Catherine Hogan, Maria Barry, Mary Burke and Pauline Joyce
The purpose of this paper is to report on a study that explores healthcare professionals' experiences of the implementation of integrated care pathways (ICPs).
Abstract
Purpose
The purpose of this paper is to report on a study that explores healthcare professionals' experiences of the implementation of integrated care pathways (ICPs).
Design/methodology/approach
This study used a phenomenological research approach with a purposive sample of ten multi‐disciplinary healthcare professionals across two acute hospitals in Ireland. Data were collected via semi‐structured interviews and analysed using Colazzi's framework.
Findings
The findings of the study are presented under four themes: buy‐in from all disciplines, multidisciplinary communication, service‐user involvement, and audit of ICPs. These themes emanated from the questions asked at interview.
Research limitations/implications
The limitations of the study include the small sample size and the use of two different interviewers across the sites. The inexperience of the interviewers is acknowledged as a limitation as the probing of some questions could have been improved. In addition the themes of the findings were predetermined by the use of the interview guide.
Practical implications
Changes in existing institutional structures and cultures are required when introducing ICPs. It is necessary for senior management in organisations to lead by example. They also need to identify where support can be offered, such as in the provision of an ICP facilitator, education sessions in relation to ICPs and the development of strategies to improve multi‐disciplinary buy‐in and participation.
Originality/value
The findings of this study respond to a gap in the literature in Ireland on the experiences of healthcare professionals who have implemented ICPs. Key findings of the study are the perception that the doctor is pivotal in driving the implementation of ICPs, yet the doctor was not always interested in this responsibility.
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EU: Hogan departure causes trade policy concerns
Details
DOI: 10.1108/OXAN-ES254882
ISSN: 2633-304X
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James P. Guthrie, Charles Joseph Coate and Catherine E. Schwoerer
Using instrumentation grounded in the “Big Five” theoretical framework, this paper empirically examines personality as a predictor of career strategy behavior. Results support…
Abstract
Using instrumentation grounded in the “Big Five” theoretical framework, this paper empirically examines personality as a predictor of career strategy behavior. Results support expectations that some aspects of personality (e.g. being extroverted or sociable) are associated with greater use of strategies involving relationships with others (e.g. seeking mentoring relationships). Other results indicate an association between personality dimensions (e.g. “openness to experience” or “intellectance”) and more self‐directed career strategies (e.g. developing skill/career flexibility). Implications of these results and directions for future study are discussed.
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Katherine Frances McLay and Vicente Chua Reyes Jr
The purpose of this paper is to compare and problematise technology and teaching reform initiatives in Australia and Singapore, demonstrating the importance of adopting a critical…
Abstract
Purpose
The purpose of this paper is to compare and problematise technology and teaching reform initiatives in Australia and Singapore, demonstrating the importance of adopting a critical stance towards technology-rich education reform. In the Australian context, the tensions and challenges of the Digital Education Revolution and the Teaching Teachers for the Future programme are illustrated. In the Singapore context, the implications of the ways in which teachers exercise their agency over technological imperatives are examined.
Design/methodology/approach
The first section of the paper draws on interview and observational data generated during a microethnographic investigation into secondary school students’ use of iPads as a learning tool in an independent school in South-East Queensland. Data “snapshots” illustrate the lingering challenges of reform designed to achieve technology-rich learning environments. The second section of the paper draws on a retrospective study of current ICT initiatives in Singapore through case studies of two schools that are heavily involved in ongoing ICT integration programmes.
Findings
While reforms are usually borne out of careful studies among policy makers and politicians to develop solutions to problems, the final version often reflects compromise between various stakeholders championing their respective agendas. As such, problematisation is imperative to develop critical and nuanced understandings. In both Australia and Singapore, it is suggested that failing to account for such ontological matters as teacher and learner identity and agency prevents meaningful change.
