1
|
Reeves V, McIntyre H, Loughhead M, Halpin MA, Procter N. Actions targeting the integration of peer workforces in mental health organisations: a mixed-methods systematic review. BMC Psychiatry 2024; 24:211. [PMID: 38500086 PMCID: PMC10949677 DOI: 10.1186/s12888-024-05664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/06/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Lived experience workforces are one of the fastest growing emerging disciplines in Australian mental health service settings. Individuals with lived and living experience of mental distress employed in mental health services, often referred to as peer or lived experience workers, are widely considered essential for mental health recovery and reform. Despite vast growth of this workforce, concerns remain over the widespread integration of peer workforces to align with recommended movement of healthcare services toward greater recovery-orientated and person-centered practices. Previous research has identified barriers for peer work integration including a lack of clear role definition, inadequate training, and poor supportive organisational culture. Stigma, discrimination and a lack of acceptance by colleagues are also common themes. This systematic review seeks to identify organisational actions to support integration of peer workforces for improved mental health service delivery. METHOD A systematic search was conducted through online databases (n = 8) between January 1980 to November 2023. Additional data were sourced from conference proceedings, hand searching grey literature and scanning reference lists. Qualitative data was extracted and synthesised utilising narrative synthesis to identify key themes and findings reported adhere to PRISMA guidelines. The review protocol was registered with Prospero (CRD: 42,021,257,013). RESULTS Four key actions were identified: education and training, organisational readiness, Structural adjustments, resourcing and support and, demonstrated commitment to peer integration and recovery practice. CONCLUSIONS The study identifies actions for mental health service organisations and system leaders to adopt in support of integrating peer and lived experience workforces in service delivery.
Collapse
Affiliation(s)
- Verity Reeves
- The University of South Australia, 5001, Adelaide, GPO Box 2471, South Australia.
| | - Heather McIntyre
- The University of South Australia, 5001, Adelaide, GPO Box 2471, South Australia
| | - Mark Loughhead
- The University of South Australia, 5001, Adelaide, GPO Box 2471, South Australia
| | | | - Nicholas Procter
- The University of South Australia, 5001, Adelaide, GPO Box 2471, South Australia
| |
Collapse
|
2
|
Degerman H, Wallo A. Conceptualising learning from resilient performance: A scoping literature review. Appl Ergon 2024; 115:104165. [PMID: 37948841 DOI: 10.1016/j.apergo.2023.104165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
Resilient performance is a crucial characteristic of complex socio-technical systems, enabling them to sustain essential functionality during changing or stressful conditions. Resilience Engineering (RE), a sub-field of safety research, focuses on this perspective of resilience. RE emphasises its "cornerstone model", presenting the RE system goals of "anticipating, monitoring, responding and learning". The cornerstone of learning remains fragmented and undertheorized in the existing literature. This paper aims to enrich RE research and its practical implications by developing a nuanced and comprehensive understanding of the role of learning from resilient performance. To achieve this aim, a scoping literature review was conducted to assess how learning is conceptualised in the RE literature and the theoretical foundations on which previous work rest. The main findings show that RE researchers view learning as the process of understanding the system, sharing knowledge, and re-designing system properties. The application of established learning theories is limited. This paper contributes to research by proposing an organisational process for the RE cornerstone of learning, paving the way for deeper discussions in future studies about learning from resilient performance within complex socio-technical systems.
