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Powell M. How did whistleblowing and the duty of candour get onto the agenda of the British national health service. J Health Organ Manag 2024; 38:583-599. [PMID: 38919009 DOI: 10.1108/jhom-07-2023-0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
PURPOSE This paper compares how the two interacting themes of "Whistleblowing" or "Speaking Up" and the duty of candour (DoC), which are both concerned with safety and quality improvement in health care, got onto the agenda of the British National Health Service (NHS). DESIGN/METHODOLOGY/APPROACH It uses the approach of multiple streams and the methodology of interpretive content analysis in a deductive approach that focusses on both manifest and latent content. It examines official documents that discuss the DoC or whistleblowing or cognate terms in connection with the British NHS from 1999 to 2019. FINDINGS The main conceptual finding, which mirrors many previous studies, is that it seems difficult to operationalise many of the sub-components of the multiple streams approach. The main empirical finding points to the "focusing event" of the Francis Report into the Mid Staffordshire Trust of 2013 and the importance of its Chair, Sir Robert Francis, as a policy entrepreneur. ORIGINALITY/VALUE This is one of the first studies to focus on both issues of whistleblowing and the DoC and the first to compare them through the lens of the multiple streams approach. It has two main conceptual advantages over most previous studies in the field: it compares whistleblowing and the duty of candour rather than the dominant approach of a single case study and explores the different outcomes of failed as well as successful couplings of the streams.
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Affiliation(s)
- Martin Powell
- Health Services Management Centre, University of Birmingham, Birmingham, UK
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Moore E, Paré C, Carde E, Pagé MG. Virtual group psychotherapy for chronic pain: exploring the impact of the virtual medium on participants' experiences. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:131-138. [PMID: 37738606 DOI: 10.1093/pm/pnad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Virtual psychotherapy for chronic pain (CP) has been shown to be feasible, efficacious, and acceptable; however, little is known about how virtual delivery of group psychotherapy affects participants' experiences. This study aimed to explore the impact of a virtual medium during the coronavirus disease 2019 (COVID-19) pandemic on social interactions and therapeutic processes in the context of group psychotherapy for CP management. METHODS This qualitative, interview-based study collected data on 18 individuals who participated in virtual group psychotherapy in a tertiary care pain management unit. RESULTS Results of the thematic analysis showed 4 themes. First, the ability to participate and connect was modified by not meeting in person. Connections also occurred differently as the usual patterns of interactions changed. Participants described important shifts in how emotions are communicated and subsequent experience of empathy. Finally, the commonality of chronic pain experience was identified as a central driver of connection between participants. CONCLUSIONS Mixed impacts of the virtual medium on group psychotherapy dynamics and processes were found. Future research could explore ways to mitigate the negative impacts.
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Affiliation(s)
- Emily Moore
- Alan Edwards Pain Management Unit, Montreal General Hospital, Montreal, QC H3G 1A4, Canada
| | - Catherine Paré
- Alan Edwards Pain Management Unit, Montreal General Hospital, Montreal, QC H3G 1A4, Canada
| | - Estelle Carde
- CREMIS (Centre de Recherche de Montréal sur les Inégalités Sociales, les Discriminations et les Pratiques Alternatives de Citoyenneté), Montreal, QC H2X 1K6, Canada
- Department of Sociology, Faculty of Arts and Sciences, Université de Montréal, Montreal, QC H3T 1N8, Canada
| | - M Gabrielle Pagé
- Alan Edwards Pain Management Unit, Montreal General Hospital, Montreal, QC H3G 1A4, Canada
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, QC H2X 0A9, Canada
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
- D epartment of Psychology, Faculty of Arts and Sciences, Université de Montréal, Montreal, QC H2V 2S9, Canada
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Schlesinger M, Grob R. When Mistakes Multiply: How Inadequate Responses to Medical Mishaps Erode Trust in American Medicine. Hastings Cent Rep 2023; 53 Suppl 2:S22-S32. [PMID: 37963044 DOI: 10.1002/hast.1520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
In this essay, we explore consequences of the systemic failure to track and to publicize the prevalence of patient-safety threats in American medicine. Tens of millions of Americans lose trust in medical care every year due to safety shortfalls. Because this loss of trust is long-lasting, the corrosive effects build up over time, yielding a collective maelstrom of mistrust among the American public. Yet no one seems to notice that patient safety is a root cause, because no one is counting. In addition to identifying the origins of this purblindness, we offer an alternative policy approach. This would call for government to transparently track safety threats through the systematic collection and reporting of patients' experiences. This alternative strategy offers real promise for stemming the erosion of trust that currently accompanies patient-safety shortfalls while staying consistent with Americans' preferences for a constrained government role with respect to medical care.
