scholarly journals Grounded accountability in life-and-death high-consequence healthcare settings

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Maureen Alice Flynn ◽  
Niamh M. Brennan
Keyword(s):  
Design Methodology ◽  
Hospital Setting ◽  
Clinical Governance ◽  
Front Line ◽  
Content Type ◽  
Life And Death ◽  
Healthcare Settings ◽  
Academic Hospitals ◽  
Felt Accountability ◽  
Legal Processes

PurposeThe paper examines interviewee insights into accountability for clinical governance in high-consequence, life-and-death hospital settings. The analysis draws on the distinction between formal “imposed accountability” and front-line “felt accountability”. From these insights, the paper introduces an emergent concept, “grounded accountability”.Design/methodology/approachInterviews are conducted with 41 clinicians, managers and governors in two large academic hospitals. The authors ask interviewees to recall a critical clinical incident as a focus for elucidating their experiences of and observation on the practice of accountability.FindingsAccountability emerges from the front-line, on-the-ground. Together, clinicians, managers and governors co-construct accountability. Less attention is paid to cost, blame, legal processes or personal reputation. Money and other accountability assumptions in business do not always apply in a hospital setting.Originality/valueThe authors propose the concept of co-constructed “grounded accountability” comprising interrelationships between the concept’s three constituent themes of front-line staff’s felt accountability, along with grounded engagement by managers/governors, supported by a culture of openness.

scholarly journals Mapping clinical governance to practitioner roles and responsibilities

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Maureen Alice Flynn ◽  
Niamh M. Brennan
Keyword(s):  
Best Practice ◽  
Clinical Governance ◽  
Front Line ◽  
Structured Interviews ◽  
Content Type ◽  
Roles And Responsibilities ◽  
Academic Hospitals ◽  
Governance Practice ◽  
Organisational Structures ◽  
Governance Roles

PurposeWhile clinical governance is assumed to be part of organisational structures and policies, implementation of clinical governance in practice (the praxis) can be markedly different. This paper draws on insights from hospital clinicians, managers and governors on how they interpret the term “clinical governance”. The influence of best-practice and roles and responsibilities on their interpretations is considered.Design/methodology/approachThe research is based on 40 in-depth, semi-structured interviews with hospital clinicians, managers and governors from two large academic hospitals in Ireland. The analytical lens for the research is practice theory. Interview transcripts are analysed for practitioners' spoken keywords/terms to explore how practitioners interpret the term “clinical governance”. The practice of clinical governance is mapped to front line, management and governance roles and responsibilities.FindingsThe research finds that interpretation of clinical governance in praxis is quite different from best-practice definitions. Practitioner roles and responsibilities held influence practitioners' interpretation.Originality/valueThe research examines interpretations of clinical governance in praxis by clinicians, managers and governors and highlights the adverse consequence of the absence of clear mapping of roles and responsibilities to clinical, management and governance practice.

An action framework for compliance and governance

2014 ◽  
Vol 19 (4) ◽  
pp. 342-359 ◽  
Author(s):  
Allen O’Neill
Keyword(s):  
Data Privacy ◽  
Design Methodology ◽  
State Of The Art ◽  
Clinical Governance ◽  
Healthcare Organisation ◽  
Privacy Risk ◽  
Content Type ◽  
Starting Point ◽  
Governance Risk ◽  
Education Process

Purpose – The purpose of this paper is to propose a framework for clinical governance, in particular, the compliance of data privacy in a healthcare organisation. Design/methodology/approach – The approach of the research was to highlight problem areas in compliance and governance risk management (governance, risk and compliance (GRC)) in general, and then identify knowledge in other domains that could be combined and applied to improve GRC management, and ultimately improve governance outcomes. Findings – There is a gap in the literature is respect of systems and frameworks to assist organisations in managing the complex minutiae associated with compliance. This paper addresses this gap by proposing a “compliance action framework” which builds on work existing in other domains in relation to education, process control and governance. Research limitations/implications – The present research provides a starting point for an implementation of the framework within a number of organisations, and opens questions for further research in the field. Originality/value – The GRC framework proposed in this paper contributes to the state of the art, by proposing processes for improving the governance capability and compliance outcomes within an organisation for governance of data privacy risk and data protection.

