Researching an overlooked workforce in a University: catering, caretaking and securtiy

A thesis submitted in partial fulfilment of the requirements University of Wolverhampton Degree of Doctor of PhilosophyCET

Covert violence in nursing: A Western Australian experience

Covert violence in the workplace has been extensively theorized amongst social scientists as having negative effects on the worker’s self esteem, job satisfaction and stress, resulting in increased absenteeism and a reduction in productivity, and yet it continues to fester in nursing. The purpose of this research was twofold. The first was to answer the question, ‘What are the characteristics of covert violence experienced by Western Australian nurses?’ and through the description of Western Australian nurses’ experience of covert violence and describe the characteristics related to this to form a definition of covert violence. The second question was ‘What are the causes of covert violence experienced by Western Australian nurses? This study explored nurses’ experiences of covert violence using an interpretive phenomenological approach as described by van Manen (1997). A literature review was conducted to establish the findings of studies in relation to covert violence in other countries and to compare similar works in Australia. Using literature review findings, interview questions were designed to identify episodes of covert violence amongst nurses, the background to the reported events and a comment by the participants as to how these episodes were dealt with. A proposed model of the causes of covert violence in nursing was developed from the literature review to be tested in relation to the research findings. Research participants were all Registered Nurses with the Nurses’ Board of Western Australia who were asked to identify and discuss their experiences of covert violence in their workplaces. The data collected was analysed using pattern matching for qualitative evaluation. Results obtained from the data analysis identified the most important factor leading to covert violence was the juxtaposition of power and powerlessness and how it was influenced by community expectations of healthcare, staffing and client characteristics, infra-staff issues and management systems. Based on the research findings a revised model of causes of covert violence was developed to identify how power and powerlessness affect the outcomes of patient care, staff morale and the ultimate retention of staff in the health service in particular and in the profession generally. To record the incidences of covert violence and how they can be dealt with, a risk action plan and a model of obligations to prevent covert violence in nursing was developed that would not only serve its purpose in the nursing profession. From these questions it was possible to develop a Risk Control Action Plan that can be applied in response to reports of covert violence and to prevent covert violence in the nursing workplace, and can be adapted to address a similar situation in any other workplace. The tools developed include ways of reducing patient stress, methods of improving staff relationships, and management tools for issues that need to be addressed by nurses and administrators. Recommendations for further research to extend this study and to test the covert violence prevention tools developed as a result of this research are made. It is anticipated that use of the revised model of covert violence in nursing, definition of covert violence and tools developed as a result of the research findings will minimise incidences of covert violence, resulting in greater job safety and satisfaction for nurses, a reduction in staff absenteeism due to job stress, and an improvement in nursing retention and productivity

Customer service challenges in a South African casino : a participatory intervention.

Doctoral Degree. University of KwaZulu-Natal, Durban.Background: In an era of global competition, customer service (CS) remains a key differentiating factor for organisations to gain a competitive advantage. Due to heighted emotions experienced by customers when winning and losing, customer mistreatment and difficulties associated with cross-cultural interactions, the casino environment remains a challenging context for the provision of excellent CS on the frontline. Literature is scarce regarding the development of interventions to improve CS within the South African casino industry. The aim of this study was to gain an understanding of CS challenges facing frontline staff within a South African casino, and develop, implement and evaluate a participatory intervention to address these challenges. The main objectives were to: 1) To identify challenges facing slots staff in providing excellent CS and generating solutions these challenges; 2) To equip slots hosts with observational skills to identify body language to pre-empt a customers’ need for assistance; 3) To equip slots hosts with skills on how to deal with difficult customers and communicate effectively when dealing with customers; 4) To improve the cultural awareness of slots hosts to enhance their ability to deal with diverse customers 5) To determine the effectiveness of the intervention in addressing CS challenges, motivate slot hosts to exceed customer expectations and provide recommendations to management for improving CS. Method: A case study using intervention research and a multi-phase mixed method design was used. Intervention research was conducted over three phases including a situation analysis, implementation of the intervention and process evaluation. For the qualitative aspect of the study, purposive sampling was used to conduct semi-structured interviews, focus groups and observations in the situation analysis to identify CS challenges facing frontline staff. These findings were thematically analysed and used to develop the CS intervention using Lewin’s Unfreeze-Move-Refreeze Change Management Model as a theoretical framework. The researcher used the participatory action research approach to both develop and facilitate the intervention. At the end of the intervention, a training evaluation questionnaire was implemented for the quantitative aspect of the research. Three indexes were developed based on face validity including learnings gained, perceptions of learning and evaluation of facilitation. In addition, T-tests and One Way ANOVA were used to analyse the quantitative data. In the process evaluation phase, a second round of semi-structured interviews, focus group and observations were conducted to determine the effect of the CS intervention. Results: The qualitative results showed that poor equipment, inadequate CS processes and high workloads were highlighted as key factors impeding service. In addition, the study found that frontline staff from disenfranchised groups responded to perceived discrimination from customers through disengagement, withdrawal or slowing down of service behaviours. These responses were interpreted as poor CS, but were found to be defensive behaviours to reduce expected discrimination. In line with emotion contagion theory, positive or negative interactions with customers were found to shift the mood states of frontline staff, which in turn affected subsequent service interactions. The quantitative results of the workshop evaluation questionnaire suggested increased skills efficacy from learners in terms of learnt CS techniques such as identifying body language leading to customer complaints, as well as being better equipped to deal with difficult customers and customers from different cultures. The intervention also motivated staff to provide better CS with a series of interventions being recommended in future for encouraging sustainable CS behaviours. Conclusion: The study established clear guidelines for management to develop, implement and evaluate a participatory intervention to address CS challenges within a casino context. The participatory approach of the intervention was found to beneficial for knowledge-sharing, allowing for co-creation of workshop content, providing a forum for open communication on CS issues and building ownership of CS issues amongst staff. Further research is recommended to better understand the dynamics and effects of cross-cultural interactions on the frontline, so as to develop tools and techniques to assist staff to respond constructively in such situations and improve frontline CS in the organisation

