scholarly journals Understanding the impact of a collective leadership intervention on team working and safety culture in healthcare teams: a realist evaluation protocol

2020 ◽  
Vol 2 ◽  
pp. 5
Author(s):  
Aoife De Brun ◽  
Lisa Rogers ◽  
Marie O'Shea ◽  
Eilish McAuliffe
Keyword(s):  
Safety Culture ◽  
Research Question ◽  
Realist Evaluation ◽  
Collective Leadership ◽  
Programme Theory ◽  
Healthcare Teams ◽  
Analysis And Synthesis ◽  
Range Theory ◽  
The Impact ◽  
Leadership Intervention

There is accumulating evidence for the value of collective and shared approaches to leadership across sectors and settings. However, relatively little research has explored collective leadership in healthcare and thus, there is little understanding of what works for healthcare teams, why, how and to what extent. This study describes the approach that will be adopted to the realist evaluation of a collective leadership intervention with four heterogenous healthcare teams in four different settings. A realist evaluation will be conducted. Realist evaluation is a theory-based approach to evaluation. It enables the use of mixed-methods to explore the research question of interest. Development of an initial programme theory (IPT) constitutes the first phase of the approach. This IPT will be informed by interviews with members of teams identified as working collectively, an examination of extant literature using realist synthesis, and will be refined through consultation with an expert panel. A multiple case study design will be adopted to explore the impact of the intervention, including quantitative scales on teamworking, leadership and safety culture, realist interviews with key informants and observations of teams during intervention sessions. Analysis of data will be guided by the IPT to refine the theory and context-mechanism-outcome configurations. Findings from the cases will be compared to identify patterns or demi-regularities and to explore if the intervention operates differently in different contexts. This analysis and synthesis of findings across the teams will inform the development of a middle range theory that will not only add to our understanding of how collective leadership influences teamwork and patient safety, but also provide guidance for future collective leadership interventions.  Favourable ethical opinion has been received from the University College Dublin Ethics Committee. Results will be disseminated via publication in peer-review journals, national and international conferences and to stakeholders/interest groups.

scholarly journals Understanding the impact of a collective leadership intervention on team working and safety culture in healthcare teams: a realist evaluation protocol

2019 ◽  
Vol 2 ◽  
pp. 5 ◽  
Author(s):  
Aoife De Brun ◽  
Lisa Rogers ◽  
Marie O'Shea ◽  
Eilish McAuliffe
Keyword(s):  
Safety Culture ◽  
Research Question ◽  
Realist Evaluation ◽  
Collective Leadership ◽  
Programme Theory ◽  
Healthcare Teams ◽  
Analysis And Synthesis ◽  
Range Theory ◽  
The Impact ◽  
Leadership Intervention

There is accumulating evidence for the value of collective and shared approaches to leadership across sectors and settings. However, relatively little research has explored collective leadership in healthcare and thus, there is little understanding of what works for healthcare teams, why, how and to what extent. This study describes the approach that will be adopted to the realist evaluation of a collective leadership intervention with four heterogenous healthcare teams in four different settings. A realist evaluation will be conducted. Realist evaluation is a theory-based approach to evaluation. It enables the use of mixed-methods to explore the research question of interest. Development of an initial programme theory (IPT) constitutes the first phase of the approach. This IPT will be informed by interviews with members of teams identified as working collectively, an examination of extant literature using realist synthesis, and will be refined through consultation with an expert panel. A multiple case study design will be adopted to explore the impact of the intervention, including quantitative scales on teamworking, leadership and safety culture, realist interviews with key informants and observations of teams during intervention sessions. Analysis of data will be guided by the IPT to refine the theory and context-mechanism-outcome configurations. Findings from the cases will be compared to identify patterns or demi-regularities and to explore if the intervention operates differently in different contexts. This analysis and synthesis of findings across the teams will inform the development of a middle range theory that will not only add to our understanding of how collective leadership influences teamwork and patient safety, but also provide guidance for future collective leadership interventions.  Favourable ethical opinion has been received from the University College Dublin Ethics Committee. Results will be disseminated via publication in peer-review journals, national and international conferences and to stakeholders/interest groups.

scholarly journals Using Co-Design to Develop a Collective Leadership Intervention for Healthcare Teams to Improve Safety Culture

