The emperor’s edicts stop at the village gate

O’Connor, Nick; Kotzé, Beth; Vine, Ruth; Patton, Murray; Newton, Richard

doi:10.1177/1039856211432460

Cited by 6 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Changing and/or developing new policy is a time-intensive and protracted process, and because it takes so long to achieve, the literature suggests that much of the initial momentum is lost and the adverse event has been replaced by more pressing concerns in the day-to-day operations of the clinical teams. 34,40,41 This was also confirmed by the participants in the current study.…”

Section: Resultssupporting

confidence: 81%

“…4 Policies are perceived to be blunt instruments for initiating and sustaining change. 33,34,42 Implementation of policy is often a lengthy and fraught process; it can be resource intensive; it often involves a top-down approach; and policies are not perceived as useful, meaningful, or potent by the clinical staff meant to implement them. 27 By the time policies are implemented, the salience and immediacy of the RCA finding have dissipated.…”

Section: Discussionmentioning

confidence: 99%

“…Risks for harm to self and others are not static; indeed, changeability has been identified as an important assessment component. 34 Risk is dynamic and risk assessments need to be conducted frequently. Even when comprehensive risk assessments have been conducted by mental health staff, this may not prevent adverse events from occurring.…”

Section: Utility Of Rcas In Mental Health Servicesmentioning

confidence: 99%

See 2 more Smart Citations

The Causes of Their Death Appear (Unto Our Shame Perpetual): Why Root Cause Analysis Is Not the Best Model for Error Investigation in Mental Health Services

Vrklevski¹,

McKechnie²,

O’Connor³

2018

J Patient Saf

View full text Add to dashboard Cite

show abstract

Section: Resultssupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Utility Of Rcas In Mental Health Servicesmentioning

confidence: 99%

See 1 more Smart Citation

The Causes of Their Death Appear (Unto Our Shame Perpetual): Why Root Cause Analysis Is Not the Best Model for Error Investigation in Mental Health Services

Vrklevski¹,

McKechnie²,

O’Connor³

2018

J Patient Saf

View full text Add to dashboard Cite

show abstract

“…Implementation was perceived as chaotic and unplanned, and managers reported feeling unskilled and unprepared for effecting change within the health setting. In this context, managers appeared to impede change by not committing adequate resources to the implementation, which resulted in clinicians becoming over‐burdened and limited success of implementation . Organizations should train managers and staff in implementation frameworks and relevant change theory, so they are better able to influence the implementation process …”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators to the implementation of a stepped care intervention for personality disorder in mental health services

Pigot

Miller

Brockman

et al. 2019

Personality & Mental Health

View full text Add to dashboard Cite

Background -Individuals with personality disorders-particularly borderline personality disorder-are high users of mental health treatment services. Emergency service responses often focus on crisis management, and there are limited opportunities to provide appropriate longer term evidence-based treatment. Many individuals with personality disorders find themselves in a revolving cycle between emergency departments and waiting for community treatment. A stepped care approach may help to triage clients and allow access to interventions with minimal client, clinician and system burden. This study aims to understand the facilitators and barriers to realworld implementation of a stepped care approach to treating personality disorders. Methods -Managers and clinicians of health services engaged in implementation were interviewed to obtain accounts of experiences. Interviews were transcribed and thematically analysed to generate themes describing barriers and facilitators. Results -Participants identified personal attitudes, knowledge and skills as important for successful implementation. Existing positive attitudes and beliefs about treating people with a personality disorder contributed to the emergence of clinical champions. Training facilitated positive attitudes by justifying the psychological approach. Management support was found to bi-directionally effect implementation. Conclusions -This study suggests specific organizational and individual factors may increase timely and efficient implementation of interventions for people with personality disorders.

show abstract

“…A tendency for some trainers to utilise WPBA in the manner they see fit may also be derived from some medical staff (who will represent the vast majority of assessors) valuing autonomy, being resistant to change, and excluding themselves from policy implementation (16). Whatever the underlying motive, it is the trainer who leads the episode and adapting it carries the potential risk of unfairness to those being assessed and misinforming those who utilise the assessments' results.…”

Section: Discussionmentioning

confidence: 99%

Workplace based assessment in clinical radiology – diverse practice and its implications

Ramsden¹,

Roberts²

2015

MedEdPublish

View full text Add to dashboard Cite

Objectives: In 2010 the Royal College of Radiologists (RCR) introduced workplace based assessment (WPBA) into clinical radiology training. The study purposes were firstly to investigate the implementation of WPBA by examining its day-today realisation in practice and to relate these findings to the guidance provided by the RCR. The second aim was to explore where the usage of WPBA differed from the RCR's declared intention and to examine the reasons for this deviation. Methods: Semi-structured interviews were undertaken with 20 radiologists (12 trainers, 8 trainees) to explore their opinions on the implementation and usage of WPBA in radiology. The interview data were analysed using thematic analysis. Results: The themes derived from the analysis were amending the assessments' purpose, altering WPBA's usage depending upon trainees' seniority or time in an attachment, amending the recording of assessments, and assessing trainees without their knowledge. In terms of amending the assessments' purpose, all interviewees thought that WPBA had a formative ethos but some assessors felt it could be used summatively in certain circumstances. The day-today realisation of WPBA varied, and although this might be seen as inevitable due to differing circumstances, there was evidence of some trainers consciously amending the process. Conclusions: There was variation in the realisation of WPBA beyond that caused by their timing or context related to conscious adaptation of the process by trainers. Although such diversity of practice may or may not have impacted adversely upon the process, there is potential to introduce unfairness into WPBA and thereby disadvantage trainees.

show abstract

The emperor’s edicts stop at the village gate

Cited by 6 publications

References 16 publications

The Causes of Their Death Appear (Unto Our Shame Perpetual): Why Root Cause Analysis Is Not the Best Model for Error Investigation in Mental Health Services

The Causes of Their Death Appear (Unto Our Shame Perpetual): Why Root Cause Analysis Is Not the Best Model for Error Investigation in Mental Health Services

Barriers and facilitators to the implementation of a stepped care intervention for personality disorder in mental health services

Workplace based assessment in clinical radiology – diverse practice and its implications

Contact Info

Product

Resources

About