Sustainable workplaces: the impact of workplace learning

The Wales Institute for Work Based Learning provides modular courses for learners in employment. For the last two years the Institute has been running two ESF projects under the pan-Wales Work-Based Learning (WIWBL) programme 2007-2014. WIWBL developed a suite of courses aimed at raising awareness of sustainability and the environment among the workforce and the corporate responsibilities for managers. As part of each course, the learners were required to examine an issue at their workplace, and in many cases this has led to the company changing its working practices to reduce waste. The legacy of the learners within their organisations is having a direct impact on the environmental effects of their activities. On the other hand, there were some disappointing lessons learned. Many companies saw sustainability as a ‘nice to have’ part of Corporate Social Responsibility, and were not thinking strategically about the future. The ability of learners embedded within organisations to initiate change with direct practical results in the short term is an area where the University is having a visible positive effect on the Welsh economy for the future. Mae Athrofa Cymru ar gyfer Dysgu Seiliedig ar Waith yn darparu cyrsiau modiwlaidd ar gyfer dysgwyr sydd mewn cyflogaeth. Dros y ddwy flynedd ddiwethaf mae’r Athrofa wedi bod yn cynnal dau brosiect Cronfa Gymdeithasol Ewrop dan raglen Dysgu Seiliedig ar waith Cymru Gyfan 2007-2014. Datblygodd yr Athrofa gyfres o gyrsiau a anelai at godi ymwybyddiaeth ynghylch cynaliadwyedd a’r amgylchedd ymhlith y gweithlu a’r cyfrifoldebau corfforaethol i reolwyr. Yn rhan o bob cwrs, roedd yn ofynnol i’r dysgwyr archwilio mater yn eu gweithle, ac mewn nifer o achosion mae hyn wedi arwain y cwmni i newid ei arferion gwaith er mwyn lleihau gwastraff. Mae gwaddol y dysgwyr o fewn eu sefydliadau’n cael effaith uniongyrchol ar effeithiau amgylcheddol eu gweithgareddau. Ar y llaw arall, dysgwyd rhai gwersi siomedig. Ystyriai llawer o gwmnïoedd gynaliadwyedd yn rhan ‘hyfryd ei chael’ o Gyfrifoldeb Cymdeithasol Corfforaethol, ac nid oeddynt yn meddwl yn strategol am y dyfodol. Mae gallu dysgwyr o fewn sefydliadau i gychwyn newid gyda chanlyniadau ymarferol uniongyrchol yn y tymor byr yn faes lle mae’r Brifysgol yn cael effaith gadarnhaol weladwy ar economi Cymru i’r dyfodol

Looped flow RAFT polymerization for multiblock copolymer synthesis

A looped flow process was designed for the synthesis of well-defined multiblock copolymers using reversible addition–fragmentation chain transfer (RAFT) polymerization. The reaction conditions were optimized to reach high conversions whilst maintaining a high end-group fidelity. The loop set-up proved to be a flexible, robust and time-efficient process for scaling-up multiblock copolymers

Lessons learned for managing projects in a Higher Education environment:organisational and individual experience

A research project examining the qualitative experiences of project managers in the Higher Education context. The research showed that the use of formal project management methodologies such as PRINCE2 was rare. It was reported that projects adapted their approach in the light of experience but organisations were poor at embedding lessons learned into future practice. A Grounded Theory analysis of the interview transcripts highlights the Emotional Labour required by the project manager role, especially feelings of Impostorship and the need to manage interactions as Adult-to-Adult rather than Parent-Child

Using online patient feedback to improve NHS services : the INQUIRE multimethod study