Collapse
Affiliation(s)
- Helene Degerman
- RISE Research Institutes of Sweden, Gothenburg, Sweden; Linköping University, Linköping, Sweden.
| | | |
Collapse
|
3
|
Sein-Echaluce ML, Fidalgo-Blanco Á, Balbín AM, García-Peñalvo FJ. Flipped Learning 4.0. An extended flipped classroom model with Education 4.0 and organisational learning processes. Univers Access Inf Soc 2022:1-13. [PMID: 36439962 PMCID: PMC9676744 DOI: 10.1007/s10209-022-00945-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
This article integrates two visions on the creation of knowledge by students: an academic vision where the person who creates knowledge uses high-level cognitive abilities and, therefore, acquires deeper learning, and an organisational learning vision, where the creation of knowledge adds value to the organisation and the individuals who work in this matter. It starts from a validated flipped classroom model and then adds procedures and cycles of knowledge that make it an active methodology, in such a way that it simultaneously supports organisational learning, using cooperative competencies characteristic of Education 4.0. This proposed hybrid model has been applied online during confinement due to the COVID-19 pandemic and, subsequently, in dual mode (students partly in person and the rest online at the same time) and face-to-face mode. The evidence of this research shows that the creation of knowledge by the students, cooperatively and with an organisational learning perspective, has repercussions for improvements in their academic performance by producing deeper learning. In addition, the development of cooperative skills is observed to create and manage a large amount of helpful knowledge for them and other students in their learning process.
Collapse
Affiliation(s)
- María Luisa Sein-Echaluce
- Department of Applied Mathematics, EINA, Universidad de Zaragoza, Calle de María de Luna 3, 50018 Saragossa, Spain
| | - Ángel Fidalgo-Blanco
- Laboratory of Innovation in Information Technologies. LITI, Universidad Politécnica de Madrid, Calle de Ríos Rosas 21, 28003 Madrid, Spain
| | - Ana María Balbín
- Education Faculty, Pontificia Universidad Católica del Perú, Av. Universitaria 1801, San Miguel, 15088 Lima Perú
| | - Francisco José García-Peñalvo
- Department of Computer Science and Automation, Science Faculty, Universidad de Salamanca, Plaza de los Caídos S/N, 37008 Salamanca, Spain
| |
Collapse
|
4
|
Christian B. A threat rather than a resource: why voicing internal criticism is difficult in international organisations. J Int Relat Dev (Ljubl) 2021; 25:425-449. [PMID: 34629944 PMCID: PMC8490833 DOI: 10.1057/s41268-021-00244-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Voicing criticism seems to be a difficult task for employees in international organisations (IOs), as numerous anecdotes in the literature suggest. This observation is alarming, since internal criticism is an indispensable resource for organisational learning processes. So why are IOs apparently not using this resource to its full potential? The present article is the first to provide a comprehensive answer to this question by combining insights from organisation theory with an empirical case study of the UN Secretariat. My general argument is that 'criticism from within' is ambivalent. It can be a resource for, but also a threat to IOs: internal criticism can endanger an IO's external reputation as well as destabilise the organisation from within. Based on this theoretical understanding, I identify and empirically examine three specific reasons for the UN Secretariat's weak criticism culture: (1) Criticism is suppressed due to a widespread fear of leaks resulting from external pressures. (2) Criticism is avoided as a strategy of self-protection in the face of (inevitable) failures. (3) Constructive criticism is difficult to express in settings where organisational hypocrisy is necessary.
Collapse
Affiliation(s)
- Ben Christian
- Peace Research Institute Frankfurt (PRIF), Leibniz-Institut Hessische Stiftung Friedens- und Konfliktforschung, Baseler Straße 27, 60329 Frankfurt am Main, Germany
| |
Collapse
|
5
|
Feng TT, Zhang X, Tan LL, Liu HP. Cross-cultural adaptation and validation of the strategic learning assessment map for Chinese nursing organisation: A cross-sectional study. Nurse Educ Pract 2021; 56:103185. [PMID: 34509748 DOI: 10.1016/j.nepr.2021.103185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/27/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022]
Abstract
AIM To translate the Strategic Learning Assessment Map into Chinese and validate it in Chinese nursing organisations. BACKGROUND Nursing is the largest occupational organisation in the health sector and its adaptation and innovation are important for the realisation of sustainable development goals. Organisational learning is critical in cultivating the adaptive and innovative abilities of organisations, but there is limited research on its measurement. Although the Strategic Learning Assessment Map is a widely acknowledged organisational measurement instrument, it has not yet been adapted and validated in China. DESIGN A cross-sectional study design was used. METHODS The Chinese version of the Strategic Learning Assessment Map was generated through forward-backward translation and was tested with a convenience sample of 2745 nurses from 7 administrative regions of mainland China. The internal consistency, content validity, structural validity and theoretical framework were examined. RESULTS Results validated the theoretical framework and showed excellent content validity, convergent validity and fitness of the measurement model; only discriminant validity was not satisfactory. Cronbach's α values for the overall scale and its subscales ranged from 0.97 to 0.99. CONCLUSIONS The Chinese version of the Strategic Learning Assessment Map is a reliable organisational learning instrument for Chinese nursing organisations.
