HEAL8180 Individual SWOT Reflection Assignment Instructions & Template
Instructions: Refer to the Instructional Plan for due dates. Complete the attached SWOT template
and upload as ONE Word document to eConestoga at the start of class to the ‘Individual SWOT
Reflection Assignment’ folder. Bullet points are acceptable for the table portion of this assignment, but
full sentences and professional language are required for the reflection component.
You were introduced to the SWOT analysis technique at the start of the semester. Each week, you
have learned about and discussed various current issues in healthcare administration and service
management and had an opportunity to reflect on your own strengths (S), weaknesses (W),
opportunities (O) and threats (T) as a healthcare leader. The attached template should be completed
in point form and submitted along with a double-spaced two-page reflection (combined into one Word
file) using professional language and full-sentences that addresses the following:
•
•
•
•
How has your initial SWOT changed/developed over the duration of the course?
What opportunities exist to build off of your professional strengths?
How will you address your areas of professional weakness and threats to your career as a
healthcare professional?
How will you remain current and up-to-date as a healthcare professional/leader?
Ensure that you include a minimum of three references to concepts discussed in course materials
over the duration of the semester (use proper APA formatting to cite the primary sources).
Structure: Maximum 5 pages total including:
•
•
•
•
1 title page
2-page reflection
1-page point form SWOT template
1-page reference list
Link to APA@Conestoga: https://lib.conestogac.on.ca/apa-conestoga
Assignment Tips: Consider your previous work experience, education, certifications, volunteer, or
internship roles when completing your SWOT table. Provide detail and specific examples where you
have demonstrated your strengths, or situations where your weaknesses have posed challenges, etc.
Then consider the course concepts and how these may impact your role as a healthcare leader.
HEAL8180 Individual SWOT Reflection Assignment Instructions & Template
Strengths:
Weaknesses:
Opportunities:
Threats:
Current Issues in Healthcare
Administration & Service
Management
HEAL8180
Week 9
Agenda
• Welcome
• Knowledge Management: characteristics & types, KM cycle
• KM Techniques
• Communities of Practice
• Storytelling
• Group Work
Unit Learning Outcomes:
•
Knowledge Management
• Define knowledge and reflect on tacit versus explicit knowledge,
organizational learning and memory.
• Define knowledge management and the describe the knowledge
management cycle.
• Explore various KM tools, including storytelling and communities of
practice.
“We need others to complement and develop our own
expertise. This collective character of knowledge does
not mean that individuals don’t count. In fact, the best
communities welcome strong personalities and
encourage disagreements and debates. Controversy
is part of what makes a community vital, effective, and
productive.”
― Etienne Wenger
Social networking, conceptual image. Photograph. Britannica ImageQuest,
Encyclopædia Britannica, 25 May 2016.
quest.eb.com/search/132_1354356/1/132_1354356/cite. Accessed 16 Aug 2021.
What is knowledge? How do we manage it?
Brainstorm as a large group any ideas that come to mind
Knowledge Management (KM)
• Numerous definitions exist and range from a wide to narrow
scope of what is included
• KM is a multidisciplinary field
• “Knowledge management is the deliberate and systematic
coordination of an organization’s people, technology,
processes, and organizational structure in order to add value
through reuse and innovation. This is achieved through the
promotion of creating, sharing, and applying knowledge as
well as through the feeding of valuable lessons learned and
best practices into corporate memory in order to foster
continued organizational learning” (Dalkir, 2011)
Knowledge Characteristics & Types
• Knowledge is more complex than data or information
• Using knowledge does not consume it
• Transferring knowledge does not result in losing it
• Knowledge is abundant, but the ability to use it is scarce
• Much of an organization’s valuable knowledge walks out the
door at the end of the day
• Major Types of Knowledge:
• Tacit – difficult to articulate and explain; resides with specific
people; may be quite valuable
• Explicit – well documented, easier to understand, explain, and
share
Source: Dalkir, 2011
Key Attributes of KM
• Generating new knowledge
• Accessing valuable knowledge from outside sources
• Using accessible knowledge in decision making
• Embedding knowledge in processes, products and/or services
• Representing knowledge in documents, databases and
software
• Facilitating knowledge growth through culture and incentives
• Transferring existing knowledge into other parts of the
organization
• Measuring the value of knowledge assets and/or impact of
knowledge management
Source: Ruggles & Holtshouse, 1999
Integrated KM Cycle
• The major stages are identified as:
• Knowledge capture and creation
• Knowledge sharing and dissemination
• Knowledge acquisition and application
Source: Dalkir, 2011
What are the benefits of knowledge
management?
Brainstorm in small groups any ideas that come to mind at the
following levels:
Individual, Organizational, System
Source: Library 2×2 Design Concept. Photograph. Britannica ImageQuest, Encyclopædia Britannica, 2 Nov 2020.
Organizational Learning & Memory
• Organizational learning is the process by which an
organization learns from past behaviour and uses information
to improve as a result
• Organizational memory is based on the premise that
knowledge is a key asset
• Organizational memory “extends and amplifies this asset by
capturing, organizing, disseminating and reusing the
knowledge created by its employees” (Dalkir, 2011)
• Also called ‘knowledge repository’ or ‘corporate memory’
Source: Dalkir, 2011
KM Tools
• There are a number of KM tools used at various stages of the
KM cycle, for example:
• Knowledge Capture/Creation Stage: templates, data mining,
blogs, taxonomies, metadata tagging, archiving, wikis, afteraction reviews
• Knowledge Sharing/Dissemination: videoconferencing,
discussion forums, social networking, knowledge
repositories/portals
• Knowledge Acquisition/Application: e-learning technologies,
artificial intelligence systems
Source: Dalkir, 2011; Tools. Clip Art. Britannica ImageQuest, Encyclopædia Britannica, 25 May
2016.
KM Techniques
What are Communities of Practice?
• “Communities of Practice are groups of people who share a
concern or a passion for something they do and learn how to
do it better as they interact regularly.” (Wenger-Trayner,
2015).
• Why are they important?
• Knowledge is actively constructed in a social setting (McDermott,
2000).
• As groups of people communicate, they mutually influence each
other’s views and create or modify their shared constructions of
reality (Klimecki & Lassleben, 1999).
