Leading through the first wave of COVID: a Canadian action research study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elizabeth Hartney ◽  
Ellen Melis ◽  
Deanne Taylor ◽  
Graham Dickson ◽  
Bill Tholl ◽  
...  
Keyword(s):  
Health Care ◽  
Action Research ◽  
Health System ◽  
Leadership Practices ◽  
Research Study ◽  
Second Phase ◽  
Content Type ◽  
Canadian Health ◽  
Action Research Study ◽  
Future Practice

Purpose This first phase of a three-phase action research project aims to define leadership practices that should be used during and after the pandemic to re-imagine and rebuild the health and social care system. Specifically, the objectives were to determine what effective leadership practices Canadian health leaders have used through the first wave of the COVID-19 pandemic, to explore how these differ from pre-crisis practices; and to identify what leadership practices might be leveraged to create the desired health and care systems of the future. Design/methodology/approach The authors used an action research methodology. In the first phase, reported here, the authors conducted one-on-one, virtual interviews with 18 health leaders from across Canada and across leadership roles. Data were analyzed using grounded theory methodology. Findings Five key practices emerged from the data, within the core dimension of disrupting entrenched structures and leadership practices. These were, namely, responding to more complex emotions in self and others. Future practice identified to create more psychologically supportive workplaces. Agile and adaptive leadership. Future practice should allow leaders to move systemic change forward more quickly. Integrating diverse perspectives, within and across organizations, leveling hierarchies through bringing together a variety of perspectives in the decision-making process and engaging people more broadly in the co-creation of strategies. Applying existing leadership capabilities and experience. Future practice should develop and expand mentorship to support early career leadership. Communication was increased to build credibility and trust in response to changing and often contradictory emerging evidence and messaging. Future practice should increase communication. Research limitations/implications The project was limited to health leaders in Canada and did not represent all provinces/territories. Participants were recruited through the leadership networks, while diverse, were not demographically representative. All interviews were conducted in English; in the second phase of the study, the authors will recruit a larger and more diverse sample and conduct interviews in both English and French. As the interviews took place during the early stages of the pandemic, it may be that health leaders’ views of what may be required to re-define future health systems may change as the crisis shifts over time. Practical implications The sponsoring organization of this research – the Canadian Health Leadership Network and each of its individual member partners – will mobilize knowledge from this research, and subsequent phases, to inform processes for leadership development and, succession planning across, the Canadian health system, particularly those attributes unique to a context of crisis management but also necessary in post-crisis recovery. Social implications This research has shown that there is an immediate need to develop innovative and influential leadership action – commensurate with its findings – to supporting the evolution of the Canadian health system, the emotional well-being of the health-care workforce, the mental health of the population and challenges inherent in structural inequities across health and health care that discriminate against certain populations. Originality/value An interdisciplinary group of health researchers and decision-makers from across Canada who came together rapidly to examine leadership practices during COVID-19’s first wave using action research study design.

scholarly journals Improving Nursing Care Documentation in Emergency Department: A Participatory Action Research Study in Iran

2018 ◽  
Vol 6 (8) ◽  
pp. 1527-1532 ◽  
Author(s):  
Seyed Majid Vafaei ◽  
Zahra Sadat Manzari ◽  
Abbas Heydari ◽  
Razieh Froutan ◽  
Leila Amiri Farahani
Keyword(s):  
Emergency Department ◽  
Action Research ◽  
Nursing Care ◽  
Medical Records ◽  
Research Study ◽  
Collaborative Action Research ◽  
Second Phase ◽  
Monitoring And Control ◽  
Action Research Study

BACKGROUND: Standardization of documentation has enabled the use of medical records as a primary tool for evaluating health care functions and obtaining appropriate credit points for medical centres. However, previous studies have shown that the quality of medical records in emergency departments is unsatisfactory.AIM: The aim of this study was improving the nursing care documentation in an emergency department, in Iran.MATERIAL AND METHODS: This collaborative action research study was carried out in two phases to improve nursing care documentation in cooperation with individuals involved in the process, from February 2015 to December 2017 in an affiliated academic hospital in Iran. The first phase featured virtual training, an educational workshop, and improvements to the hospital information system. The second phase involved the recruitment of human resources, the implementation of continuous codified training, the establishment of an appropriate reward and penalty system, and the review of patient education forms.RESULTS: The interventions improved nursing documentation quality score of 73.20%, which was the highest accreditation ranking provided by Iran’s Ministry of Health and Medical Education in 2017. In other words, this study caused a 32% improvement in the quality of nursing care documentation in the hospital.CONCLUSION: The appropriate practices for improving nursing care documentation are employee participation, managerial accountability, nurses’ adherence to documentation standards, improved leadership style, and continuous monitoring and control.