Collapse
Affiliation(s)
- Ting Ting Feng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ling Ling Tan
- The Second Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
| | - Hua Ping Liu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| |
Collapse
|
6
|
Jeppesen KH, Frederiksen K, Joergensen MJ, Beedholm K. Leadership assumptions on implementation of patient involvement methods. BMC Health Serv Res 2021; 21:505. [PMID: 34039332 PMCID: PMC8152124 DOI: 10.1186/s12913-021-06497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 05/07/2021] [Indexed: 11/12/2022] Open
Abstract
Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06497-y.
Collapse
Affiliation(s)
- Kathrine Håland Jeppesen
- Department of Public Health, Research Unit for Nursing and Health Care, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
| | - Kirsten Frederiksen
- Department of Public Health, Research Unit for Nursing and Health Care, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | | | - Kirsten Beedholm
- Department of Public Health, Research Unit for Nursing and Health Care, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| |
Collapse
|
7
|
Bendermacher GWG, Dolmans DHJM, de Grave WS, Wolfhagen IHAP, Oude Egbrink MGA. Advancing quality culture in health professions education: experiences and perspectives of educational leaders. Adv Health Sci Educ Theory Pract 2021; 26:467-487. [PMID: 33047262 PMCID: PMC8041707 DOI: 10.1007/s10459-020-09996-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
The concept of quality culture has gained increased attention in health professions education, drawing on insights that quality management processes and positive work-related attitudes of staff in synergy lead to continuous improvement. However, the directions that guide institutions from quality culture theory to educational practice have been missing so far. A prospective qualitative case study of three health professions education programmes was conducted to explore how a quality culture can be enhanced according to the experiences and perspectives of educational leaders. The data collection was structured by an appreciative inquiry approach, supported with vignette-based interviews. A total of 25 participants (a selection of course coordinators, bachelor coordinators and directors of education) reflected on quality culture themes to learn about the best of what is (Discover), envision positive future developments (Dream), identify actions to reach the desired future (Design), and determine how to support and sustain improvement actions (Destiny) within their own educational setting. The results are presented as themes subsumed under these four phases. The experiences and perspectives of educational leaders reveal that peer learning in teams and communities, attention to professional development, and embedding support- and innovation networks, are at the heart of quality culture enhancement. An emphasis on human resources, (inter)relations and contextual awareness of leaders stood out as quality culture catalysts. Educational leaders are therefore encouraged to especially fuel their networking, communication, coalition building, and reflection competencies.
