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Article
Publication date: 18 July 2008

Alexandra Kent

Over the past decade the Swedish system for dealing with patient complaints has come under increasingly intense scrutiny from both healthcare providers and consumers. This article…

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Abstract

Purpose

Over the past decade the Swedish system for dealing with patient complaints has come under increasingly intense scrutiny from both healthcare providers and consumers. This article summarizes contemporary Swedish viewpoints on the debate by using sociological theory combined with anthropological field data. Its purpose is to prompt radical reappraisal of some attitudes underlying the current handling of patient complaints in Sweden and perhaps elsewhere.

Design/methodology/approach

The material presented here is partly a collation of literature and contemporary debate articles. A number of cases are explored including material taken from ongoing anthropological fieldwork among patients who are or have lodged complaints. Fieldwork was begun in May 2006 and consists of in‐depth, semi‐structured interviews, thus far with six patients, about their experiences lodging complaints. Contact with patients is ongoing as their stories continue to unfold. Interviews have also been conducted with representatives of patient support organizations and medico‐legal specialists. The material is analyzed using recent sociological theory concerned with trust.

Findings

Patients who lodge complaints about their care are interested in achieving moral redress and trust restoration. The major authorities dealing with patient complaints in this case may, however, be mistrusted by those who have experience of them: practitioners and patients alike. In general, they seem to fail to fulfill patients' expectations of guaranteeing ethical standards within healthcare and they are felt to act as a disincentive to honest reporting of adverse incidents by practitioners.

Research limitations/implications

This study is case specific and the particular findings are not readily generalizable to other countries. However, themes concerned with trust reparation that become evident pose questions about situations elsewhere that are analogous though not identical. Conclusions drawn are, therefore, intended not necessarily to be extrapolated but rather to provoke reflection about similar issues in other cases.

Practical implications

If practices and healthcare regulation structures are to become increasingly sensitive to patients' experience then it is essential that patients' stories and struggles are aired in those forums that influence decision makers' attitudes. This article attempts to bring patients' rights, expectations and perspectives to the fore in discussion about healthcare quality assurance.

Originality/value

By presenting patients as subject rather than object, the article intends to engage the reader in the patient's quest for moral reparation when trust is breached. The use of anthropological method helps give the perspectives or experience of those who are relatively disempowered their rightful place at the heart of discussions about healthcare quality.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 January 1988

M. Rickards

During the last decade, numerous elements have combined to produce a new branch of the building industry which has come to be known as ‘in situ timber engineering’.

Abstract

During the last decade, numerous elements have combined to produce a new branch of the building industry which has come to be known as ‘in situ timber engineering’.

Details

Structural Survey, vol. 6 no. 1
Type: Research Article
ISSN: 0263-080X

Book part
Publication date: 19 September 2012

Alexandra Kent

Purpose – This chapter examines children's options for responding to parental attempts to get them to do something (directives).Methodology/approach – The data for the study are…

Abstract

Purpose – This chapter examines children's options for responding to parental attempts to get them to do something (directives).

Methodology/approach – The data for the study are video recordings of everyday family mealtime interactions. The study uses conversation analysis and discursive psychology to conduct a microanalysis of sequences of everyday family mealtimes interactions in which a parent issues a directive and a child responds.

Findings – It is very difficult for children to resist parental directives without initiating a dispute. Immediate embodied compliance was the interactionally preferred response option to a directive. Outright resistance was typically met with an upgraded and more forceful directive. Legitimate objections to compliance could be treated seriously but were not always taken as grounds for non-compliance.

Research implications – The results have implications for our understandings of the notions of compliance and authority. Children's status in interaction is also discussed in light of their ability to choose whether to ratify a parent's control attempt or not.

Originality/value of chapter – The chapter represents original work on the interactional structures and practices involved in responding to control attempts by a co-present participant. It offers a data-driven framework for conceptualising compliance and authority in interaction that is based on the orientations of participants rather than cultural or analytical assumptions of the researcher.

Details

Disputes in Everyday Life: Social and Moral Orders of Children and Young People
Type: Book
ISBN: 978-1-78052-877-9

Keywords

Book part
Publication date: 19 September 2012

Karin Aronsson is a professor at the Department of Child and Youth Studies, Stockholm University, and before that at Linköping University (1988–2008). Her work focuses on how talk…

Abstract

Karin Aronsson is a professor at the Department of Child and Youth Studies, Stockholm University, and before that at Linköping University (1988–2008). Her work focuses on how talk is used to build social organization, with a particular focus on children's peer groups, institutional encounters, and identity-in-interaction. Other research interests include children's play, informal learning, and bilingual conversations. She publishes internationally, and her most recent papers appeared in Language in Society and Discourse & Society. A recent book is: Hedegaard, M., Aronsson, K., Højholt, C., & Skjær Ulvik, O. (Eds.). Children, childhood and everyday life: Children's perspectives. Charlotte, NC: Information Age Publishing.

