The Common Barriers and Facilitators for a Healthcare Organization Becoming a High Reliability Organization

Abstract Background As the numbers of people with dementia worldwide rises, there is a need for improved knowledge and awareness about the condition across the healthcare workforce. There are concerns that traditional models of healthcare education, which focus on short-term episodes of care, limit student understanding of long-term conditions. We therefore designed and delivered the Time for Dementia programme at five Universities in the UK. Through longitudinal contact with families living with dementia, healthcare students gain increased understanding about the experiences of living with dementia. However, implementing new educational models brings challenges. To enable implementation of similar programmes in other educational institutions, this study aimed to identify the common barriers and facilitators of implementing these types of longitudinal programmes at scale. Methods To understand the facilitators and barriers of implementing a longitudinal dementia educational programme, a qualitative study was completed. Between October and December 2018, twelve in-depth semi-structured interviews were completed with university teaching staff (n = 6), programme administrators (n = 4), and Alzheimer’s Society staff (n = 2) that had key responsibilities for implementing Time for Dementia. Interview questions explored participants experiences, the facilitators, and the challenges encountered when implementing the programme. Interviews were audio recorded, transcribed verbatim, and analysed using inductive thematic analysis. Results The analysis identified five key themes: “Leadership characteristics”, “Organisational and student buy-in”, “Perceived value and motivating factors”, “Team coalition and support”, and “Time and fit”. Implementation of the programme was enhanced by resilient leaders managing the challenges of curricular change. Their belief in the value of the programme, stakeholder buy-in, and supportive team working enabled challenges to be overcome. Workload was reduced and student buy-in increased as time progressed and as more resources became available. A flexible approach to implementation was recommended to ensure the programme fits within the established curriculum. Conclusion Curricular change is a challenging task, yet necessary, if we are to improve care for people with long term conditions such as dementia. This study highlights the common barriers and facilitators experienced when implementing a longitudinal educational programme at scale. The findings presented in this study can be used by other educational institutions to manage curricular change efforts.

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Barriers and Facilitators to Implementing a Longitudinal Dementia Education Programme into Undergraduate Healthcare Curricula: A Qualitative Study.

10.21203/rs.3.rs-116750/v1 ◽

2020 ◽

Author(s):

Yvonne Anne Feeney ◽

Stephanie Daley ◽

Breda Flaherty ◽

Sube Banerjee

Keyword(s):

Education Programme ◽

Educational Programme ◽

Barriers And Facilitators ◽

Educational Institutions ◽

Curricular Change ◽

Structured Interviews ◽

Educational Models ◽

Long Term Conditions ◽

The Common ◽

Common Barriers

Abstract BackgroundAs worldwide prevalence of dementia rises, there are international calls for improved knowledge and awareness about the condition across the healthcare workforce. There are concerns that traditional models of healthcare education, which focus on short-term episodes of care limits student understanding of long-term conditions. This has led to the introduction of the Time for Dementia programme at five Universities in the UK. Through longitudinal contact with families living with dementia, healthcare students gain increased understanding about the experiences of living with dementia. However, implementing new educational models brings challenges. To enable implementation of similar models by other educational institutions, this study aimed to identify the common barriers and facilitators of implementing a longitudinal programme at scale. MethodsTwelve in-depth semi-structured interviews were completed between October and December 2018 with participants that had experience implementing the Time for Dementia programme. Interviews were analysed using inductive thematic analysis.ResultsThe analysis identified five key themes important to implementation. These were: 1) leadership, 2) organisational buy-in, 3) perceived value, 4) team coalition, and 5) time and fit. Implementation of the programme was enhanced by resilient leaders managing the challenges of curricular change. Their belief in the value of the programme, stakeholder buy-in, and supportive team working enabled challenges to be overcome. Workload reduced and student buy-in increased as time progressed and as more resources became available. A flexible approach to implementation was recommended to ensure the programme fits within the established curriculum. Conclusion Curricular change is a challenging task, yet a necessary endeavour to meet high quality educational standards. This study highlights the common barriers and facilitators experienced when implementing a longitudinal educational programme at scale. The findings presented in this study can be used by other educational institutions to manage curricular change efforts.

