scholarly journals The expected and actual communication of health care workers during the management of intrapartum: An interpretive multiple case study

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Doreen K.M. M'Rithaa ◽  
Sue Fawcus ◽  
Mikko Korpela ◽  
Retha De la Harpe
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Information Seeking ◽  
Multiple Case Study ◽  
Health Care Organisation ◽  
Critical Information ◽  
Levels Of Care ◽  
Care Organisation ◽  
Multiple Case

Background: Daily activities within a health care organisation are mediated by information communication processes (ICP) involving multiple health care professionals at different levels of care. Effective perinatal management requires critical information to be accurately communicated. If there is a breakdown in this communication patient safety is at risk for various reasons such as: inadequate critical information, misconception of information and uninformed decisions being made. The purpose of this study was to interpret the complexities around ICP in order to contribute to the effective management of the intrapartum period.Methods: Multi method, multiple case study approach was used to understand the ICP during the management of the intrapartum period. During the study, the expected ICP, the actual ICP, the challenges involved and the desired ICP were analysed. Twenty-four in-depth interviews with skilled birth attendants (SBAs) employing observer-as-participant roles, field notes, and document review methods were utilised to gather the data. Thematic analysis was utilised to analyse the data using Atlas TI software.Results: The study revealed three subthemes which emerged from the expected ICP, whilst three others that emerged formed the theme actual ICP. The subthemes from the expected ICP included: accessibility of obstetric services, expected referral, recommended tools, expected communication and expected documentation. The theme actual ICP held threee merging subthemes: the handover processes, collaborative information seeking, information communicated and referral processes.Conclusion: This study showed that what was expected was not what was actually happening. The requirements of the policies and protocols need to be effectively implemented to improve practice building these into current biomedical guidelines.

scholarly journals Development spots in communication during the management of the intrapartum period: An interpretive multiple case study in a developing context

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Doreen K.M. M'Rithaa ◽  
Susan R. Fawcus ◽  
Margaretha De la Harpe ◽  
Mikko Korpela
Keyword(s):  
Health Care ◽  
Multiple Case Study ◽  
Health Care Facilities ◽  
Information Communication ◽  
Levels Of Care ◽  
Study Approach ◽  
Communication Breakdown ◽  
Communication Processes ◽  
Multiple Case

Background: Health care activities are influenced by information communication between women during pregnancy, birth and motherhood and skilled birth attendants (SBAs) and further, between the health care workers during the continuum of care. Therefore, effective information communication processes (ICP) within and between health care facilities are a requirement for appropriate management of patients or clients. The management of the intrapartum period requires swift responses while managing critical information required for further referral and management processes. The involvement of multiple actors at different times with the same client carries the risk of communication breakdown at different points and at different levels of care. The information communicated during the intrapartum period is critical and should be accurate, timely and more importantly appropriate to enable better maternal and neonatal outcomes.Purpose: The purpose of this article is to discuss the complexities around ICP identified within a developing context that influence the management of the intrapartum period.Methods: Multi-method, multiple case study approach was used to analyse two case studies. Only the challenges from one case study (A) are discussed in this article. In-depth interviews were conducted with the SBAs. The role of observer-as-participant was utilised during the observation; field notes and document review methods were used to gather the data. Thematic analysis and activity analysis were applied to analyse the data.Results: The findings identified challenges with information and communication that influenced the management of the intrapartum period.Conclusion: This study exhibited the challenges identified as development points that can influence the management of the intrapartum period. These challenges were also identified as desirable changes from the present state depending on the perspective of the actor.

scholarly journals Critical issues for employees in inter-municipal health care services: a multiple case study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Elisabeth Holen-Rabbersvik ◽  
Tom Roar Eikebrokk ◽  
Rune Werner Fensli ◽  
Elin Thygesen ◽  
Åshild Slettebø
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Multiple Case Study ◽  
Care Services ◽  
Critical Issues ◽  
Multiple Case ◽  
Municipal Health

The potential for inadvertent adverse consequences of open disclosure in Australia: when good intentions cause further harm

2019 ◽  
Vol 59 (4) ◽  
pp. 265-274 ◽  
Author(s):  
Alice Holmes ◽  
Lyndal Bugeja ◽  
David Ranson ◽  
Debra Griffths ◽  
Joseph Elias Ibrahim
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Legal Protection ◽  
Care Providers ◽  
Health Care Organisation ◽  
Open Disclosure ◽  
Care Organisation ◽  
Family Expectations ◽  
Training And Support

