Search results

1 – 10 of 352
Article
Publication date: 21 July 2021

Mitchell Sarkies, Suzanne Robinson, Teralynn Ludwick, Jeffrey Braithwaite, Per Nilsen, Gregory Aarons, Bryan J. Weiner and Joanna Moullin

As a discipline, health organisation and management is focused on health-specific, collective behaviours and activities, whose empirical and theoretical scholarship…

Abstract

Purpose

As a discipline, health organisation and management is focused on health-specific, collective behaviours and activities, whose empirical and theoretical scholarship remains under-utilised in the field of implementation science. This under-engagement between fields potentially constrains the understanding of mechanisms influencing the implementation of evidence-based innovations in health care. The aim of this viewpoint article is to examine how a selection of theories, models and frameworks (theoretical approaches) have been applied to better understand phenomena at the micro, meso and macro systems levels for the implementation of health care innovations. The purpose of which is to illustrate the potential applicability and complementarity of embedding health organisation and management scholarship within the study of implementation science.

Design/methodology/approach

The authors begin by introducing the two fields, before exploring how exemplary theories, models and frameworks have been applied to study the implementation of innovations in the health organisation and management literature. In this viewpoint article, the authors briefly reviewed a targeted collection of articles published in the Journal of Health Organization and Management (as a proxy for the broader literature) and identified the theories, models and frameworks they applied in implementation studies. The authors then present a more detailed exploration of three interdisciplinary theories and how they were applied across three different levels of health systems: normalization process theory (NPT) at the micro individual and interpersonal level; institutional logics at the meso organisational level; and complexity theory at the macro policy level. These examples are used to illustrate practical considerations when implementing change in health care organisations that can and have been used across various levels of the health system beyond these presented examples.

Findings

Within the Journal of Health Organization and Management, the authors identified 31 implementation articles, utilising 34 theories, models or frameworks published in the last five years. As an example of how theories, models and frameworks can be applied at the micro individual and interpersonal levels, behavioural theories originating from psychology and sociology (e.g. NPT) were used to guide the selection of appropriate implementation strategies or explain implementation outcomes based on identified barriers and enablers to implementing innovations of interest. Projects aiming to implement change at the meso organisational level can learn from the application of theories such as institutional logics, which help elucidate how relationships at the macro and micro-level have a powerful influence on successful or unsuccessful organisational action. At the macro policy level, complexity theory represented a promising direction for implementation science by considering health care organisations as complex adaptive systems.

Originality/value

This paper illustrates the utility of a range of theories, models and frameworks for implementation science, from a health organisation and management standpoint. The authors’ viewpoint article suggests that increased crossovers could contribute to strengthening both disciplines and our understanding of how to support the implementation of evidence-based innovations in health care.

Open Access
Article
Publication date: 9 April 2021

Jeanette Kirk, Thomas Bandholm, Ove Andersen, Rasmus Skov Husted, Tine Tjørnhøj-Thomsen, Per Nilsen and Mette Merete Pedersen

The aim of this study is to explore and discuss key challenges associated with having stakeholders take part in co-designing a health care intervention to increase…

1209

Abstract

Purpose

The aim of this study is to explore and discuss key challenges associated with having stakeholders take part in co-designing a health care intervention to increase mobility in older medical patients admitted to two medical departments at two hospitals in Denmark.

Design/methodology/approach

The study used a qualitative design to investigate the challenges of co-designing an intervention in five workshops involving health professionals, patients and relatives. “Challenges” are understood as “situations of being faced with something that needs great mental or physical effort in order to be done successfully and therefore tests a person's ability” (Cambridge Dictionary). Thematic content analysis was conducted with a background in the analytical question: “What key challenges arise in the material in relation to the co-design process?”.

Findings

Two key challenges were identified: engagement and facilitation. These consisted of five sub-themes: recruiting patients and relatives, involving physicians, adjusting to a new researcher role, utilizing contextual knowledge and handling ethical dilemmas.

Research limitations/implications

The population of patients and relatives participating in the workshops was small, which likely affected the co-design process.

Practical implications

Researchers who want to use co-design must be prepared for the extra time required and the need for skills concerning engagement, communication, facilitation, negotiation and resolution of conflict. Time is also required for ethical discussions and considerations concerning different types of knowledge creation.