Collapse
Affiliation(s)
- G W G Bendermacher
- Faculty of Health, Medicine and Life Sciences, Institute for Education - Department of Strategy and Policy, School of Health Professions Education, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - D H J M Dolmans
- Faculty of Health, Medicine and Life Sciences, Department of Educational Development and Research, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - W S de Grave
- Faculty of Health, Medicine and Life Sciences, Department of Educational Development and Research, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - I H A P Wolfhagen
- Faculty of Health, Medicine and Life Sciences, Department of Educational Development and Research, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - M G A Oude Egbrink
- Faculty of Health, Medicine and Life Sciences, Institute for Education and Department of Physiology, School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
8
|
Tamás É, Södersved Källestedt ML, Hult H, Carlzon L, Karlgren K, Berndtzon M, Hultin M, Masiello I, Allvin R. Simulation educators in clinical work: the manager's perspective. J Health Organ Manag 2021; ahead-of-print:0. [PMID: 32073806 PMCID: PMC7410304 DOI: 10.1108/jhom-04-2018-0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Information is scarce on healthcare managers' understanding of simulation educators' impact on clinical work. Therefore, the aim of this study was to explore healthcare managers' perceptions of the significance of clinically active simulation educators for the organisation. DESIGN/METHODOLOGY/APPROACH Healthcare managers were invited to be interviewed in a semi-structured manner. Inductive thematic analysis was used to identify and analyse patterns of notions describing the managers' perceptions of simulation educators' impact as co-workers on their healthcare organisations. FINDINGS The identified relevant themes for the healthcare unit were: (1) value for the manager, (2) value for the community and (3) boundaries. Simulation educators were perceived to be valuable gatekeepers of evidence-based knowledge and partners in leadership for educational issues. Their most prominent value for the community was establishing a reflective climate, facilitating open communication and thereby improving the efficacy of teamwork. Local tradition, economy, logistics and staffing of the unit during simulation training were suggested to have possible negative impacts on simulation educators' work. PRACTICAL IMPLICATIONS The findings might have implications for the implementation and support of simulation training programs. SOCIAL IMPLICATIONS Healthcare managers appreciated both the personal value of simulation educators and the effect of their work for their own unit. Local values were prioritised versus global. Simulation training was valued as an educational tool for continual professional development, although during the interviews, the managers did not indicate the importance of employment of pedagogically competent and experienced staff. ORIGINALITY/VALUE The study provided new insights about how simulation educators as team members affect clinical practice.
Collapse
Affiliation(s)
- Éva Tamás
- Institution for Medicine and Health, Linkopings Universitet, Linkoping, Sweden
| | | | - Håkan Hult
- Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Liisa Carlzon
- Simulation Centre West, Department of Research, Education and Development, Sahlgrenska University Hospital, Goteborg, Sweden
| | - Klas Karlgren
- The Södersjukhuset Hospital and Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Berndtzon
- Metodikum - Skill Centre of Medical Simulation, Region County Jönköping, Jönköping, Sweden
| | - Magnus Hultin
- Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care (Sunderbyn), Umeå University, Umeå, Sweden
| | - Italo Masiello
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Renée Allvin
- Clinical Skills Centre, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| |
Collapse
|
9
|
Myhre J, Saga S, Malmedal W, Ostaszkiewicz J, Nakrem S. React and act: a qualitative study of how nursing home leaders follow up on staff-to-resident abuse. BMC Health Serv Res 2020; 20:1111. [PMID: 33261610 PMCID: PMC7709220 DOI: 10.1186/s12913-020-05969-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Elder abuse in nursing homes is a complex multifactorial problem and entails various associations across personal, social, and organisational factors. One way leaders can prevent abuse and promote quality and safety for residents is to follow up on any problems that may arise in clinical practice in a way that facilitates learning. How nursing home leaders follow up and what they follow up on might reflect their perceptions of abuse, its causal factors, and the prevention strategies used in the nursing home. The aim of this study was to explore how nursing home leaders follow up on reports and information regarding staff-to-resident abuse. METHODS A qualitative explorative design was used. The sample comprised 43 participants from two levels of nursing home leadership representing six municipalities and 21 nursing homes in Norway. Focus group interviews were conducted with 28 care managers, and individual interviews took place with 15 nursing home directors. The constant comparative method was used for the analyses. RESULTS Nursing home leaders followed up incidents of staff-to-resident abuse on three different levels as follows: 1) on an individual level, leaders performed investigations and meetings, guidance, supervision, and occasionally relocated staff members; 2) on a group level, feedback, openness, and reflection for shared understanding were strategies leaders used; and 3) on an organisational level, the main solutions were to adjust to available resources, training, and education. We found that leaders had difficulties defining harm and a perceived lack of power to follow up on all levels. In addition, they did not have adequate tools for evaluating the effect of the measures that were taken. CONCLUSIONS Nursing home leaders need to be clear about how they should follow up incidents of elder abuse on different levels in the organisation and about their role in preventing elder abuse. Evaluation tools that facilitate systematic organisational learning are needed. Nursing homes must operate as open, blame-free cultures that acknowledge that incidents of elder abuse in patient care arise not only from the actions of individuals but also from the complex everyday life of which they are a part and in which they operate.