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Walshe N, Burrell A, Kenny U, Mulcahy G, Duggan V, Regan A. A qualitative study of perceived barriers and facilitators to sustainable parasite control on thoroughbred studs in Ireland. Vet Parasitol 2023; 317:109904. [PMID: 36907136 DOI: 10.1016/j.vetpar.2023.109904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
In view of the rising threat of anthelmintic resistance in parasite populations and the planned change of classification of anthelmintics in Ireland for food animals to prescription-only medicines, there is a need for increased focus on parasite control strategies for horses. Effective parasite control programs (PCPs) are complex, necessitating the application of risk-assessment based on host immune status, infection pressure, type of parasite and seasonality to determine the requirement for anthelmintic administration and an understanding of parasite biology to employ effective, non- therapeutic, parasite control measures. The aim of this study was to explore horse breeders' attitudes and behaviours towards general parasite control practices and anthelmintic use on thoroughbred studs in Ireland using qualitative research methods, in order to help identify barriers to the implementation of sustainable equine PCPs supported by veterinary involvement. One-to-one, qualitative, semi-structured interviews were conducted with 16 breeders, using an interview topic guide that allowed for an open questioning style. The topic guide facilitated discussion around the following areas: (i) parasite control measures (general approach, (ii) veterinary involvement, (iii) use of anthelmintics, (iv) use of diagnostics, pasture management), (v) recording of anthelmintic use and (vi) anthelmintic resistance. Convenience, purposive (subjective selection) sampling was used to select a small group of participants that reflected the characteristics of current thoroughbred breeders in Ireland taking into account farm type, farm size, geographical location. The interviews were transcribed, and a method of inductive thematic analysis (a data driven identification and analysis of themes) was performed. Assessment of current behaviours by these participants found that PCPs were primarily based on the prophylactic use of anthelmintics without a strategic rationale. A key driver of behaviour regarding parasite prevention practices was localised routine, dictated by tradition, that gave breeders a sense of confidence and protection regarding parasite control. The perceptions of the benefits of parasitology diagnostics were varied and their application to control was poorly understood. Anthelmintic resistance was recognised as an industry threat but not an issue for individual farms. By using a qualitative approach, this study offers insights into the possible barriers to the adoption of sustainable PCPs on Irish thoroughbred farms and highlights the need for end-user involvement in the preparation of future guidelines.
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Affiliation(s)
- Nicola Walshe
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland.
| | - Alison Burrell
- Animal Health Ireland, 2-5 The Archways, Carrick-on-Shannon, Co. Leitrim., Ireland
| | - Ursula Kenny
- One Health and One Welfare Scientific Support Team, National Disease Control Centre, Department of Agriculture, Food and the Marine, Kildare St., Dublin, Ireland
| | - Grace Mulcahy
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland; Conway Institute, University College Dublin, Dublin, Ireland
| | - Vivienne Duggan
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Aine Regan
- Department of Agri-food Business & Spatial Analysis, Teagasc, Ashtown Food Research Centre, Dublin 15, Ireland
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Reupert A, Greenfeld D, May F. COVID-19 and Australian school psychology: Qualitative perspectives for enhancing future practice. SCHOOL PSYCHOLOGY INTERNATIONAL 2022; 43:219-236. [PMID: 38603190 PMCID: PMC8984599 DOI: 10.1177/01430343221091953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The challenges and changes driven by the Coronavirus Disease 2019 (COVID-19) pandemic in the education sector have been linked to high rates of anxiety, depression, and post-traumatic symptoms in school-aged populations. Despite this, it is also acknowledged that children and young people can be resilient and adaptable, with the right support in place. In schools, psychologists play an important role in supporting students' learning, behavior, wellbeing, and mental health. The aim of this study is to investigate the practices of Australian school psychologists during COVID-19 related school closures, focusing on their experiences and challenges and how they adapted their practices. Twelve Australian school psychologists were interviewed and, after member checks were undertaken, interview transcripts were analyzed using thematic analysis. Six interrelated themes were identified including: (a) heightened student psychological stress, (b) alternative delivery modes and associated challenges, (c) close collaboration with families, (d) participants personal challenges during COVID-19, (e) assessment during COVID-19, and (f) possible long-term practice changes post pandemic. The results of this study have implications for policies to support students in future pandemics or where physical school attendance is disrupted (e.g., natural disasters).
