Conference paper Use of LEGO® Serious Play® : a novel research method for exploring the lived experience of volunteers and paid staff within a professional workplace.

This paper is based on on-going doctoral research designed to investigate the lived experiences of hospice volunteers and the institutional processes that are shaping that experience. The research is being carried out in a hospice using ethnographic techniques including observation, interviews and an unconventional approach in hospice research based on the principles of LEGO® Serious Play® (LSP). LSP involves group sessions, in which the research participants have the opportunity to think and express themselves as they create using the medium of Lego models. Drawing on the experience of the researcher and data collected so far, the paper provides a critique of LSP and argues that it can be an effective technique for exploring sensitive and complex topics, as well as facilitating organisational development through the research process. As such it has the potential for wider use in research within hospices and other organisations within the voluntary sector

‘I’m only a volunteer’: unravelling the complexities of the mundane in roles undertaken by volunteers

This paper draws upon qualitative data from an ethnographic study into the lived experiences of hospice volunteers. The research is being carried out in a hospice and I have immersed myself in the setting, ‘being there’ (Trondman 2008), over an extended period, undertaking observation, shadowing volunteers and attending meetings and events at the hospice. The ethnography has been extended to include additional data collection tools including interviews and supported focus groups with both volunteers and paid staff and consideration of visual and textual artefacts. The research, whilst seeking to find out about the lived experiences of individual volunteers through an ethnographic approach, is also seeking to understand the institutional and cultural processes which shape that experience. In addition to the ‘skills-set’ of volunteers, are there institutional practices or assumptions which limit or encourage the contribution and learning of volunteers? Opinion is divided amongst hospices with regards to the training of volunteers, recognizing the delicate balance of professional socialization and the risk of undermining the added value that volunteers bring if training is too extensive (Help the Hospices 2012). Hospice work is by its very nature, challenging, demanding and emotionally laden. The hospice volunteers may work independently and alongside paid staff in all areas of the setting. Many of these roles such as reception duties, providing refreshments, gardening, driving, and administrative duties may be considered to be low skilled and in other workplaces usually low paid. Indeed one of the recurring themes when speaking with volunteers is: ‘I’m only a volunteer’. However, positioning such roles within a hospice setting serves to highlight the hidden complexities of ostensibly low status roles in the workplace when the emotional component inherent in care is overlaid. Benozzo and Colley (2012) refer to the reproduction of the Cartesian split, described as a de-emotionalized workplace in which ‘head work’ comes before the ‘heart work’ and emotion comes after knowledge. The nature of volunteers’ learning is complex and difficult to classify and this paper discusses the extent to which emotional labour (Hochschild,1983; Benozzo and Colley 2012, Colley 2006) and invisible learning (DeVault 1994) characterise the work and learning of hospice volunteers. The data shows that some of the more visible aspects of volunteers’ work associated with skills and knowledge for a specific role are made explicit within formal induction, role descriptors and training provided within a hospice. Aside from those clearly defined aspects of work however, there are less visible and arguably complex aspects of the volunteer role which are associated with enculturation of the hospice. As part of the hospice team, the study has found that volunteers acquire culturally transmitted knowledge about death and dying and find themselves needing to learn about palliative care, forming relationships and dealing with the unexpected. This learning is situated and contingent upon the culture which exists within the hospice setting. The nature of that experience is complex and difficult to classify but this ethnography is enabling me to see examples of ‘invisible work’ at first hand. Based on the data already gathered, the paper concludes that roles undertaken by volunteers within hospices, which are often perceived as low skilled and mundane, are complex and unpredictable and that those aspects of the role often remain hidden and unacknowledged by both paid staff and the volunteers themselves

Ethnography: participatory approaches and the role of the researcher

Ethnographers study the lived experiences, daily activities, and social/political context of everyday life from the perspectives of those being studied and typically the researcher immerses herself in the natural setting for long periods of time to gain a deeper understanding of people’s lives (Buch and Staller 2014). This presentation draws on the researcher’s experiences from a wider piece of research carried out in a hospice, in which the potentially sensitive and complex areas of workplace learning and the nature of relationships between paid and volunteers in a professional workplace are explored. The ethos and values underpinning the project resonate with the researcher’s personal value position whereby the research process is collaborative and emancipatory, providing an opportunity for shared participation between researcher and participants.The presentation will consider the challenges and opportunities afforded by this methodology and specifically using participatory methods and reflexivity in ethnographical studies. The session will be relevant to anyone interested in ethnography or participatory research methods

A qualitative study of views and experiences of performance management for healthcare-associated infections

Background Centrally-led performance management regimes using standard-setting, monitoring and incentives have become a prominent feature of infection prevention and control (IPC) in health systems. Aim We aimed to characterise views and experiences of regulation and performance management relating to IPC in English hospitals. Methods We analysed two qualitative datasets containing 139 interviews with healthcare workers and managers. Data directly relevant to performance management and IPC were extracted. Data analysis was based on the constant comparative method. Findings Participants reported that performance management regimes had mobilised action around specific infections. The benefits of establishing organisational structures of accountability were seen in empirical evidence of decreasing infection rates. Performance management was not, however, experienced as wholly benign, and setting targets in one area was seen to involve risks of ‘tunnel vision’ and the marginalisation of other potentially important issues. Financial sanctions were viewed particularly negatively; performance management was associated with risks of creating a culture of fearfulness, suppressing learning and disrupting inter-professional relationships. Conclusions Centrally-led performance management may have some important roles in infection prevention and control, but identifying where it is appropriate and determining its limits is critical. Persisting with harsh regimes may affect relationships and increase resistance to continued improvement efforts, but leaving all improvement to local teams may also be a flawed strategy

