scholarly journals Implementation of a standard outcome set in perinatal care: a qualitative analysis of barriers and facilitators from all stakeholder perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne L. Depla ◽  
Neeltje M. Crombag ◽  
Arie Franx ◽  
Mireille N. Bekker
Keyword(s):  
Thematic Analysis ◽  
Perinatal Care ◽  
Barriers And Facilitators ◽  
Care Practice ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Policy Makers ◽  
Stakeholder Perspectives ◽  
Outcome Set ◽  
Patient Reported

Abstract Background To improve their quality, healthcare systems are increasingly focused on value delivered to patients. For perinatal care, the International Consortium for Health Outcomes Measurement (ICHOM) proposed a patient-centred outcome set with both clinical and patient-reported measures for pregnancy and childbirth (PCB set). This study aimed to identify factors that affect the implementation of the PCB set at the pre-implementation stage, using the consolidated framework for implementation research (CFIR). Methods In this qualitative study, we conducted semi-structured interviews amongst a purposive sample of key stakeholders within an obstetric care network (OCN): 1) patients, 2) perinatal care professionals involved in the full cycle of perinatal care, and 3) policy makers, including hospital managers, administrative staff and health care insurers. While the CFIR guided data capture and structuring, thematic analysis revealed overarching themes that best reflected the barriers and facilitators from different stakeholder perspectives. Within these overarching themes, the CFIR constructs were maintained. Results Interviews were conducted with 6 patients, 16 professionals and 5 policy makers. Thematic analysis supported by the CFIR framework identified four main themes: the instrument and its implementation process, use in individual patient care, use in quality improvement, and the context of the OCN. Important barriers included professional workload, data reliability, and interprofessional and interorganizational collaboration. Potential facilitators were the PCB set’s direct value in individual care, interprofessional feedback and education, and aligning with existing systems. Prominent variations between stakeholder groups included the expected patient burden, the level of use, transparency of outcomes and the degree of integrated care. Conclusions This study clarified critical factors that affect successful implementation of the PCB set in perinatal care. Practice recommendations, suggested at multiple levels, can enable structural patient-centred care improvement and may unite stakeholders towards integrated birth care.

scholarly journals Investigating the barriers and facilitators to implementing mental health first aid in the workplace: a qualitative study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Melanie Jay Narayanasamy ◽  
Louise Thomson ◽  
Carol Coole ◽  
Fiona Nouri ◽  
Avril Drummond
Keyword(s):  
Mental Health ◽  
Good Practice ◽  
First Aid ◽  
Barriers And Facilitators ◽  
Successful Implementation ◽  
Mental Health First Aid ◽  
Structured Interviews ◽  
Content Type ◽  
Factors Affecting ◽  
Employee Characteristics

Purpose There has been little research into the use and efficacy of Mental Health First Aid (MHFA) across UK workplaces. This paper aims to investigate the implementation of MHFA across six UK organisations, identifying key barriers and facilitators. Design/methodology/approach Twenty-seven workplace representatives were recruited from six organisations through purposive sampling and took part in semi-structured interviews exploring their experiences of workplace MHFA. The data underwent thematic analysis, identifying key themes around implementation. Findings Implementation varied across organisations, including different reasons for initial interest in the programme, and variable ways that MHFA-trained employees operated post-training. Key barriers to successful implementation included negative attitudes around mental health, the perception that MHFA roles were onerous, and employees’ reluctance to engage in the MHFA programme. Successful implementation was perceived to be based on individual qualities of MHFA instructors and good practice demonstrated by trained individuals in the workplace. The role of the inner organisational setting and employee characteristics were further highlighted as barriers and facilitators to effective implementation. Research limitations/implications MHFA is a complex intervention, presenting in different ways when implemented into complex workplace settings. As such, traditional evaluation methods may not be appropriate for gaining insights into its effectiveness. Future evaluations of workplace MHFA must consider the complexity of implementing and operationalising this intervention in the workplace. Originality/value This study is the first to highlight the factors affecting successful implementation of MHFA across a range of UK workplaces.

