scholarly journals What counts as a voiceable concern in decisions about speaking out in hospitals: A qualitative study

2022 ◽  
pp. 135581962110438
Author(s):  
Mary Dixon-Woods ◽  
Emma L Aveling ◽  
Anne Campbell ◽  
Akbar Ansari ◽  
Carolyn Tarrant ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Comparative Method ◽  
Structured Interviews ◽  
Cultural Contexts ◽  
Speaking Out ◽  
System Versus ◽  
Constant Comparative Method ◽  
Hierarchical Levels ◽  
Source Of Information

Objectives Those who work in health care organisations are a potentially valuable source of information about safety concerns, yet failures of voice are persistent. We propose the concept of ‘voiceable concern’ and offer an empirical exploration. Methods We conducted a qualitative study involving 165 semi-structured interviews with a range of staff (clinical, non-clinical and at different hierarchical levels) in three hospitals in two countries. Analysis was based on the constant comparative method. Results Our analysis shows that identifying what counts as a concern, and what counts as a occasion for voice by a given individual, is not a straightforward matter of applying objective criteria. It instead often involves discretionary judgement, exercised in highly specific organisational and cultural contexts. We identified four influences that shape whether incidents, events and patterns were classified as voiceable concerns: certainty that something is wrong and is an occasion for voice; system versus conduct concerns, forgivability and normalisation. Determining what counted as a voiceable concern is not a simple function of the features of the concern; also important is whether the person who noticed the concern felt it was voiceable by them. Conclusions Understanding how those who work in health care organisations come to recognise what counts as a voiceable concern is critical to understanding decisions and actions about speaking out. The concept of a voiceable concern may help to explain aspects of voice behaviour in organisations as well as informing interventions to improve voice.

A Qualitative Study of Teachers' Understanding of Sustainability

2015 ◽  
pp. 206-234 ◽  
Author(s):  
Hsiaowei Cristina Chang ◽  
Resa Marie Kelly ◽  
Ellen P. Metzger
Keyword(s):  
Qualitative Study ◽  
Real World ◽  
Comparative Method ◽  
Social Equity ◽  
Three Dimensions ◽  
Structured Interviews ◽  
Teachers Perceptions ◽  
The Social ◽  
Constant Comparative Method ◽  
Constant Comparative

This qualitative study was focused on exploring how in-service teachers' who were attending a three-day “Educating for Sustainability” workshop made sense of sustainability. Another goal of this study was to examine teachers' perceptions of the portrayal of the three dimensions of sustainability (environment, economy and social equity) in short movies that served as “real world” exemplars of sustainability that were freely available online through YouTube or other websites. Data was collected largely through individual semi-structured interviews, but also through questionnaires and written and drawn documentation. The findings, obtained through the constant-comparative method of coding, indicated that teachers' spontaneous descriptions of sustainability emphasized the environmental and economic dimensions of sustainability, but overlooked the equity dimension of sustainability. The videos helped teachers incorporate the 3E's into their sustainability discussions when all three dimensions were addressed, but when the social equity dimension was missing, then it tended to go unnoticed.

How Evacuees Obtained Health Care Information After the Great East Japan Earthquake: A Qualitative Interview Study

2017 ◽  
Vol 11 (6) ◽  
pp. 729-734
Author(s):  
Haruka Ota ◽  
Kikuko Miyazaki ◽  
Takeo Nakayama
Keyword(s):  
Health Care ◽  
Early Stage ◽  
Comparative Method ◽  
Great East Japan Earthquake ◽  
Health Care Information ◽  
Structured Interviews ◽  
Qualitative Interview Study ◽  
Constant Comparative Method ◽  
Care Information ◽  
Factors Of Influence