Background Online customer feedback has become routine in many industries, but it has yet to be harnessed for service improvement in health care. Objectives To identify the current evidence on online patient feedback; to identify public and health professional attitudes and behaviour in relation to online patient feedback; to explore the experiences of patients in providing online feedback to the NHS; and to examine the practices and processes of online patient feedback within NHS trusts. Design A multimethod programme of five studies: (1) evidence synthesis and stakeholder consultation; (2) questionnaire survey of the public; (3) qualitative study of patients’ and carers’ experiences of creating and using online comment; (4) questionnaire surveys and a focus group of health-care professionals; and (5) ethnographic organisational case studies with four NHS secondary care provider organisations. Setting The UK. Methods We searched bibliographic databases and conducted hand-searches to January 2018. Synthesis was guided by themes arising from consultation with 15 stakeholders. We conducted a face-to-face survey of a representative sample of the UK population (n = 2036) and 37 purposively sampled qualitative semistructured interviews with people with experience of online feedback. We conducted online surveys of 1001 quota-sampled doctors and 749 nurses or midwives, and a focus group with five allied health professionals. We conducted ethnographic case studies at four NHS trusts, with a researcher spending 6–10 weeks at each site. Results Many people (42% of internet users in the general population) read online feedback from other patients. Fewer people (8%) write online feedback, but when they do one of their main reasons is to give praise. Most online feedback is positive in its tone and people describe caring about the NHS and wanting to help it (‘caring for care’). They also want their feedback to elicit a response as part of a conversation. Many professionals, especially doctors, are cautious about online feedback, believing it to be mainly critical and unrepresentative, and rarely encourage it. From a NHS trust perspective, online patient feedback is creating new forms of response-ability (organisations needing the infrastructure to address multiple channels and increasing amounts of online feedback) and responsivity (ensuring responses are swift and publicly visible). Limitations This work provides only a cross-sectional snapshot of a fast-emerging phenomenon. Questionnaire surveys can be limited by response bias. The quota sample of doctors and volunteer sample of nurses may not be representative. The ethnographic work was limited in its interrogation of differences between sites. Conclusions Providing and using online feedback are becoming more common for patients who are often motivated to give praise and to help the NHS improve, but health organisations and professionals are cautious and not fully prepared to use online feedback for service improvement. We identified several disconnections between patient motivations and staff and organisational perspectives, which will need to be resolved if NHS services are to engage with this source of constructive criticism and commentary from patient

Lessons learned for managing projects in a Higher Education environment: organisational and individual experience

This study explores the experience of lead academics undertaking externally funded projects within HEIs in the United Kingdom through qualitative analysis of semi-structured interviews. It had been expected that the study would reveal that many HEIs had adopted formal project management practices in order to monitor progress, identify and deal with issues that arose, and embed lessons learned from projects into organisational learning to inform future practice. It was found that this was not the case, and although elements of, or equivalent to, project management best practice were in place for monitoring and reporting on progress, there appeared to be little attention paid to the question of transferring knowledge derived from experience from the project team to the rest of the organisation. The lead academics involved approached their work with diligence and enthusiasm, and found themselves subject to complex social situations and feelings of impostorship, and undertaking a significant amount of Emotional Labour in order to keep their projects on track. Although they learned new information, they had not attempted to capitalise on their experience by reflecting upon it for the future

The Patient Feedback Response Framework – understanding why UK hospital staff find it difficult to make improvements based on patient feedback: A qualitative study

Patients are increasingly being asked for feedback about their healthcare experiences. However, healthcare staff often find it difficult to act on this feedback in order to make improvements to services. This paper draws upon notions of legitimacy and readiness to develop a conceptual framework (Patient Feedback Response Framework – PFRF) which outlines why staff may find it problematic to respond to patient feedback. A large qualitative study was conducted with 17 ward based teams between 2013 and 2014, across three hospital Trusts in the North of England. This was a process evaluation of a wider study where ward staff were encouraged to make action plans based on patient feedback. We focus on three methods here: i) examination of taped discussion between ward staff during action planning meetings ii) facilitators notes of these meetings iii) telephone interviews with staff focusing on whether action plans had been achieved six months later. Analysis employed an abductive approach. Through the development of the PFRF, we found that making changes based on patient feedback is a complex multi-tiered process and not something that ward staff can simply ‘do’. First, staff must exhibit normative legitimacy – the belief that listening to patients is a worthwhile exercise. Second, structural legitimacy has to be in place – ward teams need adequate autonomy, ownership and resource to enact change. Some ward teams are able to make improvements within their immediate control and environment. Third, for those staff who require interdepartmental co-operation or high level assistance to achieve change, organisational readiness must exist at the level of the hospital otherwise improvement will rarely be enacted. Case studies drawn from our empirical data demonstrate the above. It is only when appropriate levels of individual and organisational capacity to change exist, that patient feedback is likely to be acted upon to improve services

Fluctuating salience in those living with genetic risk of motor neuron disease : a qualitative interview study.