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Veränderte Kompetenzanforderungen an Mitarbeitende infolge zunehmender Automatisierung – Eine Arbeitsfeldbetrachtung

Gruppe Interaktion Organisation Zeitschrift für Angewandte Organisationspsychologie (GIO) ◽

10.1007/s11612-021-00561-1 ◽

2021 ◽

Author(s):

Michèle Rieth ◽

Vera Hagemann

Keyword(s):

High Reliability ◽

High Reliability Organizations ◽

High Reliability Organization

ZusammenfassungBasierend auf einer Arbeitsfeldbetrachtung im Bereich der Flugsicherung in Österreich und der Schweiz liefert dieser Artikel der Zeitschrift Gruppe. Interaktion. Organisation. (GIO) einen Überblick über automatisierungsbedingte Veränderungen und die daraus resultierenden neuen Kompetenzanforderungen an die Beschäftigten im Hochverantwortungsbereich. Bestehende Tätigkeitsstrukturen und Arbeitsrollen verändern sich infolge zunehmender Automatisierung grundlegend, sodass Organisationen neuen Herausforderungen gegenüberstehen und sich neue Kompetenzanforderungen an Mitarbeitende ergeben. Auf Grundlage von 9 problemzentrierten Interviews mit Fluglotsen sowie 4 problemzentrierten Interviews mit Piloten werden die Veränderungen infolge zunehmender Automatisierung und die daraus resultierenden neuen Kompetenzanforderungen an die Beschäftigten in einer High Reliability Organization dargestellt. Dieser Organisationskontext blieb bisher in der wissenschaftlichen Debatte um neue Kompetenzen infolge von Automatisierung weitestgehend unberücksichtigt. Die Ergebnisse deuten darauf hin, dass der Mensch in High Reliability Organizations durch Technik zwar entlastet und unterstützt werden kann, aber nicht zu ersetzen ist. Die Rolle des Menschen wird im Sinne eines Systemüberwachenden passiver, wodurch die Gefahr eines Fähigkeitsverlustes resultiert und der eigene Einfluss der Beschäftigten abnimmt. Ferner scheinen die Anforderungen, denen sie sich infolge zunehmender Automatisierung gegenüberstehen sehen, zuzunehmen, was in einem Spannungsfeld zu ihrer passiven Rolle zu stehen scheint. Die Erkenntnisse werden diskutiert und praktische Implikationen für das Kompetenzmanagement und die Arbeitsgestaltung zur Minimierung der identifizierten restriktiven Arbeitsbedingungen abgeleitet.

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AB1334-HPR BARRIERS AND FACILITATORS TO PHYSICAL ACTIVITY IN JUVENILE IDIOPATHIC ARTHRITIS (JIA): A SCOPING REVIEW

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3550 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1955.2-1955

Author(s):

K. O Donoghue ◽

L. Larkin

Keyword(s):

Physical Activity ◽

Juvenile Idiopathic Arthritis ◽

Children And Adolescents ◽

Scoping Review ◽

Meta Analysis ◽

Management Strategies ◽

Barriers And Facilitators ◽

Activity Levels ◽

Cross Sectional ◽

Common Barriers

Background:Physical activity is an important aspect in the management of JIA (1). However physical activity levels are low in this population (2). Limited research has been conducted to identify definitive barriers and facilitators to physical activity in children and adolescents who have JIA.Objectives:The objective of this scoping review was to identify the common barriers and facilitators to physical activity in JIA.Methods:Original studies, either quantitative or qualitative, including participants with a diagnosis of JIA, who were under 18 years of age were included. Two independent reviewers carried out a search of the literature and full text reviews of papers to determine eligibility for inclusion. The Critical Skills Appraisal Programme (CASP), Appraisal tool for Cross-Sectional Studies (AXIS) and Downs and Black critical appraisal tools were used to assess the quality of the included research articles.Results:Eighteen studies were included in the review. The included studies were of a variety of low, moderate and high quality. The synthesis of the data identified pain to be the most common barrier and the modification of physical activities to the need of the individual to be the most common facilitator to physical activity in JIA.Conclusion:Identifying the most common barriers and facilitators to physical activity allows clinicians to apply better management strategies when treating an individual with JIA. Our findings demonstrate the need for further research in this area to assist increasing physical activity participation for children and adolescents who have JIA.References:[1]Kuntze, G., Nesbitt, C., Whittaker, J.L., Nettel-Aguirre, A., Toomey, C., Esau, S., Doyle-Baker, P.K., Shank, J., Brooks, J., Benseler, S., Emery, C.A. (2018) ‘Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis’,Archives of Physical Medicine and Rehabilitation, 99(1), 178-193[2]Bos, G.J.F.J., Lelieveld, O.T.H.M., Armbrust, W., Sauer, P.J.J., Geertzen, J.H.B., Dijkstra, P.U. (2016) ‘Physical activity in children with Juvenile Idiopathic Arthritis compared to controls’, Pediatric Rheumatology, 14(1), 42.Disclosure of Interests:None declared

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