"Pixie dust"

PURPOSE

Creating a culture of patient safety and developing a skilled workforce are major challenges for health managers. However, there is limited information to guide managers as to how patient safety culture can be improved. The purpose of this paper is to explore the concept of reflexivity and develop a model for magnifying the effect of patient safety culture and demonstrating a link to improved perceptions of quality of care.

DESIGN/METHODOLOGY/APPROACH

This research employed a correlational case study design with empirical hypothesis testing of quantitative scores derived from validated survey items. Staff perceptions of patient safety, reflexivity and quality of patient care were obtained via a survey in 2015 and analysed using inferential statistics. The final sample included 227 health service staff from clinical and non-clinical designations working in a large Australian tertiary hospital and health service delivering acute and sub-acute health care.

FINDINGS

Both patient safety culture and reflexivity are positively correlated with perceived quality of patient care at the p<0.01 level. The moderating role of reflexivity on the relationship between patient safety culture and quality of care outcomes was significant and positive at the p<0.005 level.

PRACTICAL IMPLICATIONS

Improving reflexivity in a health workforce positively moderates the effect of patient safety culture on perceptions of patient quality of care. The role of reflexivity therefore has implications for future pre-professional curriculum content and post-graduate licencing and registration requirements.

ORIGINALITY/VALUE

Much has been published on reflection. This paper considers the role of reflexivity, a much less understood but equally important construct in the field of patient safety.

Making Supervision and Ongoing Development Review a Productive Experience: An Integrated Approach

In a climate of financial constraint the National Health Service (NHS) faces the challenge of simultaneously improving productivity and enhancing quality. The pledges to staff within the NHS Constitution and the launch of a Simplified Knowledge and Skills Framework recognise that an appropriately trained workforce, that feels engaged with and valued by its employers, is pivotal to success. This opinion piece proposes that these policy developments have provided opportunities to develop integrated approaches to appraisal, continuing professional development and supervision that may balance the competing demands faced by therapists working in busy health and social care environments.

Risks with Older Adults in Acute Care Settings: Occupational Therapists' and Physiotherapists' Perceptions

Introduction:

In acute care hospitals, risk assessments are integral to therapy practice. However, to date, this area has not been explored in any specific depth within occupational therapy or physiotherapy, although there is evidence that the management of risk causes uncertainty and anxiety among professionals. Different perspectives of risks may have an influence on the discharge end point.

Method:

This study explored the self-reported risk-taking behaviours of occupational therapists and physiotherapists. A qualitative approach was taken, with reflective diaries used to record the self-reported risk-taking behaviours of therapists in a teaching hospital. Eight therapists recorded 16 reflections in total, which were analysed using template analysis.

Findings:

The findings suggest that support from members of the team, collegiality and clinical confidence were important to manage risks. Therapists were willing to take risks in order to meet patient goals, to facilitate the rehabilitation process or to enhance the patient's quality of life. However, there may be instances of interprofessional differences that need to be managed.

Conclusion:

This research has highlighted the need for therapists to reflect continually upon risk situations in professional practice. There is a need for support and guidance to be put in place to enable positive risk taking.