Common Characteristics of CoPs
Source: Adapted from Wenger (1998) in Dalkir, 2011
Communities of Practice (CoPs)
• Pre-work:
• Wenger-Trayner, E. & Wenger-Trayner, B. (2015).
Communities of practice: A brief introduction.
• https://wenger-trayner.com/wp-content/uploads/2015/04/07Brief-introduction-to-communities-of-practice.pdf
• In small groups, discuss the following questions:
• Name and describe the three crucial characteristics of CoPs
• What are the kinds of activities through which communities
develop their practice?
• In what areas/industries is the CoP concept being applied?
• What are some myths about CoPs?
Source: Wenger-Trayner, 2015
Discover a CoP
In breakout groups, locate a relevant online community of
practice and explore it’s membership structure, process and
content.
Storytelling
• Storytelling is part of most cultures and has been used for
thousands of years
• As a KM technique, storytelling can be used to share
knowledge and wisdom, and to shape the vision, identity and
culture of an organization
• Stories are different than sharing information – they tend to be
used as leadership tools to make connections with people and
share insights
• The impact of stories are described by Callahan (2018):
• A story describes what happened
• A good story helps you see what happened
• A great story helps you feel what happened
Source: KMT, 2018; Callahan, 2018
My Life, My Story: VA’s healthcare
improvements through deliberate storytelling
Source: Veterans Healthcare Administration, 2015
Provider-based Storytelling
In breakout groups, share a story about your most difficult patient
encounter.
Reflect on Your SWOT & Action Plan
• Continue to refine your SWOT & Personal Action Plan
• Include any components that you hadn’t previously
considered
• Think about how various knowledge management tools might
impact your professional practice
• How can you incorporate storytelling into your practice?
• How can you become an effective member of a community of
practice?
Group Work
Summary
• Define knowledge and reflect on tacit versus explicit
knowledge, organizational learning and memory.
• Define knowledge management and the describe the
knowledge management cycle.
• Explore various KM tools, including storytelling and
communities of practice.
For next class
• Review the Instructional Plan
References
Alberta Health Services (2018). Reflections on Storytelling in Healthcare. Accessed from:
https://www.youtube.com/watch?v=qIFEYZa7V1c
Alberta Health Services (2019). Learning to Ride the Waves – Lisa’s Story. Accessed from:
=13
Callahan, S. (2018). What Makes a Compelling Story? Here are 6 Key Elements. Accessed from:
https://www.knowledge-management-tools.net/storytelling.php
Dalkir, K. (2011). Knowledge Management in Theory and Practice. 2nd Edition. The MIT Press.
Klimecki, R. & Lassleben, H. (1999). Modes of organizational learning: Indications from an empirical study.
Management Learning. 29(4):405-430.
Knowledge Management Tools (KMT) (2018). Storytelling. Accessed from: https://www.knowledgemanagement-tools.net/storytelling.php
Library 2×2 Design Concept. [Photograph]. Retrieved from Encyclopædia Britannica ImageQuest.
https://quest-eb-com.conestoga.idm.oclc.org/search/186_3414978/1/186_3414978/cite
McDermott, R. (2000). Why information technology inspired but cannot deliver knowledge management. In
Knowledge and communities, edited by E. Lesser, M. Fontaine, and J. Slusher. Boston: ButterworthHeineman.
References
Ruggles, R. & Holtshouse, D. (1999). The Knowledge Advantage. Dover, New Hampshire: Capstone
Publishers.
Social networking, conceptual image. Photograph. Britannica ImageQuest, Encyclopædia Britannica, 25
May 2016.
quest.eb.com/search/132_1354356/1/132_1354356/cite. Accessed 16 Aug 2021.
Tools. [Clip Art]. Retrieved from Encyclopædia Britannica ImageQuest.
https://quest-eb-com.conestoga.idm.oclc.org/search/186_1623680/1/186_1623680/cite
Veterans Healthcare Administration (2015). My Life, My Story: VA’s healthcare improvements through
deliberate storytelling. Accessed from: https://www.youtube.com/watch?v=fpzgVlExS20&t=2s
Wenger-Trayner, E. & Wenger-Trayner, B. (2015). Communities of practice: A brief introduction. Accessed
from: https://wenger-trayner.com/wp-content/uploads/2015/04/07-Brief-introduction-to-communities-ofpractice.pdf
Wenger-Trayner (2015). Social learning – A framework. Accessed from:
Wenger, E., Snyder, W., & McDermott, R.A. (2002). Cultivating Communities of Practice: A Guide to
Managing Knowledge. Harvard Business Review Press.
Current Issues in Healthcare
Administration & Service
Management
HEAL8180
Week 7
Agenda
•
•
•
•
•
Welcome
Review: determinants of health
Sources of workplace stress & strategies to reduce it
Workplace violence & prevention strategies in healthcare
Mindfulness
Unit Learning Outcomes:
•
Workplace Health
•
•
•
•
Review the determinants of health and their role in the
workplace.
Identify strategies to enhance health and wellness at work.
Discuss workplace violence issues in various healthcare settings
and explore the contributing factors.
Reflect on various experiences of mindfulness exercises.
Zen garden of Zuiho-in. Photo. Britannica ImageQuest, Encyclopædia Britannica, 25 May 2016.
quest.eb.com/search/167_4040193/1/167_4040193/cite. Accessed 16 Aug 2021.
“When the leader is mindful, he or she has a ripple
effect throughout the business. [Mindfulness] helps
the leader have a sense of clarity, a sense of
purpose and also a kind of calmness and peace of
mind when they approach any situation, whether it’s
chaos at work or a personal relationship.”
― Home Nguyen, 2015
What is mindfulness?
Brainstorm as a large group any ideas that come to mind
Review: Determinants of Health
•
The broad range of personal, social, economic and environmental factors
that determine individual and population health. The main determinants of
health include:
•
Income and social status
•
Employment and working conditions
•
Education and literacy
•
Childhood experiences
•
Physical environments
•
Social supports and coping skills
•
Healthy behaviours
•
Access to health services
•
Biology and genetic endowment
•
Gender
•
Culture
•
Race / Racism
Source: Government of Canada, 2019
Sources of Workplace Stress
• Salaries/wages
• Excessive workload
• Few opportunities for advancement/career growth
• Lack of engagement/challenge
• Lack of social support
• Not having control over workplace decisions
• Conflicting demands
• Unclear performance expectations
Source: Stressed surgeon.