Originality/value

Engaging stakeholders in co-design processes is increasingly encouraged. This study documents the key challenges in such processes and reports practical implications.

Details

Journal of Health Organization and Management, vol. 35 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Content available
Article
Publication date: 4 February 2014

124

Abstract

Details

Journal of Workplace Learning, vol. 26 no. 1
Type: Research Article
ISSN: 1366-5626

Keywords

Article
Publication date: 3 August 2012

Per Nilsen, Gunilla Nordström and Per‐Erik Ellström

This paper seeks to present a theoretical framework with the aim of contributing to improved understanding of how reflection can provide a mechanism to integrate…

5310

Abstract

Purpose

This paper seeks to present a theoretical framework with the aim of contributing to improved understanding of how reflection can provide a mechanism to integrate research‐based knowledge with the pre‐existing practice‐based knowledge.

Design/methodology/approach

The paper begins with an explanation of important concepts: research‐based and practice‐based knowledge, four levels of action and two modes of learning. Two mini cases concerning managers in the public sector in Sweden then provide an illustration of how research‐based knowledge can be utilized to challenge practice‐based knowledge. The concluding discussion addresses some of the challenges involved in achieving reflection in the workplace that utilizes research‐based knowledge.

Findings

The reflection programmes had several characteristics that facilitated their implementation: they achieved a balance between the workplace demands on the participating managers and time required for the reflection; the participants were specifically recruited, had full management support and were highly motivated to be part of the reflection groups; the facilitators played key roles in structuring the managers' discussions and linking their experiences to relevant research‐based knowledge.

Research limitations/implications

Methodological limitations of the cases constrain the conclusions to be drawn from these studies. However, it should be emphasized that the case studies were intended primarily as illustrations of how workplace reflection can be used to integrate research‐based and practice‐based knowledge. Obviously, there is a risk of social desirability bias because the interviewer was also involved in developing and implementing the reflection programmes. She also participated as a supervisor in mini case 2.

Originality/value

The literature on reflection has largely focused on reflection in the context of education, training and preparing for work or a profession. The role of workplace reflection and learning for practitioners and managers in work has received far less attention. The emergence of the evidence‐based practice (EBP) agenda has further highlighted the importance of workplace learning and reflection, as practitioners are increasingly expected to critically appraise research studies and integrate new findings into their practice. A more EBP requires reflecting practitioners who are able to synthesize research‐based knowledge with their own practice‐based knowledge acquired through experience. However, the process of integrating research‐based and practice‐based knowledge has not been the focus of much study.

Details

Journal of Workplace Learning, vol. 24 no. 6
Type: Research Article
ISSN: 1366-5626

Keywords

Abstract

Details

The Overtourism Debate
Type: Book
ISBN: 978-1-83867-487-8

Article
Publication date: 5 October 2015

Ursula Reichenpfader, Siw Carlfjord and Per Nilsen

This study aims to systematically review published empirical research on leadership as a determinant for the implementation of evidence-based practice (EBP) and to…

3186

Abstract

Purpose

This study aims to systematically review published empirical research on leadership as a determinant for the implementation of evidence-based practice (EBP) and to investigate leadership conceptualization and operationalization in this field.

Design/methodology/approach

A systematic review with narrative synthesis was conducted. Relevant electronic bibliographic databases and reference lists of pertinent review articles were searched. To be included, a study had to involve empirical research and refer to both leadership and EBP in health care. Study quality was assessed with a structured instrument based on study design.

Findings

A total of 17 studies were included. Leadership was mostly viewed as a modifier for implementation success, acting through leadership support. Yet, there was definitional imprecision as well as conceptual inconsistency, and studies seemed to inadequately address situational and contextual factors. Although referring to an organizational factor, the concept was mostly analysed at the individual or group level.

Research limitations/implications

The concept of leadership in implementation science seems to be not fully developed. It is unclear whether attempts to tap the concept of leadership in available instruments truly capture and measure the full range of the diverse leadership elements at various levels. Research in implementation science would benefit from a better integration of research findings from other disciplinary fields. Once a more mature concept has been established, researchers in implementation science could proceed to further elaborate operationalization and measurement.

Originality/value

Although the relevance of leadership in implementation science has been acknowledged, the conceptual base of leadership in this field has received only limited attention.

