Forum Play as a method for learning ethical practice: A qualitative study among Swedish health-care staff

2015 ◽  
Vol 11 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Anke Zbikowski ◽  
Kristin Zeiler ◽  
Katarina Swahnberg
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Care Staff ◽  
Health Care Staff ◽  
Ethical Practice ◽  
Swedish Health Care

Moving Past the Loss: A Longitudinal Qualitative Study of Health Care Staff Experiences of Disinvestment

2020 ◽  
pp. 107755872097258
Author(s):  
Deb Mitchell ◽  
Lisa O’Brien ◽  
Anne Bardoel ◽  
Terry Haines
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Services ◽  
Management Strategies ◽  
Care Staff ◽  
Health Care Staff ◽  
Modifying Factors ◽  
Big Picture ◽  
Staff Experiences ◽  
The Impact

This longitudinal qualitative study examines staff experience of disinvestment from a service they are accustomed to providing to their patients. It took place alongside a disinvestment trial that measured the impact of the removal of weekend allied health services from acute wards at two hospitals. Data were gathered from repeated interviews and focus groups with 450 health care staff. We developed a grounded theory, which explains changes in staff perceptions over time and the key modifying factors. Staff appeared to experience disinvestment as loss; a key difference to other operational changes. Early staff experiences of disinvestment were primarily negative, but evolved with time and change-management strategies such as the provision of data, clear and persistent communication approaches, and forums where the big picture context of the disinvestment was robustly discussed. These allowed the disinvestment trial to be successfully implemented at two health services, with high compliance with the research protocol.

scholarly journals Barriers to reporting clinical errors in operating theatres and intensive care units of a university hospital: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sedighe Ghobadian ◽  
Mansour Zahiri ◽  
Behnaz Dindamal ◽  
Hossein Dargahi ◽  
Farzad Faraji-Khiavi
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Qualitative Study ◽  
Qualitative Content Analysis ◽  
Operating Theatre ◽  
University Hospital ◽  
Care Staff ◽  
Health Care Staff ◽  
Organizational Problems

Abstract Background Clinical errors are one of the challenges of health care in different countries, and obtaining accurate statistics regarding clinical errors in most countries is a difficult process which varies from one study to another. The current study was conducted to identify barriers to reporting clinical errors in the operating theatre and the intensive care unit of a university hospital. Methods This qualitative study was conducted in the operating theatre and intensive care unit of a university hospital. Data collection was conducted through semi-structured interviews with health care staff, senior doctors, and surgical assistants. Data analysis was carried out through listening to the recorded interviews and developing transcripts of the interviews. Meaning units were identified and codified based on the type of discussion. Then, codes which had a common concept were grouped under one category. Finally, the codes and designated categories were analysed, discussed and confirmed by a panel of four experts of qualitative content analysis, and the main existing problems were identified and derived. Results Barriers to reporting clinical errors were extracted in two themes: individual problems and organizational problems. Individual problems included 4 categories and 12 codes and organizational problems included 6 categories and 17 codes. The results showed that in the majority of cases, nurses expressed their desire to change the current prevailing attitudes in the workplace while doctors expected the officials to implement reform policies regarding clinical errors in university hospitals. Conclusion In order to alleviate the barriers to reporting clinical errors, both individual and organizational problems should be addressed and resolved. At an individual level, training nursing and medical teams on error recognition is recommended. In order to solve organizational problems, on the other hand, the process of reporting clinical errors should be improved as far as the nursing team is concerned, but when it comes to the medical team, addressing legal loopholes should be given full consideration.

Open the Black Box: Paradoxes and Lacunas in Swedish Health Care Reforms

1995 ◽  
Vol 25 (2) ◽  
pp. 243-258 ◽  
Author(s):  
Rolf Å. Gustafsson
Keyword(s):  
Health Care ◽  
Public Administration ◽  
Labor Process ◽  
Care Staff ◽  
Health Care Staff ◽  
Strategic Choices ◽  
Health Care Reforms ◽  
Swedish Health Care ◽  
Process Perspective ◽  
The Welfare State

The idea of using contracting-out as a means for improving public administration dates back to the 1850s, but was then found to be infeasible. The same idea has now become a major building-block in Sweden's health care reforms. Driven by a productivity-focused political discourse and the premises of neoclassical economics, these reforms ignore motivational structures among health care staff. The result may be a delegitimizing of the welfare state from within—either through the extinction of care rationality and its replacement by wage rationality, or, at worst, through the spread of a commercial spirit among health care staff and/or staff frustration at the unavoidable downward adjustments in remuneration rates. The author points to three strategic choices that arise when insights from a labor-process perspective are taken into consideration.

scholarly journals Managing risk during care transitions when approaching end of life: A qualitative study of patients’ and health care professionals’ decision making

2016 ◽  
Vol 31 (7) ◽  
pp. 617-624 ◽  
Author(s):  
Maureen A Coombs ◽  
Roses Parker ◽  
Kay de Vries
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
End Of Life ◽  
Care Transitions ◽  
Care Staff ◽  
Health Care Staff ◽  
Field Observations ◽  
Transitions In Care ◽  
Managing Risk

Background: Increasing importance is being placed on the coordination of services at the end of life. Aim: To describe decision-making processes that influence transitions in care when approaching the end of life. Design: Qualitative study using field observations and longitudinal semi-structured interviews. Setting/participants: Field observations were undertaken in three sites: a residential care home, a medical assessment unit and a general medical unit in New Zealand. The Supportive and Palliative Care Indicators Tool was used to identify participants with advanced and progressive illness. Patients and family members were interviewed on recruitment and 3–4 months later. Four weeks of fieldwork were conducted in each site. A total of 40 interviews were conducted: 29 initial interviews and 11 follow-up interviews. Thematic analysis was undertaken. Findings: Managing risk was an important factor that influenced transitions in care. Patients and health care staff held different perspectives on how such risks were managed. At home, patients tolerated increasing risk and used specific support measures to manage often escalating health and social problems. In contrast, decisions about discharge in hospital were driven by hospital staff who were risk-adverse. Availability of community and carer services supported risk management while a perceived need for early discharge decision making in hospital and making ‘safe’ discharge options informed hospital discharge decisions. Conclusion: While managing risk is an important factor during care transitions, patients should be able to make choices on how to live with risk at the end of life. This requires reconsideration of transitional care and current discharge planning processes at the end of life.

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