Photograph. Britannica ImageQuest,
Encyclopædia Britannica, 26 Mar
2018.
Source: American Psychological Association, 2018
Additional Challenges in Healthcare
• In Canada, 45% of healthcare workers suffer from a high
degree of workplace stress compared to 31% in other
industries (Wilkins, 2007).
• The increasing demands on healthcare workers puts them at
risk of workplace stress including compassion fatigue, and a
decline in empathetic behaviors (Cunico et al., 2012).
• Workplace violence is associated with increased workplace
stress among healthcare workers (Magnavita, 2014).
Workplace Violence
• “Workplace Violence” is defined as (Occupational Health and
Safety Act, sec.1 (1)):
• the exercise of physical force by a person against a Worker, in a
Workplace, that causes or could cause physical injury to the
Worker,
• an attempt to exercise physical force against a Worker, in a
Workplace, that could cause physical injury to the Worker,
• a statement or behavior that it is reasonable for a Worker to
interpret as a threat to exercise physical force against the
Worker, in a Workplace, that could cause physical injury to the
Worker.
Source: Occupational Health and Safety Act, 2019
Workplace Violence in Healthcare
• Healthcare workers are at increased risk of violence in the
workplace and nurses are particularly vulnerable (CDC, 2016)
• 68% of hospital staff in Ontario reported they have been
victims of physical violence at work in the past year (Brophy et
al, 2017)
• Incidents are largely under-reported (Silliker, 2017)
• Risk factors for violence vary from hospital to hospital and in
home care settings, depending on location, size, and type of
care (CDC, 2016)
• Hospital violence is most frequent in psychiatric units,
emergency departments, waiting areas, and in geriatric/longterm care units (CDC, 2016)
Prevention Strategies
• Management Commitment
• Employee Involvement
• Worksite Analysis
• Hazard Prevention and Control
• Safety and Health Training
• Removing Impediments to Reporting
• Recordkeeping
• Program Evaluation
Source: CDC, 2016
Identifying Workplace Violence
Prevention Resources
In breakout groups, locate some workplace violence prevention
resources that will assist you in your clinical practice
Strategies to Reduce Workplace Stress
• Document your stressors
• Develop healthy responses
• Establish boundaries
• Take time to re-charge
• Learn how to relax
• Talk to your supervisor
• Access support
Source: Relaxation aids. Photography.
Britannica ImageQuest, Encyclopædia
Britannica, 25 May 2016.
Source: American Psychological Association, 2018
What can organizations do to reduce
workplace stress?
Brainstorm as a large group any ideas that come to mind
Supporting Caregivers
• Stress among healthcare providers threatens the delivery of
compassionate care
• Many caregivers do not have a structured outlet for
expressing their feelings and feel ill-prepared to cope with
difficult communication issues involving patient care
• The Schwartz Rounds® program has been implemented in
over 470 healthcare organizations globally
• It offers healthcare providers a regularly scheduled time to
openly and honestly discuss the social and emotional issues
they face at work and is distinct from regular patient rounds
• A distinct feature is the interdisciplinary component
Schwartz Rounds® at Halton Healthcare
Source: Halton Healthcare, 2019
Mindful Leader Development
• Pre-work:
Rupprecht, S., Falke, P., Kohls, N., Tamdjidi, C., Wittmann, M., &
Kersemaekers, W. (2019). Mindful Leader Development: How Leaders
Experience the Effects of Mindfulness Training on Leader Capabilities.
Frontiers in Psychology. 10, 1081.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529524/pdf/fpsyg-1001081.pdf
• In small groups, discuss the following:
• What is mindfulness and why is it important in the workplace?
• What are some possible unintended/negative impacts of
mindfulness training?
• What were the main findings of this research?
• What additional research opportunities can you think of with
respect to mindfulness?
Source: Rupprecht et al, 2019
Reflect on Your SWOT & Action Plan
• Continue to refine your SWOT & Personal Action Plan
• Include any components that you hadn’t previously
considered
• Think about how the determinants of health might impact your
professional practice
• What strategies can you use to identify and prevent workplace
violence?
• How can you incorporate mindfulness in your own practice?
Summary
• Review the determinants of health and their role in the
workplace.
• Identify strategies to enhance health and wellness at work.
• Discuss workplace violence issues in various healthcare
settings and explore the contributing factors.
• Reflect on various experiences of mindfulness exercises.
For next class
• Review the Instructional Plan
References
American Psychological Association (2018). Coping with stress at work. Accessed from:
https://www.apa.org/helpcenter/work-stress
Brophy, J.T., Keith, M.M., Hurley, M. (2017). Assaulted and Unheard: Violence Against Healthcare Staff.
NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy. 27(4):581-606.
Centers for Disease Control and Prevention (2016). Workplace Violence Prevention for Nurses. Accessed
from: https://wwwn.cdc.gov/wpvhc/Course.aspx/Slide/Intro_1
Cunico, L., Sartori, R., Marognolli, O., Meneghini, AM. (2012). Developing empathy in nursing students: a
cohort longitudinal study. Journal of Clinical Nursing. 21(13-14):2016-25.
Encyclopaedia Britannica (2016). Relaxation aids. Photography. Britannica ImageQuest, 25 May 2016.
quest-eb-com.conestoga.idm.oclc.org/search/132_1278439/1/132_1278439/cite. Accessed 18 Oct 2021.
Encyclopaedia Britannica (2018). Stressed surgeon. Photograph., 26 Mar 2018. Britannica ImageQuest
quest-eb-com.conestoga.idm.oclc.org/search/132_1545200/1/132_1545200/cite. Accessed 18 Oct 2021.
Government of Canada (2014). Social determinants of health and health inequalities. Accessed from:
https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determineshealth.html
Halton Healthcare (2019). Schwartz Rounds at Halton Healthcare. Accessed from:
References
Magnavita, N. (2014). Workplace violence and occupational stress in healthcare workers: a chicken-and-egg
situation-results of a 6-year follow-up study. Journal of Nursing Scholarship. 46(5):366-76.
