Improving the safety and quality of nursing care through standardized operating procedures in Bosnia and Herzegovina

Ausserhofer, Dietmar; Rakić, Severin; Novo, Ahmed; Dropic, Emira; Fisekovic, Eldin; Sredic, Ana; Malderen, Greet Van

doi:10.1111/inr.12237

Cited by 9 publications

(8 citation statements)

References 18 publications

(19 reference statements)

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“…Most of the papers (17/25) describe using positive deviance as a method to initiate conscious and systematic (behavioural) change in an organisation. The positive deviance method is based on the assumption that in each community, individuals or groups can find better solutions and achieve better results than their peers by executing unusual behaviour even though the circumstances and availability of materials and resources are the same for all (Ausserhofer et al, 2016 ; Baxter et al, 2018 ; Bonuel et al, 2009 ; Bristol et al, 2018 ; Clancy, 2010 ; de MacEdo et al, 2012 ; Gary, 2013 ; Gesser‐Edelsburg et al, 2018 ; Létourneau et al, 2018 ; Lindberg & Clancy, 2010 ; Lindberg & Schneider, 2013 ; Marra et al, 2011 , 2013 ; Sheard et al, 2017 ; Sreeramoju, 2019 ; Sreeramoju et al, 2018 ). These individuals or groups can be identified and pushed forward, and organisations can learn from their approaches (Baxter et al, 2018 , 2019 ).…”

Section: Resultsmentioning

confidence: 99%

“…Although the positive deviance approach seems to be a bottom‐up movement, several papers show the importance of management involvement and support (Ausserhofer et al, 2016 ; Bonuel et al, 2009 ; Chang et al, 2018 ). This is also found in the literature on tempered radicals (Brandi & Naito, 2006 ) and healthcare rebels (Wallenburg et al, 2019 ).…”

Section: Resultsmentioning

confidence: 99%

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A scoping review of rebel nurse leadership: Descriptions, competences and stimulating/hindering factors

Kok

Weggelaar-Jansen

Schoonhoven

et al. 2021

Journal of Clinical Nursing

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Aims To (1) give an overview of rebel nurse leadership by summarising descriptions of positive deviance, tempered radicals and healthcare rebels; (2) examine the competences of nurse rebel leadership; and (3) describe factors that stimulate or hinder the development of rebel nurse leadership. Background Research shows nurses have lower intention to leave their jobs when they can control their work practices, show leadership and provide the best care. However, organisational rules and regulations do not always fit the provision of good care, which challenges nurses to show leadership and deviate from the rules and regulations to benefit the patient. Three concepts describe this practice: positive deviance, healthcare rebels and tempered radicals. Design Scoping review using the Joanna Briggs Institute methodology and PRISMA‐ScR checklist. Methods Papers describing positive deviance, healthcare rebels and tempered radicals in nursing were identified by searching Scopus, CINAHL, PubMed and PsycINFO. After data extraction, these three concepts were analysed to study the content of descriptions and definitions, competences and stimulating and hindering factors. Results Of 2705 identified papers, 25 were included. The concept descriptions yielded three aspects: (1) positive deviance approach, (2) unconventional and non‐confirmative behaviour and (3) relevance of networks and relationships. The competences were the ability to: (1) collaborate in/outside the organisation, (2) gain and share expert (evidence‐based) knowledge, (3) critically reflect on working habits/problems in daily care and dare to challenge the status quo and (4) generate ideas to improve care. The factors that stimulate or hinder the development of rebel nurse leadership are as follows: (1) dialogue and reflection, (2) networking conditions and (3) the managers’ role. Conclusions Based on our analysis, we summarise the descriptions given of rebel nurse leadership, the mentioned competences and provide an overview of the factors that stimulate or hinder rebel nurse leadership. Relevance to clinical practice The descriptions produced in this review of rebel nurse leadership and the stimulating or hindering factors listed should help nurses and managers encourage rebel leadership.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A scoping review of rebel nurse leadership: Descriptions, competences and stimulating/hindering factors

