Institut für Kooperationsforschung und -entwicklung
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Publikation Managers perception of hospital employees’ effort-reward imbalance(BioMed Central, 2023) Heming, Meike; Siegrist, Johannes; Erschens, Rebecca; Genrich, Melanie; Hander, Nicole R.; Junne, Florian; Küllenberg, Janna; Müller, Andreas; Worringer, Britta; Angerer, PeterAbstract Objective Hospitals are frequently associated with poor working conditions that can lead to work stress and increase the risk for reduced employee well-being. Managers can shape and improve working conditions and thereby, the health of their teams. Thus, as a prerequisite, managers need to be aware of their employees’ stress levels. This study had two objectives: At first, it aimed to test the criterion validity of the Effort-Reward Imbalance (ERI) questionnaire measuring psychosocial workload in hospital employees. Secondly, mean scales of the ERI questionnaire filled in by employees were compared with mean scales of an adapted ERI questionnaire, in which managers assessed working conditions of their employees. Methods Managers (n = 141) from three hospitals located in Germany assessed working conditions of their employees with an adapted external, other-oriented questionnaire. Employees (n = 197) of the mentioned hospitals completed the short version of the ERI questionnaire to assess their working conditions. Confirmatory factor analyses (CFA) were applied to test factorial validity, using the ERI scales for the two study groups. Criterion validity was assessed with multiple linear regression analysis of associations between ERI scales and well-being among employees. Results The questionnaires demonstrated acceptable psychometric properties in terms of internal consistency of scales, although some indices of model fit resulting from CFA were of borderline significance. Concerning the first objective, effort, reward, and the ratio of effort-reward imbalance were significantly associated with well-being of employees. With regard to the second objective, first tentative findings showed that managers’ ratings of their employees’ effort at work was quite accurate, whereas their reward was overestimated. Conclusions With its documented criterion validity the ERI questionnaire can be used as a screening tool of workload among hospital employees. Moreover, in the context of work-related health promotion, managers’ perceptions of their employees’ workload deserve increased attention as first findings point to some discrepancies between their perceptions and those provided by employees.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Mobil-flexible Arbeit – auf den Rhythmus kommt es an(07.03.2023) Schulze, Hartmut- Hybrid Work wird zur dominierenden Arbeitsweise. - Faustregel: zwischen 2-3 Tagen remote bzw. vor Ort (v.a. im wissensintensiven Sektor) –für neue Mitarbeitende anfangs mehr vor Ort - Achtung: Entstehung von Mythenzwischen verschiedenen Mitarbeitendengruppen. - Der Ort der Arbeit ist weniger wichtig als die Häufigkeit(und ggfs. die Qualität) derKontakte - Die Raumgestaltungspielt eine Rolle für die Wahl des Arbeitsortes; eine positiv wahrgenommene Atmosphäre des Raumes wirkt sich positiv auf die Häufigkeit der Arbeit vor Ort aus und hat einen Einfluss auf die Produktivität06 - PräsentationPublikation Einblick in das Feld der Telepräsenzroboter(Schweizerischer Berufsverband der Aktivierungsfachfrauen/-männer, 2023) Schulze, Hartmut; Urech, Andreas; Rietschin, Joël; Rüegg, MichelleEinhergehend mit dem demographischen Wandel stellen sich neue Herausforderungen für den Gesundheitsbereich (Bendel, 2018), so stossen insbesondere die Leistungserbringer der Langzeitpflege auch infolge des Fachkräftemangels und der zunehmenden Kosten zunehmend an ihre Grenzen (CURAVIVA Schweiz, Fachbereich Menschen im Alter, 2020). Die Generation der Babyboomer erreicht in den nächsten Jahren sukzessive das Rentenalter. Auch wenn die Lebenserwartung kontinuierlich im weltweiten Vergleich bis 2050 auf ca. durchschnittlich 78 Jahre ansteigt (United Nations, 2019), so ist trotzdem in naher und mittlerer Zukunft mit einer deutlich ansteigenden Anzahl an betreuungs- und pflegebedürftigen Menschen zu rechnen. In Schweizer Alters- und Pflegeheimen werden ältere Menschen, die auf Langzeitpflege angewiesen sind, untergebracht. Während die Plätze in den Heimen zwar stetig zunehmen, wächst der Anteil an älteren Personen aber noch schneller. Dies bedeutet einen hohen Aufwand für die Pflege. Bereits 2021 wurden rund 42 % der Kosten der Pflegeheime durch Pflegeleistungen beansprucht (Bundesamt für Statistik, 2021). Modelle wie betreutes Wohnen oder trotz Einschränkungen im Eigenheim zu bleiben, verbreiten sich in der Schweiz immer mehr. Doch auch dort wird mit einem Anstieg von Pflegeleistungen, um +52 % bis ins Jahr 2040, ausgegangen (Pellegrini, Dutoit, Pahud & Dorn, 2022). Eine Studie im Auftrag von Pro Senectute Schweiz von 2020 (Meier et al., 2020) geht davon aus, dass in der Betreuung zu Hause die Leistungen «soziale Aktivität», «Sport ausser Haus», «Haushaltshilfe» sowie «Besuchs- und Begleitdienst» zusammen 75 % aller Einsätze ausmachen. Besonders letztere Leistungen stehen mit Einsamkeit in Verbindung und es wird ausserdem davon ausgegangen, dass einsame Personen den höchsten Anteil an Betreuungskosten verursachen. Vor diesem Hintergrund stellt sich die Frage, wie dem wachsenden Bedarf nach selbstbestimmtem Leben mit mehr oder weniger Beeinträchtigungen im Alter entsprochen werden kann und welche Betreuungs-und Pflegeansätze hier angemessen und auch umsetzbar sind. In diesem Zusammenhang hat CURAVIVA ein Wohn-und Pflegemodell 2030 erarbeitet, das in seiner überarbeiteten Version den Menschen in seinem Sozial- und Lebensraum in den Mittelpunkt stellt und die verschiedenen Betreuungsangebote und Dienstleistungen auf dieses Ziel hin konzipiert (CURAVIVA Schweiz, Fachbereich Menschen im Alter, 2020). Auch der Einsatz von Technik wird an dieser Stelle diskutiert. Eine dieser Techniklösungen könnten Roboter sein, welche für die Pflege eine ergänzende und für die älteren Personen eine unterstützende Rolle einnehmen. (Kramer et al., 2022).01B - Beitrag in Magazin oder ZeitungPublikation Interprofessionelle Qualitätszirkel für die Palliativversorgung(EMH Schweizerischer Ärzteverlag, 2021) Degen, Eveline; Liebig, BrigitteInterprofessionelle Qualitätszirkel können Fachleute unterschiedlichster Disziplinen zusammenführen, um die Herausforderungen des beruflichen Alltags in der allgemeinen und spezialisierten Palliative Care gemeinsam zu bewältigen. Ein aktuelles Projekt im Rahmen des Nationalen Forschungsprogramms «Gesundheitsversorgung » (NFP 74) hat dazu in enger Kooperation mit Hausärztinnen und Hausärzten ein Konzept und eine Agenda entwickelt.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation User Requirements for a Health Care Service Based on Point-of-care Testing in the Context of Ambulatory Care and Telemedicine for Older People.(AHFE Open Access, 2022) Mutuura, Kamalatharsie; Niederhauser, Mario; Erb, Nico; Van den Anker, FredIn healthcare, point-of-care testing, i.e., diagnostic testing at the time and place of patient care, allows for early diagnosis and therefore timely treatment of various diseases. These on-site tests are particularly beneficial to people living in remote areas and those with limited mobility. Our study focused on the design of a service for older people, whereby ambulatory care and telemedicine consultations are based on point-of-care testing. Its aim was to elicit user requirements, specifically for the use case of iron deficiency in older people. A textual scenario was developed which formed the foundation for the simulated or “enacted” scenario, with both undergoing participatory evaluations. A wide range of “socio-technical” requirements were elicited that are expected to be crucial for the implementation of this service. Based on content analysis they were categorized into technology-, people-, organization- and environment-related requirements. The results are discussed regarding the specific use case and methods used.04B - Beitrag KonferenzschriftPublikation Organizational determinants of information transfer in palliative care teams: A structural equation modeling approach(Public Library of Science, 03.06.2021) Schweighoffer, Reka; Blaese, Richard; Liebig, BrigitteSeveral organizational factors facilitate or hinder information transfer in palliative care teams. According to past research, organizational factors that reduce information transfer include the inconsistent use of shared electronic patient files, frequent changes of healthcare staff, a lack of opportunities for personal exchange, and a lack of evaluation of collaborative processes. Insufficient information sharing between professionals can negatively impact patient safety, whereas studies have shown that some organizational factors improve collaboration between professionals and thus contribute to improved patient outcomes. The main purpose of this study is thus to investigate whether, and if so how, organizational factors contribute to successful information exchange in palliative care teams in Switzerland, while also accounting for the different care contexts of primary and specialized palliative care. A nationwide survey was aimed at medical professionals working in palliative care. In total, 379 participants (mean age = 49.8 years, SD = 10.3) were included in this study. Two main outcome variables were examined: healthcare providers’ satisfaction with information transfer in their team and their overall satisfaction with communication in their team. Hypotheses were tested by employing structural equation modeling. Findings revealed that the strongest