Public affairs professionals are responsible for monitoring the sociopolitical environment and using information strategies to respond to public policy proposals on behalf of firms and organizations. To develop, implement, and legitimize public policy, lawmakers and public administrators rely on the input from external experts and stakeholders. The purpose of this research was to explore how public affairs engage with healthcare intraorganizational stakeholders to leverage their knowledge for information strategies. Knowledge transfer served as a theoretical framework through a qualitative multiple case study of 3 healthcare delivery organizations in the upper Midwest of the United States. Primary data were collected using semistructured interviews from public affairs (n = 11) and healthcare professionals (n = 18). Organizational documents and public records were reviewed to understand the internal interaction of public affairs and the development of information strategies. Patterns and themes emerged through cross case synthesis, presented as a process-based model and theory. Public affairs functions were structured inconsistently in all case sites. Decision-making processes primarily involved nonpublic affairs stakeholders approving information products. Intraorganizational engagement and knowledge transfer was found as ad-hoc and consistent, through a blending of informal and formal methods. Practitioner strategies, tactics, and challenges were identified to facilitate internal interaction. This study provides insight to improving public affairs practice and supports linking the expertise of healthcare stakeholders to policymaking. Improving the healthcare delivery system through public policymaking is fostered through aligning policy with the knowledge of healthcare professional practice.

Employees are observant to their employers' policies and practices, which can reveal a lot about an organization's commitment to procedural justice. According to Judge & Colquitt (2004), perceived procedural justice, in particular, appears to have a considerable effect on chronic stress. Chronic stress, on the other hand, can have a negative effect on one’s wellbeing (Geronimus et al., 2006). Despite this, little research on African American women’s perception of procedural justice in relation to diversity management practices has been conducted. Using a qualitative interpretative phenomenological approach, I examined African American women’s lived experiences in healthcare companies in relation to diversity management practices under a procedural justice framework to investigate if weathering is exhibited within healthcare companies. Weathering recognizes that “the cumulative health and stress disparities that African American women experience throughout their lives result in negative health outcomes” (Warren-Findlow, 2006, p. 221). Two studies were performed. Study Two was designed to replicate, validate, or bring different perspectives to Study One's findings. Its findings were consistent with those of Study One, suggesting that the weathering concept is exhibited within healthcare companies. These findings may encourage healthcare organizations to delve deeper into the origins of health disparities impacting African American female employees and members. Furthermore, the findings of this investigation advocate for research to be broadened beyond the societal level to include the experiences of African American women working in other organizations. / Business Administration/Interdisciplinary

Orientador: Otávio José de Oliveira / Resumo: A sustentabilidade ambiental tornou-se um fator considerado pelas organizações, pois há preocupações e pressões crescentes sobre os impactos que as atividades empresariais podem causar na saúde humana e no planeta. Na área hospitalar, é possível desenvolver a sustentabilidade ambiental a partir dos resultados obtidos por outros tipos de organizações. Um número crescente de hospitais estão se tornando mais interessados em sustentabilidade ambiental visando a melhoria da saúde pública, ambiental e redução dos custos operacionais. O Green Healthcare (GH) é a incorporação de estratégias de sustentabilidade ambiental aplicada nas organizações de saúde. Este trabalho tem como objetivo principal identificar e sistematizar as boas práticas e dificuldades das organizações hospitalares no desenvolvimento/operacionalização dos princípios do GH. Para desenvolver esta pesquisa foi realizada a revisão da literatura científica para identificar os princípios do GH e os fatores críticos de sucesso que impactam no seu desenvolvimento. Os princípios identificados foram: liderança, substâncias químicas, resíduos, energia, água, transportes, alimentos, produtos farmacêuticos, edifícios e compras. Embasado nos princípios, fatores críticos de sucesso e no método de pesquisa estudos de casos múltiplos, foram investigadas seis organizações hospitalares do Estado de São Paulo que participam da Agenda Global para Hospitais Verdes e Saudáveis. Como resultado desta pesquisa é feita a identificação e sist... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Organizations have made environmental sustainability as one of the factors to consider in business because of the increasing pressures and concerns that impact on business activities, human health, and the planet. In the healthcare business, it is possible to develop environmental sustainability from results obtained in other organizations. An increasing number of hospitals are becoming more interested in environmental sustainability for improving public and environmental health and reducing operating costs. Green Healthcare (GH) is the use of environmental sustainability strategies applied in healthcare organizations. This research aims to identify and systematize good practices and difficulties in hospital organizations in the development/operationalization of GH principles. To develop this research, a review of the scientific literature was carried out to identify the principles of GH and the critical success factors that impact its development. The principles identified were leadership, chemicals, waste, energy, water, transportation, food, pharmaceuticals, buildings, and purchasing. Based on the principles, critical success factors, and multiple cases study research method, six hospital organizations from the State of São Paulo that participated in the Global Green and Healthy Hospitals Agenda were investigated. As a result of this research, a systematization of actions is done to develop/operationalize the GH principles in hospital organizations. The main scientific con... (Complete abstract click electronic access below) / Mestre

Made available in DSpace on 2010-04-20T20:14:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2002-02-04T00:00:00Z / Mostra evidências de relação entre os atributos de qualidade de um serviço de reabilitação ambulatorial sob a percepção do cliente e os padrões do modelo internacional de acreditação de serviços de saúde Joint Commission on Accreditation of Healthcare Organizations. Os achados foram obtidos por meio de pesquisa exploratória com a técnica de reunião com grupo focado no Centro de Reabilitação do Hospital Israelita Albert Einstein em São Paulo.

