Video Feedback for Improving Parental Sensitivity and Attachment (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effectiveness of video feedback for improving parental sensitivity and promoting attachment security

Impact of the use of the Red Lotus Critical Health Promotion Model as a pedagogical framework on health promotion graduates' professional practice: A mixed methods study

Issue Addressed: The Red Lotus Critical Health Promotion Model (RLCHPM) is designed to support critical health promotion practice. This study investigated the impact of the use of the RLCHPM as a pedagogical framework for competency-based university curricula on the practice of graduates from health promotion programs from an Australian regional university. Methods: A mixed methods study was undertaken, including an online survey of all 195 graduates from 2008 to 2016, followed by semi-structured interviews with a subset of respondents. Results: There were 95 survey respondents and 10 interviewees. More than half of the survey respondents reported that the model impacted health promotion programs they are involved in, however, less than a quarter felt it impacted workplace policies. The impact was significantly higher for those with higher levels of knowledge about, confidence in using, and perception of utility of the RLCHPM, and stronger alignment of their practice with critical health promotion values and principles. Graduates' embodiment of the model's values and principles in practice enhanced the impact of the model. Factors that limited the impact included participants' implicit use of components of the model without explicit reference to the model, and the incongruence between participants' professional practice ideals and those of their workplace context. Conclusions: The use of the RLCHPM as a pedagogical framework for university health promotion programs positively impacted graduates' practice within the Australian context. So What?: The RLCHPM could be used as a pedagogical framework in universities to develop competency-based critical health promotion curricula to enable graduates to progress critical health promotion practice.Open access publication funding provided by the Qatar National Library

Does team reflexivity impact teamwork and communication in interprofessional hospital-based healthcare teams? : A systematic review and narrative synthesis

BACKGROUND: Teamwork and communication are recognised as key contributors to safe and high-quality patient care. Interventions targeting process and relational aspects of care may therefore provide patient safety solutions that reflect the complex nature of healthcare. Team reflexivity is one such approach with the potential to support improvements in communication and teamwork, where reflexivity is defined as the ability to pay critical attention to individual and team practices with reference to social and contextual information. OBJECTIVE: To systematically review articles that describe the use of team reflexivity in interprofessional hospital-based healthcare teams. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, six electronic databases were searched to identify literature investigating the use of team reflexivity in interprofessional hospital-based healthcare teams.The review includes articles investigating the use of team reflexivity to improve teamwork and communication in any naturally occurring hospital-based healthcare teams. Articles' eligibility was validated by two second reviewers (5%). RESULTS: Fifteen empirical articles were included in the review. Simulation training and video-reflexive ethnography (VRE) were the most commonly used forms of team reflexivity. Included articles focused on the use of reflexive interventions to improve teamwork and communication within interprofessional healthcare teams. Communication during interprofessional teamworking was the most prominent focus of improvement methods. The nature of this review only allows assessment of team reflexivity as an activity embedded within specific methods. Poorly defined methodological information relating to reflexivity in the reviewed studies made it difficult to draw conclusive evidence about the impact of reflexivity alone. CONCLUSION: The reviewed literature suggests that VRE is well placed to provide more locally appropriate solutions to contributory patient safety factors, ranging from individual and social learning to improvements in practices and systems. TRIAL REGISTRATION NUMBER: CRD42017055602

Proactive occupational safety and health management: promoting good health and good business

This research assessed the impact of organisational approaches to occupational safety and health (OSH) management on organisational performance, safety climate, employee attitudes, health and well-being. Interviews with health and safety personnel, company directors and worker representatives were used to categorise the organisations according to their approaches to OSH management, using the Continuous Improvement Cycle model (Budworth and Khan, 2003). A cross-sectional survey of 2067 employees from these organisations examined the impact of company size, industrial sector and approach to OSH management on indicators of organisational performance and employee outcomes. A structured questionnaire assessed demographic characteristics, organisation and job tenure, job satisfaction, organisational commitment, intention to quit and job motivation, safety climate, self-reported absence, performance and work-related ill-health. Organisations were also asked to provide data on profit, performance, accidents and absence indices. Organisations adopting a proactive approach to OSH management reported higher profit margins and lower accident rates, however these differences were not statistically significant. Organisations classified as ‘very good’ were found to show significantly more positive safety climate perceptions across eight out of the nine safety climate dimensions. Employees in proactive organisations were significantly more committed to their organisations and showed greater job satisfaction than employees in organisations categorised as ‘yet to be fully engaged/-complier’. Positive safety climate perceptions and organisational attitudes were associated with better self-reported physical and mental health. The findings add to the validation of the CIC model as an assessment and learning tool which may support the transition of organisations from reactive to proactive safety culture

Exploring the sociocultural contexts in which healthcare staff respond to and use online patient feedback in practice: In-depth case studies of three NHS Trusts