predictors for effective information transfer in palliative care teams were sufficient opportunities for face-to-face meetings and supervision alongside feedback tools to improve collaborative practices and the application of guidelines and standards for collaboration. Face-to-face meetings were an even greater contributor to information transfer in specialized settings, whereas sharing the same work-based values with colleagues was considered more important in primary settings. Results from this study contribute to the existing literature elucidating how information transfer is facilitated in the field of palliative care. If proposed measures are implemented, this could possibly improve patient outcomes in palliative care. Furthermore, the findings can be useful for healthcare organizations and associations to make more efficient resource allocation decisions with the aim to optimize information transfer within the workforce.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Palliative Care in der Schweiz. Die Perspektive der Leistungserbringenden(2020) Degen, Eveline; Liebig, Brigitte; Reeves, Emily; Schweighoffer, RekaIn den vergangenen Jahren wurde die Palliativversorgung in der Schweiz erheblich gestärkt. Eine steigende Zahl chronischer Erkrankungen und Bemühungen um ein Mehr an Kosteneffizienz im Gesundheitswesen bildeten wichtige Ausgangspunkte für die Erarbeitung einer «Nationalen Strategie» zur Förderung einer qualitativ hochstehenden palliativmedizinischen Versorgung. Wie aber haben sich die Bemühungen der letzten Jahre ausgewirkt? Eine qualitativ hochstehende Patientenversorgung baut auf zahlreichen Faktoren auf, von denen einige in diesem Bericht in den Fokus gerückt werden. Anknüpfend an ein in der Versorgungsforschung bekanntes Konzept zur Bewertung von Gesundheitsdienstleistungen wird ein aktuelles Bild zum Stand der Palliativversorgung aus Sicht der Leistungserbringenden in der Schweiz gezeichnet.10 - Elektronische-/ WebpublikationPublikation Collaborative Networks in Primary and Specialized Palliative Care in Switzerland - Perspectives of Doctors and Nurses(Bentham, 2020) Schweighoffer, Reka; Reeves, Emily; Liebig, BrigitteTo date, information about collaborative networks of doctors and nurses in palliative care is still scarce, yet of great importance in revealing gaps in collaboration. This paper investigates the collaboration frequencies of medical doctors and nurses within, and across, different settings of palliative care. The study was based on a Swiss national survey on “Collaboration and cooperation in Palliative Care”. The subjects surveyed included service providers in the primary and specialized palliative care sectors, as well as support services (N=1111). Information about ties between providers was gathered by asking professionals to estimate the frequency of interaction with other professionals within the last year, on a daily, weekly, monthly and yearly basis. Social network analysis was used to assess the interaction patterns of nurses and doctors (N= 728) in primary and specialized care settings. Visual representations indicated that, contrary to primary care settings, healthcare providers in specialized care settings reported of numerous interactions with other professions. In primary care, general practitioners reported the least frequent interactions with other professions. Of all providers investigated, specialized doctors in hospitals and hospices reported the densest collaborative networks. Gaps regarding collaboration in Swiss palliative care provision were revealed. Based on the results of the study, recommendations on how to improve service quality by strengthening the interaction patterns of general practitioners, as well as community-based palliative care, are provided.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Comparing the Perspectives of Professionals and Relatives Toward the Quality of Palliative Care: A Qualitative Study(LIDSEN, 2020) Reeves, Emily; Liebig, Brigitte; Degen, EvelineHigh-quality care is an important aim of palliative care services. However, the quality of care is a complex phenomenon and is subjectively perceived by those who are closest to the services and are often evaluated poorly. Prior research has highlighted the difficulties in evaluating the quality of care because of different perspectives, and still, only a little is understood about the perception of the quality of care in palliative care services. Investigating the perspectives of key individuals involved in palliative care, such as palliative professionals and relatives of palliative patients, can provide invaluable insight to understand the quality of care. To identify the perceptions of palliative professionals and relatives of the patients toward the quality of palliative care along with identifying the similarities and divergences in the perceptions, as well as