Jennifer Martin, Maureen A. Flynn, Zuneera Khurshid, John J. Fitzsimons, Gemma Moore and Philip Crowley
The purpose of this study is to present a quality improvement approach titled “Picture-Understanding-Action” used in Ireland to enhance the role of healthcare boards in the…
Abstract
Purpose
The purpose of this study is to present a quality improvement approach titled “Picture-Understanding-Action” used in Ireland to enhance the role of healthcare boards in the oversight of healthcare quality and its improvement.
Design/methodology/approach
The novel and practical “Picture-Understanding-Action” approach was implemented using the Model for Improvement to iteratively introduce changes across three quality improvement projects. This approach outlines the concepts and activities used at each step to support planning and implementation of processes that allow a board to effectively achieve its role in overseeing and improving quality. This approach matured over three quality improvement projects.
Findings
The “Picture” included quantitative and qualitative aspects. The quantitative “Picture” consisted of a quality dashboard/profile of board selected outcome indicators representative of the health system using statistical process control (SPC) charts to focus discussion on real signals of change. The qualitative picture was based on the experience of people who use and work in health services which “people-ised” the numbers. Probing this “Picture” with collective grounding, curiosity and expert training/facilitation developed a shared “Understanding”. This led to “Action(s)” from board members to improve the “Picture” and “Understanding” (feedback action), to ask better questions and make better decisions and recommendations to the executive (feed-forward action). The Model for Improvement, Plan-Do-Study-Act cycles and a co-design approach in design and implementation were key to success.
Originality/value
To the authors’ knowledge, this is the first time a board has undertaken a quality improvement (QI) project to enhance its own processes. It addresses a gap in research by outlining actions that boards can take to improve their oversight of quality of care.
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Jennifer Martin, Zuneera Khurshid, Gemma Moore, Michael Carton, John J. Fitzsimons, Colm Henry and Maureen A. Flynn
This paper describes a quality improvement project to improve oversight of quality at national board level using statistical process control (SPC) methods, complimented by a…
Abstract
Purpose
This paper describes a quality improvement project to improve oversight of quality at national board level using statistical process control (SPC) methods, complimented by a qualitative experience of patients and frontline staff. It demonstrates the application of the “Picture-Understanding-Action” approach and shares the lessons learnt.
Design/methodology/approach
Using co-design and applying the “Picture-Understanding-Action” approach, the project team supported the directors of the Irish health system to identify and test a qualitative and quantitative picture of the quality of care across the health system. A “Quality Profile” consisting of quantitative indicators, analysed using SPC methods was used to provide an overview of the “critical few” indicators across health and social care. Patient and front-line staff experiences added depth and context to the data. These methods were tested and evolved over the course of six meetings, leading to quality of care being prioritised and interrogated at board level.
Findings
This project resulted in the integration of quality as a substantive and prioritised agenda item. Using best practice SPC methods with associated training produced better understanding of performance of the system. In addition, bringing patient and staff experiences of quality to the forefront “people-ised” the data.
Originality/value
The application of the “Picture-Understanding-Action” approach facilitated the development of a co-designed quality agenda item. This is a novel process that shifted the focus from “providing” information to co-designing fit-for-purpose information at board level.
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Mags Adams, Gemma Moore, Trevor Cox, Ben Croxford, Mohamed Refaee and Stephen Sharples
This chapter considers the role and potential of sensory urbanism as an approach to exploring people's sensorial experiences and understandings of their local environments. Such…
Abstract
This chapter considers the role and potential of sensory urbanism as an approach to exploring people's sensorial experiences and understandings of their local environments. Such an approach is warranted given the influential role of the senses in developing and affecting experience of the urban environment. Debate about the role of the senses in shaping urban experience has progressed in recent years and increasingly is taking place across disciplines (Adams & Guy, 2007). Pallasmaa (2005, p. 40) describes this sensory urban engagement when he says:I confront the city with my body … I experience myself in the city, and the city exists through my embodied experience. The city and my body supplement and define each other. I dwell in the city and the city dwells in me.
Geraldine Ann Akerman, Emily Jones, Harry Talbot and Gemma Grahame-Wright
This paper aims to describe the impact of the COVID-19 pandemic on a prison-based therapeutic community (TC).
Abstract
Purpose
This paper aims to describe the impact of the COVID-19 pandemic on a prison-based therapeutic community (TC).