2018 ◽  
Vol 15 (6) ◽  
pp. 1182 ◽  
Author(s):  
Marie E. Ward ◽  
Aoife De Brún ◽  
Deirdre Beirne ◽  
Clare Conway ◽  
Una Cunningham ◽  
...  
Keyword(s):  
Safety Culture ◽  
Collective Leadership ◽  
Healthcare Teams ◽  
Leadership Intervention

scholarly journals Protocol for the impact of paramedics in NHS primary care: application of realist approaches to improve understanding and support intelligent policy and future workforce planning

2019 ◽  
Vol 4 (3) ◽  
pp. 35-42 ◽  
Author(s):  
Georgette Eaton ◽  
Veronika Williams ◽  
Geoff Wong ◽  
Nia Roberts ◽  
Kamal R. Mahtani
Keyword(s):  
Primary Care ◽  
Life Support ◽  
Evidence Synthesis ◽  
Workforce Planning ◽  
Advanced Life Support ◽  
Realist Review ◽  
Professional Associations ◽  
Realist Evaluation ◽  
Programme Theory ◽  
The Impact

Introduction: In the United Kingdom, changing demands on ambulance services has caused a change in what is expected of a paramedic. As well as advanced life support, paramedics now need to be skilled in managing a range of urgent case presentations, with emphasis on treat-at-scene. The change in the scope of work paramedics can undertake has established their role within primary care. However, as paramedics transition to roles within primary care, their knowledge and skillset will undoubtedly need to change. The current opportunities for paramedics’ employment in primary care require careful evaluation. In order to contribute to patients’ and the NHS’ primary care agenda, evidence must be generated to show how and why these changes would work, for whom, in what context and to what extent.Methods and analysis: The purpose of this research is to produce findings that will improve our understanding of the ways in which (i.e. how, why and in what contexts) paramedics impact on the primary care workforce. A theory-driven approach to evidence-synthesis will be conducted in a realist review, to produce a programme theory. This programme theory will be tested using empirical data collected through a realist evaluation. Survey and interview data will be collected from paramedics working in primary care, general practitioners and patients to assess under which contexts, and by which mechanisms, paramedics are working in primary care, and thus test the programme theory. Based on the findings, we will be able to highlight the role of paramedics in primary care, as well as how they operate and under what conditions.Ethics and dissemination: Formal ethics review is not required for the review, as it is secondary research, but will be sought for the evaluation. Findings will be disseminated in a peer-reviewed journal, at national and international conferences and to relevant professional associations.

scholarly journals Protocol for a mixed methods realist evaluation of regional District Health Board groupings in New Zealand

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e030076
Author(s):  
Tim Stokes ◽  
Carol Atmore ◽  
Erin Penno ◽  
Lauralie Richard ◽  
Emma Wyeth ◽  
...  
Keyword(s):  
Mixed Methods ◽  
New Zealand ◽  
Health Outcomes ◽  
Health Equity ◽  
Service Integration ◽  
Realist Evaluation ◽  
Health Board ◽  
Programme Theory ◽  
District Health ◽  
The Impact

IntroductionAchieving effective integration of healthcare across primary, secondary and tertiary care is a key goal of the New Zealand (NZ) Health Strategy. NZ’s regional District Health Board (DHB) groupings are fundamental to delivering integration, bringing the country’s 20 DHBs together into four groups to collaboratively plan, fund and deliver health services within their defined geographical regions. This research aims to examine how, for whom and in what circumstances the regional DHB groupings work to improve health service integration, healthcare quality, health outcomes and health equity, particularly for Māori and Pacific peoples.Methods and analysisThis research uses a mixed methods realist evaluation design. It comprises three linked studies: (1) formulating initial programme theory (IPT) through developing programme logic models to describe regional DHB working; (2) empirically testing IPT through both a qualitative process evaluation of regional DHB working using a case study design; and (3) a quantitative analysis of the impact that DHB regional groupings may have on service integration, health outcomes, health equity and costs. The findings of these three studies will allow refinement of the IPT and should lead to a programme theory which will explain how, for whom and in what circumstances regional DHB groupings improve service integration, health outcomes and health equity in NZ.Ethics and disseminationThe University of Otago Human Ethics Committee has approved this study. The embedding of a clinician researcher within a participating regional DHB grouping has facilitated research coproduction, the research has been jointly conceived and designed and will be jointly evaluated and disseminated by researchers and practitioners. Uptake of the research findings by other key groups including policymakers, Māori providers and communities and Pacific providers and communities will be supported through key strategic relationships and dissemination activities. Academic dissemination will occur through publication and conference presentations.