Kok

Weggelaar-Jansen

Schoonhoven

et al. 2021

Journal of Clinical Nursing

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“…The aim of the project was to develop core competencies for the nursing profession and provide teaching support to Western Balkan countries by European union countries (Belgium, Netherlands, and Slovakia), which are in line with the learning outcomes for nursing education. The number of challenges and obstacles negatively influencing the nursing profession and consequently holding back health outcomes in countries of this European region were identified during the project analysis in collaboration with each country's stakeholders . Notwithstanding, nursing education reform was identified as an important strategy for enhancing health workforce performance and health systems functioning; significant weaknesses in the policy capacity responsible for the leadership and governance of nursing have been found.…”

Section: Introductionmentioning

confidence: 99%

Perceptions, attitudes, and expectation of baccalaureate nurses toward position of nursing in Bosnia and Herzegovina

Račić

Pavlović

Hadživuković

et al. 2019

Health Planning & Management

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Summary Introduction Numerous challenges and barriers have emerged since changing the minimum requirement for those interested in pursuing employment as a nurse in Europe to a baccalaureate degree. To analyze the perceptions of baccalaureate nurses regarding the current status of their profession and the issues involved in implementing the prerequisite of earning a baccalaureate degree in order to practice as nurses in Bosnia and Herzegovina. Methods A series of six focus groups were undertaken with 49 baccalaureate nurses employed in primary health care centers and regional hospitals. The focus groups were recorded and transcribed verbatim. Data collected were analyzed using conventional content analysis approach. Results Baccalaureate nurses report dissatisfaction with their level of autonomy and anxiety over their limited career opportunities. They expressed concern over difficult working conditions, inadequate financial compensation, and ongoing resistance by physicians as the primary barriers to implementing advanced nursing education and professional reform. The global image of the nursing profession is negative. Conclusion The perception is that revising the legal framework regarding nursing qualifications, duties, and standards will result in reform necessary to positively affect the during profession. Progress toward implementing reform of the nursing profession is negligible. Addressing barriers such as work environment, lack of job classification, fair payment, autonomy, and interdisciplinary collaboration toward the competences of baccalaureate nurse is essential if successful reform is to occur.

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“…30 This approach has demonstrated its value in identifying organisational strategies and best practices in healthcare settings. 31,32 The approach assumes that knowledge about the best practices exists in top-performing organisations-in our case the PHC centres that have already found solutions to the financial sustainability problem in the RS context. We focused research on the PHC centres with positive financial results only, because their unique solutions could be spread to and immediately implemented by other PHC centres, without waiting for all the underlying determinants of the problem to be addressed.…”

Section: Designmentioning

confidence: 99%

Financial sustainability strategies of public primary health care centres in the Republic of Srpska, Bosnia and Herzegovina

Rakić

Djudurovic

Antonić

2021

Health Planning & Management

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Background: The literature on the functioning of public health facilities in health systems with significant arrears is limited. The growing liabilities of health facilities and the accumulating arrears have been a challenge in the Republic of Srpska. Most public primary healthcare (PHC) centres generated a gross loss in 2018. Method: Guided by the 'positive deviance' approach, we used an exploratory case study design to identify strategies used by managers to achieve financial sustainability in eight top-performing PHC centres. Qualitative data were collected through face-to-face in-depth semistructured interviews with key informants from the PHC centres that reported positive financial results in 2018. Results: Seven organisational goals, comprising 34 financial sustainability strategies, were recognised during the data analysis and were used to build an organisational-level model for a PHC centre. Conclusion: Managers concurrently used multiple strategies to ensure financial sustainability. Each centre tailored its range of strategies to the organisational context, local context, and wider environment of the health system. The strategies were conceived and implemented by managers operating at different organisational levels under the leadership of top-level managers. Managers of indebted health facilities can learn from the positively deviant peers who manage facilities that achieved satisfactory financial performance.

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Improving the safety and quality of nursing care through standardized operating procedures in Bosnia and Herzegovina

Cited by 9 publications

References 18 publications

A scoping review of rebel nurse leadership: Descriptions, competences and stimulating/hindering factors

A scoping review of rebel nurse leadership: Descriptions, competences and stimulating/hindering factors

Perceptions, attitudes, and expectation of baccalaureate nurses toward position of nursing in Bosnia and Herzegovina

Financial sustainability strategies of public primary health care centres in the Republic of Srpska, Bosnia and Herzegovina

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