Integrating the C3 Framework in the social studies: an action research study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Meghan McGlinn Man ◽  
Jeffrey A. Greiner
Keyword(s):  
Action Research ◽  
Social Studies ◽  
Teaching And Learning ◽  
Research Study ◽  
Classroom Teacher ◽  
Theory And Practice ◽  
Content Type ◽  
The Social ◽  
Teachers And Students ◽  
Action Research Study

PurposeThe C3 Framework is a recent example in a long history within the field of social studies education of efforts to engage teachers and students in inquiry-oriented teaching and learning. While there is some research regarding the efficacy of the inquiry design model (IDM) of the C3 Framework, few studies have sought to engage social studies teachers as coresearchers as they integrate the framework. This study addressed a persistent divide between the theory and practice of integrating inquiry in the social studies.Design/methodology/approachIn this study, a classroom teacher and a university-based researcher conducted a hybrid action research study to understand the instructional shifts that occur as the C3 Framework is fully implemented into instruction.FindingsBased on the findings, the authors present a theory of action to highlight key opportunities to shift instruction, while also acknowledging the factors that might mitigate those shifts. In particular, the authors focus on teacher decision-making and contextual factors that allow for and hinder the full integration of inquiry.Originality/valueThis study is unique in developing a hybrid action research/qualitative case study that provides insider knowledge related to improving social studies teaching and learning.

scholarly journals The community involvement of courts: an action research study in the context of the Polish justice system

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Przemysław Banasik ◽  
Sylwia Morawska ◽  
Agata Austen
Keyword(s):  
Action Research ◽  
Community Involvement ◽  
Justice System ◽  
Design Methodology ◽  
Research Study ◽  
Public Institutions ◽  
Anglo Saxon ◽  
Content Type ◽  
Legal Provisions ◽  
Action Research Study

Purpose As a rule, common courts are hermetic organizations, separated from their stakeholders by procedures based on legal provisions. For these reasons, they are often perceived as unreliable and non-transparent, and as such, they do not inspire trust among stakeholders. The authors posit that the court’s community involvement may lead to the increased accountability and legitimacy of courts, which should in turn result in jurisprudence benefits. This paper discusses the concept of community involvement of courts, demonstrates how this idea may be implemented and explains its benefits for courts. Design/methodology/approach The results of an action research study undertaken between June 2013 and March 2018 at the Regional Court in Gdansk (Poland) are discussed. Findings The results highlight factors underlying the implementation of the idea of community involvement, as well as the areas in which courts take these actions, and explain how it influences their accountability and legitimacy. This research describes the interests of different stakeholders and proposes a range of actions that may be taken by courts while cooperating with stakeholders to achieve the aims of community involvement. It also proposes a set of steps that enable courts to implement the idea of community involvement. Originality/value This paper develops the idea of the community involvement of courts, which may be used as an operating rule for public institutions to increase their legitimacy and accountability and explain its introduction in the context of courts. It offers a universal framework for the community involvement of courts that can be used in the context of any court in both the continental and Anglo-Saxon systems.

scholarly journals Improving Primary Care Medication Processes by Using Shared Electronic Medication Plans in Switzerland: Lessons Learned From a Participatory Action Research Study (Preprint)

2020 ◽  
Author(s):  
Benjamin Bugnon ◽  
Antoine Geissbuhler ◽  
Thomas Bischoff ◽  
Pascal Bonnabry ◽  
Christian von Plessen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Action Research ◽  
Health Care Professionals ◽  
Research Study ◽  
Medication Management ◽  
Lessons Learned ◽  
Successful Implementation ◽  
Medication Plan ◽  
Action Research Study

