scholarly journals Challenges in making standardisation work in healthcare: lessons from a qualitative interview study of a line-labelling policy in a UK region

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031771
Author(s):  
Natasha Marie Kriznik ◽  
Guillaume Lamé ◽  
Mary Dixon-Woods
Keyword(s):  
Health System ◽  
Single Case ◽  
Qualitative Interviews ◽  
Frontline Staff ◽  
Cultural Challenges ◽  
Documentary Analysis ◽  
Qualitative Interview Study ◽  
Uk National Health Service ◽  
The Uk ◽  
The Right

ObjectiveTo identify and learn from efforts to design and implement a standardised policy for labelling of invasive tubing and lines across a regional health system.DesignSingle case study involving qualitative interviews and documentary analysis.SettingA devolved health system in the UK National Health Service (NHS).ParticipantsNHS staff (n=10) and policy-makers (n=8) who were involved in the design and/or implementation of the standardised policy.ResultsThough standardising labelling of invasive tubing and lines was initially seen as a common-sense technical change, challenges during the process of developing and implementing the policy were multiple and sociotechnical in nature. Major challenges related to defining the problem and the solution, limited sustained engagement with stakeholders and users, prototyping/piloting of the solution, and planning for implementation. Some frontline staff remained unconvinced of the need for or value of the policy, since they either did not believe that there was a problem or did not agree that standardised labelling was the right solution. Mundane practical issues such authorisation and resourcing, supply chains for labels, the need to restructure work practices to accommodate the new standard, and the physical features of the labels in specific clinical settings all had important impacts.ConclusionsNewly standardised tools and practices have to fit within a system of pre-existing norms, practices and procedures. We identified a number of practical, social and cultural challenges when designing and implementing a standardised policy in a regional healthcare system. Taking account of both sociocultural and technical aspects of standardisation, combined with systems thinking, could lead to more effective implementation and increase acceptability and usability of new standards.

scholarly journals Redrawing the border through the ‘Right to Rent’: Exclusion, discrimination and hostility in the English housing market

2020 ◽  
pp. 026101831989704 ◽  
Author(s):  
Kim Mckee ◽  
Sharon Leahy ◽  
Trudi Tokarczyk ◽  
Joe Crawford
Keyword(s):  
Racial Profiling ◽  
Qualitative Interviews ◽  
Criminal Prosecution ◽  
Undocumented Migrants ◽  
Hostile Environment ◽  
Home Office ◽  
Illegal Migrants ◽  
Guidance Documents ◽  
The Uk ◽  
The Right

The UK Immigration Act 2016 is central to the Conservative Government’s drive to create a more hostile environment for potential migrants and current ‘illegal’ migrants residing in the UK. The Right to Rent provisions of the Act, which require private landlords in England to conduct mandatory immigration document checks on prospective tenants, or face sizeable fines and criminal prosecution, have been highlighted as a key facet of the legislation. Drawing on qualitative interviews with key experts and analysis of Home Office guidance documents, we argue the Right to Rent has turned the private rental market into a border-check, with landlords responsibilised to perform ‘everyday bordering’ on behalf of the State. This creates a potentially discriminatory environment for all migrants, as well as for British citizens who lack documentation and/or may be subject to racial profiling. It may also be forcing vulnerable, undocumented migrants into even more precarious housing situations.

scholarly journals GP views on strategies to cope with increasing workload: a qualitative interview study

2017 ◽  
Vol 67 (655) ◽  
pp. e148-e156 ◽  
Author(s):  
Rebecca FR Fisher ◽  
Caroline HD Croxson ◽  
Helen F Ashdown ◽  
FD Richard Hobbs
Keyword(s):  
Primary Care ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Self Management ◽  
Telephone Triage ◽  
Workload Management ◽  
Qualitative Interview Study ◽  
Data Saturation ◽  
The Uk ◽  
Maximum Variation Sample

BackgroundThe existence of a crisis in primary care in the UK is in little doubt. GP morale and job satisfaction are low, and workload is increasing. In this challenging context, finding ways for GPs to manage that workload is imperative.AimTo explore what existing or potential strategies are described by GPs for dealing with their workload, and their views on the relative merits of each.Design and settingSemi-structured, qualitative interviews with GPs working within NHS England.MethodAll GPs working within NHS England were eligible. Of those who responded to advertisements, a maximum-variation sample was selected and interviewed until data saturation was reached. Data were analysed thematically.ResultsResponses were received from 171 GPs, and, from these, 34 were included in the study. Four main themes emerged for workload management: patient-level, GP-level, practice-level, and systems-level strategies. A need for patients to take greater responsibility for self-management was clear, but many felt that GPs should not be responsible for this education. Increased delegation of tasks was felt to be key to managing workload, with innovative use of allied healthcare professionals and extended roles for non-clinical staff suggested. Telephone triage was a commonly used tool for managing workload, although not all participants found this helpful.ConclusionThis in-depth qualitative study demonstrates an encouraging resilience among GPs. They are proactively trying to manage workload, often using innovative local strategies. GPs do not feel that they can do this alone, however, and called repeatedly for increased recruitment and more investment in primary care.