Design/methodology/approach
The paper takes the form of a case study where the authors reflect on their current practice, using the findings of research on social isolation and the overarching TC principles to explore the effect of the pandemic on the TC at HMP Grendon. The authors consider how the residents and staff adjusted to the change as the parameters changed when the social distancing rules were imposed and how they adapted to the prolonged break to therapy. Sections in the paper were written by a resident and an operational member of staff. The authors conclude with their thoughts on how to manage the consequences the lockdown has brought and start to think about what returning to “normality” might mean.
Findings
The paper describes the adjustments made by the residents and staff as the UK Government imposed the lockdown. The authors, including a resident and an operational member of staff comment on the psychological and practical impact these adjustments had. The thought is given to the idea of “recovery”, returning to “normality” and how this study can be best managed once restrictions are lifted.
Research limitations/implications
At the time of writing, there are no confirmed cases of COVID-19 at HMP Grendon. The measures and commitment from all staff and residents in the prison to keep the prison environment safe may in part account for this. This paper explores the effects of lockdown on the emotional environment in a TC and highlights the consequences that social isolation can have on any individual. To the authors’ knowledge, there is currently no research undertaken on the impact of lockdown/social isolation on a TC. This research would be useful, as the authors postulate from reflections on current practice that the effects of the lockdown will be greater in a social therapy environment.
Originality/value
HMP Grendon started in 1962, as this time there have been no significant events that have meant the suspension of therapy for such a sustained period. It is, therefore, important that the impact of such is considered and reflected upon.
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Gemma Dale, Hannah Wilson and Matthew Tucker
This research investigates the personal experiences of hybrid workers, exploring their perspectives on their health and well-being when undertaking hybrid working arrangements…
Abstract
Purpose
This research investigates the personal experiences of hybrid workers, exploring their perspectives on their health and well-being when undertaking hybrid working arrangements. The research further explores how organisations can proactively support the health and wellbeing of hybrid workers, mitigating any potential health risks.
Design/methodology/approach
A cross-sectional, qualitative online survey was used to collect data from 412 hybrid workers. The data were analysed thematically. This approach allows for nuanced insights into the personal experiences of hybrid workers to be understood.
Findings
Findings indicate that employees who undertake hybrid work experience both positive and negative effects on their subjective well-being; hybrid work arrangement has the potential to act as a job resource or job demand. The study further identifies actions that can support healthy hybrid work that will be of value to organisations offering these working arrangements.
Originality/value
Although empirical research has previously examined the relationship between remote work and employee well-being, there is a lack of in-depth understanding about employees’ experiences of well-being whilst undertaking hybrid work – an emerging and relatively unexplored working arrangement. This research therefore addresses a significant gap in the literature by providing a deep understanding of how hybrid work influences employee well-being. Furthermore, previous research has not yet explored how hybrid worker health can be enabled and supported by organisations and individuals themselves.
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Hannah Kira Wilson, Matthew Tucker and Gemma Dale
This research investigates the challenges and benefits of working from home and the needs that organisations should understand when adopting working from home practices.
Abstract
Purpose
This research investigates the challenges and benefits of working from home and the needs that organisations should understand when adopting working from home practices.
Design/methodology/approach
Self-determination theory was used to understand the drivers of motivation when working from home, to provide a deep understanding of how organisations may support employees working from home. A cross-sectional qualitative survey design was used to collect data from 511 office workers during May and June of 2020.
Findings
Employees' needs for competence were thwarted by a lack of direction and focus, unsuitable work environment, work extensification and negative work culture. Employees' experiences and needs for relatedness were more diverse, identifying that they enjoyed spending more time with family and having a greater connection to the outdoors, but felt more isolated and suffered from a lack of interaction. Employees' experiences of autonomy whilst working from home were also mixed, having less autonomy from blurred boundaries between home and work, as well as childcare responsibilities. Conversely, there was more freedom to be able to concentrate on physical health.
Practical implications
Employee’s needs for competence should be prioritised. Organisations must be conscious of this and provide the support that enables direction and focus when working at home.
Originality/value
Swathes of research were conducted during the COVID-19 pandemic, but overwhelmingly focused on quantitative methods. A qualitative survey design enabled participants to answer meaningful open-ended questions, better suited to explain the complexity of their experiences, which allowed for understanding and richness not gained through previous studies.
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This paper aims to contribute to prior gender-based conceptual models within organisational and management studies by incorporating an additional lens of disability. The authors…
Abstract
Purpose
This paper aims to contribute to prior gender-based conceptual models within organisational and management studies by incorporating an additional lens of disability. The authors present a context specific and embodied based model that we call the “two-way mirror effect” which accounts for the environmental and discursive effects of gender and disability within the workplace.