scholarly journals Understanding the impact of a residential housing programme for people living with HIV/AIDS: a realist evaluation protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044522
Author(s):  
Shaneice Fletcher-Hildebrand ◽  
Hubert Alimezelli ◽  
Tracey Carr ◽  
Karen Lawson ◽  
Anum Ali ◽  
...  
Keyword(s):  
Transitional Care ◽  
Care Home ◽  
Realist Evaluation ◽  
People Living With Hiv ◽  
Programme Theory ◽  
Adherence To Medication ◽  
Institutional Review ◽  
Living With Hiv ◽  
The Impact ◽  
Hiv Aids

IntroductionHousing instability and homelessness are significant barriers to medical treatment for people living with HIV/AIDS. For these individuals, lack of stable housing and stigma is associated with insufficient access to care, poor adherence to medication and higher cost burdens to the healthcare system. This protocol reports on the efforts to evaluate Sanctum V.1.0, a hospice and transitional care home for adults with HIV/AIDS in Saskatoon, Saskatchewan, Canada. The current project was developed out of a need to identify how Sanctum V.1.0 produces varying programme outcomes to assist in endeavours to replicate the programme in other geographic locations.Methods and analysisA realist evaluation will be conducted to explore how and why Sanctum V.1.0 is successful or unsuccessful, in which circumstances and for whom. Rather than explore the degree to which a programme is effective, realist evaluations seek to uncover mechanisms that explain processual links between programme inputs and outcomes. The completed first phase of the project involved the development of an initial realist programme theory. Phases 2 and 3 will consist of methods to test, refine and validate the initial theory using various data sources.Ethics and disseminationEthics approval was obtained from the institutional review board at the University of Saskatchewan on 2 July 2020. Results will be disseminated according to stakeholders’ desires.

scholarly journals The Collective Leadership for Safety Culture (Co-Lead) Team Intervention to Promote Teamwork and Patient Safety

2020 ◽  
Vol 17 (22) ◽  
pp. 8673
Author(s):  
Aoife De Brún ◽  
Sabrina Anjara ◽  
Una Cunningham ◽  
Zuneera Khurshid ◽  
Steve Macdonald ◽  
...  
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Systematic Approach ◽  
Multidisciplinary Teams ◽  
Healthcare Staff ◽  
Collective Leadership ◽  
Healthcare Teams ◽  
Healthcare It ◽  
Enhance Patient Safety ◽  
Safety Cultures

Traditional hierarchical leadership has been implicated in patient safety failings internationally. Given that healthcare is almost wholly delivered by multidisciplinary teams, there have been calls for a more collective and team-based approach to the sharing of leadership and responsibility for patient safety. Although encouraging a collective approach to accountability can improve the provision of high quality and safe care, there is a lack of knowledge of how to train teams to adopt collective leadership. The Collective Leadership for Safety Cultures (Co-Lead) programme is a co-designed intervention for multidisciplinary healthcare teams. It is an open-source resource that offers teams a systematic approach to the development of collective leadership behaviours to promote effective teamworking and enhance patient safety cultures. This paper provides an overview of the co-design, pilot testing, and refining of this novel intervention prior to its implementation and discusses key early findings from the evaluation. The Co-Lead intervention is grounded in the real-world experiences and identified needs and priorities of frontline healthcare staff and management and was co-designed based on the evidence for collective leadership and teamwork in healthcare. It has proven feasible to implement and effective in supporting teams to lead collectively to enhance safety culture. This intervention overview will be of value to healthcare teams and practitioners seeking to promote safety culture and effective teamworking by supporting teams to lead collectively.

Impact of the ‘Learning from Excellence’ programme in NHS trusts: an exploratory study

2020 ◽  
Vol 26 (8) ◽  
pp. 1-10
Author(s):  
Maartje Kletter ◽  
Emma Plunkett ◽  
Adrian Plunkett ◽  
Helen Hunt ◽  
Paul Bird ◽  
...  
Keyword(s):  
Case Studies ◽  
Qualitative Content Analysis ◽  
Contextual Factors ◽  
Realist Evaluation ◽  
Evaluation Methodology ◽  
Organisational Performance ◽  
Programme Theory ◽  
Individual Interviews ◽  
The Uk ◽  
The Impact