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Affiliation(s)
- Andrea Reupert
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Australia
| | - Daliya Greenfeld
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Australia
| | - Fiona May
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Australia
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Adams M, Iedema R, Heazell AE, Treadwell M, Booker M, Bevan C, Hartley J, Sandall J. Investigation of the critical factors required to improve the disclosure and discussion of harm with affected women and families: a study protocol for a qualitative, realist study in NHS maternity services (the DISCERN study). BMJ Open 2022; 12:e048285. [PMID: 35115347 PMCID: PMC8814750 DOI: 10.1136/bmjopen-2020-048285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Patients and families are entitled to an open disclosure and discussion of healthcare incidents affecting them. This reduces distress and contributes to learning for safety improvement. Complex barriers prevent effective disclosure and continue in the English NHS, despite a legal duty of candour. NHS maternity services are the focus of significant efforts to improve this. There is limited understanding of how, and to what effect, they are achieving this. METHODS AND ANALYSIS: A 27-month, three-phased realist evaluation identifying the critical factors contributing to improvements in the disclosure and discussion of incidents with affected families. The evaluation asks 'what works, for whom, in what circumstances, in why respects and why?'.Phase 1: establish working hypotheses of key factors and outcomes of interventions improving disclosure and discussion, by realist literature review and in-depth realist interviews with key stakeholders (n=approximately 20]Phase 2: refine or overturn hypotheses, by ethnographic case-study analysis using triangulated qualitative methods (non-participant observation, interviews (n=12) and documentary analysis) in up to 4 purposively sampled NHS trusts.Phase 3: consider hypotheses and design outputs during seven interpretive forums. ETHICS AND DISSEMINATION: Phase 1 study approval by King's College London's Ethics Panel (BDMRESC 22033) and National Research Ethical Approval for Phases 2-3 (IRASID:262197) (CAG:20/CAG/0121) (REC:20/LO/1152). Study sponsorship by King's College London (HS&DR 17/99/85).Findings to be disseminated through tailored management briefings; clinician and family guidance (written and video); lay summaries, academic papers, and report with outputs tailored to maximise academic and societal impact. Views of women/family groups are represented throughout.
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Affiliation(s)
- Mary Adams
- Faculty of Life Science and Medicine, Department of Women and Children's Health, King's College London, London, UK
| | - Rick Iedema
- Centre for Team Based Practice and Learning in Health Care, King's College London, London, UK
| | - Alexander Edward Heazell
- Division of Developmental Biology and Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
| | | | | | | | - Julie Hartley
- Faculty of Life Science and Medicine, Department of Women and Children's Health, King's College London, London, UK
| | - Jane Sandall
- Faculty of Life Science and Medicine, Department of Women and Children's Health, King's College London, London, UK
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Malik RF, Buljac-Samardžić M, Amajjar I, Hilders CGJM, Scheele F. Open organisational culture: what does it entail? Healthcare stakeholders reaching consensus by means of a Delphi technique. BMJ Open 2021; 11:e045515. [PMID: 34521658 PMCID: PMC8442051 DOI: 10.1136/bmjopen-2020-045515] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Open organisational culture in hospitals is important, yet it remains unclear what it entails other than its referral to 'open communication' in the context of patient safety. This study aims to identify the elements of an open hospital culture. METHODS In this group consensus study with a Delphi technique, statements were constructed based on the existing patient safety literature and input of 11 healthcare professionals from different backgrounds. A final framework consisting of 36 statements was reviewed on inclusion and exclusion, in multiple rounds by 32 experts and professionals working in healthcare. The feedback was analysed and shared with the panel after the group reached consensus on statements (>70% agreement). RESULTS The procedure resulted in 37 statements representing tangible (ie, leadership, organisational structures and processes, communication systems, employee attitudes, training and development, and patient orientation) and intangible themes (ie, psychological safety, open communication, cohesion, power, blame and shame, morals and ethics, and support and trust). The culture themes' teamwork and commitment were not specific for an open culture, contradicting the patient safety literature. Thereby, an open mind was shown to be a novel characteristic. CONCLUSIONS Open culture entails an open mind-set and attitude of professionals beyond the scope of patient safety in which there is mutual awareness of each other's (un)conscious biases, focus on team relationships and professional well-being and a transparent system with supervisors/leaders being role models and patients being involved. Although it is generally acknowledged that microlevel social processes necessary to enact patient safety deserve more attention, research has largely emphasised system-level structures and processes. This study provides practical enablers for addressing system and microlevel social processes to work towards an open culture in and across teams.