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Contexte : dans les pays de l’OCDE, la plupart des organisations de santé ont mis en place différentes approches afin d’accroître l’engagement des patients que ce soit au niveau des soins ou au niveau de l’amélioration de la qualité. Au Canada, la province du Québec se caractérise par un contexte particulièrement novateur en matière d’engagement des patients au sein des organisations de santé. Alors que les démarches d’engagement se sont généralisées dans bon nombre d’organisations, peu de connaissances existent sur leur mise en oeuvre dans différents contextes cliniques et organisationnels. La littérature sur l’engagement des patients identifie principalement les facteurs facilitants et entravants, sans comprendre les rôles et pratiques clés des gestionnaires à différents niveaux des organisations de santé. Objectif : l’objectif de la thèse est d’analyser les rôles et les pratiques des gestionnaires, à différents niveaux des organisations de santé, dans la mise en oeuvre de l’engagement des patients. Méthodologie : la thèse repose sur la réalisation d’études de cas multiples (articles 1 et 3) et d’une étude transversale (article 2), mobilisant des données qualitatives et quantitatives, qui ont donné lieu à trois articles. Dans les deux premières études, des données qualitatives (entrevues, groupes de discussion et documents) ont été utilisées afin d’explorer les rôles et les pratiques des gestionnaires pour favoriser l’engagement des patients dans les démarches d’amélioration de la qualité. La dernière recherche repose sur l’utilisation de méthodes mixtes (entrevues, groupes de discussions, documents et questionnaires) en vue d’explorer les pratiques de gestion visant à renforcer l’engagement des patients dans leurs soins. Au total, 74 entrevues ont été réalisées auprès de gestionnaires à différents niveaux de gestion (stratégique n=26, tactique n=28 et opérationnel n=20) et 11 groupes de discussion ont été effectués auprès de professionnels de la santé (n=7) et de patients en oncologie et en santé mentale (n=4). De plus, des questionnaires ont été administrés auprès de patients en santé mentale. Résultats : la thèse met en évidence six résultats principaux. 1-Les pratiques de gestion sont un levier important d’intégration de la perspective des patients dans les soins et les efforts d’amélioration de la qualité. 2-L’intégration de l’engagement des patients implique une coopération renforcée entre les gestionnaires à différents niveaux de gestion. 3-Le leadership des gestionnaires se situe à différents niveaux de gestion en fonction du niveau d’intégration des patients (organisationnel ou clinique). 4-Les pratiques des gestionnaires sont soutenues par un ensemble de facteurs contextuels propices à l’intégration de l’engagement des patients. 5- L’intégration de la participation des patients favorise l’émergence de nouvelles pratiques de gestion au sein des organisations de santé. Enfin, 6-La mise en oeuvre de l’engagement des patients crée des défis et des paradoxes auxquels les gestionnaires doivent répondre. Contribution scientifique : les résultats de la thèse contribuent au développement des connaissances dans le domaine de l’engagement des patients et ouvre la voie à un nouveau champ de recherche sur la gestion de l’engagement des patients. / Background: In OECD countries, most health organizations have implemented approaches to increase patient engagement in direct care and quality improvement. In Canada, the province of Quebec stands out by an innovative context in terms of patient engagement in healthcare organizations. While patient engagement approaches are becoming widespread in many organizations, little is known about their implementation in different clinical and organizational contexts. The patient engagement literature primarily identifies facilitating and impeding factors, without understanding the key roles and practices of managers at different levels of healthcare organizations. Objective: This thesis aims at analyzing the roles and practices of managers, at different levels of health care organizations, in integrating patient engagement in care and quality improvement. Methods: The thesis is based on multiple case studies (articles 1 and 3) and one cross-sectional study (article 2) using both qualitative and quantitative data and methods. In the two first studies, qualitative data have been used to explore managerial roles and practices that aims at enhancing patient engagement in quality improvement. In the last study, a mixed-methods approach has been used to understand managers’ practices that contribute to improve patient engagement in their care. In total, 74 interviews were conducted with managers at different levels of management (top-level n=26, mid-level n=28 and front-line level n=20) and 11 focus groups have been realized with health care professionals (n=7) and patients in oncology and mental health (n=4). In addition, surveys have been administered to patients in mental health. Findings: This thesis highlights six main results. 1-Management practices are an important lever for integrating the patient perspective into care and quality improvement efforts. 2-The implementation of patient engagement approaches requires enhanced cooperation between managers at different levels of management. 3-Managers’ leadership is situated at different levels of management, depending on the level of patients’ integration (organizational or clinical). 4-Managers’ roles and practices are supported by a set of contextual factors which foster patient engagement. 5-The integration of patient participation creates innovative management practices within healthcare organizations. Finally, 6-The implementation of patient engagement generates challenges and paradoxes that managers have to face. Scientific contribution: Our findings contribute to the development of knowledge in the field of patient engagement and can pave the way for a new research area on the management of patient engagement.