Design/methodology/approach
The paper reviews existing literature on gender, disability and employment and uses that literature to construct and support the concept of a two-way mirror effect.
Findings
By drawing on organisation and management-based studies, the authors have shown how previous models do not currently account for the experiences of disabled women within the workplace. Disabled workers, and especially disabled women face a myriad of unique barriers, including masculine and able-bodied employment practices (e.g. performative expectations) and exclusionary physical spaces (e.g. access, location to required facilities), that exclude them from full employment participation.
Practical implications
The review of existing literature and conceptual models reveal the gaps in research that academics and practitioners can build upon and the paper identifies the dominant norms that are embedded within organisational practices, which can be challenged to promote inclusion and equality.
Originality/value
The authors present a new intersectional-based conceptual model to fill a gap in organisational and management-based studies that accounts for the unique employment experiences of disabled employees, specifically disabled women.
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The purpose of this paper is to suggest that the emergence of substituted cathinones or M-cat drugs (notably mephedrone and methylone) and their rapid proliferation of use…
Abstract
Purpose
The purpose of this paper is to suggest that the emergence of substituted cathinones or M-cat drugs (notably mephedrone and methylone) and their rapid proliferation of use, amongst drug users in the UK from 2009 onwards, signals changes in the habits, preferences and lifestyle choices made by certain drug users, whilst also indicating a pronounced increase in the levels of co-morbid mental health conditions experienced by another, yet often distinct, group of users.
Design/methodology/approach
This latter group of users, it is suggested, tend to initiate use of psychoactive substances (including tobacco and alcohol) at a younger age. In addition, it is suggested, they often present to treatment and criminal justice services with a history of chronic childhood relational trauma, as a background against which severe patterns of drug abuse has evolved. In this light the lack of significant supplies of social capital, as a protective factor against the development of chronic drug use, is further considered in the paper that follows though a brief literature review and qualitative clinical case reports.
Findings
Novel psychoactive substances ( Newcombe, 2013) appear so seductive, for a certain group of users, because they seem to provide a temporary form of cognitive and emotional anaesthesia, enabling users to self-medicate, often against experiences of profound psychological trauma and contemporary lives that are typically experienced as boring, hopeless and pointless. The euphoric effects of psycho-stimulants such as mephedrone are particularly appealing to individuals attempting to escape a subjective sense of daily dysphoria and may on this basis lead to, rather than recreational use, more persistent patterns of drug use. However, in contradistinction to this group of users, another recreational – mainly weekend leisure – group of users continues to evidence a voracious appetite for psycho-stimulant substances.
Originality/value
It is suggested that this second group of users has been particularly influential in substitute displacement towards the emergence of legal highs, due to the poor quality and illegal status of street drugs such as cocaine, amphetamine sulphate and MDMA (ecstasy).
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Gemma Edgar and Frances Lockie
The purpose of this paper is to focus on compacts and their effectiveness in ensuring that non‐government organisations (NGOs) are able to remain independent, critical checks on…
Abstract
Purpose
The purpose of this paper is to focus on compacts and their effectiveness in ensuring that non‐government organisations (NGOs) are able to remain independent, critical checks on government.
Design/methodology/approach
The experiences of the English Compact and the Working Together for NSW agreement, created in the Australian state of New South Wales (NSW). The analysis of Working Together relies upon interviews conducted with key informants involved in its negotiation. Using these cases the effectiveness of compacts in supporting NGOs, particularly in their role as advocates is examined.
Findings
The paper finds that, despite the similarities between the English Compact and Working Together, the NSW government has not produced similar supporting structures or mechanisms and that no champion exists to drive it within government. As a result, awareness of Working Together is low in both the NSW government and among NGOs, and, unlike the English Compact, it has had little effect on the ability of NGOs to advocate independently. As such, it is suggested that compacts do not offer long‐term solutions to the difficulties in the relationship between governments and NGOs. This is because their efficacy is reliant upon the support of government.
Research limitations/implications
The list of interviewees is by no means exhaustive. Despite numerous attempts, the authors were unable to obtain interviews from a number of figures approached from middle‐level departments within the NSW state government.
Originality/value
The interviews are original and new to the literature on compacts. This interview material is especially useful as little literature exists that analyses the Working Together for NSW agreement.