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Affiliation(s)
| | | | | | - Carina G J M Hilders
- Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Fedde Scheele
- Research and Education, OLVG, Amsterdam, The Netherlands
- Obstetrics and Gynaecology, Amsterdam University Medical Center, Amsterdam, The Netherlands
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The Effective Strategies to Avoid Medication Errors and Improving Reporting Systems. MEDICINES 2021; 8:medicines8090046. [PMID: 34564088 PMCID: PMC8468915 DOI: 10.3390/medicines8090046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 11/28/2022]
Abstract
Background: Population-based studies from several countries have constantly shown excessively high rates of medication errors and avoidable deaths. An efficient medication error reporting system is the backbone of reliable practice and a measure of progress towards achieving safety. Improvement efforts and system changes of medication error reporting systems should be targeted towards reductions in the likelihood of injury to future patients. However, the aim of this review is to provide a summary of medication errors reporting culture, incidence reporting systems, creating effective reporting methods, analysis of medication error reports, and recommendations to improve medication errors reporting systems. Methods: Electronic databases (PubMed, Ovid, EBSCOhost, EMBASE, and ProQuest) were examined from 1 January 1998 to 30 June 2020. 180 articles were found and 60 papers were ultimately included in the review. Data were mined by two reviewers and verified by two other reviewers. The search yielded 684 articles, which were then reduced to 60 after the deletion of duplicates via vetting of titles, abstracts, and full-text papers. Results: Studies were principally from the United States of America and the United Kingdom. Limited studies were from Canada, Australia, New Zealand, Korea, Japan, Greece, France, Saudi Arabia, and Egypt. Detection, measurement, and analysis of medication errors require an active rather than a passive approach. Efforts are needed to encourage medication error reporting, including involving staff in opportunities for improvement and the determination of root cause(s). The National Coordinating Council for Medication Error Reporting and Prevention taxonomy is a classification system to describe and analyze the details around individual medication error events. Conclusion: A successful medication error reporting program should be safe for the reporter, result in constructive and useful recommendations and effective changes while being inclusive of everyone and supported with required resources. Health organizations need to adopt an effectual reporting environment for the medication use process in order to advance into a sounder practice.
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A qualitative study of LoveYourBrain Yoga: a group-based yoga with psychoeducation intervention to facilitate community integration for people with traumatic brain injury and their caregivers. Disabil Rehabil 2019; 42:2482-2491. [PMID: 30741032 DOI: 10.1080/09638288.2018.1563638] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To explore participants' experiences in a group-based yoga with psychoeducation intervention designed to facilitate community integration for people with traumatic brain injury and their caregivers.Materials and methods: We conducted semi-structured interviews with 13 people with traumatic brain injury and three caregivers who had completed LoveYourBrain Yoga, a 6-session, manualized, group-based yoga intervention that incorporates breathing exercises, yoga, meditation, and psychoeducation. Interviews were analyzed using content analysis.Results: We identified seven themes: ease of participation, belonging, sustaining community connection, physical health, self-regulation, self-efficacy, and resilience. All participants valued the community-based yoga studio environment and multifaceted structure of the program. Participants reported improvements in strength, balance, flexibility, and attention control, and a greater sense of belonging, community connection, and ability to move forward with their lives. Participants reported ongoing use of tools (e.g., breathing exercises) to cope with negative emotions and stress. About half of participants sustained relationships built during LoveYourBrain Yoga and felt more capable of accessing other activities in their community.Conclusions: LoveYourBrain Yoga successfully promoted community integration for people with traumatic brain injury. It also facilitated diverse and meaningful physical, psychological, and social health benefits, which suggest that it may be an effective mode of community-based rehabilitation.Implications for rehabilitationTraumatic brain injury survivors often struggle to participate in their community, the ultimate goal of rehabilitationYoga is a holistic therapy with many benefits, yet is not accessible to the traumatic brain injury population at the community levelParticipants in a community-based yoga with psychoeducation intervention in six states experienced diverse and meaningful physical, psychological, and social health benefitsGroup-based yoga with psychoeducation may be an effective mode of community integration and community-based rehabilitation for traumatic brain injury survivors.
