scholarly journals A qualitative study of decision-making and safety in ambulance service transitions

2014 ◽  
Vol 2 (56) ◽  
pp. 1-138 ◽  
Author(s):  
Rachel O’Hara ◽  
Maxine Johnson ◽  
Enid Hirst ◽  
Andrew Weyman ◽  
Deborah Shaw ◽  
...  
Keyword(s):  
Decision Making ◽  
Patient Safety ◽  
Risk Aversion ◽  
Focus Groups ◽  
Service User ◽  
Ambulance Service ◽  
Future Research ◽  
Phase 2 ◽  
Alternative Care ◽  
Service Setting

BackgroundDecisions made by front-line ambulance staff are often time critical and based on limited information, but wrong decisions in this context could have serious consequences for patients. There has been little research carried out in the ambulance service setting to identify areas of risk associated with decisions about patient care.AimThe aim of this study was to qualitatively examine potential system-wide influences on decision-making in the ambulance service setting and to identify useful areas for future research and intervention.MethodsWe used a multisite, multimethod qualitative approach across three ambulance service trusts. In phase 1 we carried out 16 interviews to contextualise the study and provide discussion points for phase 2. For phase 2, university and ambulance service researchers observed paramedics on 34 shifts and 10 paramedics completed ‘digital diaries’ that reported challenges to decision-making or to patient safety. Six focus groups were held, three with staff (n = 21) and three with service users (n = 23). From observation and diary data we developed a typology of decisions made at the scene. Data from these and other sources were also coded within a human factors framework and then thematically analysed to identify influences on those decisions. In phase 3, workshops were held at each site to allow participants and stakeholders (n = 45) to comment on the study findings. Participants were asked to rank influences on decisions using a ‘paired comparison’ method.ResultsInterviews provided the context for further qualitative exploration. Nine types of decision were identified from observations and digital diaries, ranging from emergency department conveyance and specialist emergency pathways to non-conveyance. A synthesis of findings from the observations, diaries and staff focus groups revealed seven overarching system influences on decision-making and potential risk factors: meeting increasing demand for emergency care; impacts of performance regime and priorities on service delivery; access to appropriate care options; disproportionate risk aversion; education, training and professional development for crews; communication and feedback to crews; and ambulance service resources. Safety culture issues were also identified. Data from the service user focus groups reflected similar issues to those identified from the staff focus groups. Service user concerns included call handling and communication, triage, patient involvement in decisions, balancing demand, resources, access to care, risk aversion, geographical location and vulnerable patients. Group discussions highlighted a lack of awareness by the public of how best to use emergency and urgent care services. Workshop attendees were satisfied that the findings reflected relevant issues. The two issues ranked highest for warranting attention were staff training and development and access to alternative care.ConclusionsMultiple qualitative methods allowed a range of perspectives to be accessed and validation of issues across perspectives. Recommendations for future research include exploring effective ways of providing access to alternative care pathways to accident and emergency, assessing public awareness and expectations of ambulance and related services, exploring safe ways of improving telephone triage decisions and assessing the effects of different staff skill levels on patient safety.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

PP34 The experiences and attitudes of ambulance staff towards the counter-terrorism ‘PREVENT’ training: a survey-based service evaluation

2021 ◽  
Vol 38 (9) ◽  
pp. A14.2-A14
Author(s):  
Tessa Mochrie ◽  
Theresa Foster ◽  
Larissa Prothero ◽  
Nigel South
Keyword(s):  
Service Evaluation ◽  
Ambulance Service ◽  
Future Research ◽  
Duty Of Care ◽  
Training Module ◽  
Counter Terrorism ◽  
Service Setting ◽  
Emergency Ambulance ◽  
Question Survey ◽  
Do So