An ethnography of housing : public housing work in Victoria

This thesis examines the everyday practices of housing officers working in the Victorian Office of Housing, a large public sector statutory authority providing rental housing to low&ndash;income households. Housing officer work has changed substantially associated with the shift from the provision of &lsquo;public housing&rsquo; in the post&ndash;WWII period to the provision of &lsquo;welfare housing&rsquo; from the early 1980s. These changes are evident in both the formal organisation of work and day&ndash;to&ndash;day practices. The principal research question addressed is &lsquo;How has the work of staff in the Victorian Office of Housing changed as a consequence of the shift from the provision of &lsquo;public housing&rsquo; in the post&ndash;WWII period to the provision of &lsquo;welfare housing&rsquo; from the early 1980s?&rsquo; This question is addressed by presenting an historically informed ethnography of the Office of Housing. Research was undertaken over a twelve&ndash;month period through interviews, participant observation and the collection of documents. The data collected through the use of these methods provided the basis for the presentation of &lsquo;thick descriptions&rsquo; of the work of staff employed to provide rental housing to low&ndash;income households. The research into this large hierarchical formal organisation was undertaken in three offices: a local suburban office, a regional office and head office. This enabled connections and tensions in direct service delivery work and policy work to be identified and analysed. It revealed that the experience of the shift from the provision of public housing to the provision of welfare housing has not been uniform and underscores the importance of understanding organisations as socially constructed. Staff work was analysed by distinguishing four overarching problems consistently referred to by staff and highlighted in formal reviews. First, &lsquo;problems with tenants&rsquo; refers to the changing profile of tenants and staff responses and interactions. Second, the &lsquo;problem with rent&rsquo; centres on setting and collecting rents from very low&ndash;income tenants. Third, the &lsquo;problem with housing standards and assets&rsquo; focuses on housing quality, maintaining properties and the tenant use of properties. Fourth, the &lsquo;problems with the organisation&rsquo; are found in the constant searching for the best ways of defining roles, leading and communicating within a large and geographically distributed organisation. These are the features of work which present dilemmas for those who seek to produce better services for households who live in public housing. <br /

A year in the life of the primary head teacher

This study was conducted to establish patterns of Primary Head Teacher behaviour over a complete school year, including weekends and holidays. Certain aspects of the role of the Primary Headteacher were also investigated. Two Head Teachers kept diaries, recording daily the nature of activities being undertaken and the length and frequency of them. A group of 25 Head Teachers also participated by completing diaries for periods of 2 weeks each - at different times of the year. The diaries were analysed by classifying recorded activities against category criteria, which had been agreed and devised with the Head Teachers prior to the commencement of the project. The evidence, once interpreted and collated, was brought to the attention of the two principal respondents one year after their diaries had been completed to assess their response and seek their views. This was repeated after a further period of twelve months had elapsed. The study shows that Primary Head Teachers' behaviour is characterised by long hours spent on multifarious tasks and activities of varying importance, with frequent interruptions and often brief duration. One of the main diary keepers was an experienced Head Teacher, the other was beginning her first Headship, whilst the remaining Head Teachers had a range of experience. The total amounts of time devoted to school-related issues, the range of activities being undertaken and the frequency of activity change were remarkably similar for all Head Teachers. Head Teachers bring experience, knowledge, skills, beliefs, attitudes and values to their schools and attempt to recreate these in the hearts and minds of those associated with their schools