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Donnelly KZ, Dehlendorf C, Reed R, Agusti D, Thompson R. Adapting the Interpersonal Quality in Family Planning care scale to assess patient perspectives on abortion care. J Patient Rep Outcomes 2019; 3:3. [PMID: 30666466 PMCID: PMC6340910 DOI: 10.1186/s41687-018-0089-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/04/2018] [Indexed: 11/18/2022] Open
Abstract
Background Women value receiving quality interpersonal care during abortion services, yet no measure exists to assess this outcome from patients’ perspectives. We sought to adapt the Interpersonal Quality in Family Planning care scale (Dehlendorf et al., American Journal of Obstetrics Gynaecology 10.1016/j.ajog.2016.01.173, 2016) for use in abortion care. Methods We adapted items from the original scale for the abortion context, and conducted cognitive interviews to explore the acceptability, understandability, and importance of the adapted items. Adults who spoke English and/or Spanish, had an abortion in the past year, and lived in the US were eligible to participate. Interview memos were analyzed concurrently with data collection to refine the measure in stages. Results We interviewed 26 participants. Items were tested over seven stages and led to four main changes. First, we revised three items to reflect concepts perceived as important to the specific decision-making context of abortion. Second, we removed two items that emerged as potentially inappropriate for this context. Third, we modified language in four items to improve their appropriateness for this context (e.g., ‘telling me’ to ‘explaining’; ‘letting me say’ to ‘listening to’). Fourth, we modified language in three items to improve their clarity. Three items remained unchanged, as there was consistent agreement on their importance, understandability, and relevance. Conclusions The resulting 10-item measure, the Interpersonal Quality in Abortion Care scale, was perceived to be highly important, understandable, and feasible to complete. Future psychometric evaluation can prepare it for use in clinical practice to ensure women feel adequately informed and supported during abortion care.
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Affiliation(s)
- Kyla Z Donnelly
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, 1 Medical Drive, Lebanon, NH, 03756, USA.
| | - Christine Dehlendorf
- UCSF Department of Family and Community Medicine, 1001 Potrero Avenue, San Francisco, CA, 94110, USA.,UCSF Department of Epidemiology & Biostatistics, San Francisco, 94158, CA, USA.,UCSF Department of Obstetrics, Gynecology, & Reproductive Sciences, San Francisco, 94158, CA, USA
| | - Reiley Reed
- UCSF Department of Family and Community Medicine, 1001 Potrero Avenue, San Francisco, CA, 94110, USA
| | - Daniela Agusti
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, 1 Medical Drive, Lebanon, NH, 03756, USA
| | - Rachel Thompson
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, 2006, NSW, Australia
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Kok J, Leistikow I, Bal R. Patient and family engagement in incident investigations: exploring hospital manager and incident investigators' experiences and challenges. J Health Serv Res Policy 2018; 23:252-261. [PMID: 30027771 PMCID: PMC6187500 DOI: 10.1177/1355819618788586] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective There is growing recognition among health care providers and policy makers that when things go wrong, the patient or their families should be heard and participate in the incident investigation process. This paper explores how Dutch hospitals organize patient or family engagement in incident investigations, maps out incident investigators' experiences of involving patients or their families in incident investigations and identifies the challenges encountered. Methods Semi-structured interviews were conducted with managers and incident investigators in 13 Dutch hospitals. Study participants (n = 18) were asked about the incident investigation routines and their experiences of involving affected patients or family members. Interview transcripts were coded and analysed using thematic content analysis. Results Our findings reveal that patient or family involvement in incident investigations is typically organized as a one-time interview event. Interviews with patients or their families were considered to be valuable and important in their own right and seen as a way to do justice to the individual needs of the patient or their family. Yet, the usefulness and validity of the patient or family perspective for incident investigations was often seen to be limited, with the professional perspective afforded more weight. This was particularly the case when the patient or their family were unable to provide verifiable details of the incident under investigation. Study participants described challenges when involving patients or family members, including in relation to the available timeframe for incident investigations, legal issues, managing trust and working with intense emotions. Conclusions We propose that by placing patient and family criteria of significance at the centre of incident investigations (i.e. an 'emic' research approach), hospitals may be able to expand their learning potential and improve patient-centeredness following an incident.
