{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:24:46Z","timestamp":1784287486832,"version":"3.55.0"},"reference-count":59,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate nursing and allied health professional perceptions of the interrelationship between avoidable hospital readmissions and fundamental care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative, exploratory study using a critical realist approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>One\u2010to\u2010one semi\u2010structured interviews with 14 nursing and allied health professionals conducted between May and September 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Several tensions and contradictions were identified in the data, which demonstrated clinicians' perceptions about the priority of both fundamental care and two avoidable readmission conditions (aspiration pneumonia and constipation). These tensions are illustrated in two major themes: Avoidable versus inevitable; and everyone versus no one. The first theme demonstrates clinicians' perceptions that readmissions for aspiration pneumonia and constipation are not common, despite acknowledging that they generally lacked knowledge on readmission rates; and that these conditions may not be preventable in acute settings. The second theme demonstrates clinicians' perception that preventing readmissions is everyone's responsibility, however, this was coupled with a lack of articulation around how this multidisciplinary approach could be achieved, leading to a distinct lack of agency for care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Articulating the tensions described in the results provides vital knowledge for understanding how clinicians may respond to initiatives designed to reduce avoidable readmissions. Avoidable hospital readmissions may be usefully understood as a wicked problem: one that is complex and requires adaptive, not linear, solutions. Wicked problems pose a challenge for leaders and managers in healthcare because top\u2010down, hierarchical strategies are unlikely to be successful. Effective prevention of avoidable readmissions requires leaders to enable facilitator\u2010led change through relational leadership strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Avoidable hospital readmissions are a global problem increasingly addressed via funding changes and the introduction of penalties to hospitals. This study provides insights on clinicians' perspectives of avoidable hospital readmissions and their prevention, demonstrating the complexity of this challenge and the need for healthcare leaders to enable individual and organizational readiness for change.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.15220","type":"journal-article","created":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T22:55:01Z","timestamp":1648162501000},"page":"1031-1043","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Why reducing avoidable hospital readmissions is a \u2018wicked\u2019 problem for leaders: A qualitative exploration of nursing and allied health perceptions"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9414-2242","authenticated-orcid":false,"given":"Rebecca","family":"Feo","sequence":"first","affiliation":[{"name":"College of Nursing and Health Sciences Flinders University  Bedford Park South Australia Australia"},{"name":"Caring Futures Institute Flinders University  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8381-4354","authenticated-orcid":false,"given":"Kristi","family":"Urry","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences Flinders University  Bedford Park South Australia Australia"},{"name":"Caring Futures Institute Flinders University  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0653-7960","authenticated-orcid":false,"given":"Tiffany","family":"Conroy","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences Flinders University  Bedford Park South Australia Australia"},{"name":"Caring Futures Institute Flinders University  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3053-8381","authenticated-orcid":false,"given":"Alison L.","family":"Kitson","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Sciences Flinders University  Bedford Park South Australia Australia"},{"name":"Caring Futures Institute Flinders University  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Avoidable hospital readmissions: Report on Australian and international indicators, their use and the efficacy of interventions to reduce readmissions","author":"Australian Commission on Safety and Quality in Health Care","year":"2019"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2017.08.036"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/2045\u20104015\u20102\u20101"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/10376178.2018.1439395"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.24083\/apjhm.v12i1.103"},{"key":"e_1_2_10_7_1","volume-title":"Complexity science in healthcare\u2010aspirations, approaches, applications and accomplishments: A white paper","author":"Braithwaite J.","year":"2017"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-10-5251-4_103"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzaa064"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474124.2020.1781617"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472\u20106955\u201013\u201011"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2020.07.012"},{"key":"e_1_2_10_14_1","volume-title":"All complications should count: Using our data to make hospitals safer","author":"Duckett S.","year":"2018"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010015\u20102831\u20105"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.14247"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1108\/JHOM\u201002\u20102018\u20100037"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2016.01.006"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.14313"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010018\u20103769\u20103"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2018.09.017"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102834.2012.1478.x"},{"key":"e_1_2_10_23_1","unstructured":"Independent Hospital Pricing Authority. 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