Building a global training initiative fit for KONE’s diverse workforce

2018 ◽  
Vol 17 (2) ◽  
pp. 91-94
Author(s):  
Samantha Caine
Keyword(s):  
Design Methodology ◽  
Training Programme ◽  
Local Market ◽  
Front Line ◽  
Content Type ◽  
Diverse Workforce ◽  
Course Materials ◽  
The Uk ◽  
Global Training ◽  
Multiple Languages

Purpose Business Linked Teams was tasked with creating a training programme for KONE to transform sales people in various markets to communicate value, differentiate the organisation from its competitors, improve margins and increase orders. Design/methodology/approach Business Linked Teams developed a global solution that is adaptable to local market conditions with case studies, activities and role plays and further course materials developed specifically for each respective front line of sales staff. The programme was also developed to run in multiple languages. The solution comprises two modules that are run approximately six months apart, supported by online learning elements. Findings In the UK, the results nine months post-training were that 72 participants had identified £11,463,378 worth of orders achieved as a result of the skills and processes they were able to use after the training, with £5,044,942 of future orders in the pipeline. Originality/value Business Linked Teams created an original training programme that was tailored to the unique needs of KONE. Each training programme that was created was designed to meet the specific goals of the organisation to ensure that the most effective route possible is taken and to maximise uptake of learning once the programmes have ended.

scholarly journals Cultural humility in libraries

2019 ◽  
Vol 47 (4) ◽  
pp. 544-555
Author(s):  
David A. Hurley ◽  
Sarah R. Kostelecky ◽  
Lori Townsend
Keyword(s):  
Cultural Competence ◽  
Intercultural Communication ◽  
Cultural Competency ◽  
Design Methodology ◽  
Cultural Humility ◽  
Front Line ◽  
Content Type ◽  
Systematic Exploration ◽  
Practical Implications ◽  
Competence Models

Purpose The purpose of this paper is to introduce the idea of cultural humility, distinguish it from cultural competence and explore how it fits within librarianship. Design/methodology/approach The authors use an interdisciplinary exploration of the concept of humility to understand what cultural humility means and how it differs from cultural competence and other approaches to intercultural communication in libraries. Findings Despite some reservations with the term itself, the authors find that a practice of cultural humility is more appropriate to front-line interactions in library contexts than cultural competence models. Practical implications Libraries looking to address issues in intercultural communication and services to multicultural populations will find an approach that may be better suited to their contexts than prevailing models of cultural competency. Social implications Librarians need to commit to redressing the power imbalances and other structural issues that interfere with library service, for the benefit of the patrons, the library and librarians themselves. Originality/value While cultural humility is increasingly being used in librarianship, there has not been a systematic exploration of the concept and how it applies to library contexts.

scholarly journals Life, death, ethnography: epistemologies and methods of the quasi-event

2017 ◽  
Vol 17 (3) ◽  
pp. 177-187 ◽  
Author(s):  
Silvia Posocco
Keyword(s):  
Design Methodology ◽  
Cultural Theory ◽  
Content Type ◽  
Life And Death ◽  
The Everyday ◽  
Contemporary Life ◽  
Anthropological Research ◽  
Modes Of Existence ◽  
Methodological Reflection

Purpose What difference, if any, does it make to appeal to the ordinary and the everyday, the situated and always-already-in-relation, the emergent and the quasi-event (Povinelli, 2011), as simultaneously sites, objects and frames? The paper aims to discuss these issues. Design/methodology/approach Through a focus on epistemological and methodological reflection, this paper asks: what is the relation between the biopolitical and necropolitical terrain in and through which experience unravels and the conceptual apparatuses which hold the promise of analysis and critique? What analytics, methods and ethics do contemporary life and death formations and intersecting precarious modes of existence elicit? Findings In this paper, I approach these questions ethnographically, with reference to debates in social and cultural theory and drawing on long-term anthropological research in Guatemala. Originality/value This paper aims to make contribution to debates on biopolitical and necropolitical processes and dynamics, by reflecting on the implications for epistemologies, methods and infrastructures.