Collapse
Affiliation(s)
- Janne Myhre
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Susan Saga
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Wenche Malmedal
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Joan Ostaszkiewicz
- Centre for Quality and Patient Safety Research - Barwon Health Partnership, Institute for Healthcare Transformation, Deakin University, Geelong, VIC, Australia
- National Ageing Research Institute, Parkville, VIC, 3052, Australia
| | - Sigrid Nakrem
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
10
|
Etchegaray JM, Thomas EJ, Profit J. Preoccupation with failure and adherence to shared baselines: Measuring high-reliability organizational culture. J Patient Saf Risk Manag 2019; 24:147-152. [PMID: 31903449 PMCID: PMC6941901 DOI: 10.1177/2516043519838185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To create, administer, and psychometrically examine a survey to measure two new organizational culture factors - preoccupation with failure and adherence to shared baselines - in healthcare settings. METHOD Direct care providers (n = 4484) from a large healthcare system in the Southern United States completed a survey as part of their annual safety culture assessment. RESULTS We provide evidence about the internal consistency (Cronbach's alpha ranged from .80 to .89) factor structure, concurrent validity (correlation with overall patient safety grade ranged from .60 to .67, p <.05), and discriminant validity (correlations less than .85 with safety and teamwork culture) of these two factors. CONCLUSIONS We established evidence for internal consistency and validity of two new factors that measure aspects of organizational culture - preoccupation with failure and adherence to shared baselines - that are distinct from safety culture and teamwork culture.
Collapse
Affiliation(s)
| | - Eric J Thomas
- The University of Texas - Memorial Hermann Center for Healthcare Quality and Safety, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jochen Profit
- Division of Neonatal and Developmental Medicine, Stanford University
| |
Collapse
|
11
|
Dowson J. Transferring knowledge into practice? Exploring the feasibility of action learning for improving knowledge, skills and confidence in clinical communication skills. BMC Med Educ 2019; 19:37. [PMID: 30691472 PMCID: PMC6350350 DOI: 10.1186/s12909-019-1467-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/15/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Effective communication between patients and practitioners is fundamental to the delivery of high-quality care. This is particularly important in the complex and challenging nature of working in palliative and end of life care. Following specialist communication skills training, a group of healthcare professionals explored the impact of action learning (AL) on the perceptions of their knowledge, skills and confidence in communication skills. The research also aimed to establish an evidence base by exploring the nature and impact of the AL approach employed to facilitate improvements in professional practice. METHODS The research employed a mixed methods approach. Learners (n = 57) scored their perceptions in key areas of communication skills through questionnaires as a baseline measure at time point T0. From this group, 12 participants were selected to undertake further follow-up, divided into Control (n = 6) and Intervention arms (n = 6). All repeated the same questionnaire at 3 subsequent time points (T1, T2, T3) scheduled monthly. Half also received additional telephone-coaching conversation intervention based on Weber's TLA® critical and reflexive approach (2014). To explore and assess perceptions, similarities and differences of their experience of undertaking the specific AL approach and processes, all completed participants (n = 4) and coaches (n = 2) were interviewed at time point T4 (33% response rate). Quantitative data from questionnaires was analysed for comparison of variables to provide a visual illustration of perceived learning journeys. Qualitative data from coaching conversations, interviews and questionnaire responses was analysed inductively to create final themes. RESULTS Perceived improvements in knowledge, skills and confidence measured at 35% at time point T0, and improvement of 46% reported at time point T3. In the Control arm this was calculated at 25%, and at 67% from the Intervention arm. Findings indicate encouraging evidence for perceived improvements of knowledge, skills and confidence. CONCLUSIONS The research demonstrates a positive appetite for, and experience of, the process and method. The value of such a solution-focused, critically reflexive AL practice suggests this may act as a facilitator for successful transfer of learning into practice for individuals and their organisations.