BackgroundUnderstanding the views and opinions of ambulance clinicians about counter-terrorism is limited, as are the roles they have in identifying individuals vulnerable to radicalisation. The aim of this survey was to investigate ambulance clinician views and preparedness to identify individuals at risk of radicalisation and whether the current national PREVENT training offered is suitable for this clinical setting.MethodsA purpose-designed, 18-question survey, was developed to understand staff attitudes and content knowledge of the national PREVENT training module. The survey was opened to all emergency ambulance clinicians in one UK ambulance service during August 2020, resulting in a sample of 123 responses which were analysed using descriptive and thematic approaches.ResultsMost respondents (87%; n=107) were aware of the PREVENT strategy, with almost three-quarters (73%; n=90) receiving training within the previous three years. Respondents were asked to score training received: the majority (89%; n=110) reported 5/10 or less. Whilst most (79%; n=97) identified the correct way to refer an individual, few had completed a PREVENT referral (9%; n=11). ‘Gut instinct’ was utilised by respondents to support their knowledge obtained via PREVENT training (70%, n=86). Respondents felt the national PREVENT training lacked relevance to their role and recommended ambulance-specific training packages be made available. They recognised their responsibility of identifying radicalisation and the opportunities their unique position offered to do so. Having a ‘duty of care’ and ‘moral responsibilities’ to make PREVENT referrals, and the importance of treating individuals as patients (not criminals), was also highlighted.ConclusionsAmbulance staff have highlighted the importance of a clear and robust referral pathway for individuals vulnerable to radicalisation. Current training lacks specificity and effectiveness for the ambulance service setting. As this survey was limited to one ambulance service, future research is warranted to ensure PREVENT training is appropriate for all ambulance staff.

scholarly journals Identifying research priorities for patient safety in mental health: an international expert Delphi study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e021361 ◽  
Author(s):  
Lindsay H Dewa ◽  
Kevin Murray ◽  
Bethan Thibaut ◽  
Sonny Christian Ramtale ◽  
Sheila Adam ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Safety ◽  
Delphi Study ◽  
Service User ◽  
Patient Perspective ◽  
Research Priorities ◽  
Mental Healthcare ◽  
Field Research ◽  
Future Research ◽  
A Priority

ObjectivePhysical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health.DesignSemistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements.Setting and participantsAcademic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included.Main outcome measuresAgreement in research priorities on a five-point scale.ResultsSeventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important.ConclusionsThis is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this.

Healthy Hospital: Toward a Better Tomorrow a Demonstration Project to Promote Culture Change through Participatory Decision Making

1997 ◽  
Vol 10 (3) ◽  
pp. 24-33 ◽  
Author(s):  
J. Allan Best ◽  
Geoff Walsh ◽  
Fred Muzin ◽  
Jonathan Berkowitz
Keyword(s):  
Job Satisfaction ◽  
Decision Making ◽  
Focus Groups ◽  
Job Stress ◽  
Self Esteem ◽  
Demonstration Project ◽  
Future Research ◽  
Participatory Decision Making ◽  
Key Informant ◽  
Satisfaction Evaluation

The three-year “Healthy Hospital” project was designed to increase participatory decision making, thereby decreasing job stress and increasing job satisfaction. Evaluation methods included employee surveys, focus groups and key informant interviews. Overall stress levels, job satisfaction and self-esteem generally improved. The diverse types of evaluation converge on a conclusion that the project achieved modest but significant gains throughout the organization. Lessons for future research and applications are discussed.

SERVICE USER PERSPECTIVES ON PATIENT SAFETY IN THE AMBULANCE SERVICE

2015 ◽  
Vol 32 (6) ◽  
pp. e12.1-e12 ◽  
Author(s):  
Rachel O'Hara ◽  
Enid Hirst ◽  
Maxine Johnson ◽  
Chris Newman ◽  
Deborah Shaw ◽  
...  
Keyword(s):  
Patient Safety ◽  
Service User ◽  
Ambulance Service ◽  
User Perspectives

Prophetic Leadership Model: Conceptualizing a Prophet’s Leadership Behaviour, Leader-Follower Mutuality and Altruism to Decision Making Quality