AbstractObjectiveTo explore how evacuees obtained health care information at their evacuation destinations after the Great East Japan Earthquake.MethodsWe conducted semi-structured interviews of 11 evacuees who moved to City A in Kyoto Prefecture following the Great East Japan Earthquake. The interviews explored how the evacuees obtained health care information, including the main factors of influence. The interviews were transcribed and analyzed to identify trends by using the constant comparative method.ResultsFour categories emerged from 6 concepts. Mother-children evacuees and family evacuees tended to obtain health care information in different ways. Family evacuees had moved as a family unit and had obtained their health care information from local neighbors. Mother-children evacuees were mothers who had moved with their children, leaving behind other family members. These evacuees tended to obtain information from other mother-children evacuees. At the time of evacuation, we found 2 factors, emotions and systems, influencing how mother-children evacuees obtained health care information.ConclusionsWe found 2 different ways of obtaining health care information among mother-children evacuees and other evacuees. At the time of evacuation, 2 factors, emotions and systems, influenced how mother-children evacuees obtained health care information. Community-building support should be a priority from an early stage after a disaster for health care management. (Disaster Med Public Health Preparedness. 2017;11:729–734)

Dual leadership in a hospital practice

2017 ◽  
Vol 30 (1) ◽  
pp. 101-112 ◽  
Author(s):  
Bettina Ravnborg Thude ◽  
Svend Erik Thomsen ◽  
Egon Stenager ◽  
Erik Hollnagel
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Design Methodology ◽  
Leadership Teams ◽  
Decision Processes ◽  
Power Balance ◽  
Structured Interviews ◽  
Hospital Practice ◽  
Content Type ◽  
Danish Hospital

Purpose Despite the practice of dual leadership in many organizations, there is relatively little research on the topic. Dual leadership means two leaders share the leadership task and are held jointly accountable for the results of the unit. To better understand how dual leadership works, this study aims to analyse three different dual leadership pairs at a Danish hospital. Furthermore, this study develops a tool to characterize dual leadership teams from each other. Design/methodology/approach This is a qualitative study using semi-structured interviews. Six leaders were interviewed to clarify how dual leadership works in a hospital context. All interviews were transcribed and coded. During coding, focus was on the nine principles found in the literature and another principle was found by looking at the themes that were generic for all six interviews. Findings Results indicate that power balance, personal relations and decision processes are important factors for creating efficient dual leaderships. The study develops a categorizing tool to use for further research or for organizations, to describe and analyse dual leaderships. Originality/value The study describes dual leadership in the hospital context and develops a categorizing tool for being able to distinguish dual leadership teams from each other. It is important to reveal if there are any indicators that can be used for optimising dual leadership teams in the health-care sector and in other organisations.

scholarly journals Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns

2018 ◽  
Vol 27 (9) ◽  
pp. 710-717 ◽  
Author(s):  
Graham P Martin ◽  
Emma-Louise Aveling ◽  
Anne Campbell ◽  
Carolyn Tarrant ◽  
Peter J Pronovost ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Comparative Method ◽  
Employee Voice ◽  
Senior Leaders ◽  
Speaking Up ◽  
Academic Hospitals ◽  
Wide Range ◽  
Constant Comparative Method ◽  
Organisational Intervention

BackgroundHealthcare organisations often fail to harvest and make use of the ‘soft intelligence’ about safety and quality concerns held by their own personnel. We aimed to examine the role of formal channels in encouraging or inhibiting employee voice about concerns.MethodsQualitative study involving personnel from three academic hospitals in two countries. Interviews were conducted with 165 participants from a wide range of occupational and professional backgrounds, including senior leaders and those from the sharp end of care. Data analysis was based on the constant comparative method.ResultsLeaders reported that they valued employee voice; they identified formal organisational channels as a key route for the expression of concerns by employees. Formal channels and processes were designed to ensure fairness, account for all available evidence and achieve appropriate resolution. When processed through these formal systems, concerns were destined to become evidenced, formal and tractable to organisational intervention. But the way these systems operated meant that some concerns were never voiced. Participants were anxious about having to process their suspicions and concerns into hard evidentiary facts, and they feared being drawn into official procedures designed to allocate consequence. Anxiety about evidence and process was particularly relevant when the intelligence was especially ‘soft’—feelings or intuitions that were difficult to resolve into a coherent, compelling reconstruction of an incident or concern. Efforts to make soft intelligence hard thus risked creating ‘forbidden knowledge’: dangerous to know or share.ConclusionsThe legal and bureaucratic considerations that govern formal channels for the voicing of concerns may, perversely, inhibit staff from speaking up. Leaders responsible for quality and safety should consider complementing formal mechanisms with alternative, informal opportunities for listening to concerns.