Objectives: Patients are increasingly reporting about their healthcare experiences online and NHS Trusts are adopting different approaches to responding. However, the sociocultural contexts underpinning these organisational approaches remain unclear. Therefore, we aimed to explore the sociocultural contexts underpinning three organisations who adopted different approaches to responding to online patient feedback. Methods: Recruitment of three NHS Trusts was theoretically guided, and determined based on their different approaches to responding to online patient feedback (a nonresponding organisation, a generic responding organisation and an organisation providing transparent, conversational responses). Ethnographic methods were used during a year of fieldwork involving staff interviews, observations of practice and documentary analysis. Three in-depth case studies are presented. Findings: The first organisation did not respond to or use online patient feedback as staff were busy firefighting volumes of concerns received in other ways. The second organisation adopted a generic responding style due to resource constraints, fears of public engagement and focus on resolving known issues raised via more traditional feedback sources. The final organisation provided transparent, conversational responses to patients online and described a 10-year journey enabling their desired culture to be embedded. Conclusions: We identified a range of barriers facing organisations who ignore or provide generic responses to patient feedback online. We also demonstrated the sociocultural context in which online interactions between staff and patients can be embraced to inform improvement. However, this represented a slow and difficult organisational journey. Further research is needed to better establish how organisations can recognise and overcome barriers to engaging with online patient feedback, and at pace. Keywords General, digital health, studies, qualitative, patient feedback, patient experience, patient safet

Do healthcare professionals work around safety standards, and should we be worried? A scoping review.

Background Healthcare staff adapt to challenges faced when delivering healthcare by using workarounds. Sometimes, safety standards, the very things used to routinely mitigate risk in healthcare, are the obstacles that staff work around. While workarounds have negative connotations, there is an argument that, in some circumstances, they contribute to the delivery of safe care. Objectives In this scoping review, we explore the circumstances and perceived implications of safety standard workarounds (SSWAs) conducted in the delivery of frontline care. Method We searched MEDLINE, CINAHL, PsycINFO and Web of Science for articles reporting on the circumstances and perceived implications of SSWAs in healthcare. Data charting was undertaken by two researchers. A narrative synthesis was developed to produce a summary of findings. Results We included 27 papers in the review, which reported on workarounds of 21 safety standards. Over half of the papers (59%) described working around standards related to medicine safety. As medication standards featured frequently in papers, SSWAs were reported to be performed by registered nurses in 67% of papers, doctors in 41% of papers and pharmacists in 19% of papers. Organisational causes were the most prominent reason for workarounds. Papers reported on the perceived impact of SSWAs for care quality. At times SSWAs were being used to support the delivery of person-centred, timely, efficient and effective care. Implications of SSWAs for safety were diverse. Some papers reported SSWAs had both positive and negative implications for safety simultaneously. SSWAs were reported to be beneficial for patients more often than they were detrimental. Conclusion SSWAs are used frequently during the delivery of everyday care, particularly during medication-related processes. These workarounds are often used to balance different risks and, in some circumstances, to achieve safe care

Strategies and lessons learnt from user involvement in researching quality and safety in nursing homes and homecare

Purpose The purpose is to share strategies, rationales and lessons learnt from user involvement in a quality and safety improvement research project from the practice field in nursing homes and homecare services. Design/methodology/approach This is a viewpoint paper summarizing how researchers and co-researchers from the practice field of nursing homes and homecare services (nurse counsellors from different municipalities, patient ombudsman and next-of-kin representatives/and elderly care organization representant) experienced user involvement through all phases of the research project. The project included implementation of a leadership intervention. Findings Multiple strategies of user involvement were applied during the project including partnership in the consortium, employment of user representatives (co-researchers) and user-led research activities. The rationale was to ensure sound context adaptation of the intervention and development of tailor-made activities and tools based on equality and mutual trust in the collaboration. Both university-based researchers and Co-researchers experienced it as useful and necessary to involve or being involved in all phases of the research project, including the designing, planning, intervention implementation, evaluation and dissemination of results. Originality/value User involvement in research is a growing field. There is limited focus on this aspect in quality and safety interventions in nursing homes and homecare settings and in projects focussing on the leadership' role in improving quality and safety.publishedVersio

Unpacking the Cinderella black box of complex intervention development through the Partners at Care Transitions (PACT) programme of research

Introduction: Complex intervention development has been described as the ‘Cinderella’ black box in health services research. Greater transparency in the intervention development process is urgently needed to help reduce research waste. Methods: We applied a new consensus‐based framework for complex intervention development to our programme of research, in which we developed an intervention to improve the safety and experience of care transitions for older people. Through this process, we aimed to reflect on the framework's utility for intervention development and identify any important gaps within it to support its continued development. Findings: The framework was a useful tool for transparent reporting of the process of complex intervention development. We identified potential ‘action’ gaps in the framework including ‘consolidation of evidence’ and ‘development of principles’ that could bracket and steer decision‐making in the process. Conclusions: We consider that the level of transparency demonstrated in this report, aided through use of the framework, is essential in the quest for reducing research waste. Patient or Public Contribution: We have involved our dedicated patient and public involvement group in all work packages of this programme of research. Specifically, they attended and contributed to co‐design workshops and contributed to finalizing the intervention for the pilot evaluation. Staff also participated by attending co‐design workshops, helping us to prioritize content ideas for the intervention and supporting the development of intervention components outside of the workshops