2015 ◽  
Vol 3 (1) ◽  
pp. 93
Author(s):  
Nik Maheran Nik Muhammad
Keyword(s):  
Decision Making ◽  
Social Network ◽  
A Priori ◽  
Complex Function ◽  
Spiritual Leadership ◽  
Leadership Theory ◽  
Future Research ◽  
Leadership Model ◽  
Leadership Behaviour ◽  
Current Leadership

This article advocates that research is lacking on the connection between leadership theory and social network theory. To date, little empirical research has been conducted on leadership and social networks. Thus, the proposition of this article goes beyond traditional leadership models to advocate for a fuller and more integrative focus that is multilevel, multi-component and interdisciplinary, while recognizing that leadership is a complex function of both the organisational leaders and the followers who perform tasks, all of which subsequently leads to decision making qualities. Indeed, the current leadership model focuses on leadership behaviour and the ability to gain followers mutuality, to achieve decision making quality involving the integration of leadership and social network theories. Given the apparent mutable palette of contemporary leadership theory, this emergent construct of the leadership paradigm can expand the poles of the leadership continuum and contribute to a richer and deeper understanding of the relationships and responsibilities of leaders and followers as they relate to decision making qualities. This new construct, which is termed prophetic leadership, explores the literature of the life experiences of the prophet in the ‘Abrahamic Faith’ religion. Drawing on a priori links between the personality trait and spiritual leadership that has recently garnered the interest of scholars, the present study asserts a normative leadership theory that links the personal quality of a leader, posture and principal (based on the Prophet’s leadership behaviour) to synergy and decision making quality. Altruism is proposed to enhance relationships between leadership behaviour and decision making quality. For future research, much work needs to be done specifically aiming to (a) achieve greater clarity of construct definitions, (b) address measurement issues, and (c) avoid construct redundancy.

Prophetic Leadership Model: Conceptualizing a Prophet’s Leadership Behaviour, Leader-Follower Mutuality and Altruism to Decision Making Quality

2015 ◽  
Vol 1 (3) ◽  
pp. 93
Author(s):  
Nik Maheran Nik Muhammad
Keyword(s):  
Decision Making ◽  
Social Network ◽  
A Priori ◽  
Complex Function ◽  
Spiritual Leadership ◽  
Leadership Theory ◽  
Future Research ◽  
Leadership Model ◽  
Leadership Behaviour ◽  
Current Leadership

This article advocates that research is lacking on the connection between leadership theory and social network theory. To date, little empirical research has been conducted on leadership and social networks. Thus, the proposition of this article goes beyond traditional leadership models to advocate for a fuller and more integrative focus that is multilevel, multi-component and interdisciplinary, while recognizing that leadership is a complex function of both the organisational leaders and the followers who perform tasks, all of which subsequently leads to decision making qualities. Indeed, the current leadership model focuses on leadership behaviour and the ability to gain followers mutuality, to achieve decision making quality involving the integration of leadership and social network theories. Given the apparent mutable palette of contemporary leadership theory, this emergent construct of the leadership paradigm can expand the poles of the leadership continuum and contribute to a richer and deeper understanding of the relationships and responsibilities of leaders and followers as they relate to decision making qualities. This new construct, which is termed prophetic leadership, explores the literature of the life experiences of the prophet in the ‘Abrahamic Faith’ religion. Drawing on a priori links between the personality trait and spiritual leadership that has recently garnered the interest of scholars, the present study asserts a normative leadership theory that links the personal quality of a leader, posture and principal (based on the Prophet’s leadership behaviour) to synergy and decision making quality. Altruism is proposed to enhance relationships between leadership behaviour and decision making quality. For future research, much work needs to be done specifically aiming to (a) achieve greater clarity of construct definitions, (b) address measurement issues, and (c) avoid construct redundancy.

