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Showing results for tags 'Qualitative'.
Found 66 results
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Content ArticleIn this article, Wu et al. argue that the enduring sociological concepts of the informal organisation and formal organisation offer analytical purchase in understanding the causes of such problems and how they can be addressed. Their analysis emphasises the interdependence of the formal and informal organisation. The formal organisation describes codified and formalised elements of structures, procedures and processes for the exercise of voice, but participants often found it frustrating, ambiguous, and poorly designed. The informal organisation—the informal practices, social connections, and methods for making decisions that are key to coordinating organisational activity—could facilitate voice through its capacity to help people to understand complex processes, make sense of their concerns, and frame them in ways likely to prompt an appropriate organisational response. Sometimes the informal organisation compensated for gaps, ambiguities and inconsistencies in formal policies and systems. At the same time, the informal organisation had a dark side, potentially subduing voice by creating informal hierarchies, prioritising social cohesion, and providing opportunities for retaliation. The formal and the informal organisation are not exclusive or independent: they interact with and mutually reinforce each other. The findings have implications for efforts to improve culture and processes in relation to voice in healthcare organisations, pointing to the need to address deficits in the formal organisation, and to the potential of building on strengths in the informal organisation that are crucial in supporting voice.
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Content ArticleThe research team interviewed 40 mental health clinicians and managers from a variety of healthcare systems who were participating in a burnout intervention. The team determined results of those interviews could be broken down into three themes around how organisations might reduce burnout. A work culture that prioritizes person-centered care over productivity and other performance metrics. Management skills and practices to overcome bureaucracy. Opportunities for employee professional development and self care. "Clinicians told us that they chose this line of work because they wanted to help people. When policies get in the way of providing good care, it undermines morale and engagement," said Dr. Rollins. "This particular study focused on mental health providers, but this is likely applicable to all healthcare professions. This isn't an issue that can be solved at the individual or supervisor levels. The health system is out of balance, and that needs to be addressed. This research can be used to inform the development of health system, organizational and program-level initiatives."
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Content ArticleThis study from Manbinder Sidhu and Jack Pollard investigated: what specifically has led to hospitals and GP practices being run by the same organisation; how it is done; the expectations of the GPs and NHS managers who made it happen; whether those expectations are being fulfilled; and whether there are any other consequences. To do this, they have interviewed GPs, NHS managers and other staff, 52 people in all, at two locations in England and one in Wales. They have also observed management meetings and reviewed documents referred to by interviewees. They found that the dominant reason for hospitals to run GP practices was to enable some practices that would otherwise have closed to keep going. This has so far been successful. These practices are also increasingly able to offer patients the opportunity to consult a range of health care professionals at the local practice, not just GPs, but also staff with special training to provide specific types of health care, for example, for diabetes or for problems with joint pain. Various legal arrangements were developed in different places to enable hospitals to run GP practices, including setting up an NHS-owned company and making the practices part of an existing NHS organisation.
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Content ArticleThe dataset included interviews and focus groups with 121 participants from primary care (33 patients, 55 GPs, 11 other clinicians, nine managers, four support staff, four national policymakers, five technology industry). The results found, with few exceptions, video consultations were either never adopted or soon abandoned in general practice despite a strong policy push, short-term removal of regulatory and financial barriers, and advances in functionality, dependability, and usability of video technologies (though some products remained ‘fiddly’ and unreliable). The relative advantage of video was perceived as minimal for most of the caseload of general practice, since many presenting problems could be sorted adequately and safely by telephone and in-person assessment was considered necessary for the remainder. Some patients found video appointments convenient, appropriate, and reassuring but others found a therapeutic presence was only achieved in person. Video sometimes added value for out-of-hours and nursing home consultations and statutory functions (for example, death certification). The authors of the study concluded that efforts to introduce video consultations in general practice should focus on situations where this modality has a clear relative advantage (for example, strong patient or clinician preference, remote localities, out-of-hours services, nursing homes).
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Content ArticleKey findings: There are calls for greater use of ‘soft’ intelligence around quality and safety. Little research examines the challenges and opportunities soft data present. This study in the English NHS found clinicians and managers saw utility in soft data. Dominant approaches to interpretation risked obscuring their greatest value. Soft data might better be used to disrupt understanding and challenge consensus.
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Content ArticleThis was an explorative study, with qualitative in-depth interviews of 23 family carers of older people with suspected or diagnosed dementia. Family carers participated after receiving information primarily through health professionals working in dementia care. A semi-structured topic guide was used in a flexible way to capture participants’ experiences. A four-step inductive analysis of the transcripts was informed by hermeneutic-phenomenological analysis.
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Content ArticleThe results found there were 129 unique mentions of barriers to patient safety; these barriers were categorised into five major themes. ‘Limited resources’ was the most prominent theme, followed by barriers related to health systems issues, the medical culture, provider training and patient education/awareness. Although inadequate resources are likely a substantial challenge to the improvement of patient safety in India, other patient safety barriers such as health systems changes, training, and education, could be addressed with fewer resources. While initial approaches to improving patient safety in India and other low- and middle-income countries have focused on implementing processes that represent best practices, this study suggests that multifaceted interventions to also address more structural problems (such as resource constraints, systems issues, and medical culture) may be important.
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Content ArticleResources: driver diagrams (tree diagrams) the health and wellbeing framework and diagnostic tool workforce stress and the supportive organisation — a framework for improvement.
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Content ArticleKey messages Most opportunities to raise safety concerns may arise in routine clinical work. Informal strategies for raising concerns are multiple and often effective. Use of strategies varies within and between professional groups and hierarchies. Increased focus on effective use of informal strategies of social control is needed.
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West of England AHSN: PReCePT resources
Claire Cox posted an article in AHSNs
This QI toolkit contains all the documents you will need to understand, plan and implement PReCePT in your maternity unit. Based on the success of the initial PReCePT project, some of the documents are categorised as ‘essential’ for successful implementation, others are ‘strongly recommended’ and some are ‘optional’. The toolkit includes: PReCePT QI Toolkit PDF PReCePT Programme Implementation Guide PReCePT Clinical Guideline Flow Chart PReCePT Magnesium Sulphate Quick Reference Poster PReCePT Management of Preterm Labour Proforma PReCePT Magnet Instructions PReCePT Infographic Poster PReCePT Think Magnesium Too Poster Magnesium Sulphate Parent Leaflet Quality Improvement Learning Log (PDF) Midwife Lead Role Obstetrician Lead Role -
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