Occupational Health and Safety Act. (2019). Accessed from: https://www.ontario.ca/laws/statute/90o01
Rupprecht, S., Falke, P., Kohls, N., Tamdjidi, C., Wittmann, M., & Kersemaekers, W. (2019). Mindful Leader
Development: How Leaders Experience the Effects of Mindfulness Training on Leader Capabilities. Frontiers
in Psychology, 10, 1081.Accessed from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529524/pdf/fpsyg10-01081.pdf
Shallow, P. (2015). Mindfulness meditation melts away work-related stress. CBS News. January 15.
Accessed from: https://www.cbsnews.com/news/mindfulness-meditation-melts-away-work-related-stress/
Silliker, A. (2107). Health-care workers victims of physical violence more now than ever before. Canadian
Occupational Safety Standard. Accessed from: https://www.cos-mag.com/psychological-healthsafety/34266-health-care-workers-victims-of-physical-violence-more-now-than-ever-before
Tedx Newcastle (2014). Mindful exercise. Accessed from: https://www.youtube.com/watch?v=EpQFq9NtR1k
References
The Schwartz Center for Compassionate Care (2019). Schwartz Rounds®. Accessed from:
https://www.theschwartzcenter.org/supporting-caregivers/schwartz-center-rounds/
Wilkins, K (2007). Work stress among health care providers. Health Reports. 18(4):33-6. Accessed from:
https://www150.statcan.gc.ca/n1/en/pub/82-003-x/2006011/article/10367-eng.pdf?st=UshxOYID
Zen garden of Zuiho-in. Photo. Britannica ImageQuest, Encyclopædia Britannica, 25 May 2016.
quest.eb.com/search/167_4040193/1/167_4040193/cite. Accessed 16 Aug 2021.
Current Issues in Healthcare
Administration & Service
Management
HEAL8180
Week 6
Agenda
•
•
•
•
•
Welcome
Interprofessional collaboration and related terminology
Implementation barriers and facilitators
Tools for improved communication
Newer models of care delivery
Unit Learning Outcomes:
•
New Models and Methods of Working
• Identify new models and methods of working across multiple
providers and care settings
• Discuss barriers and facilitators to successful implementation of
these models and methods
• Reflect on current practices and discuss how to incorporate new
models and methods
• Communicate professionally using appropriate interpersonal
skills
“Coming together is a beginning, staying together is
progress, and working together is success.”
― Henry Ford
Nurse and doctor discussing patient notes.
Photograph. Britannica ImageQuest, Encyclopædia
Britannica, 2 Mar 2017.
quest.eb.com/search/132_1426942/1/132_1426942/cite.
Accessed 16 Aug 2021.
What is interprofessional collaboration &
why is it important in healthcare?
Brainstorm as a large group any ideas that come to mind
Interprofessional Collaboration
• “A partnership between a team of health providers and a client
in a participatory collaborative and coordinated approach to
shared decision making around health and social issues”
(Canadian Interprofessional Health Collaborative, 2010).
• Important elements include: decision-making, communication,
knowledge and skill, shared accountability, cooperation,
assertiveness, autonomy, mutual trust and respect
• Interprofessional teams work towards shared goals to improve
patient outcomes
Source: Canadian Interprofessional Health Collaborative, 2010; Kasperski, 2000
Understanding Terminology
• ‘Multidisciplinary’ means that each team member uses his or
her own expertise to develop individual care goals
• ‘Interdisciplinary’ means that two or more disciplines work or
learn together to solve a problem or gather information
• ‘Interprofessional’ describes the relationship between
various disciplines as they purposely interact to work and
learn together to achieve a common goal
Source: Ferguson, 2014
Why are ‘Inter’ Approaches Becoming
More Common?
• An aging population with chronic and complex needs
• Increasing knowledge and skill required to provide
comprehensive care to patients
• Increasing specialization in healthcare fields
• Growing encouragement to develop multi-faceted teams in
healthcare
• Increased emphasis on continuity in care planning
Source: Ferguson, 2014
Types of Interprofessional Care Models
• Interprofessional team models
• Nurse-led models
• Case management models
• Patient navigation models
• Shared care models
Medical staff. Photography. Britannica ImageQuest,
Encyclopædia Britannica, 25 May 2016.
Source: Canadian Health Services Research Foundation, 2012
Barriers & Enablers to Interprofessional
Care Models
• Policy/system factors (favourable legislation for optimizing
scope of practice)
• Appropriate model of care factors (suitable to patient
population needs)
• Individual/team factors (effective interprofessional
collaboration)
• Organizational factors (appropriate business case)
• Implementation factors (training, integrated work processes)
Source: Canadian Health Services Research Foundation, 2012
Teaching Interprofessional Collaboration
• Prework:
Bridges, D. R., Davidson, R. A., Odegard, P. S., Maki, I. V., & Tomkowiak, J.
(2011). Interprofessional collaboration: three best practice models of
interprofessional education. Medical education online, 16, 10.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081249/pdf/MEO-16-6035.pdf
• In small groups, discuss the following:
• What is interprofessional education and why is it important?
• Describe each of the three models.
• Discuss the similarities and differences between the models.
• What factors are associated with program success?
Source: Bridges et al., 2011
Tools for Improved Communication
• The SBAR (Situation-Background-AssessmentRecommendation) technique provides a framework for
communication between members of the health care team
about a patient’s condition.
• S = Situation (a concise statement of the problem)
• B = Background (pertinent and brief information related to the
situation)
• A = Assessment (analysis and considerations of options —
what you found/think)
• R = Recommendation (action requested/recommended — what
you want)
Source: IHI, 2018
TeamSTEPPS®
• TeamSTEPPS® is an evidence-based set of teamwork tools,
aimed at optimizing patient outcomes by improving
communication and teamwork skills among health care
professionals
• It includes ready-to-use materials and a training curriculum to
successfully integrate teamwork principles into all areas of
your health care system
• TeamSTEPPS Canada™ has been adopted and adapted by
the Canadian Patient Safety Institute (CPSI) and made
available to the Canadian healthcare field
Source: Agency for Healthcare Research and Quality, 2018
TeamSTEPPS Canada™ SBAR Video
Source: TeamSTEPPS CanadaTM, 2021
TeamSTEPPS® Case Studies
• In breakout groups, review one of the TeamSTEPPS® Impact
Case Studies listed in the following website:
• https://www.ahrq.gov/teamstepps/case-studies/index.html
• Provide a brief overview of the case
• Discuss the results and achievements
Source: AHRQ, 2018
Successful Outcome Using
TeamSTEPPS® In the Dental Office
Source: AHRQ, 2015
TRIZ (Theory of Inventive Problem Solving)
• Group facilitation activity that helps improve communication
and foster creativity and innovative thinking
• Originally developed by the Soviet inventor Genrich Altshuller
• Purpose of TRIZ is to “make space for innovation by helping a
group let go of what it knows (but rarely admits) limits its
success and by inviting creative destruction”
• Fundamental question is “What must we stop doing to make
progress on our deepest purpose?”