Background/Aims The ‘Learning from Excellence’ (LfE) programme aims to provide a means to identify, appreciate, study and learn from episodes of excellence in frontline healthcare. The aim of this study was to explore the impact of LfE on organisational performance in NHS trusts in the United Kingdom (UK), how this impact is achieved and which contextual factors facilitate or hinder impact. Methods A survey and case studies, including individual interviews, were conducted. Data were analysed through qualitative content analysis, informed by realist evaluation methodology. Contextual factors, mechanisms and outcomes were coded, sub-themes were generated and a programme theory was developed. Results There were 47 respondents to the survey (27% response rate) and three case studies were performed. A total of 25 contextual factors were identified, of which 18 acted as a facilitator to uptake or as a barrier if absent. Additionally, 11 mechanisms and 9 outcomes were identified. A programme theory explaining how LfE can impact organisational performance in NHS trusts in the UK, and which contextual factors play a role before design, during design and during implementation, was developed. Conclusions LfE was welcomed by participants, but at the time of this study LfE had not been implemented for long enough for outcomes to be measured. Further research, particularly measuring outcomes and validating mechanisms, as well as exploring the learning based on reported events, is needed.

The Fiscal Effects of Economic Immigration on Subnational Government Finance in Poland

e-Finanse ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. 45-58
Author(s):  
Marzanna Poniatowicz ◽  
Agnieszka Piekutowska
Keyword(s):  
Social Policy ◽  
Income Tax ◽  
Research Question ◽  
Personal Income Tax ◽  
Government Finance ◽  
Subnational Government ◽  
Migration Research ◽  
The Impact ◽  
High Share

AbstractThe aim of the paper is to analyse the effects of economic immigration on subnational government finance (SNG) in Poland. The goal to achieve is to answer the following research question: what are the fiscal effects of immigration on SNG budget revenues and expenditures. To answer this question, logarithmic models were developed. The analysis refers to the years 2007-2016. In this respect, data from Statistics Poland - referring to budget revenues and expenditures of communes, cities of district status, districts and voivodeships - were used. As far as immigration statistics are concerned, data from the Ministry of Family, Labour and Social Policy were used. The results indicate an increase in both revenues and expenditures of SNG as a result of immigration. Such results can be explained inter alia by the nature of migration - research were focused on economic immigration. Results confirm that the level of employment of foreigners is one of the determinants shaping the fiscal effect of immigration. Moreover, the impact of economic immigration on SNG budget revenues and expenditures depends on the structure of this budget. This explains the differentiated results of the analysis of the impact of immigration on SNG in different countries. The positive correlation between immigration and SNG revenues in Poland can be associated with a high share of subnational governments in personal income tax revenues as this tax is one of the main categories of SNG revenues. Furthermore, results show that the impact of immigration on local government budgets in Poland is modest. This confirms the conclusions drawn by other authors (e.g. Auerbach and Oreopoulos), that in the long term, immigration cannot be considered as a potential instrument for resolving fiscal imbalances.

The specifics of shadow economic activity in Russia

2020 ◽  
Vol 19 (10) ◽  
pp. 1896-1915
Author(s):  
E.R. Ermakova ◽  
O.M. Lizina
Keyword(s):  
Economic Activity ◽  
Shadow Economy ◽  
Integrated Approach ◽  
Economic Activities ◽  
Reproductive Process ◽  
Scientific Methods ◽  
Current Period ◽  
Russian Economy ◽  
Analysis And Synthesis ◽  
The Impact

Subject. The article addresses the specifics of shadow economic activities in reformed Russia in the context of systemic transformations. Objectives. We focus on determining the role of shadow economy in the reproductive process, identifying and understanding the specifics of underground economic activity of the Russian economy. Methods. The study rests on general scientific methods (scientific abstraction, unity of historical and logical, analysis and synthesis, induction and deduction, comparison and analogy) and special methods of cognition (monetary methods). We employ the systems and integrated approach. The official statistics, regulations, works of leading researchers on shadow economy expansion, resources of reference and legal systems like Garant and ConsultantPlus serve as the study's information base. Results. We present a retrospective rapid analysis of the extent of shadow economic activity in the domestic economy, establishing the relationships with the processes that take place at different stages of the country's development. We also reveal the specifics of shadow economy relations in Russia, factors that play a key role in expansion for a particular period, a shift to another form of shadow economy. The study characterizes the current period of development, assesses the impact of external shocks on shadow economy expansion. Conclusions. The current period is characterized by the digitization of shadow relations, the shift of corruption to the upper echelons of power, the continued outflow of capital abroad, and increased penalties for underground activities.

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