Collapse
|
12
|
Turner S, Higginson J, Oborne CA, Thomas RE, Ramsay AIG, Fulop NJ. Codifying knowledge to improve patient safety: a qualitative study of practice-based interventions. Soc Sci Med 2014; 113:169-76. [PMID: 24880659 DOI: 10.1016/j.socscimed.2014.05.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 04/17/2014] [Accepted: 05/20/2014] [Indexed: 11/28/2022]
Abstract
Although it is well established that health care professionals use tacit and codified knowledge to provide front-line care, less is known about how these two forms of knowledge can be combined to support improvement related to patient safety. Patient safety interventions involving the codification of knowledge were co-designed by university and hospital-based staff in two English National Health Service (NHS) hospitals to support the governance of medication safety and mortality and morbidity (M&M) meetings. At hospital A, a structured mortality review process was introduced into three clinical specialities from January to December 2010. A qualitative approach of observing M&M meetings (n = 30) and conducting interviews (n = 40) was used to examine the impact on meetings and on front-line clinicians and hospital managers. At hospital B, a medication safety 'scorecard' was administered on a general medicine and elderly care ward from September to November 2011. Weekly feedback meetings were observed (n = 18) and interviews with front-line staff conducted (n = 10) to examine how knowledge codification influenced behaviour. Codification was shown to support learning related to patient safety at the micro (front-line service) level by structuring the sharing of tacit knowledge, but the presence of professional and managerial boundaries at the organisational level affected the codification initiatives' implementation. The findings suggest that codifying knowledge to support improvement presents distinct challenges at the group and organisational level; translating knowledge across these levels is contingent on the presence of enabling organisational factors, including the alignment of learning from clinical practice with its governance.
Collapse
Affiliation(s)
- Simon Turner
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
| | | | - C Alice Oborne
- Pharmacy Department, Guy's and St Thomas' NHS Foundation Trust, London, UK; Institute of Pharmaceutical Science, King's College London, London, UK
| | - Rebecca E Thomas
- Pharmacy Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Angus I G Ramsay
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Naomi J Fulop
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| |
Collapse
|
13
|
Waring J, Currie G, Crompton A, Bishop S. An exploratory study of knowledge brokering in hospital settings: facilitating knowledge sharing and learning for patient safety? Soc Sci Med 2013; 98:79-86. [PMID: 24331885 DOI: 10.1016/j.socscimed.2013.08.037] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 06/27/2013] [Accepted: 08/23/2013] [Indexed: 11/20/2022]
Abstract
This paper reports on an exploratory study of intra-organisational knowledge brokers working within three large acute hospitals in the English National Health Services. Knowledge brokering is promoted as a strategy for supporting knowledge sharing and learning in healthcare, especially in the diffusion of research evidence into practice. Less attention has been given to brokers who support knowledge sharing and learning within healthcare organisations. With specific reference to the need for learning around patient safety, this paper focuses on the structural position and role of four types of intra-organisational brokers. Through ethnographic research it examines how variations in formal role, location and relationships shape how they share and support the use of knowledge across organisational and occupational boundaries. It suggests those occupying hybrid organisational roles, such as clinical-managers, are often best positioned to support knowledge sharing and learning because of their 'ambassadorial' type position and legitimacy to participate in multiple communities through dual-directed relationships.
Collapse
|