Challenges of Green Office Implementation: A Case Study in Penang, Malaysia

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ong Yee Sin ◽  
◽  
Nor'Aini Yusof ◽  
Atasya Osmadi ◽  
◽  
...  
Keyword(s):  
State Government ◽  
Thematic Analysis ◽  
Green Building ◽  
Green Buildings ◽  
Office Buildings ◽  
Structured Interviews ◽  
Policy Makers ◽  
Green Practices

This study was conducted in response to the lack of green office buildings in Malaysia, despite the fact that the green concept has been initiated in Malaysia for many years. The Penang State Government has taken the initiative to establish the Penang Green Council (PGC) as the first state in Malaysia, and the implementation of green offices is one of its programme initiatives. Nonetheless, green offices are still in scarcity across Penang. This study identified the challenges faced in implementing green offices. Data were collected from five green building owners using semi-structured interviews and the data were analysed using thematic analysis. The outcomes revealed that the main challenges faced by green office adoption were lack of budget, lack of awareness, lack of expertise, ownership factor, and type of building. This study offers several implications for practitioners and policy makers to improve the adoption of green office in Malaysia. The results may be applied to raise awareness amongst practitioners and office owners regarding green practices in office buildings. The study outcomes may serve as reference to policy makers on enhancing the development of green buildings.

A closer look at opportunities for blind adults: Impacts of stigmatization and ocularcentrism

2020 ◽  
Vol 38 (3) ◽  
pp. 270-283
Author(s):  
Laura Yvonne Bulk ◽  
Andrea Smith ◽  
Laura Nimmon ◽  
Tal Jarus
Keyword(s):  
Visual Acuity ◽  
Social Isolation ◽  
Thematic Analysis ◽  
Blind People ◽  
Structured Interviews ◽  
Policy Makers ◽  
Initial Analysis ◽  
Effective Interventions ◽  
The Common

Blind Canadians experience higher rates of unemployment, social isolation, and poverty than sighted Canadians. Examining what influences opportunities can help to identify the factors that disable blind people. During initial analysis, stigma and ocularcentrism emerged as important factors. Thus, this article examines how stigma operates culturally, socially, politically, and economically to shape opportunities among blind adults. Data were collected through in-depth, semi-structured interviews with six legally blind participants (visual acuity of 20/200 or below), aged 19–65 years. Thematic analysis was employed to understand the common and diverging narratives of participants. Within participant narratives, ocularcentrism is found to contribute to stigmatization at societal, interpersonal, and internalized levels. Opportunities are experienced within this context, and the stigmatization experienced both shaped and was shaped by participation in activities. It is imperative that a closer look is given to how stigma shapes the opportunities for blind people, so that individuals, teachers, practitioners, and policy makers can develop relevant and effective interventions and can challenge stigmatization.

scholarly journals Challenges faced by Malaysian private HLIs in providing quality education: a thematic analysis

2018 ◽  
Vol 26 (3) ◽  
pp. 349-373 ◽  
Author(s):  
Azilah Anis ◽  
Rafikul Islam ◽  
Nur Anisah Abdullah
Keyword(s):  
Thematic Analysis ◽  
Quality Education ◽  
Regulatory Agencies ◽  
Structured Interviews ◽  
Term Survival ◽  
Policy Makers ◽  
Content Type ◽  
The Public ◽  
Prospective Employer ◽  
Learning Institutions

