Understanding the activity of oncology nurse coordinators: An elaboration of a framework based on an abductive approach

Acero, Maria-Ximena; Minvielle, Étienne; Waelli, Mathias

doi:10.1016/j.healthpol.2023.104737

Cited by 2 publications

(4 citation statements)

References 41 publications

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“…Data analyses were performed using our previously developed Activity of PAtient PAthway Nurse Coordinators in Oncology (APANCO) framework [ 22 ]. Unlike other NC work models, APANCO not only accounts for NC activity but also highlights the influence of organizational strategies in an institutional context.…”

Section: Methodsmentioning

confidence: 99%

“…After dividing NC observations into AUs, MXA coded information in Excel spreadsheets (one Excel sheet/category) using APANCO items as a grid. Standardizing coding analyses were performed in our preliminary research [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, to advance our knowledge in this area and to capture NCs real activity in an organizational environment, NC activities should be investigated as they are performed in real-time work situations, i.e., for NCs in hospital contexts, their work content may be influenced by the organizational structure of the HCO [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Within this context, our aim was to identify and quantify all activities performed by NCs in oncology care settings. Rather than a clinical analysis, our goal was to propose an organizational analysis of NC activity [ 22 ]. Oncology is a good field to observe NCs; firstly, PPC requirements are numerous, especially during transitions between ambulatory and inpatient care [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Are Nurse Coordinators Really Performing Coordination Pathway Activities? A Comparative Analysis of Case Studies in Oncology

2023

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Patient Pathway Coordination (PPC) improves patient care quality and safety, particularly in oncology. PPC roles, such as nurse coordinators (NCs), have positively impacted the quality of patient care and reduced financial costs. However, NCs and their real activities in Health Care Organizations (HCOs) are unclear. Our aim was to identify, quantify, and compare all activities performed by NCs in oncology care settings from an organizational approach. Methods: We used qualitative and quantitative approaches based on case study principles. We accumulated 325 observation hours by shadowing and timing the activities of 14 NCs in four French HCO in oncology. Data analysis was conducted using an analytical framework to investigate the Activity of PAtient PAthway Nurse Coordinators in Oncology (APANCO). Results: Our research generated important findings: (1) NC roles and job titles are not standardized. (2) Non-coordination related activities are important in NC work content. Non-coordination times were consistent with distribution times between ward NCs and NCs in centralized structures. Ward NCs had higher non-coordination activities when compared with NCs in centralized structures. (3) PPC times varied for both ward NCs and NCs in centralized structures. Ward NCs performed less design coordination when compared with NCs in centralized structures, and this latter group also performed more external coordination than ward NCs. Conclusions: NCs do not just perform PPC activities. Their position in HCO structures, wards, or centralized structures, influence their work content. Centralized structures allow NCs to focus on their PPC roles. We also highlight different dimensions of NC work and training requirements. Our study could help managers and decision-makers develop PPC roles in oncology.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Are Nurse Coordinators Really Performing Coordination Pathway Activities? A Comparative Analysis of Case Studies in Oncology

2023

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Contribution of Coordination Theories to the Determination of Human Factors Associated With Operating Room Perceived Performance

Dahmani,

Waelli,

Dariel

2024

Anesthesia &Amp; Analgesia

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BACKGROUND: The efficient and fluid organization of surgical interventions in an operating room (OR) and operating suite (OS) is important as these are among the most expensive units to run in medical-surgical facilities. The complexity of OS organization requires careful coordination, defined here as the directing of individuals’ efforts toward achieving common and explicitly recognized goals. There is currently sparse literature on OS coordination, especially in the French context. This study aimed to respond to this gap by reporting on the coordination mechanisms associated with the perceived performance of OS across 4 facilities in an urban setting in France. METHODS: We used a qualitative comparative case study based on ethnographic methodology to explore 4 facilities (2 teaching, 1 general, and 1 private). Several investigation techniques were used for data collection (semistructured interviews, participant and nonparticipant observations, and informal interviews) in the OR, the OS, the regulation council (dedicated to adapting the necessary resources to specific procedures and patients’ health status), and the OS council (dedicated to strategic and operational OS transformations and adaptations, and responsible for finding solutions to organizational problems). Analysis was guided by Okhuysen and Bachky’s theoretical framework on coordination and multi-team systems theory. Data were compared across the 4 facilities and triangulated using the different techniques to ensure coherence and accuracy. RESULTS: Overall, 48 interviews with health care providers and hospital managers and 200 hours of direct observations were performed. The OR exhibited a high degree of coordination, whereas improved perception of performance in the OS depended on managerial competency, trust, and authority. Perceived performance in the regulation council and OS council, on the other hand, depended on the identification of formal objectives by all stakeholders and the development of common understanding (developing agreement, direct information sharing, creating common perspective, substitution, bringing groups together, and storing of knowledge). CONCLUSIONS: Based on existing literature on multi-team systems (as represented in the OS organization), this study identifies success factors influencing OS coordination. These include the OS manager’s leadership skills; the identification of formal system objectives; and professional differentiation between stakeholders (absence/decrease of a sense of belonging to a multi-team system). This differentiation was related to the high degree of specialization within OS teams, each bringing different norms, cultures, and contingencies that induce dissonance in organization and task performance. Interventions targeting these success factors might improve coordination, and thus performance, in the OS.

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Understanding the activity of oncology nurse coordinators: An elaboration of a framework based on an abductive approach

Cited by 2 publications

References 41 publications

Are Nurse Coordinators Really Performing Coordination Pathway Activities? A Comparative Analysis of Case Studies in Oncology

Are Nurse Coordinators Really Performing Coordination Pathway Activities? A Comparative Analysis of Case Studies in Oncology

Contribution of Coordination Theories to the Determination of Human Factors Associated With Operating Room Perceived Performance

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