How can health bureaucracies consult effectively about their policies and practices?: some lessons from an Australian study

Putland, Christine; Baum, Fran; MacDougall, Colin

doi:10.1093/heapro/12.4.299

Cited by 22 publications

(20 citation statements)

References 5 publications

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“…System inflexibility is a characteristic of the bureaucracy of acute hospital environments 25. As can be seen from fig 2, the local collaborative team achieved improvements in the number of patients receiving documented levels of titrated ACE inhibitors and β blockers.…”

Section: Resultsmentioning

confidence: 98%

Barriers and facilitators to the implementation of the collaborative method: reflections from a single site

Newton

Davidson

Halcomb

et al. 2007

Quality and Safety in Health Care

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Background: A collaborative is an effective method of implementing evidence-based practice across multiple sites through the sharing of experience and knowledge of others in a similar setting, over a short period of time. Collaborative methods were first used in the USA but have been adopted internationally. Aim: This paper sought to document the facilitators and barriers to the implementation of the collaborative method, based on a single site's experience of participating in a multisite, state-wide heart failure collaborative. Method: Qualitative data was collected using three complementary methods: participant observation, reflective journalling and key informant interviews. Quantitative monitoring of team performance occurred monthly according to prespecified performance indicators. Findings: Barriers and facilitators that were identified by this study included: organisational factors, team composition, dynamics and networking, changing doctor behaviour, clinical leadership and communication. Conclusion:The findings from this study underscore the importance of leadership, communication and team cohesion for the successful implementation of the collaborative method at individual sites. In addition, the importance of a preparatory stage that deals with known barriers and facilitators to the collaborative method before the commencement of the official study period was highlighted. The potential for the collaborative approach to improve clinical outcomes warrants further systematic evaluation of process issues and consideration of the barriers and facilitators to implementation in various settings.

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Section: Resultsmentioning

confidence: 98%

Barriers and facilitators to the implementation of the collaborative method: reflections from a single site

Newton

Davidson

Halcomb

et al. 2007

Quality and Safety in Health Care

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“…8,136 The key conditions that the survey highlighted as enabling an organisation to consult effectively were similar to those in involving consumers in research agenda setting: official endorsement of consultation at senior levels; staff with expertise, experience and skills in consultative practices; constructive and on-going relationships with communities; valuing the knowledge and experience of community members; and representative mechanisms which recognise and respect difference. Other conditions that may also be transferable to consumer involvement in research agenda setting were decentralised and devolved decision-making for greater accessibility, responsiveness and flexibility; simple, clear and consistent structures and procedures; stability in functional responsibilities and continuity of staff; and balanced requirements for economic efficiency and social justice.…”

Section: Related Literaturementioning

confidence: 96%

Involving consumers in research and development agenda setting for the NHS: developing an evidence-based approach

Oliver¹,

Clarke‐Jones²,

Rees³

et al. 2004

Health Technol Assess

324

351

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“…2 It takes time to build relationships and trust. 34 Rural communities can be conservative and suspicious of change, making the role of service providers living locally who are seen as imposing change uncomfortable. 35 Health system employees who live locally can use the lens of a community member to analyse and lead actions to build and engage community capacity for health development.…”

Section: Participation Frameworkmentioning

confidence: 99%

Multi‐level rural community engagement in health

Kilpatrick

2009

Australian J Rural Health

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Community participation in health is consistent with notions of democracy. A systems perspective of engagement can see consumers engaged to legitimise government agendas. Often community participation is via consultation instead of partnership or delegation. A community development approach to engagement can empower communities to take responsibility for their own health care. Understanding rural place facilitates alignment between health programs and community, assists in incorporating community resources into health care and provides information about health needs. Rural communities, health services and other community organisations need skills in working together to develop effective partnerships that transfer some power from health systems. Rural engagement with national/state agendas is a challenge. Community engagement takes time and resources, but can be expected to lead to better health outcomes for rural residents.

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How can health bureaucracies consult effectively about their policies and practices?: some lessons from an Australian study

Cited by 22 publications

References 5 publications

Barriers and facilitators to the implementation of the collaborative method: reflections from a single site

Barriers and facilitators to the implementation of the collaborative method: reflections from a single site

Involving consumers in research and development agenda setting for the NHS: developing an evidence-based approach

Multi‐level rural community engagement in health

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