Publication :
Orthopedist involvement in the management of clinical activities : a case study

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Date
2021-04-01
Direction de publication
Direction de recherche
Titre de la revue
ISSN de la revue
Titre du volume
Éditeur
Springer Nature
Projets de recherche
Structures organisationnelles
Numéro de revue
Résumé
Background The rapid shift in hospital governance in the past few years suggests greater orthopedist involvement in management roles, would have wide-reaching benefits for the efficiency and effectiveness of healthcare delivery. This paper analyzes the dynamics of orthopedist involvement in the management of clinical activities for three orthopedic care pathways, by examining orthopedists’ level of involvement, describing the implications of such involvement, and indicating the main responses of other healthcare workers to such orthopedist involvement. Methods We selected four contrasting cases according to their level of governance in a Canadian university hospital center. We documented the institutional dynamics of orthopedist involvement in the management of clinical activities using semi-structured interviews until data saturation was reached at the 37th interview. Results Our findings show four levels (Inactive, Reactive, Contributory and Active) of orthopedist involvement in clinical activities. With the underlying nature of orthopedic surgeries, there are: (i) some activities for which decisions cannot be programmed in advance, and (ii) others for which decisions can be programmed. The management of unforeseen events requires a higher level of orthopedist involvement than the management of events that can be programmed. Conclusions Beyond simply identifying the underlying dynamics of orthopedists’ involvement in clinical activities, this study analyzed how such involvement impacts management activities and the quality-of-care results for patients.
Description
Revue
BMC health services research, Vol. 21 (299), 1-11 (2021)
DOI
10.1186/s12913-021-06299-2
URL vers la version publiée
Mots-clés
Care management , Physician incentive , Patient outcomes , Quality of healthcare , Orthopedic surgeries
Citation
Type de document
article de recherche