title: Clinical Governance, Performance Appraisal and Interactional and Procedural Fairness at a New Zealand Public Hospital

authors: Clarke, Carol

subjects: clinical governance

abstract: This paper explores the conduct of performance appraisals of nurses in a New Zealand hospital, and how fairness is perceived in such appraisals. In the health sector, performance appraisals of medical staff play a key role in implementing clinical governance, which, in turn, is critical to containing health care costs and ensuring quality patient care. Effective appraisals depend on employees perceiving their own appraisals to be fair both in terms of procedure and interaction with their respective appraiser. We examine qualitative data from interviews and focus groups, involving 22 nurses in a single department, to determine whether perceived injustices impact on the effective implementation of the appraisal system. Our results suggest that particular issues had been causing some sense of injustice, and most of these were procedural. Potential solutions focus on greater formalisation of the performance appraisal process, and more training for appraisers and appraisees.

text: Clinical Governance, Performance Appraisal and Interactional and Procedural Fairness at a New Zealand Public Hospital This paper explores the conduct of performance appraisals of nurses in a New Zealand hospital, and how fairness is perceived in such appraisals. In the health sector, performance appraisals of medical staff play a key role in implementing clinical governance, which, in turn, is critical to containing health care costs and ensuring quality patient care. Effective appraisals depend on employees perceiving their own appraisals to be fair both in terms of procedure and interaction with their respective appraiser. We examine qualitative data from interviews and focus groups, involving 22 nurses in a single department, to determine whether perceived injustices impact on the effective implementation of the appraisal system. Our results suggest that particular issues had been causing some sense of injustice, and most of these were procedural. Potential solutions focus on greater formalisation of the performance appraisal process, and more training for appraisers and appraisees.

year: 2012

title: Vitamin D, innate immunity and outcomes in community acquired pneumonia

authors: Leow, Leong

subjects: Vitamin D

abstract: We investigated the associations between vitamin D status, the antimicrobial peptides cathelicidin and beta defensin-2 and outcomes in community acquired pneumonia. In hospitalised patients with community acquired pneumonia, vitamin D deficiency but not antimicrobial peptide levels were associated with increased 30-day mortality. Vitamin D was not associated with levels of the antimicrobial peptide cathelicidin or beta defensin-2.

text: Vitamin D, innate immunity and outcomes in community acquired pneumonia We investigated the associations between vitamin D status, the antimicrobial peptides cathelicidin and beta defensin-2 and outcomes in community acquired pneumonia. In hospitalised patients with community acquired pneumonia, vitamin D deficiency but not antimicrobial peptide levels were associated with increased 30-day mortality. Vitamin D was not associated with levels of the antimicrobial peptide cathelicidin or beta defensin-2.

year: 2011

title: He Pikinga Waiora Implementation Framework: A tool for chronic disease intervention effectiveness in Maori and other indigenous communities

authors: Oetzel, John G.

subjects: Science & Technology

abstract: Introduction: Health outcomes for Māori are significantly worse than non-Maori in New Zealand; these inequities mirror those found in indigenous communities elsewhere. Evidence-based interventions with established efficacy may not be effective in indigenous communities without addressing specific implementation challenges. We present an implementation framework for chronic condition interventions for Māori.

Theory/Methods: The He Pikinga Waiora Implementation Framework has indigenous self-determination at its core and consists of four elements: cultural-centeredness, community engagement, systems thinking, and integrated knowledge translation.  All elements have demonstrated evidence of positive implementation outcomes.  A coding scheme derived from the Framework was applied to 13 studies of diabetes prevention in indigenous communities from a systematic review.

Results: Cross-tabulations demonstrated that culture-centeredness (p=.008) and community engagement (p=.009) explained differences in diabetes outcomes and community engagement (p=.098) explained difference in blood pressure outcomes.

Discussion and Conclusions: The He Pikinga Waiora Implementation Framework is well suited to advance implementation science for Māori and other indigenous communities. The framework has promise as a policy and planning tool to evaluate and design effective interventions for chronic disease prevention.

Lessons Learned: We needed to revise the coding framework in order to make the implication framework concrete.

Limitations: This study has a limitation in that we coded information about interventions from the published articles and not the interventions themselves. Additionally, the study only included 13 interventions.

Suggestions for Future Direction: Further research should provide stronger evidence of the usefulness of the framework particularly with Māori end-users. There will also be a need to understand the differential contribution of each of the four elements to health outcomes.

text: He Pikinga Waiora Implementation Framework: A tool for chronic disease intervention effectiveness in Maori and other indigenous communities Introduction: Health outcomes for Māori are significantly worse than non-Maori in New Zealand; these inequities mirror those found in indigenous communities elsewhere. Evidence-based interventions with established efficacy may not be effective in indigenous communities without addressing specific implementation challenges. We present an implementation framework for chronic condition interventions for Māori.

Theory/Methods: The He Pikinga Waiora Implementation Framework has indigenous self-determination at its core and consists of four elements: cultural-centeredness, community engagement, systems thinking, and integrated knowledge translation.  All elements have demonstrated evidence of positive implementation outcomes.  A coding scheme derived from the Framework was applied to 13 studies of diabetes prevention in indigenous communities from a systematic review.

Results: Cross-tabulations demonstrated that culture-centeredness (p=.008) and community engagement (p=.009) explained differences in diabetes outcomes and community engagement (p=.098) explained difference in blood pressure outcomes.

Discussion and Conclusions: The He Pikinga Waiora Implementation Framework is well suited to advance implementation science for Māori and other indigenous communities. The framework has promise as a policy and planning tool to evaluate and design effective interventions for chronic disease prevention.

Lessons Learned: We needed to revise the coding framework in order to make the implication framework concrete.

Limitations: This study has a limitation in that we coded information about interventions from the published articles and not the interventions themselves. Additionally, the study only included 13 interventions.

Suggestions for Future Direction: Further research should provide stronger evidence of the usefulness of the framework particularly with Māori end-users. There will also be a need to understand the differential contribution of each of the four elements to health outcomes.

year: 2018