Open disclosure is a valuable process which has the potential to benefit both the patients who receive the open disclosure and the health care professionals (or organisations) who provide it. The benefits from open disclosure will most often be seen when open disclosure is performed in an ‘ideal’ manner. When open disclosure is suboptimal, it can lead to harmful consequences for patients and health care providers alike. Numerous factors may contribute to an inadequate open disclosure including: potentially inadequate legal protection for health care professionals or organisations; failing to meet patient and/or family expectations; health care professionals experiencing a lack of education, training and support from the health care organisation; or a fear of litigation. An inadequate open disclosure may result in inadvertent consequences including: patients/families who are dissatisfied; potentially preventable litigation; legal repercussions for health care professionals and organisations; and patient harm where open disclosure is not implemented. This article seeks to explore these barriers and considers how the implementation of open disclosure could be improved to overcome these barriers. Overcoming these barriers should help to reduce the risk of inadvertent consequences and lead to better outcomes for patients, health care professionals and health care organisations.

scholarly journals Implementation of cancer screening in rural primary care practices after joining an accountable care organisation: a multiple case study

2021 ◽  
Vol 9 (4) ◽  
pp. e001326
Author(s):  
Heather Nelson-Brantley ◽  
Edward F Ellerbeck ◽  
Stacy McCrea-Robertson ◽  
Jennifer Brull ◽  
Jennifer Bacani McKenney ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
Multiple Case Study ◽  
Accountable Care ◽  
Rural Primary Care ◽  
Care Organisation ◽  
Multiple Case ◽  
Care Practices ◽  
Primary Care Practices

ObjectiveTo describe common strategies and practice-specific barriers, adaptations and determinants of cancer screening implementation in eight rural primary care practices in the Midwestern United States after joining an accountable care organisation (ACO).DesignThis study used a multiple case study design. Purposive sampling was used to identify a diverse group of practices within the ACO. Data were collected from focus group interviews and workflow mapping. The Consolidated Framework for Implementation Research (CFIR) was used to guide data collection and analysis. Data were cross-analysed by clinic and CFIR domains to identify common themes and practice-specific determinants of cancer screening implementation.SettingThe study included eight rural primary care practices, defined as Rural-Urban Continuum Codes 5–9, in one ACO in the Midwestern United States.ParticipantsProviders, staff and administrators who worked in the primary care practices participated in focus groups. 28 individuals participated including 10 physicians; one doctor of osteopathic medicine; three advanced practice registered nurses; eight registered nurses, quality assurance and licensed practical nurses; one medical assistant; one care coordination manager; and four administrators.ResultsWith integration into the ACO, practices adopted four new strategies to support cancer screening: care gap lists, huddle sheets, screening via annual wellness visits and information spread. Cross-case analysis revealed that all practices used both visit-based and population-based cancer screening strategies, although workflows varied widely across practices. Each of the four strategies was adapted for fit to the local context of the practice. Participants shared that joining the ACO provided a strong external incentive for increasing cancer screening rates. Two predominant determinants of cancer screening success at the clinic level were use of the electronic health record (EHR) and fully engaging nurses in the screening process.ConclusionsJoining an ACO can be a positive driver for increasing cancer screening practices in rural primary care practices. Characteristics of the practice can impact the success of ACO-related cancer screening efforts; engaging nurses to the fullest extent of their education and training and integrating cancer screening into the EHR can optimise the cancer screening workflow.

scholarly journals Vaccination as a scheduled demand: a day in the life of users

2020 ◽  
Vol 73 (4) ◽  
Author(s):  
Deborah Correia Duarte ◽  
Selma Maria da Fonseca Viegas ◽  
Fernanda Moura Lanza ◽  
Valéria Conceição de Oliveira
Keyword(s):  
Health Care ◽  
Multiple Case Study ◽  
Western Region ◽  
Missed Opportunities ◽  
Primary Health ◽  
Minas Gerais State ◽  
Data Record ◽  
Multiple Case ◽  
Effective Use

ABSTRACT Objectives: to understand vaccination as a scheduled demand and access to this demand in a day in the life of health services, from the perspective of users. Methods: holistic-qualitative multiple case study, based on the Quotidian Comprehensive Sociology, with 74 users from four health microregions of the Extended Western Region of Minas Gerais State. Results: scheduling vaccination demand in a day in the life of services is compromised by the fragility in data record, by computerized systems underutilization and by the loss of the immunization tracking card, resulting in missed opportunities of immunization and unnecessary revaccinations. The Primary Health Care team’s non-involvement also compromised access to this action. Final Considerations: there is a need for more effort to be dispensed with for the effective use of computerized systems and Permanent Education of professionals in order to take advantage of all the opportunities of orientations and referrals of users to the vaccination room.

scholarly journals Why do certain primary health care teams respond better to intimate partner violence than others? A multiple case study

2019 ◽  
Vol 33 (2) ◽  
pp. 169-176 ◽  
Author(s):  
Isabel Goicolea ◽  
Bruno Marchal ◽  
Anna-Karin Hurtig ◽  
Carmen Vives-Cases ◽  
Erica Briones-Vozmediano ◽  
...  
Keyword(s):  
Health Care ◽  
Intimate Partner Violence ◽  
Primary Health Care ◽  
Partner Violence ◽  
Multiple Case Study ◽  
Intimate Partner ◽  
Health Care Teams ◽  
Primary Health ◽  
Multiple Case
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