Leadership for careful and kind care

Allwood, Dominique; Koka, Sreenivas; Armbruster, Ryan; Montori, Víctor M.

doi:10.1136/leader-2021-000451

Cited by 18 publications

(24 citation statements)

References 29 publications

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“…Only by integrating the perspective of the different stakeholders involved the current HRT model, it will be possible to identify the major drawbacks and aspire for an improved and integrated healthcare model. The careful and kind care model could be a good reference and, as Allwood et al suggested, healthcare should be "elegant" (no waste or haste), "focused" on the relevant elements of biology and biography, "sensitive" to each patient's problems and "minimally disruptive", with little interference in the lives of patients [30].…”

Section: Discussionmentioning

confidence: 99%

The Portuguese Model of Home Respiratory Care: Healthcare Professionals’ Perspective

et al. 2021

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Patients’ and carers’ views regarding the Portuguese model of home respiratory care were recently described, yet the complementary perspective of healthcare professionals (HCPs) is still to be investigated. Thus, this study explored HCPs experience in the management of patients needing home respiratory therapies (HRT), and their perspective about the Portuguese model. A phenomenological descriptive study, using focus groups, was carried out with 28 HCPs (median 42 y, 68% female) with distinct backgrounds (57% pulmonologists, 29% clinical physiologists, 7% physiotherapists, 7% nurses). Three focus groups were conducted in three regions of Portugal. Thematic analysis was performed by two independent researchers. HCPs have in general a positive view about the organization of the Portuguese model of home respiratory care, which was revealed in four major topics: Prescription (number of references, n = 171), Implementation and maintenance (n = 162), Carer involvement (n = 65) and Quality of healthcare (n = 247). Improvements needed were related to patients’ late referral, HRT prescription (usability of the medical electronic prescription system and renewals burden), patients’ education, access to hospital care team, lack of multidisciplinary work and articulation between hospital, primary and home care teams. This study describes the perspective of HCPs about the Portuguese model of home respiratory care and identifies specific points where improvements and reflections are needed. This knowledge may be useful to decision makers improve the current healthcare model.

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Section: Discussionmentioning

confidence: 99%

The Portuguese Model of Home Respiratory Care: Healthcare Professionals’ Perspective

et al. 2021

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“…It is noteworthy that the recent high-profile critique of the industrialisation of care by Allwood et al (2021) echoes some of the language cited above about rhythm and the aesthetics of sociality by arguing for what the authors call 'elegance' in communication. In contrast to 'hurried' conversations-motivated by efficiency but actually inefficient-elegance, the authors argue, may not require more time and can also save much waste of time and other resources elsewhere.…”

Section: Original Researchmentioning

confidence: 95%

Aesthetics for everyday quality: one way to enrich healthcare improvement debates

Cribb

Pullin

2022

Med Humanities

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In this paper we seek to illuminate the importance of aesthetics for healthcare quality and encourage more explicit discussion of aesthetics in healthcare improvement scholarship and practice. We hope to contribute to and help develop the hinterland between arts-based initiatives in healthcare and the ‘normal business’ of healthcare quality improvement. Our broad contention is: (1) That aesthetic considerations should be seen as of universal relevance across quality debates (2) That they never be assumed to have a marginal or even secondary status; and (3) That taking aesthetic considerations seriously calls for explicit discussion of associated uncertainties and dilemmas and a readiness to welcome aesthetics expertise into improvement debates.

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“…Healthcare organisations are responding to this growing demand with increasing levels of industrialisation: efficiently processing people, treating them according to protocols while limiting access through triage, automatisation, and administrative hindrances. These efforts have produced pathologies of care,1 such as cruel delays to accessing care, onerous administrative tasks, “not our job” frustrations when navigating the system, and hurried conversations that result in generic (care for patients like this rather than for this patient) and burdensome care offered by clinicians unfamiliar with and to the patient. Forty percent of patients with multiple chronic conditions report being unable to sustain the work healthcare has delegated on to them2; 40% of healthcare encounters are spent with the clinician attending to the demands of the computer3; 40% of clinicians report symptoms of burnout, with many leaving clinical care or curtailing their patient care hours 4.…”

Section: Healthcare Is Unsustainablementioning

confidence: 99%