Study of safety culture in healthcare institutions: case of an Algerian hospital

2019 ◽  
Vol 32 (7) ◽  
pp. 1081-1097 ◽  
Author(s):  
Assia Boughaba ◽  
Salah Aberkane ◽  
Youcef-Oussama Fourar ◽  
Mébarek Djebabra
Keyword(s):  
Safety Culture ◽  
Design Methodology ◽  
Hospital Setting ◽  
Patient Safety Culture ◽  
Healthcare Services ◽  
Content Type ◽  
Improvement Plan ◽  
Culture Dimensions ◽  
Safety Improvement ◽  
The Individual

Purpose For many years, the concept of safety culture has attracted researchers from all over the world, and more particularly in the area of healthcare services. The purpose of this paper is to measure safety culture dimensions in order to improve and promote healthcare in Algeria. Design/methodology/approach The used approach consists of getting a better understanding of healthcare safety culture (HSC) by measuring the perception of healthcare professionals in order to guide promotion actions. For this, the Hospital Survey on Patient Safety Culture questionnaire was used in a pilot hospital setting where it was distributed on a number of 114 health professionals chosen by stratified random sampling. Findings The results showed that the identified priority areas for HSC improvement help in establishing a trust culture and a non-punitive environment based on the system and not on the individual. Originality/value Safety is recognized as a key aspect of service quality, thus measuring the HSC can help establish an improvement plan. In Algerian health facilities, this study is considered the first to examine perceptions in this particular area. The current results provide a baseline of strengths and opportunities for healthcare safety improvement, allowing the managers of this type of facilities to take steps that are more effective.

scholarly journals Care transitions as street-level work

2017 ◽  
Vol 25 (3) ◽  
pp. 196-207 ◽  
Author(s):  
Michele Foster ◽  
Desley Harvey ◽  
Rachel Quigley ◽  
Edward Strivens
Keyword(s):  
Design Methodology ◽  
Service Providers ◽  
Quality Care ◽  
Care Transitions ◽  
Front Line ◽  
Policy And Practice ◽  
Content Type ◽  
Street Level ◽  
Local Setting ◽  
Front Line Workers

Purpose Quality care transitions of older people across acute, sub-acute and primary care are critical to safety and cost, which is the reason interventions to improve practice are a priority. Yet, given the complexity of providers and services involved it is often difficult to know the types of tensions that arise in day-to-day transition work or how front-line workers will respond. To that end, this innovative study differs from the largely descriptive studies by conceptualising care transitions as street-level work in order to capture how transition practice takes shape within the complexities and dynamics of the local setting. The paper aims to discuss these issues. Design/methodology/approach Data were collected from 23 hospital health professionals and community service providers across primary, sub-acute and acute care through focus groups. A thematic analysis and interrogation of themes using street-level concepts derived three key themes. Findings The themes of risk logics and dilemmas of fragmentation make explicit both the local constraints and opportunities of care transitions and how these intersect to engender a particular logic of practice. By revealing the various discretionary tactics adopted by front-line providers, the third theme simultaneously highlights how discretionary spaces might represent both possibilities and problematics for balancing organisational and patient needs. Originality/value The study contributes to the knowledge of street-level work in health settings and specifically, the nature of transition work. Importantly, it benefits policy and practice by uncovering mechanisms that could facilitate and impede quality transitions in discrete settings.