scholarly journals Peer influence as a driver of technological innovation in the UK National Health Service: a qualitative study of clinicians’ experiences and attitudes

2018 ◽  
Vol 4 (2) ◽  
pp. 68-74 ◽  
Author(s):  
Claire Greszczuk ◽  
Faraz Mughal ◽  
Rammya Mathew ◽  
Ahmed Rashid
Keyword(s):  
Peer Influence ◽  
Qualitative Interviews ◽  
Supporting Evidence ◽  
Leadership Roles ◽  
Front Line ◽  
Change Initiatives ◽  
Work Related ◽  
Healthcare Settings ◽  
Uk National Health Service ◽  
The Uk

BackgroundAccelerating innovation to improve quality is a key policy target for healthcare systems around the world. Effectively influencing individuals’ behaviour is crucial to the success of innovation initiatives. This study explores UK clinicians’ lived experiences of, and attitudes towards, clinical peers endorsing healthcare innovations.MethodsQualitative interviews with UK-based clinicians in one of two groups: (1) clinicians working in ‘front-line’ service provision and (2) clinicians in strategic leadership roles within health institutions. Participants were identified through purposive sampling, and participated in semistructured telephone interviews. Thematic analysis was used to identify and analyse themes in the data.Results17 participants were recruited: eight clinicians from front-line UK healthcare settings and nine clinicians in leadership roles. Two major themes were identified from the interviews: power and trust. Participants recognised and valued peers’ powerful influence, exerted in person via social networks and routine work-related activities. Peers were implicitly trusted, although often on condition of their credibility and deservingness of respect, supporting evidence and absence of conflict of interest. While the groups shared similar views, they diverged on the subject of institutions, felt to be powerful by strategic leaders yet scarcely mentioned by front-line clinicians.ConclusionsUK clinicians view peers as a powerful and trustworthy source to promote innovative technologies. Policies that aim to support this process should seek to control the wider conditions that nurture peer-to-peer influence. Further research into interpersonal influence in health settings may improve implementation of change initiatives.

scholarly journals Being an ‘older parent’: Chrononormativity and practices of stage of life categorisation

2019 ◽  
Vol 39 (4) ◽  
pp. 465-487 ◽  
Author(s):  
Virpi Ylänne ◽  
Pirjo Nikander
Keyword(s):  
Social Identity ◽  
Qualitative Interviews ◽  
Heterosexual Couples ◽  
Discursive Practices ◽  
Older Parents ◽  
Temporal Aspects ◽  
The Uk ◽  
The Right ◽  
First Time ◽  
Age Category

Abstract This article investigates the discursive practices of older first-time parents in interview interaction. Our focus is on the ways in which cultural notions surrounding the timing of parenthood are mobilised, and how speakers orient to potential discrepancies between the category ‘parent’ and their own stage of life (SOL) or age category. The data corpus comprises qualitative interviews with 15 heterosexual couples and individuals in the UK who became parents between the ages of 35–57 years. Examining reproductive biographical talk at midlife at a time when the average age of first time parents is rising and delayed parenting is increasing across Western countries provides a testing ground for the analysis of norms concerning the ‘right time’ of lifetime transitions, and age-appropriateness more generally. Inspired by Elizabeth Freeman’s notion of ‘chrononormativity’, our analysis demonstrates that ‘older parents’ engage in considerable discursive work to bridge temporal aspects of their parenthood. Moreover, we show how the notion of chrononormativity can be theoretically and empirically elaborated through the adoption of membership categorisation and discourse analysis. In explicating how taken-for-granted, temporal notions of lifespan events are mobilised, our findings contribute to research on age-in-interaction, social identity and categorisation, and on the methodology for analysing the discursive age-order and chrononormativity more broadly.

