scholarly journals Barriers and facilitators to learn and improve through morbidity and mortality conferences: a qualitative study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018833 ◽  
Author(s):  
Marit S de Vos ◽  
Jaap F Hamming ◽  
Perla J Marang-van de Mheen
Keyword(s):  
Qualitative Study ◽  
Physician Assistants ◽  
Barriers And Facilitators ◽  
Morbidity And Mortality ◽  
Negative Effects ◽  
Factors Affecting ◽  
Surgical Department ◽  
Morbidity And Mortality Conferences ◽  
Case Type ◽  
Organisational Factors

ObjectivesTo explore barriers and facilitators to successful morbidity and mortality conferences (M&M), driving learning and improvement.DesignThis is a qualitative study with semistructured interviews. Inductive, thematic content analysis was used to identify barriers and facilitators, which were structured across a pre-existing framework for change in healthcare.SettingDutch academic surgical department with a long tradition of M&M.ParticipantsAn interview sample of surgeons, residents and physician assistants (n=12).ResultsA total of 57 barriers and facilitators to successful M&M, covering 18 themes, varying from ‘case type’ to ‘leadership’, were perceived by surgical staff. While some factors related to M&M organisation, others concerned individual or social aspects. Eight factors, of which four were at the social level, had simultaneous positive and negative effects (eg, ‘hierarchy’ and ‘team spirit’). Mediating pathways for M&M success were found to relate to availableinformation, staffmotivationandrealisationprocesses.ConclusionsThis study provides leads for improvement of M&M practice, as well as for further research on key elements of successful M&M. Various factors were perceived to affect M&M success, of which many were individual and social rather than organisational factors, affecting information and realisation processes but also staff motivation. Based on these findings, practical recommendations were formulated to guide efforts towards best practices for M&M.

From the Frontlines: A Qualitative Study of Staff Experiences With Clinical Event Debriefing

2021 ◽  
Author(s):  
Meghan M. Galligan ◽  
Mary Haggerty ◽  
Heather A. Wolfe ◽  
Dawn Debrocco ◽  
Katherine Kellom ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Inductive Reasoning ◽  
Improve Patient Care ◽  
Barriers And Facilitators ◽  
Clinical Event ◽  
Frontline Staff ◽  
Factors Affecting ◽  
Participant Engagement ◽  
Practice Recommendations ◽  
Staff Experiences

OBJECTIVES Clinical event debriefing (CED) can improve patient care and outcomes, but little is known about CED across inpatient settings, and participant experiences have not been well described. In this qualitative study, we sought to characterize and compare staff experiences with CED in 2 hospital units, with a goal of generating recommendations for a hospital-wide debriefing program. METHODS We conducted 32 semistructured interviews with clinical staff who attended a CED in the previous week. We explored experiences with CED, with a focus on barriers and facilitators. We used content analysis with constant comparative coding to understand priorities identified by participants. We used inductive reasoning to develop a set of CED practice recommendations to match participant priorities. RESULTS Three primary themes emerged related to CED barriers and facilitators. (1) Factors affecting attendance: most respondents voiced a need for frontline staff inclusion in CED, but they also cited competing clinical duties and scheduling conflicts as barriers. (2) Factors affecting participant engagement: respondents described factors that influence participant engagement in reflective discussion. They described that the CED leader must cultivate a psychologically safe environment in which participants feel empowered to speak up, free from judgment. (3) Factors affecting learning and systems improvement: respondents emphasized that the CED group should generate a plan for improvement with accountable stakeholders. Collectively, these priorities propose several recommendations for CED practice, including frontline staff inclusion. CONCLUSIONS In this study, we propose recommendations for CED that are derived from first-hand participant experiences. Future study will explore implementation of CED practice recommendations.

scholarly journals How do doctors experience the interactions among professional fulfilment, organisational factors and quality of patient care? A qualitative study in a Norwegian hospital

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026971 ◽  
Author(s):  
Fredrik Baathe ◽  
Judith Rosta ◽  
Berit Bringedal ◽  
Karin Isaksson Rø
Keyword(s):  
Qualitative Study ◽  
Patient Care ◽  
Quality Care ◽  
Surgical Department ◽  
Individual Interviews ◽  
Quality Of Patient Care ◽  
Provide Quality Care ◽  
Workplace Values ◽  
Organisational Factors

ObjectivesDoctors increasingly experience high levels of burnout and loss of engagement. To address this, there is a need to better understand doctors’ work situation. This study explores how doctors experience the interactions among professional fulfilment, organisational factors and quality of patient care.DesignAn exploratory qualitative study design with semistructured individual interviews was chosen. Interviews were transcribed verbatim and analysed by a transdisciplinary research group.SettingThe study focused on a surgical department of a mid-sized hospital in Norway.ParticipantsSeven doctors were interviewed. A purposeful sampling was used with gender and seniority as selection criteria. Three senior doctors (two female, one male) and four in training (three male, one female) were interviewed.ResultsWe found that in order to provide quality care to the patients, individual doctors described ‘stretching themselves’, that is, handling the tensions between quantity and quality, to overcome organisational shortcomings. Experiencing a workplace emphasis on production numbers and budget concerns led to feelings of estrangement among the doctors. Participants reported a shift from serving as trustworthy, autonomous professionals to becoming production workers, where professional identity was threatened. They felt less aligned with workplace values, in addition to experiencing limited management recognition for quality of patient care. Management initiatives to include doctors in development of organisational policies, processes and systems were sparse.ConclusionThe interviewed doctors described their struggle to balance the inherent tension among professional fulfilment, organisational factors and quality of patient care in their everyday work. They communicated how ‘stretching themselves’, to overcome organisational shortcomings, is no longer a feasible strategy without compromising both professional fulfilment and quality of patient care. Managers need to ensure that doctors are involved when developing organisational policies, processes and systems. This is likely to be beneficial for both professional fulfilment and quality of patient care.

scholarly journals Organisational factors affecting performance in delivering influenza vaccination to staff in NHS Acute Hospital Trusts in England: A qualitative study

Vaccine ◽  
2020 ◽  
Vol 38 (15) ◽  
pp. 3079-3085 ◽  
Author(s):  
Sandra Mounier-Jack ◽  
Sadie Bell ◽  
Tracey Chantler ◽  
Angela Edwards ◽  
Jo Yarwood ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Influenza Vaccination ◽  
Acute Hospital ◽  
Factors Affecting ◽  
Organisational Factors ◽  
Factors Affecting Performance

Studying the Birth Outcome in Tikrit Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Areej Noaman
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Teaching Hospital ◽  
Birth Outcome ◽  
Morbidity And Mortality ◽  
Healthy Baby ◽  
Factors Affecting ◽  
Neonatal Deaths ◽  
Healthy Mother

  Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

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