BACKGROUND Several countries have launched health information technology (HIT) systems for shared electronic medication plans. These systems enable patients and health care professionals to use and manage a common list of current medications across sectors and settings. Shared electronic medication plans have great potential to improve medication management and patient safety, but their integration into complex medication-related processes has proven difficult, and there is little scientific evidence to guide their implementation. OBJECTIVE The objective of this paper is to summarize lessons learned from primary care professionals involved in a pioneering pilot project in Switzerland for the systemwide implementation of shared electronic medication plans. We collected experiences, assessed the influences of the local context, and analyzed underlying mechanisms influencing the implementation. METHODS In this formative action research study, we followed 5 clusters of health care professionals during 6 months. The clusters represented rural and urban primary care settings. A total of 18 health care professionals (primary care physicians, pharmacists, and nurses) used the pilot version of a shared electronic medication plan on a secure web platform, the precursor of Switzerland’s electronic patient record infrastructure. We undertook 3 group interviews with each of the 5 clusters, analyzed the content longitudinally and across clusters, and summarized it into lessons learned. RESULTS Participants considered medication plan management, digitalized or not, a core element of good clinical practice. Requirements for the successful implementation of a shared electronic medication plan were the integration into and simplification of clinical routines. Participants underlined the importance of an enabling setting with designated reference professionals and regular high-quality interactions with patients. Such a setting should foster trusting relationships and nurture a culture of safety and data privacy. For participants, the HIT was a necessary but insufficient building block toward better interprofessional communication, especially in transitions. Despite oral and written information, the availability of shared electronic medication plans did not generate spontaneous demand from patients or foster more engagement in their medication management. The variable settings illustrated the diversity of medication management and the need for local adaptations. CONCLUSIONS The results of our study present a unique and comprehensive description of the sociotechnical challenges of implementing shared electronic medication plans in primary care. The shared ownership among multiple stakeholders is a core challenge for implementers. No single stakeholder can build and maintain a safe, usable HIT system with up-to-date medication information. Buy-in from all involved health care professionals is necessary for consistent medication reconciliation along the entire care pathway. Implementers must balance the need to change clinical processes to achieve improvements with the need to integrate the shared electronic medication plan into existing routines to facilitate adoption. The lack of patient involvement warrants further study.

Developing a Preceptorship Programme for Newly Qualified Occupational Therapists: Action Research

2007 ◽  
Vol 70 (8) ◽  
pp. 330-338 ◽  
Author(s):  
Mary Morley
Keyword(s):  
Action Research ◽  
Occupational Therapy ◽  
Research Study ◽  
Occupational Therapists ◽  
Evaluation Study ◽  
Second Phase ◽  
Department Of Health ◽  
Transitional Experience ◽  
Making A Difference ◽  
Action Research Study

This action research study used three focus groups and one interview to explore the experiences of five recently qualified occupational therapists, four supervisors and five occupational therapy managers. The participants were asked to identify the perceived development needs of new practitioners and the mechanisms that supported or hindered these being met. The findings showed that the recently qualified occupational therapists experienced satisfaction at making a difference in their first posts. However, for some, their first post had fallen short of their expectations because they faced challenges when moving from student to practitioner, sometimes with limited support. The participants identified development needs that they felt were common to other new practitioners and also the factors that constrained or enabled the meeting of these needs. These findings informed the second phase of the action research study to design a preceptorship programme that was compliant with the revised National Health Service employment contract (Department of Health 2005) and would improve the transitional experience of occupational therapists. This paper presents the focus group results and the rationale for the preceptorship programme, which was launched as a pilot evaluation study with occupational therapy staff from over 20 organisations in Autumn 2005.