Originality/value
Global reform to achieve technology-rich teaching and learning environments reflects the ubiquity of such initiatives across geographical and cultural boundaries. Such reforms have been driven and supported by a substantial body of research, much of which has uncritically accepted the view that technology-rich reform is inherently “good” or necessary. Learning technology research has thus tended to focus on epistemological matters such as learning design at the expense of ontology. This paper engages with emerging research into technology as an identity issue for learners and teachers to explore the implications of technology-driven education reform on educational institutions, policies and practices.
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The following bibliography focuses mainly on programs which can run on IBM microcomputers and compatibles under the operating system PC DOS/MS DOS, and which can be used in online…
Abstract
The following bibliography focuses mainly on programs which can run on IBM microcomputers and compatibles under the operating system PC DOS/MS DOS, and which can be used in online information and documentation work. They fall into the following categories:
Catherine C. Quatman-Yates, Mark V. Paterno, Mariann L. Strenk, Michelle A. Kiger, Tory H. Hogan, Brian Cunningham and Rebecca Reder
The importance of culture is often emphasized for continuous learning and quality improvement within health care organizations. Limited empirical evidence for cultivating a…
Abstract
The importance of culture is often emphasized for continuous learning and quality improvement within health care organizations. Limited empirical evidence for cultivating a culture that supports continuous learning and quality improvement in health care settings is currently available.
The purpose of this report is to characterize the evolution of a large division of physical therapists and occupational therapists in a pediatric hospital setting from 2005 to 2018 to identify key facilitators and barriers for cultivating a culture empowered to engage in continuous learning and improvement.
An ethnographic methodology was used including participant observation, document review, and stakeholder interviews to acquire a deep understanding and develop a theoretical model to depict insights gained from the investigation.
A variety of individual, social, and structural enablers and motivators emerged as key influences toward a culture empowered to support continuous learning and improvement. Features of the system that helped create sustainable, positive momentum (e.g., systems thinking, leaders with grit, and mindful design) and factors that hindered momentum (e.g., system uncertainty, staff turnover, slow barrier resolution, and competing priorities) were also identified.
Individual-level, social-level, and structural-level elements all influenced the culture that emerged over a 12-year period. Several cultural catalysts and deterrents emerged as factors that supported and hindered progress and sustainability of the emergent culture.
Cultivating a culture of continuous learning and improvement is possible. Purposeful consideration of the proposed model and identified factors from this report may yield important insights to advance understanding of how to cultivate a culture that facilitates continuous learning and improvement within a health care setting.
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Larry W. Isaac, Daniel B. Cornfield, Dennis C. Dickerson, James M. Lawson and Jonathan S. Coley
While it is generally well known that nonviolent collective action was widely deployed in the US southern civil rights movement, there is still much that we do not know about how…
Abstract
While it is generally well known that nonviolent collective action was widely deployed in the US southern civil rights movement, there is still much that we do not know about how that came to be. Drawing on primary data that consist of detailed semistructured interviews with members of the Nashville nonviolent movement during the late 1950s and 1960s, we contribute unique insights about how the nonviolent repertoire was diffused into one movement current that became integral to moving the wider southern movement. Innovating with the concept of serially linked movement schools – locations where the deeply intense work took place, the didactic and dialogical labor of analyzing, experimenting, creatively translating, and resocializing human agents in preparation for dangerous performance – we follow the biographical paths of carriers of the nonviolent Gandhian repertoire as it was learned, debated, transformed, and carried from India to the Fellowship of Reconciliation (FOR) and Howard University to Nashville (TN) and then into multiple movement campaigns across the South. Members of the Nashville movement core cadre – products of the Nashville movement workshop schools – were especially important because they served as bridging leaders by serially linking schools and collective action campaigns. In this way, they played critical roles in bridging structural holes (places where the movement had yet to be successfully established) and were central to diffusing the movement throughout the South. Our theoretical and empirical approach contributes to the development of the dialogical perspective on movement diffusion generally and to knowledge about how the nonviolent repertoire became integral to the US civil rights movement in particular.
