Equipped: overcoming barriers to change to improve quality of care (theories of change)

Lachman, Peter; Runnacles, Jane; Dudley, Jan

doi:10.1136/archdischild-2013-305193

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…Kotter's eight stage theory of organizational change [15] is a promising approach that is congruent with the use of CBPR. The first step is creating a sense of urgency and seizing or creating a significant opportunity to sensitize people to get involved in change.…”

Section: Discussionmentioning

confidence: 99%

“…The first step is creating a sense of urgency and seizing or creating a significant opportunity to sensitize people to get involved in change. [15] Stakeholders of nursing education expressed concern that clinical nursing standards in Ghana were dropping and attributed it to increased student nurse numbers. There was agreement that changes in clinical education in schools of nursing are needed.…”

Section: Discussionmentioning

confidence: 99%

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Assessing challenges of clinical education in a baccalaureate nursing program in Ghana

Asirifi

Ogilvie

Barton

et al. 2017

JNEP

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Background: A 2010 study of preceptorship as a clinical teaching model in Ghana revealed weaknesses related to high student-preceptor ratios and inadequate support from faculty in the educational institution. A four-cycle community-based participatory action research study was designed to further delineate clinical teaching and learning issues and partner with Ghanaian stakeholders in critical analysis of possibilities for positive change in clinical nursing education. The purpose of this paper, taken from Cycle One of the study, is to provide understanding of the challenges of the current clinical teaching model(s) used in the study institution from the perspectives of students and faculty. Early engagement of external stakeholders is described. Methods: Each university target group was invited to complete a semi-structured questionnaire. Interviews were conducted with representatives from the Ministry of Health, the Nursing and Midwifery Council of Ghana, and the Ghana Registered Nurses' and Midwives' Association. Clinical documents were examined. Results: Clinical teaching and learning issues identified included the need for: a) more effective clinical teaching and supervision; b) adequate equipment for practice; c) meaningful evaluation of performance; d) enhanced collaboration between the school and clinical settings; and, e) reduced travel time to clinical opportunities. External stakeholders became aware and supportive of the research endeavour. Conclusions: Participants acknowledged changes are needed in order to improve clinical nursing education in Ghana. Clinical teaching and learning issues were identified and formed a baseline from which more in-depth discussion of resources, constraints and possibilities for change could ensue in subsequent cycles of the study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessing challenges of clinical education in a baccalaureate nursing program in Ghana

Asirifi

Ogilvie

Barton

et al. 2017

JNEP

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“…37 Aside from the PTC's strengthening, intra-hospital communication and multidisciplinary teamwork under the leadership support of the organization were mentioned as micro-and meso-contributions to the quality of healthcare in many studies. 28,29,[38][39][40] Participants perceived that effective communication between the healthcare provider and the patient was a facilitating factor because the patient's acceptance of treatment was directly related to the effectiveness of doctor-patient communication.…”

Section: The Impacts On the Individual Level And Organizational Levelmentioning

confidence: 99%

Facilitators and barriers of the rational drug use hospital program in Thailand

Khumsikiew,

Sripa,

Moolasarn

et al. 2023

PHARMPRACT

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The Thailand Ministry of Public Health has started a rational drug use (RDU) policy, which includes multifaceted strategies as well as the RDU hospital program to tackle irrational drug use. Objective: To investigate facilitators and barriers related to the CIPP model of the RDU hospital program in Thailand. Methods: This is a qualitative study. Data were collected through semi-structured interviews with regional policymakers who were members of the executive board for RDU management in the 10th health region. The interviews were conducted via telephone using a topic guide informed by the CIPP framework and reviewed for content validity by the research team. Data were transcribed, and thematically analyzed. Results: Fifteen pharmaceutical policymakers were interviewed. The main facilitators related to context, input, and process were the national policy on RDU, RDU awareness/practices among health professionals, particularly prescribers, and multidisciplinary teamwork under the organization's leadership to use data feedback to improve the program. The main barriers related to context, input, and process were a lack of policy advocacy at the regional and provincial levels, doctor-related reasons such as medicolegal concerns, and a lack of multidisciplinary teamwork. For the product theme, participants were very satisfied and perceived positive impacts at both the individual and organizational levels, such as increased RDU awareness in patients and multidisciplinary teams, as well as RDU prescription. However, negative impacts, such as tensions surrounding professional responsibility and accountability, have been observed. Conclusion: Although the participants expressed high satisfaction levels and positive impacts, there is still room for improvement in the specified themes. In addition, drug regulatory policies in all accessible channels, a multidisciplinary RDU curriculum, and public education to control irrational medication use and raise patient awareness should be increased to encourage sustainable RDU behavior..

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“…The RCP Quality Improvement Hub will engage clinicians at an early stage of their training to make changes to their day-to-day work and encourage the use of appropriate data as a driver for improvement. 36 The hub will aim to achieve this by supporting and mentoring teams undertaking quality improvement work in addition to focusing on the psychology of change, such as challenging the beliefs, values and assumptions of those working in the system. 24,36 The RCP is committed to ensuring 'the best possible health and healthcare for everyone' and emphasises the need to improve care for patients via 'quality and service improvement'.…”

Section: The Purpose Of the Quality Improvement Hubmentioning

confidence: 99%

“…36 The hub will aim to achieve this by supporting and mentoring teams undertaking quality improvement work in addition to focusing on the psychology of change, such as challenging the beliefs, values and assumptions of those working in the system. 24,36 The RCP is committed to ensuring 'the best possible health and healthcare for everyone' and emphasises the need to improve care for patients via 'quality and service improvement'. 37 The hub will aim to build on this by supporting clinicians to develop and establish sustainable quality improvement competencies and capability, and enabling capacity for improvement to be developed across the clinical team.…”

Section: The Purpose Of the Quality Improvement Hubmentioning

confidence: 99%

The Royal College of Physician’s Quality Improvement Hub – how can it help physicians to improve patient care?

Choudry

Stewart

Woodhead

2016

Future Hospital Journal

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Doctors have a central role in managing patients across a multitude of clinical environments, which places them in the ideal position to identify systemic issues. Traditional medical training focuses on the knowledge and technical skills required; rarely are doctors trained in leadership, management or how to analyse and understand systems so as to design safer, better care. Quality improvement methodology is an approach that is known to enable improvement of the systems in which healthcare professionals work in order to provide safe, timely, evidence-based, equitable, efficient and patient-centred care. To address the current disparity, the Royal College of Physicians (RCP) has launched a Quality Improvement Hub, which will aim to support physicians to face the challenges of improving medical care, enabling them to navigate the tools with more confidence and share and implement the learning more swiftly.

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Equipped: overcoming barriers to change to improve quality of care (theories of change)

Cited by 6 publications

References 12 publications

Assessing challenges of clinical education in a baccalaureate nursing program in Ghana

Assessing challenges of clinical education in a baccalaureate nursing program in Ghana

Facilitators and barriers of the rational drug use hospital program in Thailand

The Royal College of Physician’s Quality Improvement Hub – how can it help physicians to improve patient care?

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