Factors Affecting Customer Switching Behavior towards Hybrid Electrical Vehicles (HEV’s) from a Customer Perspective in Jordan

2018 ◽  
Vol 1 (3) ◽  
pp. 53
Author(s):  
Bushra Mahadin
Keyword(s):  
Decision Making ◽  
Consumer Behaviour ◽  
New Technologies ◽  
International Marketing ◽  
Current Trend ◽  
Switching Behavior ◽  
Future Research ◽  
Decision Making Process ◽  
Customer Switching ◽  
Electrical Vehicles

Purpose-This paper aims to investigate factors that affect customer switching from Internal Combustion Engine Vehicles (ICEV’s) to Hybrid Electrical Vehicles (HEV’s), in Jordan for the period of (2010-2014).Design/methodology/approach-A self-administered survey was hand-delivered to the targeted sample of car users in Jordan. The authors delivered 400 questionnaires to customers, from which 333 were deemed valid for the analysis, corresponding to the percentage of (83.25%) which indicates the validity of the study. Findings- There was no difference in switching behavior between (ICEV’s) and (HEV’s) based on gender in the Jordanian market. Fuel consumption efficiency was the number one variable that supports the switching behavior towards (HEV's), followed by Eco friendliness, lower taxes and technological features. Price and the current trend in the market were the least supporting factors. In addition to that the perception of the battery life of (HEV's), limited choices in the market, lack of information and fear of the relatively new technology were the major hindering factors of choosing an (HEV).Research limitations-Future research needs to investigate other factors that may affect customers’ behavior such as perceived image, trust, and subjective norms. Future research should investigate into the importance of environmental awareness and new technologies, and gender differences in behavior. From an international marketing standpoint, comparative studies between Jordanian and non-Jordanian customers are potential areas of future research for international marketing strategies and cross-cultural consumer behaviour analysis. Practical implications-The paper identifies the determinants of switching behavior. marketers should focus addressing customers concerns in terms of providing enough information and building awareness towards the technology and it's benefits towards the society and the environment.Originality/value-Our study is one of the few in Jordan that investigates the switching behavior towards vehicles technology. Our study is thought to have made a modest contribution to consumer behaviour literature and, specifically, for decision making process. It offers marketers insights into the determinants of switching behavior towards the hybrid vechicle technology and how this contribute to consumers’ decision making process and attitudes to achieve the intended behavioural outcomes

The impact of patient narratives on medical students’ perceptions of shared decision making: A randomized controlled trial

2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Shared Decision Making ◽  
Medical Training ◽  
Controlled Trial ◽  
Future Research ◽  
Shared Decision ◽  
Randomized Controlled ◽  
Information Text ◽  
The Impact

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.

The security of being grateful: Gratitude promotes risk aversion in decision-making

2019 ◽  
Vol 15 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Yufeng Zhang ◽  
Zhuo Job Chen ◽  
Shiguang Ni
Keyword(s):  
Decision Making ◽  
Risk Aversion

scholarly journals A survey of methods for evaluating mini-publics

2021 ◽  
Author(s):  
Takeuchi Ayano
Keyword(s):  
Decision Making ◽  
Academic Research ◽  
Future Research ◽  
The Political ◽  
Decision Making Process ◽  
Sufficient Information ◽  
Practical Case ◽  
Political Decision ◽  
Wide Range ◽  
Political Decision Making

AbstractPublic participation has become increasingly necessary to connect a wide range of knowledge and various values to agenda setting, decision-making and policymaking. In this context, deliberative democratic concepts, especially “mini-publics,” are gaining attention. Generally, mini-publics are conducted with randomly selected lay citizens who provide sufficient information to deliberate on issues and form final recommendations. Evaluations are conducted by practitioner researchers and independent researchers, but the results are not standardized. In this study, a systematic review of existing research regarding practices and outcomes of mini-publics was conducted. To analyze 29 papers, the evaluation methodologies were divided into 4 categories of a matrix between the evaluator and evaluated data. The evaluated cases mainly focused on the following two points: (1) how to maintain deliberation quality, and (2) the feasibility of mini-publics. To create a new path to the political decision-making process through mini-publics, it must be demonstrated that mini-publics can contribute to the decision-making process and good-quality deliberations are of concern to policy-makers and experts. Mini-publics are feasible if they can contribute to the political decision-making process and practitioners can evaluate and understand the advantages of mini-publics for each case. For future research, it is important to combine practical case studies and academic research, because few studies have been evaluated by independent researchers.

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