The Jobseeker’s Allowance Skills Conditionality Pilot

"The Jobseeker’s Allowance (JSA) Skills Conditionality Pilot was launched in April 2010 with the aim of exploring the labour market effects of mandating participation in training. The pilot targeted JSA claimants entering stage 3 of the Jobseeker’s Regime and Flexible New Deal (JRFND) who had an identified skills need. It was based on a random assignment design whereby the requirement to participate would be imposed on the basis of National Insurance number (NINO) to half of those referred to training. If carried out effectively, differences revealed through a comparison of outcomes post-randomisation can be viewed as being caused by the conditionality. This report presents the findings from two parallel studies of the pilot. The quantitative analysis used administrative data to provide details on the implementation of the pilot and whether it could be used to provide valid estimates of the impact of mandation. The qualitative analysis explored the experiences and views of participants in the pilots: principally mandated claimants and Jobcentre Plus advisers, but also training providers" -- page 1

Leading change in a clinical practice empowering front line staff to lead change

This practice-based study investigates the implications for NHS leadership, leadership development and organisation development of the current government's vision of the future NHS as set out in the NHS Improvement Plan (2004). The study is based on two projects; an in-depth organisation development programme located in a high security mental health hospital and a pilot project on the future role of leadership carried out on behalf of the five Strategic Health Authorities in London. The research paradigm is that of naturalistic inquiry using action research and a single case method involving participant observation. Focus groups and a modified Delphi-consultation are used to elicit views about future leadership roles and competences. The two-project design was developed to address the range of leadership roles to be explored, the interplay between leadership development and organisation development and the need to understand both current realities and future developments. The study concludes that successful realisation of the vision set out in the NHS Improvement Plan will require a re-conceptualisation of the roles and competences of both organisational leaders and leaders working at the interface with service users. The study suggests that organisational leaders will need to become adept at shaping the cultures and practices of organisations and systems of organisations (enabling leadership) whereas leaders working at the interface with service users will need to become adept at case management. The study also suggests that leadership development and organisation development need to be closely integrated if either is to make a worthwhile contribution to the development of the NHS. Finally, the study suggest that success in past or current leadership roles in the NHS is likely to be a poor predictor of future success as the leadership requirements of the future will be significantly different from those which prevail currently or which have prevailed in the recent past

Implementation of Complex Interventions in UK General Practice

The pace of change in UK healthcare continues to be rapid with a drive to implement more clinically and cost-effective interventions in order to improve practice/care. Literature suggests that the take-up of these interventions is often slow. This delay in translation of evidence-based interventions into routine clinical practice is known as the ‘Evidence-to-Practice Gap’. Almost all changes to practice involve ‘complex interventions’. Such interventions can be particularly hard to implement as they are likely to require change at multiple levels. Initially a systematic review of reviews was conducted to synthesise the literature on a) explanation(s) as to why complex interventions are not implemented and b)the effectiveness of strategies in facilitating implementation. A key insight was that despite an increasing recognition of the role of context in implementation there is a lack of empirical evidence. None of the reviews addressed context and the contextual influences were largely reported as perceived barriers and facilitators. Studies tended to focus on one intervention when in reality more than one intervention is likely to be implemented simultaneously in any given setting. The systematic review led to a qualitative case study to investigate the implementation of multiple complex interventions in three GP practices, focusing on the role of context as an explanation. Initial practice meetings indicated all three practices were implementing various changes to improve patient access. The decision was taken to focus on online and telephone access and the Named GP scheme. Data from observation, interviews and documentations were analysed using thematic analysis. This study enhances understanding of the process in which multiple complex interventions are implemented into general practice. Paying particular attention to the ‘shifts’ of context and how changes in the ‘fit’ between the intervention and the context over time, may increase the likelihood of implementation success. The study reveals the importance of relative intervention prioritisation particularly when practices face competing intervention options, as a novel explanation of why some interventions get implemented/prioritised first before others