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1 – 10 of over 7000The purpose of this paper is to investigate the process and impact of patient involvement in locally defined improvement projects in two hospital clinics. The paper particularly…
Abstract
Purpose
The purpose of this paper is to investigate the process and impact of patient involvement in locally defined improvement projects in two hospital clinics. The paper particularly aims to examine how patient narratives, in the form of diaries and radio montage, help to create new insights into patient experience for healthcare professionals, and support professionals’ enrolment and mobilisation in innovation projects.
Design/methodology/approach
Two case studies were undertaken. These drew upon qualitative interviews with staff and participant observation during innovation workshops. Patient diaries and a recorded montage of patient voices were also collected.
Findings
The findings illuminate translation processes in healthcare innovation and the emergence of meaning making process for staff through the active use of patient narratives. The paper highlights the critical role of meaning making as an enabler of patient-centred change processes in healthcare via: local clinic mangers defining problems and ideas; collecting and sharing patient narratives in innovation workshops; and healthcare professionals’ interpretation of patient narratives supporting new insights into patient experience.
Practical implications
This study demonstrates how healthcare professionals’ meaning making can be supported by articulating, constructing, listening and interpreting patient narratives. The two cases demonstrate how patient narratives serve as reflective devices for healthcare professionals.
Originality/value
This study presents a novel demonstration of the importance of patient narratives for translating healthcare innovation in a clinical practice setting.
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Jette Ernst and Astrid Jensen Schleiter
The purpose of this paper is to look at the ways in which standardization for patient safety is approached from different positions in the field, namely nurses and managers in a…
Abstract
Purpose
The purpose of this paper is to look at the ways in which standardization for patient safety is approached from different positions in the field, namely nurses and managers in a hospital department, the hospital management and standard inventers. We understand safety standardization and the responses to it as a strategizing process, where standards are legitimized, taken up, handled or countered.
Design/methodology/approach
Ethnographic fieldwork was conducted in a Danish hospital department. The study included observations, interviews and documents studies. The authors apply a Bourdieusian perspective, where the authors focus on the narratives told by standard inventers, managers and nurses to examine and understand their strategizing activities in relation to safety standardization. We understand strategizing as interested action emerging in the dialectics between a habitus and a position in a field.
Findings
The authors show how the standardization of work rests on the master narrative of patient safety management and how this narrative clashes with the nurses’ practical perception of good care, which rests on the counter-narrative of the clinical judgment.
Originality/value
Safety standardization in healthcare is often studied within the broader framework of performance management using functionalist outside-in and prescriptive approaches. This study contributes to this literature by approaching standardization and the responses to it as taking place in a dialectic movement between subjective shop floor experiences and wider field-level forces. Furthermore, the study contributes to the organization and management literature concerned with change and strategic action by endorsing the Bourdieusian conception of strategizing.
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Joyce M. Latham and Sarah Cooke
This project examines how queer and trans zines have complicated the notion of traditional patient narratives and provides insight into the issues that LGBTQ+ (lesbian, gay…
Abstract
This project examines how queer and trans zines have complicated the notion of traditional patient narratives and provides insight into the issues that LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning) populations face when accessing healthcare information and resources. Historically, information about queer and trans identities has been suppressed in the United States, reflecting dominant social values that pathologize queer identities. Using health-related zines housed at the Queer Zine Archive Project as a case study, this project investigates how queer and trans zines about healthcare have resisted these homophobic and transphobic ideologies. The analysis reveals that queer and trans zinesters use their feelings of impatience with the medical industry to fuel communal solutions to accessing and providing health care information.
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Patricia Drentea, Beverly Rosa Williams, Karen Hoefer, F. Amos Bailey and Kathryn L. Burgio
Purpose: To explore how families respond to the death and dying of their loved ones in a hospital setting, archival research was conducted using eight qualitative articles…
Abstract
Purpose: To explore how families respond to the death and dying of their loved ones in a hospital setting, archival research was conducted using eight qualitative articles describing next-of-kins’ perceptions of end-of-life care in Veterans Affairs Medical Centers (VAMCs). The articles were based on the qualitative arm of the VA Health Services Research and Development (HSR&D) study entitled, “Best Practices for End-of-life Care and Comfort Care Order Sets for our Nation’s Veterans” (BEACON).
Design: The archival research consisted of an interactive methodological process of data immersion, analysis, and interpretation which resulted in the emergence of two overarching thematic frameworks called “losing control” and “holding on.”
Findings: “Losing control” is the process that occurs when the patient experiences a cascading sequence of deleterious biological events and situations rendering the caregiver no longer able to direct the timing or setting of the dying trajectory. The notion of “holding on” captures family member’s responses to the need to maintain control after relinquishing the patient’s care to the institutional setting. During the patient’s hospitalization, the dual dynamics of “losing control” and “holding on” unfolded in the spatial, temporal, and life narrative domains.
Originality: The findings not only contribute to better overall understanding of family members’ responses to death in the pre-COVID-19 hospital setting but also heighten the awareness of the complex spatial, temporal, and narrative issues faced by family members who lost a hospitalized loved one during the COVID-19 pandemic.
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Ava Easton and Karl Atkin
This paper provides a brief chronicle of medicine and narratives, the aim being to understand the role of people's narratives historically, including how they have developed and…
Abstract
This paper provides a brief chronicle of medicine and narratives, the aim being to understand the role of people's narratives historically, including how they have developed and changed over time, and in particular the rising interest in the neuro‐narrative. The paper ends by reflecting on what practicing physicians, nurses, therapists, and social care workers might want to think about when considering the use of narratives with their clients.
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Ruamsak Veerasoontorn and Rian Beise‐Zee
The purpose of this paper is to propose a general model that examines the contextual factors underlying the decision‐making process of international hospital outshopping.
Abstract
Purpose
The purpose of this paper is to propose a general model that examines the contextual factors underlying the decision‐making process of international hospital outshopping.
Design/methodology/approach
Patients who chose medical treatment abroad were selected to analyze the drivers of internationalization in medical services. A total number of 27 international patients who traveled from developed countries to receive medical treatment at the largest hospital in Thailand were interviewed and their responses assessed through narrative analysis.
Findings
The narrative analysis reveals that while high costs and the deteriorating conditions of health care in developed countries are initially driving consumers to leave their local service area and choose foreign service providers, pull factors such as innovation, organizational efficiency, emotional service quality and patient‐doctor relationships in service encounters are nurturing a real preference for choosing foreign health care providers.
Research limitations/implications
This exploratory study is limited to the largest hospital in South East Asia. Future research could expand upon its findings and comparisons be made with other different foreign health care providers.
Practical implications
In order to attract foreign customers a personal service, such as medical treatment, must be based on and sustained by continuous innovation in service quality.
Originality/value
The paper is the first empirical in‐depth study that examines the factors underlying the decision‐making process of international hospital outshopping.
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