In defence of research.

BSA members currently working in the UK as academic researchers are often asked about the impact of their work. In this article, the author writes about her research with the armed forces reserves

"There are too many, but never enough": qualitative case study investigating routine coding of clinical information in depression.

We sought to understand how clinical information relating to the management of depression is routinely coded in different clinical settings and the perspectives of and implications for different stakeholders with a view to understanding how these may be aligned

Assessment of patient safety culture in an adult oncology department in Saudi Arabia

Objectives: The aim of this research was to evaluate patient safety culture across different healthcare professionals from different countries of origin working in an adult oncology department at King Fahad Medical City. Methods: This was a cross-sectional survey of 130 healthcare staff (doctors, pharmacists, nurses) working in an adult oncology department in Saudi Arabia. We used the Hospital Survey of Patient Safety Culture (HSOPSC) to examine perceptions of safety culture during the month of February 2017. Data were analysed using SPSS v24 for descriptive statistical analysis, calculating composite positivity, and running t-test, ANOVA test, and linear regression to identify factors influencing the patient safety culture. Result: 127 of 130 questionnaires were returned, yielding a response rate of 97.7%. Eight out of the twelve HSOPSC composites were considered as areas for improvement (percent positivity < 50%). Significantly different mean scores were observed across the three professional groups in all twelve HSOPSC composites. Doctors tended to rate patient safety culture significantly more positively than nurses or pharmacists. Nurses scored significantly lower than pharmacists in the majority of HSOPSC composites. No significant differences in patient safety culture composite scores were observed between Saudi/Gulf Cooperation Council (GCC) and non-Saudi/GCC groups. Regression analysis showed that frequency of reported events is predicted by feedback and communication about errors, and teamwork across units, while perception of patient safety is associated with respondents’ profession and teamwork across units. Conclusion: This study brings to the fore the assumption that all healthcare professionals have a shared understanding of patient safety. We urge healthcare leaders and policy makers to look at patient safety culture at this granular level in their contexts, and use this information to develop strategies and training to improve patient safety culture

Exploring healthcare professionals’ perceptions of medication errors in an adult oncology department in Saudi Arabia: A qualitative study

Objective: Adverse events which result from medication errors are considered to be one of the most frequently encountered patient safety issues in clinical settings. We undertook a qualitative investigation to identify and explore factors relating to medication error in an adult oncology department in Saudi Arabia from the perspective of healthcare professionals.\ud Methods: This was a qualitative study conducted in an adult oncology department in Saudi Arabia. After obtaining required ethical approvals and written consents from the participants, semi-structured interviews and focus group discussions were carried out for data collection. A stratified purposive sampling strategy was used to recruit medical doctors, pharmacists, and nurses. NVivo Pro version 11 was used for data analyses. Inductive thematic analysis was adopted in the primary coding of data while secondary coding of data was carried out deductively applying the Hospital Survey of Patient Safety Culture (HSOPSC) framework. Result: The total number of participants were 38. Majority of the participants were nurses (n = 24), females (n = 30), and not of Saudi nationality (n = 31) with an average age of 36 years old. Causes of medication errors were categorized into 6 themes. These causes were related teamwork across units, staffing, handover of medication related information, accepted behavioural norms, frequency of events reported, and non-punitive response to error. Conclusion: There were numerous causes for medication errors in the adult oncology department. This means substantive improvement in medication safety is likely to require multiple, inter-relating, complex interventions. More research should be conducted to examine context-specific interventions that may have the potential to improve medication safety in this and similar departments

Improving access to service charities for female veterans.

To date, considerations of improving access to and quality of care for veterans often emphasise male perspectives. This may not reflect the needs of female veterans, nor anticipate the needs of the increasing numbers of female service personnel as they leave service. In the work reported here we aimed to investigate public and charitable sector (service and nonservice) perspectives on the challenges and enablers female veterans face in accessing service charities, to inform and prioritise recommendations for tangible improvements in access to veteran specific services for female veterans. We achieved this aim by conducting a literature review, followed by a qualitative research study. This qualitative study comprised profiling the evolution of conditions for military service for females in UK Armed Forces, 38 stakeholder interviews, and website analysis. Findings and recommendations were discussed with an expert panel and the Project Advisory Group, and disseminated to a range of stakeholders over the course of the project. This report presents the findings of this research, discusses them in the context of previous work, and makes recommendations for service provision, policy and research

Public perception and acceptance of CCUS: preliminary findings of a qualitative case study in Greece.