• example: For reducing harm to patients experiencing safety
lapses (e.g., wrong-side surgery, patient falls, medication errors)
with cross-functional groups: “How can we make sure we always
operate on the wrong side?”
Source: Liberating Structures, 2019; TRIZ Innovation Centre, 2019
TRIZ Activity
• As a class, discuss the following question:
• How can we ensure that we get a failing grade on this group
project?
• Then, in your project breakout groups, discuss the following:
• Is there anything that we are currently doing that in any way,
shape or form resembles this?
• Once you have identified one or two counterproductive activities,
discuss how you might change this.
Source: Liberating Structures, 2019; TRIZ Innovation Centre, 2019
How can we get a failing grade on our
group project?
Newer Models of Care Delivery
• Newer models of healthcare financing and delivery have
emerged in recent years with the goal of improving patient
outcomes in an efficient and high-quality manner
• Some examples include:
• Bundled care – a group of care providers receives a single
payment to cover all of the care needs for an individual patient
for a specific health issue (e.g., COPD); similar to accountable
care organizations in the United States
• Medical home – also called ‘primary care medical home’,
‘patient-centered medical home’ whereby patient treatment is
coordinated through their primary care physician to ensure they
receive the necessary care when and where they need it, in a
manner they can understand
Source: Ontario Ministry of Health and Long-Term Care, 2018; College of Family Physicians of Canada, 2019
Integrated Comprehensive Care
Demonstration Project (ICCP)
• St. Joseph’s Healthcare Hamilton’s Integrated
Comprehensive Care Demonstration Project (ICCP) was the
first team to pioneer the bundled care model in Ontario
• An integrated care coordinator ensures cross-sector
collaboration among all providers
• This approach enables enhanced collaboration and
communication among a cross-sector health care team and
maximizes resources
Integrated Comprehensive Care Project
Source: St. Joseph’s Healthcare Hamilton and Foundation, 2013
Reflect on Your SWOT & Action Plan
• Continue to refine your SWOT & Personal Action Plan
• Include any components that you hadn’t previously
considered
• Think about how interprofessional collaboration and new
models and ways of working might impact your professional
practice
• How can you improve your communication skills to become a
more effective team member?
Summary
• Identify new models and methods of working across
multiple providers and care settings
• Discuss barriers and facilitators to successful
implementation of these models and methods
• Reflect on current practices and discuss how to incorporate
new models and methods
• Communicate professionally using appropriate
interpersonal skills
For next class
• Review the Instructional Plan
References
Agency for Healthcare Research and Quality (2018). TeamSTEPPS® Accessed from:
https://www.ahrq.gov/teamstepps/index.html
Agency for Healthcare Research and Quality (2015). Successful Outcome Using
TeamSTEPPS in the Dental Office. Accessed from:
Bridges, D. R., Davidson, R. A., Odegard, P. S., Maki, I. V., & Tomkowiak, J. (2011).
Interprofessional collaboration: three best practice models of interprofessional education.
Medical education online, 16, 10. Accessed from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081249/pdf/MEO-16-6035.pdf
Canadian Health Services Research Foundation (2012). Interprofessional Collaborative
Teams. Commissioned Paper by Canadian Nurses Association. Accessed from:
https://www.cfhi-fcass.ca/sf-docs/default-source/commissioned-research-reports/ViraniInterprofessional-EN.pdf?sfvrsn=0
Canadian Interprofessional Health Collaborative (2010). A national interprofessional
competency framework.
References
College of Family Physicians of Canada (2019). Patient’s Medical Home. Accessed from:
Ferguson, M. (2014). Multidisciplinary vs. Interdisciplinary Teamwork: Becoming a More
Effective Practitioner. SWHELPER. Accessed from:
https://www.socialworkhelper.com/2014/01/14/multidisciplinary-vs-interdisciplinary-teamworkbecoming-effective-practitioner/
Institute for Healthcare Improvement (2018). SBAR Tool: Situation-Background-AssessmentRecommendation. Accessed from: http://www.ihi.org/resources/Pages/Tools/SBARToolkit.aspx
Kasperski, M. (2000). Implementation strategies: ‘Collaboration in primary care family doctors
and nurse practitioners delivering shared care.’ Toronto, ON: Ontario College of Family
Physicians.
Liberating Structures (2019). Making Space with TRIZ. Accessed from:
http://www.liberatingstructures.com/6-making-space-with-triz/
Medical staff. Photography. Britannica ImageQuest, Encyclopædia Britannica, 25 May 2016.
quest-eb-com.conestoga.idm.oclc.org/search/132_1271882/1/132_1271882/cite. Accessed 7
Oct 2021.
References
Nurse and doctor discussing patient notes. Photograph. Britannica ImageQuest,
Encyclopædia Britannica, 2 Mar 2017.
quest.eb.com/search/132_1426942/1/132_1426942/cite. Accessed 16 Aug 2021.
Ontario Ministry of Health and Long-Term Care (2018). Bundled Care (Integrated Funding
Models). Accessed from: http://www.health.gov.on.ca/en/pro/programs/ecfa/funding/ifm/
St. Joseph’s Healthcare Hamilton (2013). Integrated Comprehensive Care Project (ICCP):
Project Summary and Interim Results. Accessed from:
https://www.stjosephshomecare.ca/client-services/integrated-comprehensive-care-icc-/iccbrochure-feb2013.pdf
St. Joseph’s Healthcare Hamilton and Foundation (2013). Integrated Comprehensive Care
Project. Accessed from:https://www.youtube.com/watch?v=r68ebcy3KPw
TRIZ Innovation Centre (2019). What is TRIZ? Accessed from: https://www.triz.co.uk/what-istriz
Current Issues in Healthcare
Administration & Service
Management
HEAL8180
Week 5
Agenda
•
•
•
•
•
Welcome
Developing Powerful Questions
Validity & Reliability
Assessing Internet Information
Evaluating Clinical Practice Guidelines
Unit Learning Outcomes:
Developing Powerful Questions and Evaluating Information
• Develop powerful questions to address a current issue in
healthcare
• Distinguish between source validity, accuracy and reliability
• Evaluate information from multiple sources designed to address
a current issue in healthcare
“If I had an hour to solve a
problem and my life depended
on the solution, I would spend
the first 55 minutes determining
the proper question to ask, for
once I know the proper
question, I could solve the
problem in less than five
minutes.”