Exploring the Landscape of Hospice Volunteering: an ethnographic study of the lived experiences of hospice volunteers

This thesis is an ethnographic study of hospice volunteers based in a UK adult hospice. Studies into hospice volunteers often tend to consider volunteers as an homogenous group (Morris et al 2013), but this research takes account of the diversity represented within a volunteer cohort and examines a range of volunteer roles, including specific consideration of trustees and professionals working as volunteers. In the United Kingdom there are at least 125 000 volunteers supporting hospice care (Hospice UK 2020a). As hospices look to expand their services and with an increasing demand for End of Life Care in a variety of settings, the role of volunteers in sustaining that provision is likely to become increasingly important (Scott et al 2018). The ethnography incorporated participant observation, interviews, specialist focus groups based on the principles of LEGO® Serious Play® and hospice documentation and artefacts. Data from the study are used to investigate the complexities of hospice volunteering. The thesis draws on theories of situated learning and emotional labour to better understand the work and learning of hospice volunteers and the concept of liminality is used to explicate unique characteristics of hospice volunteering. Acknowledging the liminal space which hospice volunteers populate, helps to articulate the value and importance of hospice volunteers, and their place in the organisation. It explains the characteristics of volunteering which distinguish it from paid employment and implications for management and policy involving volunteers. The main findings of the research include those relating to less tangible, social and emotional aspects of volunteering, revealing the rich and often hidden complexity of the role of hospice volunteers which contribute to the work of the hospice and End of Life Care. The thesis argues that hospice volunteering affords significant benefits to both the individual volunteers and to the organisation, but these beneficial outcomes are predicated upon the culture and practices which exist within the hospice. There are challenges involved in sustaining and developing hospice volunteering in the future, and maximising the use of volunteers’ skills and expertise, especially in relation to volunteers’ involvement in direct patient care. Finally, it contends that it is the liminal space of volunteering and the volunteers who occupy that space which help to sustain the unique character and ethos of hospice care

Use of LEGO® Serious Play® : a novel research method for exploring the lived experience of volunteers and paid staff within a professional workplace.

This presentation is based on on-going doctoral research designed to investigate the lived experiences of hospice volunteers and the institutional processes that are shaping that experience. The research is being carried out in a hospice using ethnographic techniques including observation, interviews and an unconventional approach in hospice research based on the principles of LEGO® Serious Play® (LSP). LSP involves group sessions, in which the research participants have the opportunity to think and express themselves as they create using the medium of Lego models. Drawing on the experience of the researcher and data collected so far, the paper provides a critique of LSP and argues that it can be an effective technique for exploring sensitive and complex topics, as well as facilitating organisational development through the research process. As such it has the potential for wider use in research within hospices and other organisations within the voluntary sector

Taking the heat or taking the temperature? A qualitative study of a large-scale exercise in seeking to measure for improvement, not blame.

Measurement of quality and safety has an important role in improving healthcare, but is susceptible to unintended consequences. One frequently made argument is that optimising the benefits from measurement requires controlling the risks of blame, but whether it is possible to do this remains unclear. We examined responses to a programme known as the NHS Safety Thermometer (NHS-ST). Measuring four common patient harms in diverse care settings with the goal of supporting local improvement, the programme explicitly eschews a role for blame. The study design was ethnographic. We conducted 115 hours of observation across 19 care organisations and conducted 126 interviews with frontline staff, senior national leaders, experts in the four harms, and the NHS-ST programme leadership and development team. We also collected and analysed relevant documents. The programme theory of the NHS-ST was based in a logic of measurement for improvement: the designers of the programme sought to avoid the appropriation of the data for any purpose other than supporting improvement. However, organisational participants - both at frontline and senior levels - were concerned that the NHS-ST functioned latently as a blame allocation device. These perceptions were influenced, first, by field-level logics of accountability and managerialism and, second, by specific features of the programme, including public reporting, financial incentives, and ambiguities about definitions that amplified the concerns. In consequence, organisational participants, while they identified some merits of the programme, tended to identify and categorise it as another example of performance management, rich in potential for blame. These findings indicate that the search to optimise the benefits of measurement by controlling the risks of blame remains challenging. They further suggest that a well-intentioned programme theory, while necessary, may not be sufficient for achieving goals for improvement in healthcare systems dominated by institutional logics that run counter to the programme theory

Information and Design: Book Symposium on Luciano Floridi’s The Logic of Information

Purpose – To review and discuss Luciano Floridi’s 2019 book The Logic of Information: A Theory of Philosophy as Conceptual Design, the latest instalment in his philosophy of information (PI) tetralogy, particularly with respect to its implications for library and information studies (LIS). Design/methodology/approach – Nine scholars with research interests in philosophy and LIS read and responded to the book, raising critical and heuristic questions in the spirit of scholarly dialogue. Floridi responded to these questions. Findings – Floridi’s PI, including this latest publication, is of interest to LIS scholars, and much insight can be gained by exploring this connection. It seems also that LIS has the potential to contribute to PI’s further development in some respects. Research implications – Floridi’s PI work is technical philosophy for which many LIS scholars do not have the training or patience to engage with, yet doing so is rewarding. This suggests a role for translational work between philosophy and LIS. Originality/value – The book symposium format, not yet seen in LIS, provides forum for sustained, multifaceted and generative dialogue around ideas