Purpose The paper aims to identify the emerging themes on the challenges faced by the Malaysian private higher learning institutions (HLIs) in the provision of providing quality education. Design/methodology/approach Semi-structured interviews were purposively conducted with 29 of the Malaysian private HLI internal and external stakeholders ranging from the relevant personnel of the institutions (the quality director, administrators and senior academics), regulatory agencies, prospective employer, students and parents. Thematic analysis was then applied to analyze the participants’ responses in determining and clarifying the challenges faced by the Malaysian private HLIs in the issue of providing quality education. Findings Eight overarching themes were identified, namely, Academics, Facilities, Students, Programs and curriculum, Competition, Accreditation, Finance and Research. Academics represent the most frequent challenge raised by the participants, whereas Research emerged as the least mentioned challenge during the interview sessions. Research limitations/implications The present paper focused solely on Malaysian private HLIs, and thus, the findings may not be applicable to the foreign private HLIs that are operating in Malaysia as well as to the public HLIs. Originality/value The findings are expected to provide valuable guidelines to the Malaysian Private HLIs in areas where resources need to be critically disbursed. To the regulatory agencies and policy-makers, the findings could enlighten them on the difficulties faced by these privately funded institutions so that further policies can be designed and implemented to assist these institutions in their operations and long-term survival.

scholarly journals It’s Just Steam: a qualitative analysis of New Zealand ENDS users’ perceptions of secondhand aerosol

2020 ◽  
Vol 30 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Kerri Haggart ◽  
Lindsay Robertson ◽  
Mei-Ling Blank ◽  
Lucy Popova ◽  
Janet Hoek
Keyword(s):  
New Zealand ◽  
Qualitative Analysis ◽  
Thematic Analysis ◽  
Secondhand Smoke ◽  
Structured Interviews ◽  
Policy Makers ◽  
Sensory Experiences ◽  
Clean Air ◽  
Former Smokers ◽  
Free Area

IntroductionMany smokers who begin using electronic nicotine delivery systems (ENDS) report vaping in settings where they would not have smoked and believe secondhand aerosol (SHA) is simply steam. However, current understanding of how ENDS users differentiate between secondhand smoke and SHA, or how vaping norms develop, is limited.MethodsWe conducted in-depth, semi-structured interviews with 39 current ENDS users (dual users and former smokers, now exclusive ENDS users) from New Zealand to explore participants’ perceptions of SHA. We probed how these perceptions arose and examined implications for vaping practices and policy. We managed the data using NVivo V.11 and used a thematic analysis approach to interpret the transcripts.ResultsParticipants had limited understanding of SHA, its constituents or its possible effects on others. They drew on the absence of harm information, and their sensory experiences and perceptions of others’ views of vaping, to support the conclusion that SHA posed few, if any, risks to bystanders. Yet despite this perception, some felt they should recognise others’ rights to clean air and most would not vape around children to avoid setting an example.ConclusionsIn the absence of trusted information, participants used sensory heuristics to rationalise their ENDS practices. Policy-makers face the challenge of correcting misperceptions about SHA without deterring full transition from smoking to ENDS use. They could consider including vaping in current smoke-free area policies; this measure would signal that SHA is not harmless, and could protect clean-air settings and reduce potential normalisation of vaping among non-smokers.

scholarly journals Barriers and Facilitators to Advance Care Panning Among Veterans Aging With HIV

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 424-424
Author(s):  
Sean Halpin ◽  
Vincent Marconi ◽  
Amy Justice ◽  
Theodore Johnson ◽  
D Keith McInnes ◽  
...  
Keyword(s):  
Cohort Study ◽  
Thematic Analysis ◽  
Social Ties ◽  
Medical Center ◽  
Barriers And Facilitators ◽  
Care Planning ◽  
Structured Interviews ◽  
Healthcare Experiences ◽  
Advance Care ◽  
Living With Hiv

Abstract Advance care planning (ACP) and hospice services are underutilized by patients living with HIV (PWH). Little is known about how older PWH approach ACP; the purpose of this qualitative study was to understand barriers and facilitators to ACP within the context of the patient-clinician relationship. Data are from a larger multimethod study designed to understand social determinants of health (SDH) that shape the lives and healthcare experiences of veterans aging with HIV. The sample includes 25 veterans from the Veterans Aging Cohort Study (VACS) recruited from an urban VA medical center. Semi-structured interviews were performed and analyzed using thematic analysis. Less than half of participants reported engaging in ACP. Key barriers to ACP include: fragile social ties, distrust of the healthcare system, and fear of disclosure and discrimination. We offer several recommendations for clinicians to engage in these conversations successfully and highlight the importance of considering SDH when designing interventions.