scholarly journals Care of Children With Disabilities in Rural Areas: Meanings and Impact on Everyday life and Health. Study Protocol

2020 ◽  
Vol 19 ◽  
pp. 160940692094760
Author(s):  
Pablo A. Cantero-Garlito ◽  
Juan Antonio Flores-Martos ◽  
Pedro Moruno-Miralles
Keyword(s):  
Rural Areas ◽  
Children With Disabilities ◽  
Daily Life ◽  
Comparative Method ◽  
Health Study ◽  
Structured Interviews ◽  
The Social ◽  
Maternal Caregiving ◽  
Constant Comparative Method ◽  
The Impact

The general objective of this study is to describe and analyze the meanings that participants gave to the experience related to maternal caregiving activities of children with disabilities in the rural context and their impact on daily life and health. In order to achieve this general objective, the following specific objectives were established: (1) To describe the meanings given to experiences related to caregiving activities of children with disabilities; (2) To analyze the impact on daily life and health that these mothers attribute to those activities; (3) To describe how they experience the support provided by the social and healthcare system in rural areas. An interpretative paradigm was selected, using a qualitative approach and a phenomenological design. Twelve mothers were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was performed using open, axial, and selective coding processes and the constant comparative method.

scholarly journals Psychological distress among Iranian health-care providers exposed to coronavirus disease 2019 (COVID-19): a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Azizeh Alizadeh ◽  
Hamid Reza Khankeh ◽  
Mohammad Barati ◽  
Yazdan Ahmadi ◽  
Arash Hadian ◽  
...  
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Psychological Distress ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Personal Support ◽  
Corona Virus ◽  
Organizational Demands

Abstract Background Novel corona virus, named COVID-19, has spread rapidly to other countries like Italy, Iran and South Korea and affected all people, especially health-care providers. Therefore, due to the rapid spread of the disease in Iran, the aim of the present study was to explore psychological distress experienced by Iranian health-care providers in the first few weeks of the corona virus outbreak. Methods The present qualitative study was conducted on 18 Iranian health-care providers exposed to COVID − 19 using a content analysis method. Purposeful sampling was used to select the participants and continued until data saturation was reached. Data were collected using semi-structured interviews and then the qualitative data were analyzed through direct content analysis. Results By analyzing 236 primary codes, two main categories were extracted from the experiences of health-care providers during corona virus outbreak. The first category included Occupational demands with three sub-categories: nature of illness, Organizational demands and social demands. The second category was Supportive resources included personal support and social support. Conclusions The results of this study found that there were some barriers and challenges to medical personnel exposed to COVID-19 that caused psychological distress. Some of these problems related to the nature of illness, others related to social and organizational demands and some of supportive resources buffer the relationship between occupational demands and psychological distress.

Communication, Respect, and Leadership: Interprofessional Collaboration in Hospitals of Rural Ontario

2014 ◽  
Vol 75 (4) ◽  
pp. 173-179 ◽  
Author(s):  
Diane Morris ◽  
June Matthews
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Comparative Method ◽  
Rural Hospitals ◽  
Interprofessional Practice ◽  
Interprofessional Teams ◽  
Northern Areas ◽  
Constant Comparative Method

