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McDonald N, McKenna L, Vining R, Doyle B, Liang J, Ward ME, Ulfvengren P, Geary U, Guilfoyle J, Shuhaiber A, Hernandez J, Fogarty M, Healy U, Tallon C, Brennan R. Evaluation of an Access-Risk-Knowledge (ARK) Platform for Governance of Risk and Change in Complex Socio-Technical Systems. Int J Environ Res Public Health 2021; 18:ijerph182312572. [PMID: 34886304 PMCID: PMC8657006 DOI: 10.3390/ijerph182312572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/16/2022]
Abstract
Three key challenges to a whole-system approach to process improvement in health systems are the complexity of socio-technical activity, the capacity to change purposefully, and the consequent capacity to proactively manage and govern the system. The literature on healthcare improvement demonstrates the persistence of these problems. In this project, the Access-Risk-Knowledge (ARK) Platform, which supports the implementation of improvement projects, was deployed across three healthcare organisations to address risk management for the prevention and control of healthcare-associated infections (HCAIs). In each organisation, quality and safety experts initiated an ARK project and participated in a follow-up survey and focus group. The platform was then evaluated against a set of fifteen needs related to complex system transformation. While the results highlighted concerns about the platform's usability, feedback was generally positive regarding its effectiveness and potential value in supporting HCAI risk management. The ARK Platform addresses the majority of identified needs for system transformation; other needs were validated in the trial or are undergoing development. This trial provided a starting point for a knowledge-based solution to enhance organisational governance and develop shared knowledge through a Community of Practice that will contribute to sustaining and generalising that change.
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Affiliation(s)
- Nick McDonald
- Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, D02 PN40 Dublin, Ireland; (N.M.); (B.D.); (M.E.W.)
| | - Lucy McKenna
- ADAPT Centre, School of Computing, Dublin City University, D09 PX21 Dublin, Ireland; (L.M.); (J.L.); (J.H.); (R.B.)
| | - Rebecca Vining
- Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, D02 PN40 Dublin, Ireland; (N.M.); (B.D.); (M.E.W.)
- Correspondence:
| | - Brian Doyle
- Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, D02 PN40 Dublin, Ireland; (N.M.); (B.D.); (M.E.W.)
- Health and Safety Unit, Dublin Fire Brigade, D02 RY99 Dublin, Ireland; (J.G.); (C.T.)
| | - Junli Liang
- ADAPT Centre, School of Computing, Dublin City University, D09 PX21 Dublin, Ireland; (L.M.); (J.L.); (J.H.); (R.B.)
| | - Marie E. Ward
- Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, D02 PN40 Dublin, Ireland; (N.M.); (B.D.); (M.E.W.)
- Quality and Safety Improvement Directorate, St. James’s Hospital Dublin, D08 NHY1 Dublin, Ireland; (U.G.); (M.F.); (U.H.)
| | - Pernilla Ulfvengren
- KTH Royal Institute of Technology, Industrial Economics and Management, 100 44 Stockholm, Sweden;
| | - Una Geary
- Quality and Safety Improvement Directorate, St. James’s Hospital Dublin, D08 NHY1 Dublin, Ireland; (U.G.); (M.F.); (U.H.)
| | - John Guilfoyle
- Health and Safety Unit, Dublin Fire Brigade, D02 RY99 Dublin, Ireland; (J.G.); (C.T.)
| | - Arwa Shuhaiber
- Beacon Renal, Sandyford Business Park, D18 TH56 Dublin, Ireland;
| | - Julio Hernandez
- ADAPT Centre, School of Computing, Dublin City University, D09 PX21 Dublin, Ireland; (L.M.); (J.L.); (J.H.); (R.B.)
| | - Mary Fogarty
- Quality and Safety Improvement Directorate, St. James’s Hospital Dublin, D08 NHY1 Dublin, Ireland; (U.G.); (M.F.); (U.H.)
| | - Una Healy
- Quality and Safety Improvement Directorate, St. James’s Hospital Dublin, D08 NHY1 Dublin, Ireland; (U.G.); (M.F.); (U.H.)
| | - Christopher Tallon
- Health and Safety Unit, Dublin Fire Brigade, D02 RY99 Dublin, Ireland; (J.G.); (C.T.)
| | - Rob Brennan
- ADAPT Centre, School of Computing, Dublin City University, D09 PX21 Dublin, Ireland; (L.M.); (J.L.); (J.H.); (R.B.)
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Ward ME, De Brún A, Beirne D, Conway C, Cunningham U, English A, Fitzsimons J, Furlong E, Kane Y, Kelly A, McDonnell S, McGinley S, Monaghan B, Myler A, Nolan E, O'Donovan R, O'Shea M, Shuhaiber A, McAuliffe E. Using Co-Design to Develop a Collective Leadership Intervention for Healthcare Teams to Improve Safety Culture. Int J Environ Res Public Health 2018; 15:ijerph15061182. [PMID: 29874883 PMCID: PMC6025638 DOI: 10.3390/ijerph15061182] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 11/16/2022]
Abstract
While co-design methods are becoming more popular in healthcare; there is a gap within the peer-reviewed literature on how to do co-design in practice. This paper addresses this gap by delineating the approach taken in the co-design of a collective leadership intervention to improve healthcare team performance and patient safety culture. Over the course of six workshops healthcare staff, patient representatives and advocates, and health systems researchers collaboratively co-designed the intervention. The inputs to the process, exercises and activities that took place during the workshops and the outputs of the workshops are described. The co-design method, while challenging at times, had many benefits including grounding the intervention in the real-world experiences of healthcare teams. Implications of the method for health systems research are discussed.
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Affiliation(s)
- Marie E Ward
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Aoife De Brún
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Deirdre Beirne
- Integrated Care Team Older Persons, Community Healthcare Organisation 6, Clonskeagh, Dublin 6, Ireland.
| | - Clare Conway
- Midlands Regional Hospital Mullingar, Longford Road, Mullingar, Co. Westmeath, Ireland.
| | - Una Cunningham
- Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
| | | | - John Fitzsimons
- Quality Improvement Division HSE & Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland.
| | - Eileen Furlong
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Yvonne Kane
- Midlands Regional Hospital Mullingar, Longford Road, Mullingar, Co. Westmeath, Ireland.
| | - Alan Kelly
- Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
| | - Sinéad McDonnell
- Integrated Care Team Older Persons, Community Healthcare Organisation 6, Clonskeagh, Dublin 6, Ireland.
| | - Sinead McGinley
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | | | - Ann Myler
- Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
| | - Emer Nolan
- Integrated Care Team Older Persons, Community Healthcare Organisation 6, Clonskeagh, Dublin 6, Ireland.
| | - Róisín O'Donovan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Marie O'Shea
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Arwa Shuhaiber
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
| | - Eilish McAuliffe
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
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