-Albert Einstein
Paper mosaic triangles texture question mark. Clip Art. Britannica
ImageQuest, Encyclopædia Britannica, 25 May 2016.
quest.eb.com/search/186_1627805/1/186_1627805/cite.
Accessed 16 Aug 2021.
Why Are Powerful Questions Important?
• The quality of the questions we ask will determine the
usefulness of the information we acquire and the actions we
take
• Good questions can inspire change and spark creativity and
innovation
• e.g., Theory of relativity developed by Einstein resulted from a
question he had posed as a teen: “What would the universe look
like if I were riding on the end of light beam at the speed of light?”
• e.g., Discovery of the double helix resulted from the question
“What might DNA look like in a 3D form?” posed by Watson &
Crick
Source: Vogt et al, 2003
What Makes a Question Powerful?
• “If the right question is applied, and it digs deep enough, then
we can stir up all the creative solutions.” (Fran Peavey, 1994)
• Characteristics of powerful questions:
•
Stimulates curiosity
•
Promotes reflective conversation
•
Thought-provoking
•
Unearths underlying assumptions
•
Welcomes creativity and possibilities
•
Generates energy and forward movement
•
Channels attention and focuses inquiry
•
Remains on the minds of participants
•
Deep meanings
•
Promotes more questions
Source: Vogt et al, 2003; Peavey, 1994
Questions to Consider
• Which of the following questions is the most
powerful?:
• Did the patient receive his medication?
• What dose did the patient receive?
• What symptoms did he experience after taking his
medication?
• What possibilities exist to prevent the patient from
missing his regular dose of medication?
Capsules in question mark, illustration. Photograph. Britannica
ImageQuest, Encyclopædia Britannica, 22 Oct 2018.
quest.eb.com/search/132_1563224/1/132_1563224/cite.
Accessed 16 Aug 2021.
Developing Powerful Questions
• Consider the characteristics of powerful questions.
• In breakout groups, develop a powerful question to address
an aspect of healthcare in one of the following areas:
• Cost
• Quality
• Population aging
• Chronic disease management
• Dementia care
What strategies do you use to evaluate
information?
Brainstorm as a large group any ideas that come to mind
Source Validity
• A valid source is “any source that has competence in the field
of interest, without any biases or conflicts of interest related to
the topic. Finding reliable sources is important in order to
ensure that what is written or reported is accurate.”
• If a source is not considered reliable, the quality of the
information can be questioned
Source: https://www.reference.com/education/definition-reliable-source-e8c87b325117b2f5
Validity in Measurement
• Validity – there are various types of validity that need to be
considered particularly in health services research (e.g., when
developing surveys, questionnaires, rating scales, etc)
• Face Validity – Does look like it will measure what it is intended
to measure?
• Content Validity – Does it actually measure what it is intended to
measure?
• Construct Validity – Does it measure the abstract concept
adequately?
• Criterion Validity – Is it able to produce accurate findings when
compared to a “gold standard”?
Source: Institute for Work and Health, 2016
Reliability in Measurement
• Reliability is the probability that a system, product or process
will perform as expected a high proportion of the time
• Test-retest reliability – Will you get similar results in a repeated
test if the conditions have not changed?
• Internal consistency – Do similar questions give rise to similar
answers?
• Inter-rater reliability – Would different individuals assessing the
same thing score the same way?
Source: Institute for Work and Health, 2016
Assessing Internet Information
• Assessing various internet sources is a critical
component to ensuring source validity
• A number of criteria can be used to help determine the
validity and reliability of this information
• For example:
• Audience – Who is the intended audience? Is it relevant?
• Authority – Is the author identified and credible?
• Accuracy – Has the content been edited or peer reviewed?
• Objectivity – Are multiple points of view explored?
• Currency – How recent is the information?
• URL – .com, .ca, .edu, .org, .gov
Source: University of Edinburgh, 2017
Preparing – Types of Resources, Part 2:
Websites
Source: Conestoga College Library, 2014
Assessing Internet Information Cont’d…
• Refer back to your powerful question to address an aspect of
healthcare in one of the following areas:
• Cost, Quality, Population aging, Chronic disease management,
Dementia care
• In breakout groups, identify 1 internet source (not journal
articles) and reflect on the following assessment criteria:
• Audience – Who is the intended audience? Is it relevant?
• Authority – Is the author identified and credible?
• Accuracy – Has the content been edited or peer reviewed?
• Objectivity – Are multiple points of view explored?
• Currency – How recent is the information?
• URL – .com, .ca, .edu, .org, .gov
Source: University of Edinburgh, 2017
Additional Tools to Evaluate Information
• CARS Evaluation Tool – Credibility, Accuracy,
Relevance, and Support
• CRAAP – Currency, Relevance, Accuracy, Authority and
Purpose
• SIFT: Online Verification Skills – Stop, Investigate, Find
better coverage, and Trace claims
• Tools available through Library Services
Appraising Clinical Practice Guidelines
• A clinical practice guideline (CPG) is a systematically
developed statement to help people make decisions in
clinical settings
• There are thousands of guidelines developed through
multiple methods and by a variety of developers
• The quality of the development of these guidelines can
vary considerably
• The healthcare field is changing rapidly and new
information is constantly published and evolving, making
it challenging for care providers to evaluate CPGs
Source: National Collaborating Centre for Methods and Tools, 2011
Possible CPG Sources
• Provider & Professional Associations
• e.g., RNAO Best Practice Guidelines
• e.g., Diabetes Canada
• e.g., ADA Center for Evidence Based DentistryTM
• Professional Journals
• e.g., Journal of Clinical Endocrinology & Metabolism
• Clinical practice guideline databases
• CPG Infobase
• National Guideline Clearinghouse
• SPOR Evidence Alliance
AGREE II
• An international team of guideline developers and
researchers, known as the AGREE Collaboration (Appraisal of
Guidelines, Research and Evaluation), was established to
develop such a tool
• The AGREE II Instrument assesses the methodological rigour
of how a clinical practice guideline was developed
• It consists of 23 items organized into 6 quality domains:
• Scope and purpose;
• Stakeholder involvement;
• Rigour of development;
• Clarity of presentation;
• Applicability; and
• Editorial independence.