scholarly journals Patient-reported outcome measures in oncology: a qualitative study of the healthcare professional’s perspective

2021 ◽  
Author(s):  
Caitlin Graupner ◽  
S. O. Breukink ◽  
S. Mul ◽  
D. Claessens ◽  
A. H. M. Slok ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Barriers And Facilitators ◽  
Local Context ◽  
Healthcare Organisation ◽  
Successful Implementation ◽  
Oncological Care ◽  
Patient Reported

Abstract Background In the last decades, the number of cancer survivors has increased significantly due to improved treatment and better detection of recurrence. This increased survival redirects the scope from survival towards optimising functional outcomes and improving health-related quality of life (HRQol). Functional and HRQoL outcomes can be assessed with patient-reported outcome measures (PROMs). However, the use of PROMs in daily oncological care is not common. This qualitative study investigates the barriers and facilitators of PROM use in an oncological setting, from the perspective of the healthcare professionals (HCPs). Methods Individual semi-structured interviews were conducted among Dutch oncological HCPs. Barriers and facilitators of PROM implementation were identified on various levels of the healthcare system (i.e. level of the patient, individual professional, medical team, and healthcare organisation). Interviews were audio recorded and transcribed verbatim. Transcripts were manually analysed by two independent reviewers using a thematic approach. Identified barriers and facilitators were categorised into Grol and Wensing’s framework for changing healthcare practice. Results Nineteen oncological HCPs working in academic and non-academic hospitals were interviewed. Barriers for PROM implementation were lack of good IT support, lack of knowledge on how to use PROMs, lack of time to complete and interpret PROMs, and a high administrative burden. PROM implementation can be facilitated by providing clear guidance regarding PROM interpretation, evidence that PROMs can save time, and stimulating multidisciplinary teamwork. Conclusion From a HCP point of view, adequately functioning IT technology, sufficient knowledge on PROMs, and dedicated time during the consultation are essential for successful implementation of PROMs in oncological care. Additional local context-specific factors need to be thoroughly addressed.

scholarly journals Telephone outreach by community workers to improve uptake of NHS Health Checks in more deprived localities and minority ethnic groups: a qualitative investigation of implementation

2019 ◽  
Vol 42 (2) ◽  
pp. e198-e206
Author(s):  
T J Stone ◽  
E Brangan ◽  
A Chappell ◽  
V Harrison ◽  
J Horwood
Keyword(s):  
Care Practice ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Health Checks ◽  
Minority Ethnic Groups ◽  
Outreach Workers ◽  
Risk Assessment And Management ◽  
Minority Ethnic ◽  
Nhs Health Checks ◽  
Outreach Intervention

Abstract Background NHS Health Checks is a national cardiovascular risk assessment and management programme in England. To improve equity of uptake in more deprived, and Black, Asian and minority ethnic (BAME) communities, a novel telephone outreach intervention was developed. The outreach call included an invitation to an NHS Health Check appointment, lifestyle questions, and signposting to lifestyle services. We examined the experiences of staff delivering the intervention. Methods Thematic analysis of semi-structured interviews with 10 community Telephone Outreach Workers (TOWs) making outreach calls, and 5 Primary Care Practice (PCP) staff they liaised with. Normalization Process Theory was used to examine intervention implementation. Results Telephone outreach was perceived as effective in engaging patients in NHS Health Checks and could reduce related administration burdens on PCPs. Successful implementation was dependent on support from participating PCPs, and tensions between the intervention and other PCP priorities were identified. Some PCP staff lacked clarity regarding the intervention aim and this could reduce the potential to capitalize on TOWs’ specialist skills. Conclusions To maximize the potential of telephone outreach to impact equity, purposeful recruitment and training of TOWs is vital, along with support and integration of TOWs, and the telephone outreach intervention, in participating PCPs.