ACKNOWLEDGEMENTS The authors would like to thank all the participants who took part in interviews and the advisory panel who supported and advised them over the study. This study was supported by a project grant from the Motor Neurone Disease (MND) Association (Locock/Sept19/941-794), which included funding for healthtalk.org dissemination.Jade Howard's PhD funding was awarded by the Institute of Applied Health Sciences, University of Aberdeen. For the purpose of open access, the authors have applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission Funding information Motor Neurone Disease Association, Grant/Award Number: Locock/Sept19/941‐ 794; University of AberdeenPeer reviewe

A novel experience-based internet intervention for smoking cessation : feasibility randomised controlled trial

The iPEx programme presents independent research funded by the UK National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0608-10147). The views expressed in this paper are those of the authors, representing iPEx, and not necessarily those of the NHS, the NIHR or the Department of Health.Peer reviewe

Examining the role of patients' experiences as a resource for choice and decision-making in health care: a creative, inter-disciplinary mixed method study in digital health

BackgroundTraditional health information has been based on facts and figures, not patients’ experiences. Websites featuring people’s accounts of their experiences of health and illness are popular as a source of information support and much else. However, there are concerns that experiential information on the internet might have adverse effects on health. Aims To find out whether, when and how the NHS should incorporate people’s experiences (PEx) into online health information and elucidate the mechanisms through which PEx might influence health, develop a tool to measure the effects of online PEx, explore how PEx is used, and to investigate the feasibility and acceptability of a randomized controlled trial of online PEx. Methods Mixed methods including a conceptual literature review, qualitative secondary data analysis, development of a new questionnaire, online ethnography, observational and experimental studies in an internet café environment, and finally feasibility trials to compare new websites based on PEx with those based on facts and figures. Results The review concluded that online PEx could affect health outcomes through seven domains (information, support, affecting relationships, providing ideas on how to use health services, influencing behaviour change, learning to tell the story and visualising illness). We developed the e-Health Impact Questionnaire (eHIQ) which demonstrates good psychometric properties and is suitable for use across different health groups and various styles of online information. Online ethnographic studies found three types of PEx on Multiple Sclerosis (MS) platforms: accounts of ‘living with MS’, self-expression and creativity, and experiences of healthcare and treatment. Observational and lab-based methods included studies of how people find and use PEx to inform health choices. We developed a three stage model (Gating, the Engagement loop and Outcomes) which guided the development of six prototype multimedia websites featuring either experiential information (intervention) or factual information (comparator) for three exemplar health issues. We evaluated the feasibility and acceptability of a trial of the prototype PEx websites, comparing self-report and process measures with a comparator. In the three conditions we randomised 87 (smoking cessation), 148 (asthma), and 42 (caring for someone with MS) participants. At final (two-week) follow up, retention rates were 75%, 82% and 86% respectively. Usage of the allocated websites was low. The median number of logins to the websites over the two week period was two, two and four; the median number of page views was 10, 15 and 27.5; with a median total duration on site of 9 minutes, 17 minutes, and 31.5 minutes respectively. There were no reported adverse events or harms. The qualitative interviews with 30 trial participants found that the trial methods were acceptable and not burdensome and that preferences for combinations of different types of information were both idiosyncratic and dependent on timing and need. Limitations This programme used a pragmatic, mixed methods approach, in which we adapted some standard approaches (eg Realist Review). The conceptual review provided a framework for the whole programme but did not draw on a single over-arching theoretically informed approach. Instead we used relevant theory and methods from the work package leads who represented a range of disciplines. Conclusions Online PEx is not seen as an alternative to facts, or to care from a health professional, but is used in addition to other sources of information, support and expression. This programme of work indicates how the sharing of online patient experiences may benefit people, and how this can be measured. An RCT is feasible but an allocated ‘exposure’ to a ‘dose of information’ is far from from how online experiences are shared in everyday life. Future work evaluating online health interventions which incorporate personal experiences should aim to reflect ‘natural’ use of the internet and might include online ethnography and offline interviews. Studies might explore how and why people use online sources of experience-based health information, and the effects on subsequent behaviour and health and social outcomes in different conditions. Future intervention research evaluating online health interventions should examine and explain issues of engagement and use, and seek to identify how to increase engagement

Reducing bias in trials from reactions to measurement : the MERIT study including developmental work and expert workshop

Funding Funded by the Medical Research Council UK and the National Institute for Health Research as part of the Medical Research Council–National Institute for Health Research Methodology Research Programme.Peer reviewedPublisher PD