Source: AGREE Next Steps Consortium, 2017
AGREE Reporting Checklist Video
Abstract
Source: British Medical Journal, 2019
Reflect on Your SWOT & Action Plan
• Continue to refine your SWOT & Personal Action Plan
• Include any components that you hadn’t previously
considered (e.g., are there CPGs you should be aware of?)
• Think about the importance of assessing information (from
internet sources, clinical practice guidelines, etc) and how this
might impact your professional practice
Summary
• Develop powerful questions to address a current issue in
healthcare
• Distinguish between source validity, accuracy and reliability
• Evaluate information from multiple sources designed to
address a current issue in healthcare
For next class
• Review the Instructional Plan
References
ADA Center for Evidence Based DentistryTM (2019). Clinical Practice Guidelines. Retrieved from:
https://ebd.ada.org/en/evidence/guidelines
AGREE Next Steps Consortium (2017). The AGREE II Instrument. Retrieved from http://www.agreetrust.org
British Medical Journal (2019). AGREE Reporting Checklist Video Abstract. Accessed from:
Capsules in question mark, illustration. Photograph. Britannica ImageQuest, Encyclopædia Britannica, 22
Oct 2018.
quest.eb.com/search/132_1563224/1/132_1563224/cite. Accessed 16 Aug 2021.
Conestoga College Library (2014). Preparing: Types of Resources, Part 2: Websites. Accessed from:
CPG Infobase (2019). Retrieved from: https://joulecma.ca/cpg/homepage
Diabetes Canada (2019). Clinical Practice Guidelines. Retrieved from: https://guidelines.diabetes.ca/
Eady, E.A., Layton, A.M., Sprakel, J., Arents, B.W.M., Fedorowicz, Z., & van Zuuren, E.J. (2017). AGREE II
assessments of recent acne treatment guidelines: how well do they reveal trustworthiness as defined by the
U.S. Institute of Medicine criteria? British Journal of Dermatology. 177(6):1716-1725. Retrieved from:
https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.15777
References
Institute for Work and Health (2016). What researchers mean by… validity and reliability. At Work newsletter.
Issue 84, Spring, 2016. https://www.iwh.on.ca/sites/iwh/files/iwh/at-work/at_work_84.pdf
National Collaborating Centre for Methods and Tools (2011). Critically appraising practice guidelines: The
AGREE II instrument. Hamilton, ON: McMaster University. (Updated 12 September, 2017) Retrieved from
http://www.nccmt.ca/resources/search/100.
National Guideline Clearinghouse (2018). Retrieved from: https://www.ahrq.gov/gam/index.html
Paper mosaic triangles texture question mark. Clip Art. Britannica ImageQuest, Encyclopædia Britannica, 25
May 2016.
quest.eb.com/search/186_1627805/1/186_1627805/cite. Accessed 16 Aug 2021.
Peavey, F. (1994). “Strategic Questioning” in By Life’s Grace: Musings on the Essence of Social Change. New
Society Publishers.
Reference.com website: https://www.reference.com/education/definition-reliable-source-e8c87b325117b2f5
Registered Nurses Association of Ontario (2019). Nursing Best Practice Guidelines. Retrieved from:
https://rnao.ca/bpg
SPOR Evidence Alliance (2019). Retrieved from: https://sporevidencealliance.ca/cpg-database/
References
The University of Edinburgh (2017). How to evaluate website content. Retrieved from:
https://www.ed.ac.uk/information-services/library-museum-gallery/finding-resources/librarydatabases/databases-overview/evaluating-websites
The University of Edinburgh (2017). How to evaluate website content. Retrieved from:
https://www.ed.ac.uk/information-services/library-museum-gallery/finding-resources/librarydatabases/databases-overview/evaluating-websites
Current Issues in Healthcare
Administration & Service
Management
HEAL8180
Week 4
Agenda
•
•
•
•
•
Welcome
Innovation in healthcare – drivers, barriers, facilitators
Disruptive innovation
Diffusion of innovation theory
Group Work
Unit Learning Outcomes:
Innovation in Healthcare
• Define innovation and disruptive innovation
• Explore various innovations in healthcare from a variety of
perspectives
• Identify barriers and facilitators to successful implementation in
healthcare settings
• Discuss the diffusion of innovation theory
“Vulnerability is the birthplace of innovation,
creativity and change.”
― Brene Brown, 2012
Source: Walters, 2012
Medicine Future Technology Flowchart. Photograph. Britannica ImageQuest, Encyclopædia Britannica, 2 Nov 2020.
quest.eb.com/search/186_3415772/1/186_3415772/cite. Accessed 16 Aug 2021.
What is innovation?
Brainstorm as a large group any ideas that come to mind
Canada: A Nation of Innovators
Source: Innovation, Science & Economic Development Canada, 2016
What do we mean by innovation in
healthcare?
• Pre-work:
Kimble, L., & Massoud, R. (2017). What do we mean by innovation in
healthcare? European Medical Journal.1(1):89-91. Accessed from:
https://emj.europeanmedical-group.com/wpcontent/uploads/sites/2/2018/01/What-do-we-mean-by-Innovation-inHealthcare…pdf
• In small groups, discuss the following:
• How would you define innovation in healthcare?
• Compare and contrast social innovation, process innovation and
technological innovation
• What factors affect uptake of healthcare innovations?
Source: Kimble & Massoud, 2017
Possible Areas of Innovation
• Innovation can occur in many areas including:
• Product — what we produce and sell
• Service — exceeding customer expectations
• Process — continuous improvement of how we do things
• Management — business strategies, systems and structures
• Open — working beyond boundaries and collaborating globally
• Value — creating unique value that eliminates the cost to
compete
Source: Gerrish, 2008
Invention vs. Innovation
• “Invention is the process of coming up with a truly novel idea
whereas innovation is the process of using ideas to offer new
or improved products and services at the same factor cost”
(Breznitz, 2021).