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Affiliation(s)
- Josje Kok
- 1 PhD candidate Healthcare Governance, Erasmus School of Health Policy and Management, Erasmus University, the Netherlands
| | - Ian Leistikow
- 2 Professor of Governmental Supervision on Quality and Safety in Health Care, Erasmus School of Health Policy and Management, Erasmus University, the Netherlands.,3 Senior inspector and advisor, Health and Youth Care Inspectorate, the Netherlands
| | - Roland Bal
- 4 Professor of Healthcare Governance, Erasmus School of Health Policy and Management, Erasmus University, the Netherlands
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Sahlström M, Partanen P, Rathert C, Turunen H. Patient participation in patient safety still missing: Patient safety experts' views. Int J Nurs Pract 2016; 22:461-469. [PMID: 27507224 DOI: 10.1111/ijn.12476] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/02/2016] [Accepted: 06/22/2016] [Indexed: 12/11/2022]
Abstract
The aim of this study was to elicit patient safety experts' views of patient participation in promoting patient safety. Data were collected between September and December in 2014 via an electronic semi-structured questionnaire and interviews with Finnish patient safety experts (n = 21), then analysed using inductive content analysis. Patient safety experts regarded patients as having a crucial role in promoting patient safety. They generally deemed the level of patient safety as 'acceptable' in their organizations, but reported that patient participation in their own safety varied, and did not always meet national standards. Management of patient safety incidents differed between organizations. Experts also suggested that patient safety training should be increased in both basic and continuing education programmes for healthcare professionals. Patient participation in patient safety is still lacking in clinical practice and systematic actions are needed to create a safety culture in which patients are seen as equal partners in the promotion of high-quality and safe care.
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Affiliation(s)
- Merja Sahlström
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland. .,Ylä-Savo SOTE Joint Municipal Authority, Iisalmi, Finland.
| | - Pirjo Partanen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Cheryl Rathert
- Department of Health Administration, School of Allied Health Professions, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hannele Turunen
- Department of Nursing Science, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
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Heyhoe J, Birks Y, Harrison R, O'Hara JK, Cracknell A, Lawton R. The role of emotion in patient safety: Are we brave enough to scratch beneath the surface? J R Soc Med 2016; 109:52-8. [PMID: 26682568 PMCID: PMC4793767 DOI: 10.1177/0141076815620614] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Healthcare professionals work in emotionally charged settings; yet, little is known about the role of emotion in ensuring safe patient care. This article presents current knowledge in this field, drawing upon psychological approaches and evidence from clinical settings. We explore the emotions that health professionals experience in relation to making a medical error and describe the impact on healthcare professionals and on their professional and patient relationships. We also explore how positive and negative emotions can contribute to clinical decision making and affect responses to clinical situations. Evidence to date suggests that emotion plays an integral role in patient safety. Implications for training, practice and research are discussed in addition to strategies to facilitate health services to understand and respond to the influence of emotion in clinical practice.
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Affiliation(s)
- Jane Heyhoe
- Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, BD9 6RJ, UK
| | - Yvonne Birks
- Social Policy Research Unit, University of York, York YO10 5DD, UK
| | - Reema Harrison
- Sydney Medical School, University of Sydney, Sydney NSW 2006, Australia
| | - Jane K O'Hara
- Leeds Institute for Medical Education, University of Leeds, Leeds LS2 9NL, UK
| | | | - Rebecca Lawton
- School of Psychology, University of Leeds, Leeds LS2 9NL, UK Quality and Safety Research Group, Bradford Institute for Health Research, Bradford BD9 6RJ, UK
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