Purpose: Health care professionals are expected to work collaboratively across diverse settings. In rural hospitals, these professionals face different challenges from their urban colleagues; however, little is known about interprofessional practice in these settings. Methods: Eleven health care professionals from 2 rural interprofessional teams were interviewed about collaborative practice. The data were analyzed using a constant comparative method. Results: Common themes included communication, respect, leadership, benefits of interprofessional teams, and the assets and challenges of working in small or rural hospitals. Differences between the cases were apparent in how the members conceptualized their teams, models of which were then compared with an “Ideal Interprofessional Team”. Conclusions: These results suggest that many experienced health care professionals function well in interprofessional teams; yet, they did not likely receive much education about interprofessional practice in their training. Providing interprofessional education to new practitioners may help them to establish this approach early in their careers and build on it with additional experience. Finally, these findings can be applied to address concerns that have arisen from other reports by exploring innovative ways to attract health professionals to communities in rural, remote, and northern areas, as there is a constant need for dietitians and other health care professionals in these practice settings.

scholarly journals A Grounded theory study of the intention of nurses to leave the profession

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Leyla Alilu ◽  
Vahid Zamanzadeh ◽  
Leila Valizadeh ◽  
Hosein Habibzadeh ◽  
Mark Gillespie
Keyword(s):  
Grounded Theory ◽  
Comparative Method ◽  
Intention To Leave ◽  
Self Control ◽  
Structured Interviews ◽  
Grounded Theory Method ◽  
Psychosocial Concerns ◽  
Constant Comparative Method ◽  
Bedside Nursing ◽  
Organizational Expectations

ABSTRACT Objective: this study explores the process of the development of an intention to leave bedside nursing. Method: the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results: according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion: the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them.

scholarly journals Cultural identity of bilingual adults : a case study

2021 ◽  
Author(s):  
◽  
Anastasiia Gorlova
Keyword(s):  
Cultural Identity ◽  
Comparative Method ◽  
The United States ◽  
Structured Interviews ◽  
Graduate Studies ◽  
Hybrid Identities ◽  
Language And Culture ◽  
Constant Comparative Method ◽  
Research Findings

This case study of the cultural identity of bilingual adults aims to discover the changes in the self-identification of sequential Russian-English bilingual adults that occur as a result of the immersion in the second language and culture. The study strives to answer the question of the change in self-identification of bilingual adults and the way they perceive those changes as well as the role that language plays in the transformation of identity. The participants of the study are Russian-born graduate students pursuing their graduate studies at the Universities in the United States. The data for this qualitative study were gathered through oral semi-structured interviews and samples of participants' writing and analyzed using the constant comparative method. The research findings show that the participants of the study are situated on a various levels of the construction of hybrid identities. Among the factors that influenced that transformation of identity, the most were the loss of network and connections and the differences between American and Russian cultures. Additionally, language as a factor in the change of self-identification affects the identity when individuals temporarily lose the ability to communicate and then learn new communication strategies that involve a system of both languages based on the principles of efficient communication.

scholarly journals Psychological Distress among Iranian Health-Care Providers Exposed to Coronavirus Disease 2019 (COVID-19): A Qualitative Study

2020 ◽  
Author(s):  
Azizeh Alizadeh ◽  
Hamid Reza Khankeh ◽  
Mohammad Barati ◽  
Yazdan Ahmadi ◽  
Arash Hadian ◽  
...  
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Psychological Distress ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Corona Virus ◽  
Data Saturation ◽  
Health Demands

Abstract Background Novel corona virus pneumonia, named COVID-19, has spread rapidly to other countries like Italy, Iran and South Korea and affected all people, especially health-care providers. Therefore, due to the rapid spread of the disease in Iran, the aim of the present study was to explore psychological distress experienced by Iranian health-care providers in the first few weeks of the corona virus outbreak. Methods The present qualitative study was conducted on 18 Iranian health-care providers exposed to COVID − 19 using a content analysis method. Purposeful sampling was used to select the participants and continued until data saturation was reached. Data were collected using semi-structured interviews and then the qualitative data were analyzed through direct content analysis. Results By analyzing 236 primary codes, three main categories, including demands, job resources and individual resources were extracted from the experiences of health-care providers during corona virus outbreak. These categories each included several sub-categories, which were classified according to their significant characteristics. Conclusions .Psychological protection of health care workers is an important component in addressing the COVID-19 epidemic. Understanding the health care providers’ experiences and their mental health demands during public health emergency might help medical workers and managers to response better to a disaster.

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