CGIJ review

2013 ◽  
Vol 19 (1) ◽  
pp. 56-60
Author(s):  
Fiona MacVane Phipps
Keyword(s):  
Design Methodology ◽  
Clinical Governance ◽  
Healthcare Provision ◽  
Review Section ◽  
Content Type

Purpose – The purpose of this review is to enable readers of the journal to gain a quick over-view of articles published in this issue. Design/methodology/approach – A review of articles published within this issue of CGIJ with added commentary. Findings – Clinical governance continues to be an important issue in contemporary healthcare and the concept is being applied to many different facets of healthcare provision. Originality/value – The originality value is that CGIJ is the only Emerald journal containing this type of review section.

Do different approaches to clinical governance development and implementation make a difference? Findings from Ireland and New Zealand

2017 ◽  
Vol 31 (7/8) ◽  
pp. 682-695 ◽  
Author(s):  
Robin Gauld ◽  
Simon Horsburgh ◽  
Maureen Alice Flynn ◽  
Deirdre Carey ◽  
Philip Crowley
Keyword(s):  
New Zealand ◽  
Policy Implementation ◽  
Health Professionals ◽  
Design Methodology ◽  
Local Level ◽  
Response Rates ◽  
Clinical Governance ◽  
Local Approach ◽  
Content Type ◽  
High Performing

Purpose Clinical governance (CG) is an important foundation for a high-performing health care system, with many countries supporting its development. CG policy may be developed and implemented nationally, or devolved to a local level, with implications for the overall approach to implementation and policy uptake. However, it is not known whether one of these two approaches is more effective. The purpose of this paper is to probe this question. Its setting is Ireland and New Zealand, two broadly comparable countries with similar CG policies. Ireland’s was nationally led, while New Zealand’s was devolved to local districts. This leads to the question of whether these different approaches to implementation make a difference. Design/methodology/approach Data from surveys of health professionals in both countries were used to compare performance with CG development. Findings The study showed that Ireland’s approach produced a slightly better performance, raising questions about the merits of devolving responsibility for policy implementation to the local level. Research limitations/implications The Irish and New Zealand surveys both had lower-than-desirable response rates, which is not uncommon for studies of health professionals such as this. The low response rates mean the findings may be subject to selection bias. Originality/value Despite the importance of the question of whether a national or local approach to policy implementation is more effective, few studies specifically focus on this, meaning that this study provides a new contribution to the topic.

Deciding on tax evasion – front line discretion and constraints

2015 ◽  
Vol 4 (2) ◽  
pp. 193-207 ◽  
Author(s):  
Karen Boll
Keyword(s):  
Public Administration ◽  
Tax Evasion ◽  
Design Methodology ◽  
Tax Administration ◽  
Front Line ◽  
Content Type ◽  
Revenue Collection ◽  
Set Up ◽  
Everyday Reasoning ◽  
The Individual

Purpose – The purpose of this paper is to analyse everyday reasoning in public administration. This is done by focusing on front line tax inspectors’ decisions about tax evasion. Design/methodology/approach – The paper presents ethnography of bureaucracy and field audits. The material stems from fieldwork conducted in the Central Customs and Tax Administration. Findings – The paper shows that the tax inspectors reason about tax evasion in a casuistic manner. They pay attention to similar cases and to particular circumstances of the individual cases. In deciding on tax evasion, the inspectors do not just administer the laws; they also enact a policy of fair-mindedness. Doing this they are constrained by time and man-powers, but also enabled by various organizational devices. Research limitations/implications – The tax inspectors that the author followed were carefully chosen and acted in accordance with procedures. The ethnography should be understood in relation to this set-up. Originality/value – The originality of the paper is that it shows that ethnography can open the territory of everyday reasoning in public administration. Also, it shows the discretionary room that any front line tax inspector navigates in. This is significant as revenue collection often is described as formal and dominated by a legal steering in which rules are univocal.

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