Resources, capabilities and public value creation in a healthcare IT project: an action research study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Per Svejvig ◽  
Bjarne Rerup Schlichter
Keyword(s):  
Action Research ◽  
Value Creation ◽  
Research Study ◽  
Research Question ◽  
Health Information System ◽  
Public Healthcare ◽  
Public Value ◽  
Content Type ◽  
Healthcare It ◽  
Action Research Study

PurposeThis paper reports on an action research study based optimization project related to healthcare IT implemented on the Faroe Islands. The aims were to study what constitutes value in the public healthcare setting by applying and activating existing resources in the organization, hence answering the overall research question: How can a resource-based view (RBV) improve benefits management (BM) practices?Design/methodology/approachBy applying a RBV to findings from an action research study of an optimization project of an integrated health information system (HIS), a framework of capabilities needed in a public HIS setting to create value was developed.FindingsThe theoretical contribution is a framework explaining how BM practices and, hence, value can be interrelated in a public healthcare IT system.Research limitations/implicationsThe study shows the need for academic IT professionals to structure and facilitate value generation, especially in the form of creating an innovative and learning environment in the form of an action research based project.Practical implicationsThis study suggests which actors should be motivated and developed in order to ensure value in healthcare IT projects. Having value creation in mind, the model could have potentially broad applicability in a variety of healthcare IT settings.Social implicationsThe findings leads to better usage of public healthcare resources.Originality/valueThe present research studies real problems in a real setting, thus providing distinct ideas on how to improve public value creation by direct engagement of researchers.

scholarly journals Improving Primary Care Medication Processes by Using Shared Electronic Medication Plans in Switzerland: Lessons Learned From a Participatory Action Research Study

10.2196/22319 ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. e22319
Author(s):  
Benjamin Bugnon ◽  
Antoine Geissbuhler ◽  
Thomas Bischoff ◽  
Pascal Bonnabry ◽  
Christian von Plessen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Action Research ◽  
Health Care Professionals ◽  
Research Study ◽  
Medication Management ◽  
Lessons Learned ◽  
Successful Implementation ◽  
Medication Plan ◽  
Action Research Study

Background Several countries have launched health information technology (HIT) systems for shared electronic medication plans. These systems enable patients and health care professionals to use and manage a common list of current medications across sectors and settings. Shared electronic medication plans have great potential to improve medication management and patient safety, but their integration into complex medication-related processes has proven difficult, and there is little scientific evidence to guide their implementation. Objective The objective of this paper is to summarize lessons learned from primary care professionals involved in a pioneering pilot project in Switzerland for the systemwide implementation of shared electronic medication plans. We collected experiences, assessed the influences of the local context, and analyzed underlying mechanisms influencing the implementation. Methods In this formative action research study, we followed 5 clusters of health care professionals during 6 months. The clusters represented rural and urban primary care settings. A total of 18 health care professionals (primary care physicians, pharmacists, and nurses) used the pilot version of a shared electronic medication plan on a secure web platform, the precursor of Switzerland’s electronic patient record infrastructure. We undertook 3 group interviews with each of the 5 clusters, analyzed the content longitudinally and across clusters, and summarized it into lessons learned. Results Participants considered medication plan management, digitalized or not, a core element of good clinical practice. Requirements for the successful implementation of a shared electronic medication plan were the integration into and simplification of clinical routines. Participants underlined the importance of an enabling setting with designated reference professionals and regular high-quality interactions with patients. Such a setting should foster trusting relationships and nurture a culture of safety and data privacy. For participants, the HIT was a necessary but insufficient building block toward better interprofessional communication, especially in transitions. Despite oral and written information, the availability of shared electronic medication plans did not generate spontaneous demand from patients or foster more engagement in their medication management. The variable settings illustrated the diversity of medication management and the need for local adaptations. Conclusions The results of our study present a unique and comprehensive description of the sociotechnical challenges of implementing shared electronic medication plans in primary care. The shared ownership among multiple stakeholders is a core challenge for implementers. No single stakeholder can build and maintain a safe, usable HIT system with up-to-date medication information. Buy-in from all involved health care professionals is necessary for consistent medication reconciliation along the entire care pathway. Implementers must balance the need to change clinical processes to achieve improvements with the need to integrate the shared electronic medication plan into existing routines to facilitate adoption. The lack of patient involvement warrants further study.

scholarly journals Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanda Phelan ◽  
Daniela Rohde ◽  
Mary Casey ◽  
Gerard Fealy ◽  
Patrick Felle ◽  
...  
Keyword(s):  
Health Care ◽  
Action Research ◽  
Research Study ◽  
Action Research Study
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