All I said is I can help... My journey with thematic analysis

Summary

Chris Elston, a patient safety education lead, shares his journey on how he learnt and used thematic analysis in his trust, which led to him designing a lesson for his colleagues and then wider teaching outside his organisation.

Content

For many years I have thought that we could make a bigger impact on patient safety if we could examine low harm events or near misses in greater detail. Historically, they have often been left to local areas to investigate and close them. With all the time pressures and demands on them, it is hardly surprising that many get a superficial look rather than an examination.

Thematic analysis allows us to do a good delve into these areas and so I sought to complete two analyses: one on falls and the other on pressure ulcers. I thought that they lent themselves to this style of analysis.

I mean how hard could it be, a week or two and the analysis would be done. Simple, isn’t it? Well, I can only say how wrong I was. The first analysis took about three months to complete, the second one, a little longer. At this point, I will be honest—despite the raft of available data sources, I only used the adverse event reports (AERs). I think it may have been longer if other data sources had been used.

I was pleased with the result; it showed lots of useful information that could be shared with the steering groups and individual areas to help inform their practice.

Soon after this, the Patient Safety Incident Response Framework (PSIRF) was introduced and the use of thematic analysis was one of the tools that PSIRF recommended. This meant that a greater understanding of thematic analysis was required. So, after a brief hiatus, I started to research a little more about thematic analysis and its application and found there was much more to thematic analysis than I had first realised.

Designing a lesson

I wanted to design a thematic analysis lesson for my trust. What did people need to know before they could use it? I was no expert and I needed to learn before I attempted to teach it, so what did I need to know?

My initials thought were:

• How do you define thematic analysis?
• What types are there?
• When could it be used?
• What are the advantages and disadvantages of thematic analysis?
• Where can we get data from?
• How can we code/map the data into themes?

So began a journey; what should have been a short journey but has taken a few twists along the way.

I developed a 2-hour lesson with what I considered to be the essentials of thematic analysis. This was then delivered in my trust, which led to some changes in our processes. This meant that thematic analysis became much more of a featured learning response.

Following this, I was then asked to assist one of our wards on a project and we started with a … thematic analysis. I never dreamed I would be doing something like this.

Expanding the training

After a year or so, I answered a question posed on NHS Futures about thematic analysis training. I replied that I had a lesson and was willing to meet and discuss with people. I did not expect the response that I got. People from all sorts of healthcare organisations, within the NHS and outside of it, wanted to discuss thematic analysis. 

I was shocked and stunned at the response. I have often said, if we do not collaborate then we will never drive patient safety forwards at a great enough pace to safeguard patients and staff. So I elected to share some of my teaching.

My trust offered to host some meetings, we discussed the training I could provide and what I felt comfortable sharing.

There was just over 100 people interested in attending the meetings. As the time got closer, I became increasingly nervous. The imposter syndrome hit hard—I was going to be found out as a fraud and not nearly as switched on as many appeared to think. Was this such a clever idea?

Conclusion

We are now about 6 weeks from the last meeting and I can breathe a sigh of relief. Everything went ahead in a positive manner. Feedback has been good, although I think I could have made better use of technology and that is a lesson learnt for the future.

Many in healthcare are willing to make the necessary changes but they want support in this; coaching and mentoring will be critical to  delivering PSIRF. This is just one step on that path (motorway, could be a better analogy!).

The experience has shown how powerful collaboration is.

Further reading on the hub:

• Patient Safety: Emerging Applications of Safety Science
• "The greatest part of this adventure has been the sharing of information."
• Conducting a systems review of pressure ulcers in the intensive care unit

About the Author

Chris Elston is Patient Safety Education Lead for University Hospital Southampton NHS Foundation Trust and Chair of the Patient Safety Education Network. 

The Network is open to those who teach any element of patient safety or provide learning from patient safety incidents. The network is hosted on the hub. You can join by signing up to the hub today. When putting in your details, please tick ‘Patient Safety Education Network’ in the ‘Join a private group’ section. If you are already a member of the hub, please email [email protected].