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Larry W. Isaac, Daniel B. Cornfield and Dennis C. Dickerson
Knowledge of how social movements move, diffuse, and expand collective action events is central to movement scholarship and activist practice. Our purpose is to extend…
Abstract
Knowledge of how social movements move, diffuse, and expand collective action events is central to movement scholarship and activist practice. Our purpose is to extend sociological knowledge about how movements (sometimes) diffuse and amplify insurgent actions, that is, how movements move. We extend movement diffusion theory by drawing a conceptual analogue with military theory and practice applied to the case of the organized and highly disciplined nonviolent Nashville civil rights movement in the late 1950s and early 1960s. We emphasize emplacement in a base-mission extension model whereby a movement base is built in a community establishing a social movement school for inculcating discipline and performative training in cadre who engage in insurgent operations extended from that base to outlying events and campaigns. Our data are drawn from secondary sources and semi-structured interviews conducted with participants of the Nashville civil rights movement. The analytic strategy employs a variant of the “extended case method,” where extension is constituted by movement agents following paths from base to outlying campaigns or events. Evidence shows that the Nashville movement established an exemplary local movement base that led to important changes in that city but also spawned traveling movement cadre who moved movement actions in an extensive series of pathways linking the Nashville base to events and campaigns across the southern theater of the civil rights movement. We conclude with theoretical and practical implications.
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Stella Williams, Anatoli Karypidou, Catherine Steele and Lorna Dodd
The purpose of this paper is to adopt the perspective of personal construct theory to conceptualise employability. The study explores differences in the implicit employability…
Abstract
Purpose
The purpose of this paper is to adopt the perspective of personal construct theory to conceptualise employability. The study explores differences in the implicit employability theories of those involved in developing employability (educators) and those selecting and recruiting higher education (HE) students and graduates (employers).
Design/methodology/approach
A repertory grid technique (RGT) was employed to uncover the implicit theories of 22 employers and 14 educators across the UK.
Findings
A total of 717 constructs were elicited. A differential analysis of data gathered demonstrated several areas of consensus among employers and educators (including emotional management, confidence, professionalism), as well as divergence in representations of commitment, proactivity, interpersonal competencies and vision to the conceptualisation of employability.
Practical implications
Findings from this analysis indicate a need to integrate group process assessments within undergraduate programmes and recruitment procedures.
Originality/value
This study represents a personal construct approach to employability, utilising the unique value of RGT to further inform our understanding of employability within an HE context. This study contributes to an understanding of employability as a continually re-constructed concept. This study provides insights to its nature via two information rich cases that have extensive knowledge on the topic.
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This chapter describes a case study of a social change project in medical education (primary care), in which the critical interpretive evaluation methodology I sought to use came…
Abstract
This chapter describes a case study of a social change project in medical education (primary care), in which the critical interpretive evaluation methodology I sought to use came up against the “positivist” approach preferred by senior figures in the medical school who commissioned the evaluation.
I describe the background to the study and justify the evaluation approach and methods employed in the case study – drawing on interviews, document analysis, survey research, participant observation, literature reviews, and critical incidents – one of which was the decision by the medical school hierarchy to restrict my contact with the lay community in my official evaluation duties. The use of critical ethnography also embraced wider questions about circuits of power and the social and political contexts within which the “social change” effort occurred.
Central to my analysis is John Gaventa’s theory of power as “the internalization of values that inhibit consciousness and participation while encouraging powerlessness and dependency.” Gaventa argued, essentially, that the evocation of power has as much to do with preventing decisions as with bringing them about. My chosen case illustrated all three dimensions of power that Gaventa originally uncovered in his portrait of self-interested Appalachian coal mine owners: (1) communities were largely excluded from decision making power; (2) issues were avoided or suppressed; and (3) the interests of the oppressed went largely unrecognized.
The account is auto-ethnographic, hence the study is limited by my abilities, biases, and subject positions. I reflect on these in the chapter.
The study not only illustrates the unique contribution of case study as a research methodology but also its low status in the positivist paradigm adhered to by many doctors. Indeed, the tension between the potential of case study to illuminate the complexities of community engagement through thick description and the rejection of this very method as inherently “flawed” suggests that medical education may be doomed to its neoliberal fate for some time to come.