Details

Disputes in Everyday Life: Social and Moral Orders of Children and Young People
Type: Book
ISBN: 978-1-78052-877-9

Content available
Book part
Publication date: 19 September 2012

Abstract

Details

Disputes in Everyday Life: Social and Moral Orders of Children and Young People
Type: Book
ISBN: 978-1-78052-877-9

Book part
Publication date: 19 September 2012

Susan Danby and Maryanne Theobald

Disputes in everyday life – Social and moral orders of children and young people has papers written by researchers whose interests lie in studying children's everyday…

Abstract

Disputes in everyday life – Social and moral orders of children and young people has papers written by researchers whose interests lie in studying children's everyday interactions, with a balance of papers from emerging and well-established researchers in this field. The volume draws on scholarship from Australia, England, New Zealand, Sweden, Turkey, United States of America (USA), and Wales, investigating everyday practices of children's disputes in Australia, England, Italy, Sweden, USA, and Wales. The papers themselves speak to the theme of the volume, so we only briefly summarize their contents.

Details

Disputes in Everyday Life: Social and Moral Orders of Children and Young People
Type: Book
ISBN: 978-1-78052-877-9

Article
Publication date: 10 June 2021

Julie MacInnes, Jenny Billings, Alexandra Lelia Dima, Chris Farmer and Giel Nijpels

The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the…

Abstract

Purpose

The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice.

Design/methodology/approach

An integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis.

Findings

Twelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers.

Originality/value

This review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred.

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 23 October 2023

Germano Araujo Coelho, Fabiana da Cunha Saddi, Stephen Peckham, Mariana de Andrade da Silva, Jaqueline Damasceno Silva, Maria Luiza Pereira Barretos, Gabriela Rocha, Alexandra Novais, Cristiane Lopes Simão Lemos and Amélia Cohn

The study compares how distinct mechanisms that connect pre-established policy objectives to professionals' practices, and the health policy implementation context influenced…

Abstract

Purpose

The study compares how distinct mechanisms that connect pre-established policy objectives to professionals' practices, and the health policy implementation context influenced different approaches to frontline staff participation. The authors analysed 26 teams in six cities from two Brazilian states, during the last cycle of the National Program for Improving Access and Quality of Primary Care (PMAQ).

Design/methodology/approach

About 172 in-depth interviews were conducted with frontliners – community health workers (78), nurses (37), doctors (30) – and managers (27). Interview guides were based on key issues identified in the implementation and pay-for-performance (P4P) literature. Drawing on thematic analysis and synthesis of the literature, three types of participation mechanisms were identified: relational, motivational and incremental learning. They were analysed considering distinct contexts at the local level to understand how they influenced different forms of participation: mere adherence, result-oriented and transformative.

Findings

Administrations with stronger institutional organizational structures were able to control work processes and reduce professional discretion. However, sustained participation was more likely where there was greater integration between management and frontline health care teams. Motivation based only on financial incentives could not bring about transformative participation. This depended on the degree of professional's ideational motivation towards primary care. Finally, contexts with unfavourable working conditions tend to demotivate professionals, but incremental learning helps teams cope with these obstacles.

Originality/value

The study overcomes gaps in the literature in relation to PMAQ's implementation process. Overall, the study delves into which/how mechanisms alter frontliners participation in performance-oriented health programs.

Details

International Journal of Public Sector Management, vol. 36 no. 6/7
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 7 August 2018

Alexandra Khoury, Mark Jones, Christopher Buckle, Mark Williamson and Guy Slater

Weekend surgery carries higher mortality than weekday surgery, with complications most commonly arising within the first 48 hours. There is a reduced ability to identify…

Abstract

Purpose

Weekend surgery carries higher mortality than weekday surgery, with complications most commonly arising within the first 48 hours. There is a reduced ability to identify complications at the weekend, with early signs going undetected in the absence of thorough early patient review, particularly in the elderly with multiple co-morbidities. Weekend working practices vary amongst UK hospitals and specialties. The weekend effect has been a prominent feature in the literature over the past decade. The purpose of this paper is to identify the number of patients undergoing weekend surgery who receive a Day 1 post-operative review and improve this outcome by implementing an effective change.

Design/methodology/approach

It was observed that not all patients undergoing surgery on a Friday or Saturday at the authors’ District General Hospital were receiving Day 1 post-operative review by a clinician. A retrospective audit was carried out to identify percentage of patients reviewed on post-operative Day 1 at the weekend. A change in handover practice was implemented before re-audit.

Findings

In Phase 1, 54 per cent of patients received Day 1 post-operative reviews at the weekend against a set standard of 100 per cent. A simple change to handover practice was implemented to improve patient safety in the immediate post-operative period resulting in 96 per cent of patients reviewed on Day 1 post-operatively at re-audit.

Originality/value

This study confirms that simple changes in handover practices can produce effective and translatable improvements to weekend working. This further contributes to the body of literature that acknowledges the existence of a weekend effect, but aims to evolve weekend working practices to accommodate improvement within current staffing and resource availability by maximising efficiency and communication.

Details

International Journal of Health Governance, vol. 23 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

Content available
Book part
Publication date: 16 October 2018

Abstract

Details

Research in Social Movements, Conflicts and Change
Type: Book
ISBN: 978-1-78756-895-2

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