scholarly journals Psychosocial barriers and facilitators for a successful return to work following injury within firefighters

2021 ◽  
Author(s):  
Liam Noll ◽  
Adrian Mallows ◽  
Jason Moran
Keyword(s):  
Physical Activity ◽  
Return To Work ◽  
Thematic Analysis ◽  
Fire Service ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Work Process ◽  
Topic Guide ◽  
Psychosocial Barriers

Abstract Objective The aim was to explore firefighter’s experiences during their recovery from injury. Focused specifically on exploring perceived psychosocial barriers and facilitators firefighters faced during recovery and return to work. Methods Semi-structured interviews were used to provide an in-depth understanding of the firefighter’s experiences. The semi-structured interviews were informed by a topic guide. The topic guide focused on five main themes, (1) overall experience of returning to operational duties following an injury, (2) perceived barriers experienced during their return to work, (3) perceived facilitators experienced during their return to work, (4) confidence in participating in physical activity following injury and (5) where they felt areas of improvement could be made with the return to work process. Thematic analysis of the data collected was undertaken using The Framework Method. Results Two main themes were sought after transcription: barriers and facilitators. From these, nine subthemes were identified (1) communication, (2) confidence in physical activity participation, (3) modified duties, (4) physiotherapy, (5) return to operational duties, (6) support, (7) inconsistency, (8) use of station gyms, (9) detachment from the watch. Conclusions Consideration should be made for the consistency of procedures followed during an individual’s return to work following an injury. Further research is needed to understand if the themes identified in this study are the same for other fire services. Further research is also needed to understand how the findings may be best implemented within the fire service.

scholarly journals Introducing Patient Reported Measures (PRMs) Into Finnish Public Maternity Service: A Study on Professionals’ Views

2021 ◽  
Author(s):  
An Chen ◽  
Kirsi Väyrynen ◽  
Riikka-Leena Leskelä ◽  
Seppo Heinonen ◽  
Paul Lillrank ◽  
...  
Keyword(s):  
Maternity Care ◽  
Care Service ◽  
Health Care Service ◽  
Routine Practice ◽  
Successful Implementation ◽  
Maternity Service ◽  
Structured Interviews ◽  
Pregnancy And Childbirth ◽  
Patient Reported ◽  
Patient Reported Measures

Abstract Background: The importance and potential benefits of introducing patient reported measures (PRMs) into health care service have been widely acknowledged, yet the experience regarding their implementation into practice is limited. There is a considerable paucity of research in adopting PRMs in maternity care. This study, which utilizes the PRMs included in Pregnancy and Childbirth (PCB) outcome set developed by International Consortium for Health Outcomes Measurement (ICHOM) as sample measures, aims to elicit Finnish professionals’ views on PRMs and to explore the applicability of PRMs in Finnish public maternity care. Methods: This qualitative study, applying semi-structured interviews, is designed to describe the local professionals’ views towards the application of PRMs in Finnish public maternity care. Professionals were asked to assess the PRMs defined in ICHOM PCB set and provide their expectations and concerns on the implementation of PRMs in Finnish public maternity service. Results: Twenty professionals participated in the interviews. Participants agreed on the importance and relevance of the PRMs questions included in ICHOM PCB set for delivering and developing maternity care in Finland. However, they criticized the number and length of questions as well as the recommended time points of data collection. In addition, for a successful implementation, various steps like developing suitable questions, redesigning service pathway and protocols, and motivating patients were considered to be important. Also, some potential obstacles, difficulties and risks associated with the implementation were underlined. Conclusion: This study indicates that the implementation of PRMs into Finnish public maternity service is possible, highly relevant and important. However, the adoption of PRMs into routine practice may be challenging and will require a series of efforts. This study shows viewpoints from Finnish professionals who have not participated in developing the ICHOM PCB standard set and provides important insights on the development and implementation of PRMs.

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