• e.g., mRNA vaccine for COVID-19 is an example of an invention
– it became an innovation when the idea was actualized in reality
– produced, supplied, distributed
• Incremental and process innovation can be powerful (e.g.,
infusing innovation into already established industries;
reconfiguring and expanding a product’s use).
Economic Change For The Better Isn’t
Easy
Source: The Agenda with Steve Paikin, 2021
Disruptive Innovation
• Disruptive innovation – “is the introduction of a product or
service into an established industry that performs better and,
generally, at a lower cost than existing offerings, thereby
displacing the market leaders in that particular market space
and transforming the industry.” (Rouse, 2017)
Source: Rouse, 2017
Medical Innovations
• Review the following press release:
• Cleveland Clinic Unveils Top 10 Medical Innovations for 2022
– Cleveland Clinic Newsroom
• As a class, vote on watching 2-3 videos that are of interest
(each video is approximately 2 minutes long)
• Which innovations are most interesting to you and why?
Source: Cleveland Clinic, 2021
Barriers to Healthcare Innovation
• Determining the efficacy of the proposed innovation
• Navigating a complex supply chain for product distribution
• Limited access to manufacturers
• Difficulty locating data/information about purchasing to make
planning decisions
• Regulatory oversight is substantial
• Intellectual property laws are difficult to navigate
• Organizational culture
• High stress environment
• Value analysis is complex
• Misconceptions about what innovation is
Source: Grajewski, 2015
What are the barriers to innovation in
healthcare?
Source: Institution of Engineering & Technology, 2019
What facilitates innovation in
healthcare?
Brainstorm as a large group any ideas that come to mind
Diffusion of Innovation Theory
• Developed by E.M. Rogers in 1962
• Social science theory that describes how an idea, product or
process gains momentum and diffuses (or spreads) through a
specific population or system over time
• There are specific categories of adopters with distinct
characteristics
Source: Rogers, 1962; LaMorte, 2018
Adoption of Innovations
• In order to successfully adopt an innovation, there are a
number of requirements that must be fulfilled:
• Awareness of the need for an innovation
• Decision to adopt (or reject) the innovation
• Preliminary testing of the innovation
• Ongoing use of the innovation
• Factors that influence adoption:
• Relative advantage
• Compatibility
• Complexity
• Trialability
• Observability
Source: Rogers, 1962; LaMorte, 2018
Group Work
• Your group will conduct a mini environmental scan to explore
various healthcare innovations in one or more of the following
areas:
• Product — what we produce and sell
• Service — exceeding customer expectations
• Process — continuous improvement of how we do things
• Management — business strategies, systems and structures
• Open — working beyond boundaries and collaborating globally
• Value — creating unique value that eliminates the cost to
compete
• Discuss some preliminary ideas in your breakout groups
Source: Gerrish, 2008
Reflect on Your SWOT & Action Plan
• Continue to refine your SWOT & Personal Action Plan
• Include any components that you hadn’t previously
considered
• Think about how innovation might impact your professional
practice
• Consider where you need to focus your innovative efforts and
write down a couple of project ideas/potential focus areas
Summary
• Define innovation and disruptive innovation
• Discuss the diffusion of innovation theory
• Explore various innovations in healthcare from a variety of
perspectives
• Identify barriers and facilitators to successful
implementation in healthcare settings
For next class
• Review the Instructional Plan
References
Balasubramanian, S. Innovation in Healthcare: How Far Should We Go? TEDx event. Accessed from:
Breznitz, D (2021). Innovation in Real Places. New York: Oxford University Press.
Cleveland Clinic (2018). Cleveland Clinic Unveils Top 10 Medical Innovations for 2019. Accessed from:
https://newsroom.clevelandclinic.org/2018/10/24/cleveland-clinic-unveils-top-10-medical-innovations-for2019/
Gerrish, R. (2008). Six Types of Innovation. CBS News. Moneywatch. Accessed from:
https://www.cbsnews.com/news/six-types-of-innovation/
Grajewski, B (2015). 10 Barriers to Healthcare Innovation. The Guardian. Accessed from:
https://www.theguardian.com/healthcare-network/2015/jan/23/barriers-healthcare-innovation
Innovation, Science & Economic Development Canada (2016). Canada: A nation of innovators.
Accessed from: https://www.youtube.com/watch?v=AI-4OT4h_JY&feature=emb_logo
Institution of Engineering & Technology (2019). What are the barriers to innovation in healthcare?
Accessed from: https://www.youtube.com/watch?v=6hzL70OElKw&t=3s
Kimble, L., & Massoud, R. (2017). What do we mean by innovation in healthcare? European Medical
Journal.1(1):89-91. Accessed from: https://emj.europeanmedical-group.com/wpcontent/uploads/sites/2/2018/01/What-do-we-mean-by-Innovation-in-Healthcare…pdf
References
Knowledge@Wharton (2015). What drives innovation in healthcare? Accessed from:
LaMorte, W.W. (2018). Diffusion of Innovation Theory. Accessed from:
http://sphweb.bumc.bu.edu/otlt/MPHModules/SB/BehavioralChangeTheories/BehavioralChangeTheories4.html
Medicine Future Technology Flowchart. Photograph. Britannica ImageQuest, Encyclopædia Britannica,
2 Nov 2020.
quest.eb.com/search/186_3415772/1/186_3415772/cite. Accessed 16 Aug 2021.
Rogers, E.M. (1962). Diffusion of Innovations. Free Press of Glencoe: New York.
Rouse, M. (2017). Disruptive Innovation. TechTarget. Accessed from:
https://searchcio.techtarget.com/definition/disruptive-innovation
The Agenda with Steve Paikin (2021). Economic Change For The Better Isn’t Easy. Accessed from:
Walters, H. (2012). Vulnerability is the birthplace of innovation, creativity and change: Brené Brown at
TED2012. TEDblog. Accessed from: https://blog.ted.com/vulnerability-is-the-birthplace-of-innovationcreativity-and-change-brene-brown-at-ted2012/