highlighting the complexity of quality in palliative care settings while indicating their areas of improvement. This was a qualitative study that involved semi-structured interviews for the evaluation of palliative care guided by the proposed system approach model [1]. The interviews were conducted with a total number of 38 professionals working in palliative care along with 26 relatives of palliative patients across four Swiss cantons (Ticino, Basel, Vaud, and Lucerne). These professionals worked in primary palliative care (PPC) and specialized palliative care (SPC), where 11 general practitioners (GP’s) and 12 nurses were from primary palliative care services. Additionally, 15 interviews were conducted with 9 specialized medical doctors (e.g., oncologists) and 6 specialized palliative care nurses from different hospitals, hospices, mobile palliative care teams (MPCT’s), and specialist private practice. The results revealed considerable differences between the perspectives of professionals and relatives regarding the following aspects of care: 1) the availability, 2) client-centeredness (including respect for patient’s wishes and relative’s involvement in care, 3) satisfaction (including physical and psychosocial), and 4) communication and information transfer. Mainly, the family members felt that care was not being always readily available and coordinated poorly, the patient’s needs were overlooked because of the lack of time. Also, some professionals were perceived to be incompetent with a lack of communication and negligence toward the psychosocial needs of the patient. On the other hand, professionals indicated that relatives may be too involved in the patient care and might have expressed concern due to the high risk of burn out caused by extreme stress and emotionally taxing circumstances of palliative care. The different perspectives uncovered both the similarities and discrepancies, representing a demand for addressing the shortcomings of palliative care services. Specifically, findings indicated that professionals may overestimate the quality of palliative care. Also, future initiatives were needed to ensure that the family members of palliative patients were adequately supported, both psycho-socially and financially, justifying the investment. These findings would help in informing the health policy about the aspects of care that require specific attention to improve the overall quality of care and urge future research to explore the best ways to support these aspects of care.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Care Coordination in Palliative Home Care: Who Plays the Key Role?(Ubiquity Press, 2020) Reeves, Emily; Liebig, Brigitte; Schweighoffer, RekaBackground: Clearly identified professionals who are appointed for care coordination are invaluable for ensuring efficient coordination of health care services. However, challenges to identifying roles in palliative care are well documented in literature. Notably, in order to meet high demands on palliative home care settings, many care practitioners perform tasks that surpass the responsibilities and regulations of their role, including care coordination. Without clearly defined roles, standards of care cannot be guaranteed. Yet, little is understood about who plays the key role in palliative home care. Aim: The present study aims to address the gap in the research by identifying who plays a key role in coordination in palliative home care. Methods: Interviews with general practitioners (GPs), nurses and relatives of palliative patients were carried out in Swiss cantons (Vaud, Ticino, Luzern and Basel) to identify key coordinators of care. Interviews were analyzed using content analysis and presented using grounded theory. Results: Findings indicated that there was considerable ambiguity of the key coordinator role. 1) Causal conditions of this phenomenon were; informality of professional roles and lack of communication between team members, 2) Consequences of this included; conflicting understandings of key coordinator role and family members feeling overburdened, 3) Strategies adopted by interviewees included; adapting or taking control of care coordination. These findings are highly indicative of areas for improvement for care coordination in palliative home care settings. Specifically, they underline a profound need for clear communication between palliative care service providers regarding which professionals assume a key coordative role, or who are delegated a coordinative role at any given time. Crucially, since the findings reveal that relatives are intimately involved in care coordination, the findings point to a lack of adequate financial and psycho-social support for relatives of palliative patients who are burdened with coordination tasks, without the appropriate recompense.01A - Beitrag in wissenschaftlicher Zeitschrift