Multidimensional collaboration; reflections on action research in a clinical context

This paper reflects on the challenges and benefits of multidimensional collaboration in an action research study to evaluate and improve preoperative education for patients awaiting colorectal surgery. Three cycles of planning, acting,observing and reflecting were designed to evaluate practice and implement change in this interactive setting, calling for specific and distinct collaborations. Data collection includes: observing educational interactions; administering patient evaluation questionnaires; interviewing healthcare staff, patients and carers; patient and carer focus groups; and examining written and audiovisual educational materials. The study revolves around and depends on multi-dimensional collaborations. Reflecting on these collaborations highlights the diversity of perspectives held by all those engaged in the study and enhances the action research lessons. Successfully maintaining the collaborations recognises the need for negotiation, inclusivity, comprehension, brokerage,and problem-solving. Managing the potential tensions is crucial to the successful implementation of changes introduced to practice and thus has important implications for patients’ well-being. This paper describes the experiences from an action research project involving new and specific collaborations, focusing on a particular healthcare setting. It exemplifies the challenges of the collaborative action research process and examines how both researchers and practitioners might reflect on the translation of theory into educational practices within a hospital colorectal department. Despite its context-specific features, the reflections on the types of challenges faced and lessons learned provide implications for action researchers in diverse healthcare settings across the world

Franchising in Frontier Markets: What's Working, What's Not, and Why

Summarizes research on franchising as a way to scale small businesses and, in turn, provide jobs and economic and skills development in Africa and South Asia. Examines successful models, conditions, challenges, barriers, and synergies with microfinance

Knowledge in development aid and healthcare: a comparative analysis

Effective delivery in the fields of development aid and healthcare relies on knowledge and its communication. Institutions, practitioners and the end-users are examined in these two fields as key actors in the production and communication of knowledge. Similarities and differences, and strengths and weaknesses of their approaches to knowledge are compared. Knowledge is shown to be an intrinsically political process in which institutions and practitioners play a critical role in its communication. Establishing a common background is essential to communicate knowledge effectively. The World Bank’s notion that knowledge is a simple commodity should be challenged

The Rhetoric of Health and Medicine as a “Teaching Subject”: Lessons from the Medical Humanities and Simulation Pedagogy

The rhetoric of health and medicine has only begun to intervene in health pedagogy. In contrast, the medical humanities has spearheaded curriculum to address dehumanizing trends in medicine. This article argues that rhetorical scholars can align with medical humanities’ initiatives and uniquely contribute to health curriculum. Drawing on the author’s research on clinical simulation, the article discusses rhetorical methodologies, genre theory, and critical lenses as areas for pedagogical collaboration between rhetoricians and health practitioners

Overcoming change fatigue: lessons from Glasgow's National Health Service

Structured Abstract Purpose of this paper This paper explores the practicalities of organizational change in complex settings where much change has already occurred. It therefore offers insights into tackling and overcoming change fatigue. Design/methodology/approach The paper uses a longitudinal study of change within a healthcare organization. The paper draws on interviews, focus groups and observations during a 2.5 year long action research project. Findings The paper reports findings on the speed at which change takes place, the importance of communication and the burden placed on senior officers during such communication and consultation processes, the use of appropriate external resources and expertise, the benefits of sharing best practice across sectors and the role of academic researchers in change processes. What is original/value of paper The paper offers valuable insights to those charged with effecting organizational change in change fatigued settings

GAP WORK project report: training for youth practitioners on tackling gender-related violence

This project sought to challenge gender-related violence against (and by) children and young people by developing training for practitioners who have everyday contact with general populations of children and young people (‘youth practitioners’). Through improved knowledge and understanding practitioners can better identify and challenge sexist, sexualising, homophobic or controlling language and behaviour, and know when and how to refer children and young people to the most appropriate support services. This summary outlines the Project and our initial findings about the success of the four training programmes developed and piloted.Co-funded by the DAPHNE III programme of the EU

Using patient-reported measures to drive change in healthcare: the experience of the digital, continuous and systematic PREMs observatory in Italy

BACKGROUND: The use of Patient Reported Experience Measures (PREMs) has great potential in healthcare service improvement, but a limited use. This paper presents an empirical case of PREMs innovation in Italy, to foster patient data use up to the ward level, by keeping strengths and addressing weaknesses of previous PREMs survey experiences. The paper reports key lessons learned in this ongoing experience of action research, directly involving practitioners. METHODS: The aim of this paper is to present the results of an ongoing action research, encompassing the innovation of PREMs collection, reporting and use, currently adopted by 21 hospitals of two Italian regions. The continuous and systematic PREMs collection has been implemented between 2017 and 2019 and includes: a continuous web-based administration, using web-services; an augmented and positive questionnaire matching standard closed-ended questions with narrative sections; the inclusion and benchmarking of patient data within a shared performance evaluation system; public disclosure of aggregated anonymized data; a multi-level and real-time web-platform for reporting PREMs to professionals. The action research was carried out with practitioners in a real-life and complex context. The authors used multiple data sources and methods: observations, feedback of practitioners, collected during several workshops and meetings, and analysis of preliminary data on the survey implementation. RESULTS: A continuous and systematic PREMs observatory was developed and adopted in two Italian regions. PREMs participation and response rates tend to increase over time, reaching stable percentages after the first months. Narrative feedback provide a 'positive narration' of episodes and behaviours that made the difference to patients and can inform quality improvement actions. Real-time reporting of quantitative and qualitative data is enabling a gratifying process of service improvement and people management at all the hospitals' levels. CONCLUSIONS: The PREMs presented in this paper has been recognized by healthcare professionals and managers as a strategic and positive tool for improving an actual use of PREMs at system and ward levels, by measuring and highlighting positive deviances, such as compassionate behaviours

Setting priorities to inform assessment of care homes’ readiness to participate in healthcare innovation: a systematic mapping review and consensus process

© 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedOrganisational context is known to impact on the successful implementation of healthcare initiatives in care homes. We undertook a systematic mapping review to examine whether researchers have considered organisational context when planning, conducting, and reporting the implementation of healthcare innovations in care homes. Review data were mapped against the Alberta Context Tool, which was designed to assess organizational context in care homes. The review included 56 papers. No studies involved a systematic assessment of organisational context prior to implementation, but many provided post hoc explanations of how organisational context affected the success or otherwise of the innovation. Factors identified to explain a lack of success included poor senior staff engagement, non-alignment with care home culture, limited staff capacity to engage, and low levels of participation from health professionals such as general practitioners (GPs). Thirty-five stakeholders participated in workshops to discuss findings and develop questions for assessing care home readiness to participate in innovations. Ten questions were developed to initiate conversations between innovators and care home staff to support research and implementation. This framework can help researchers initiate discussions about health-related innovation. This will begin to address the gap between implementation theory and practice.Peer reviewe