The development and implementation of carbon capture, utilisation and storage (CCUS) technologies plays an increasingly important part in European Union (EU) and global decarbonisation policies and strategies that seek to address climate change to achieve the Paris Agreement goals. Several studies have shown the important role social acceptance plays in determining the outcomes of CCUS projects and how social acceptance is shaped by the national and local contexts. Yet most studies on CCUS and social acceptance have focused on countries in northern Europe and North America despite the increasing numbers of CCUS projects in other regions of the world. This study seeks to help address this gap by conducting a case study on how local dynamics shaped people's acceptance and awareness of CCUS in a Greek community. Based on semi-structured interviews with community members near a CCUS pilot plant, this single case study explores the factors and dynamics that shaped the interviewees' perceptions of CCUS technologies. Our findings indicate that, despite the low level of awareness of CCUS technologies, participants could draw on their situated knowledge to identify potential drawbacks with their application. We identified scepticism regarding the adoption of new technologies and the organisations involved based on past experiences, and a notable lack provision of technology and location-specific information as well public engagement by the project consortium. Our recommendations for future projects and community engagement include the early involvement of the public in project development, location-based transparent information, appropriate channels to facilitate knowledge exchange, and educational initiatives to build communities' capability to influence projects

Strangeness of the familiar : re-conceptualising change in organisations

Introduction: This thesis proposes new ways to think about change, a much discussed yet under-defined concept within organisational studies. The vast majority of existing work focuses on processes of organisational change, i.e. the management of change, whilst a small minority considers change in organisations, offering theories of change at the individual level. This study aimed to reverse the established research order by exploring individual interpretations of experiences of change at work to enrich and inform our understandings and indicate further and alternate areas for study. Methods: A Foucauldian theoretical lens was utilised to consider how ideas about change in the workplace have been constructed over time and why we think about change the way we do. A mixed methods approach was utilised. Bibliometric analysis and meta-narrative review were used to explore the development of the concept of change within organisational studies. A qualitative study was then conducted within the United Kingdom Ministry of Defence and National Health Service in England as organisations generally acknowledged to have undergone sustained, significant change over time. In-depth interviews (n=40) were conducted together with documentary analysis of materials volunteered by participants in order to investigate what individuals mean by change, how they distinguish between change and that which remains relatively constant (i.e. between change and stability), and how relationships are affected by change in organisations. These data were analysed using deductive and inductive analytical frameworks. A reflexive approach was adopted throughout data collection and analysis. How these insights might inform further research into change in organisations was then discussed in the context of related literature. Results: Six themes emerged from the investigation, namely: i) uncertainty at work; ii) progress and change; iii) dissonance and division; iv) definitions and boundaries; v) risks and vulnerabilities; vi) the role of stability. Participants described an organisational context dominated by change, most particularly frequent, imposed changes involving re-structuring and job moves. Change was seen to have created divisions between employees and the organisation, their colleagues and their sense of self, highlighting dissonance between personal/ professional and organisational values. Change was seen to go beyond the boundaries of the organisation into social and intimate worlds beyond work. Accounts of change included vulnerabilities for the organisation (e.g. reduced performance and employee dis-identification) and for individuals (e.g. employees’ well-being and the potential for discrimination). In contrast, stability was a neglected but important consideration for participants. Conclusion: This study suggests the normalisation of change as an everyday undertaking at work, contributing to individual and organisational uncertainty and vulnerability. This indicates not only a need to more clearly define change as a subject for study, but also a lack of consideration of stability as a source of certainty and balance. The use of change as a mechanism of control has contributed to a growth of managerialism and individualism and there is a need to better understand the troublesome effects of imposed change and its associated risks within and beyond the organisation. Conversely, the dynamic effects of organic change may offer significant benefits in allowing the organisation to adapt in accord with the wider environment

A narrative synthesis of qualitative studies conducted to assess patient safety culture in hospital settings.

This review aimed to identify methodological aspects of qualitative studies conducted to assess patient safety culture (PSC) in hospital settings. Searches of Google Scholar (Google LLC, Menlo Park, California, USA), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands), PsycINFO (American Psychological Association, Washington, District of Columbia, USA) and Web of Science (Clarivate Analytics, Philadelphia, Pennsylvania, USA) databases were used to identify qualitative articles published between 2000 and 2017 that focused on PSC. A total of 22 studies were included in this review and analysis of methodological approaches showed that most researchers adopted purposive sampling, individual interviews, inductive content and thematic analysis. PSC was affected by factors related to staffing, communication, nonhuman resources, organisation and patient-related factors. Most studies lacked theoretical frameworks. However, many commonalities were found across studies. Therefore, it is recommended that future studies adopt a mixed methods approach to gain a better understanding of PSC