The British paid labour market1

2019 ◽  
pp. 45-62
Author(s):  
Eva A. Duda-Mikulin
Keyword(s):  
Labour Force ◽  
Qualitative Interviews ◽  
Real Life ◽  
Foreign Born ◽  
Women Migrants ◽  
Economic Migration ◽  
Customer Services ◽  
The Uk ◽  
The Right ◽  
The Eu

Chapter three explores the British paid labour market and more specifically economic migration to the UK and its impact with the message that migrants contribute through taxation and alleviating labour and skills shortages. I discuss existing statistical data on UK’s labour force and its characteristics. This quantitative data is complemented with rich qualitative accounts from recent Polish women migrants to the UK. Different sectors of the economy are explored, in particular agriculture, hospitality, customer services and healthcare. These are said to be most reliant on workforce from the EU. Data on population characteristics is analysed taking into account the fact that it is ageing rapidly as is the rest of Europe. This increases the need for foreign-born labour to take on jobs unpopular with British workers, particularly when the EU labour force is younger and fitter in comparison to UK-born workers. This also suggests that after Brexit the UK is likely to experience issues with staff recruitment and labour shortages in certain areas of the economy. The chapter is supported by extracts from qualitative interviews with women migrants from Poland with the aim to bring in real-life stories from those who took advantage of the right to free movement.

scholarly journals Sense of Belonging, Intercultural and Academic Experiences among International Students at a University in Northern Ireland

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Elida Cena ◽  
Stephanie Burns ◽  
Paul Wilson
Keyword(s):  
International Students ◽  
Northern Ireland ◽  
Social Relations ◽  
International Student ◽  
Learning Experience ◽  
Qualitative Interviews ◽  
Cultural Barriers ◽  
Academic Challenges ◽  
Cultural Challenges ◽  
The Uk

Higher education institutions have a strong interest in attracting international students, however, there is little research on international students' experience while studying in the UK and how this relates to their adjustment and belonging. This research was conducted with 16 international students at a HE institution in Northern Ireland, using qualitative interviews to examine academic and socio-cultural challenges they experience while studying and living in a country different from their own. Findings suggest that the academic challenges posed by a different educational system, issues affecting social relations within the campus, and living in a homogenous society can have an impact on the international student experience. Adjustment challenges were primarily attributable to language and cultural barriers. These findings highlight that it is vital for institutions to better understand students’ needs and tailor their services to enhance international students’ learning experience. 

scholarly journals Improving Music Streaming Services Through Metadata: Case Study from JOOX Indonesia

2021 ◽  
Vol 7 (1) ◽  
pp. 125-133
Author(s):  
Muhammad Usman Noor ◽  
Wihdah Askariyyah
Keyword(s):  
Single Case ◽  
Qualitative Interviews ◽  
Access Point ◽  
Digital Music ◽  
Metadata Standard ◽  
Documentary Analysis ◽  
Streaming Services ◽  
Music File ◽  
Music Streaming

Background of this Study: This article examines how digital music handled on music streaming services, JOOX Indonesia in particular. Purposes: The aims was to bring insight that metadata management skill could help an enhancement over music streaming services through metadata and to improve the user experience when using music streaming services.  Method:A single case study is chosen as the research method for this paper. The researcher did three months internship to see how the music file handled on the back end of JOOX. Semi-structured qualitative interviews and documentary analysis were used to collect and triangulate the qualitative data. Findings: The result shows JOOX using its operational self-possession procedures to handle its digital music file and using its own metadata standard with adaptation from music metadata standard. JOOX has a feature that utilizes music lyric. We found that lyric metadata embedded as a distinct entity on their backend system. Since lyric frequently used by the user as an access point when they do the retrieval, we propose to embed lyric as a field on music metadata to improve search result. Conclusion: These research shows are lyric as the essential part when users enjoy the music in music streaming services. By embed lyric on music metadata, lyric could be able as an access point for retrieval. Moreover, lyric as metadata could be part of music digital file handling.

scholarly journals Knowledge mobilisation: an exploratory qualitative interview study to confirm and envision modification of lay and practitioner eczema mindlines to improve consultation experiences and self-management in primary care in the UK

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028225 ◽  
Author(s):  
Fiona Cowdell
Keyword(s):  
Primary Care ◽  
Qualitative Interviews ◽  
Virtual Space ◽  
Self Management ◽  
Core Content ◽  
Qualitative Interview Study ◽  
Primary Care Practitioners ◽  
The Uk ◽  
Consistent Information ◽  
Constant Comparative Analysis

