factors are most important.

Objective: This study explores the views of patients with a chronic condition on factors influencing their involvement in treatment decisions.

Coproducing care and support delivery in healthcare triads: Dutch case managers for people with dementia at home using strategies to handle conflict in the healthcare triad.

Dutch policy stipulates that people with dementia should remain at home for as long as possible. If they need care, they must preferably appeal to family, friends and neighbours. Professional help and nursing homes are deemed last resorts.

Organization and Outcomes of Integrated Inpatient Medical and Psychiatric Care Units: A Systematic Review.

Objective: The goal of this review was to assess the relationships among aims, designs, and outcomes of integrated inpatient medical and psychiatric care units (IMPUs) and gather the evidence base on the effectiveness of these units.

Methods: Using online searches of Embase, Medline, Web of Science, PsycINFO, Scopus, CINAHL, Cochrane, and Google Scholar, the authors identified and reviewed literature describing the aims and outcomes of specific IMPU designs.

Results: The search yielded 55 studies, in which the authors identified 39 IMPUs that focused on patients with mood, psychotic, somatic symptom, substance use, organic, and personality disorders and a broad array of medical diagnoses.

Dreaming the impossible dream? An exploratory study on the expectations of Dutch clients with multiple problems concerning the co-production of public services.

Currently, many policymakers try to encourage client involvement during the public service delivery process and make it a co-production. Clients are encouraged to act as active agents and embrace an integrated approach to address their problems to empower them. However, different studies have raised questions regarding to what extent these ambitions are appropriate for clients with vulnerabilities, such as clients with multiple problems.

Integrating Palliative Care by Virtue of Diplomacy; A Cross-sectional Group Interview Study of the Roles and Attitudes of Palliative Care Professionals to Further Integrate Palliative Care in Europe.

Background: Palliative care involves the care for patients with severe and advanced diseases with a focus on quality of life and symptom management. Integration of palliative care with curative and/or chronic care is expected to lead to better results in terms of quality of life and reduced costs. Although initiatives in different countries in Europe choose different structures to integrate care, they face similar challenges when it comes to creating trust and aligning visions, cultures and professional values.

'Hybrid' top down bottom up health system innovation in rural China: A qualitative analysis.

Introduction: China has made considerable progress with health system reforms in recent years. Rural China, however, has lagged behind as the diversity of needs of China's 3,000 rural counties were not always well addressed by national top-down reforms. China's Rural Health Reform Project Health XI (HXI) piloted a hybrid process of top down and bottom up implementation of health system reforms which were tailored to rural county level needs and covered a population of more than 21 million.

Adaptive design: adaptation and adoption of patient safety practices in daily routines, a multi-site study.

Background: Most interventions to improve patient safety (Patient Safety Practices (PSPs)), are introduced without engaging front-line professionals. Administrative staff, managers and sometimes a few professionals, representing only one or two disciplines, decide what to change and how. Consequently, PSPs are not fully adapted to the professionals' needs or to the local context and as a result, adoption is low.

Interventions to improve team effectiveness within health care: a systematic review of the past decade.

Background: A high variety of team interventions aims to improve team performance outcomes. In 2008, we conducted a systematic review to provide an overview of the scientific studies focused on these interventions. However, over the past decade, the literature on team interventions has rapidly evolved.

Identifying value-based quality indicators for general hospital psychiatry.

Objective: To define generic quality indicators for general hospital psychiatry from the perspectives of patients, professionals (physicians, nurses, and managers), and payers (health insurance companies).

Methods: Quality variables were identified by reviewing the relevant literature. A working.