Understanding how professionals cultures impact implementation of a pediatric oncology genomic test: Using ethnographic participant observation in deliberative stakeholder consultations
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 28 November 2019
Issue publication date: 3 December 2019
Abstract
Purpose
Healthcare innovation, exemplified by genomic medicine, requires increasingly sophisticated understanding of the interdisciplinary-organizational context in which new innovations are implemented. Deliberative stakeholder consultations are public engagement tools that are gaining increasing traction in health care, as a means of maximizing the diversity of roles and interests vested in a particular policy or practice issue. They engage participants from different knowledge systems (“cultures”) in mutually respectful debate to enable group consensus on implementation strategies. Current deliberation analytic methods tend to overlook the cultural contexts of the deliberative process. The paper aims to discuss this issue.
Design/methodology/approach
This conceptual paper proposes adding ethnographic participant observation to provide a more comprehensive account of the process that gives rise to deliberative outputs. To underpin this conceptual paper, the authors draw on the authors’ experience engaging healthcare professionals during implementation of genomics in the care for pediatric oncology patients with treatment-resistant glioblastoma at two tertiary care hospitals.
Findings
Ethnography enabled a deeper understanding of deliberative outcomes by combining rhetorical and non-rhetorical analysis to identify the implementation and coordination of care barriers across professional cultures.
Originality/value
This paper highlights the value of ethnographic methods in enabling a more comprehensive assessment of the quality of engagement across professional cultures in implementation studies.
Keywords
Acknowledgements
Funding for this project was provided to G. Bartlett as a co-investigator on the grant entitled, “Biomarkers for Pediatric Glioblastoma through Genomics and Epigenomics” awarded to Dr Nada Jabado through the 2012 Large-Scale Applied Research Project Competition – Genomics and Personalized Health funded by Genome Canada, Genome Quebec and the Canadian Institutes for Health Research. The authors have no conflict of interest to declare.
Citation
Gagnon, J., Rahimzadeh, V., Longo, C., Nugus, P. and Bartlett, G. (2019), "Understanding how professionals cultures impact implementation of a pediatric oncology genomic test: Using ethnographic participant observation in deliberative stakeholder consultations", Journal of Health Organization and Management, Vol. 33 No. 7/8, pp. 919-928. https://doi.org/10.1108/JHOM-10-2018-0297
Publisher
:Emerald Publishing Limited
Copyright © 2019, Emerald Publishing Limited