ObjectivesTo investigate whether initial eczema mindlines, ‘collectively reinforced, internalised, tacit guidelines’, are an accurate representation of the experiences of lay people and practitioners in primary care and to explore how these mindlines may best be revised to improve eczema care.DesignExploratory qualitative interviews with constant comparative analysis and data mining.SettingUK, primary care.ParticipantsPeople with eczema or parents of children with eczema (n=19) and primary care practitioners (n=13).ResultsInterview data were analysed using constant comparison of new data with existing initial eczema mindlines to identify areas of agreement and disagreement. Data were mined for participant’s thoughts aboutwhosemindlines should be modified,howthis may be achieved andwhatcore content is essential. Eczema mindlines and the spiral of knowledge creation, from which they evolved, intuitively made sense. Participants offered examples of how their eczema knowledge is continually produced and transformed as they interact with others. They reported diverse and wide-ranging influences on their thinking and recognised the critical relationship between lay and practitioner mindlines. For this reason they advocated modifying lay and practitioner mindlines in parallel. Participants advised amendment based on consistent information directed to all who influence eczema care. Information should come from trusted sources and be easy to access, distilled, practical, contextually relevant and amenable to assimilation.ConclusionsThe purpose here is to improve primary care consultation experiences and self-management in eczema. The remaining challenge is to find novel, simple and pragmatic methods of modifying eczema mindlines to instil shared and consistent understanding. Given the prevalence of eczema and the scope of people who influence self-care, interventions should transcend patient-practitioner boundaries and address the wider community. One conceptually congruent approach is to create aBa, which in this case would be a virtual space for generating and sharing eczema knowledge.

scholarly journals Process of implementing and delivering the Prevention of Delirium system of care: a mixed method preliminary study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Mary Godfrey ◽  
John Green ◽  
Jane Smith ◽  
Francine Cheater ◽  
Sharon K. Inouye ◽  
...  
Keyword(s):  
Qualitative Interviews ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Training Programme ◽  
System Of Care ◽  
Comparative Case Study ◽  
Delirium Prevention ◽  
Uk National Health Service ◽  
The Uk ◽  
Hospital Wards

Abstract Background Delirium is a frequent complication of hospital admission among older people. Multicomponent interventions which can reduce incident delirium by ≈one-third are recommended by the National Institute of Health and Care Excellence. Currently, a standardised delirium prevention system of care suitable for adoption in the UK National Health Service does not exist. The Prevention of Delirium (POD) system of care is a theory informed, multicomponent intervention and systematic implementation process which includes a role for hospital volunteers. We report POD implementation and delivery processes in NHS hospital wards, as part of a feasibility study. Methods A comparative case study design and participatory, multi-method evaluation was performed with sequential six month preparatory and six month delivery stages. Six wards in five hospitals in Northern England were recruited. Methods included: facilitated workshops; observation of POD preparatory activities; qualitative interviews with staff; collection of ward organisational and patient profiles; and structured observation of staff workload. Results POD implementation and delivery was fully accomplished in four wards. On these wards, implementation strategies informed by Normalization Process Theory operated synergistically and cumulatively. An interactive staff training programme on delirium and practices that might prevent it among those at risk, facilitated purposeful POD engagement. Observation of practice juxtaposed to action on delirium preventive interventions created tension for change, legitimating new ways of organising work around it. Establishing systems, processes and documentation to make POD workable in the ward setting, enhanced staff ownership. ‘Negotiated experimentation’ to involve staff in creating, appraising and modifying systems and practices, helped integrate the POD care system in ward routines. Activating these change mechanisms required a particular form of leadership: pro-active ‘steer’, and senior ward ‘facilitator’ to extend ‘reach’ to the staff group. Organisational discontinuity (i.e. ward re-location and re-modelling) disrupted and extended POD implementation; staff shortages adversely affected staff capacity to invest in POD. Findings resulted in the development of ‘site readiness’ criteria without which implementation of this complex intervention was unlikely to occur. Conclusions POD implementation and delivery is feasible in NHS wards, but a necessary context for success is ‘site readiness.’

scholarly journals Societal Sentience

2017 ◽  
Vol 43 (4) ◽  
pp. 671-693 ◽  
Author(s):  
Pru Hobson-West ◽  
Ashley Davies
Keyword(s):  
Drug Testing ◽  
Qualitative Interviews ◽  
Research Field ◽  
Animal Research ◽  
Ethical Concerns ◽  
Legal Documents ◽  
Commercial Laboratory ◽  
Documentary Analysis ◽  
Veterinary Surgeons ◽  
The Uk

The use of nonhuman animals as models in research and drug testing is a key route through which contemporary scientific knowledge is certified. Given ethical concerns, regulation of animal research promotes the use of less “sentient” animals. This paper draws on a documentary analysis of legal documents and qualitative interviews with Named Veterinary Surgeons and others at a commercial laboratory in the UK. Its key claim is that the concept of animal sentience is entangled with a particular imaginary of how the general public or wider society views animals. We call this imaginary societal sentience. Against a backdrop of increasing ethnographic work on care encounters in the laboratory, this concept helps to stress the wider context within which such encounters take place. We conclude that societal sentience has potential purchase beyond the animal research field, in helping to highlight the affective dimension of public imaginaries and their ethical consequences. Researching and critiquing societal sentience, we argue, may ultimately have more impact on the fate of humans and nonhumans in the laboratory than focusing wholly on ethics as situated practice.

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