Details

Leadership in Health Services, vol. 28 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 11 May 2015

Margit Saskia Neher, Christian Ståhl and Per Nilsen

This paper aims to explore what opportunities for learning practitioners in rheumatology perceive of in their daily practice, using a typology of workplace learning to…

Abstract

Purpose

This paper aims to explore what opportunities for learning practitioners in rheumatology perceive of in their daily practice, using a typology of workplace learning to categorize these opportunities.

Design/methodology/approach

Thirty-six practitioners from different professions in rheumatology were interviewed. Data were analyzed using conventional qualitative content analysis with a directed approach, and were categorized according to a typology of formal and informal learning.

Findings

The typology was adjusted to fit the categories resulting from the analysis. Further analysis showed that work processes with learning as a by-product in general, and relationships with other people in the workplace in particular, were perceived as important for learning in the workplace. The use of many recognized learning opportunities was lower. Barriers for learning were a perceived low leadership awareness of learning opportunities and factors relating to workload and the organization of work.

Research limitations/implications

The generalizability of results from all qualitative inquiries is limited by nature, and the issue of transferability to other contexts is for the reader to decide. Further studies will need to confirm the results of the study, as well as the proposed enhancement of the typology with which the results were categorized.

Practical implications

The study highlights the importance of relationships in the workplace for informal learning in rheumatology practice. In the clinical context, locally adapted strategies at organizational and individual levels are needed to maximize opportunities for both professional and interprofessional informal learning, taking the importance of personal relationships into account. The findings also suggest a need for increased continuing professional education in the specialty.

Originality/value

The workplace learning typology that was used in the study showed good applicability to empirical health-care study data, but may need further development. The study confirmed that informal workplace learning is an important part of learning in rheumatology. Further studies are needed to clarify how informal and formal learning in the rheumatology clinic may be supported in workplaces with different characteristics.

Details

Journal of Workplace Learning, vol. 27 no. 4
Type: Research Article
ISSN: 1366-5626

Keywords

Content available
Article
Publication date: 3 August 2012

Sara Cervai and Tauno Kekale

1

Abstract

Details

Journal of Workplace Learning, vol. 24 no. 6
Type: Research Article
ISSN: 1366-5626

Article
Publication date: 1 March 2000

Gérard Richez

The Banff National Park is the most famous of Canada. The development of the recent years has been considered as to fast and to massive. The author analyses the key…

Abstract

The Banff National Park is the most famous of Canada. The development of the recent years has been considered as to fast and to massive. The author analyses the key factors of success of the park development. He describes the new strategic park policy which takes into account the carrying capacity and the protection of the great nature and landscape.

Details

The Tourist Review, vol. 55 no. 3
Type: Research Article
ISSN: 0251-3102

Keywords

Article
Publication date: 1 March 2006

Kirsti Nilsen

The purpose of this paper is to compare user perspectives on visits to in‐person and virtual reference services conducted by participants in the Library Visit Study, an…

3531

Abstract

Purpose

The purpose of this paper is to compare user perspectives on visits to in‐person and virtual reference services conducted by participants in the Library Visit Study, an ongoing research project.

Design/methodology/approach

This paper compares satisfaction rates, identifies staff behaviours that influence user satisfaction, and suggests how both face‐to‐face and virtual reference can be improved. Since 1990, participants in the Library Visit Study have been MLIS students who ask questions at in‐person and virtual reference desks, and report on their experiences. In addition to these accounts, students complete questionnaires on their experiences. Level of satisfaction with the in‐person or virtual transactions, based on the “willingness to return” criterion, are computed. Satisfaction is compared with other factors such as correctness of answers and friendliness of library staff. Underlying problems that influence satisfaction are identified. Findings – Data from 261 in‐person and 85 virtual reference transaction accounts (both e‐mail and chat) show that virtual reference results in lower satisfaction than in‐person reference. Underlying problems that are associated with user dissatisfaction were identified in face‐to‐face reference and carry over to virtual reference, including lack of reference interviews, unmonitored referrals and failure to follow‐up. Research limitations/implications – The number of virtual reference visits is relatively small (85) compared with 261 in‐person visits. Practical implications – The reasons for ongoing failures are examined and solutions that can help improve both face‐to‐face and virtual reference are identified. Education and training of reference staff can be improved by recognition of the behavioural causes of dissatisfaction in users. Originality/value – This paper provides empirical data that compare user perceptions of in‐person and virtual reference.

Details

New Library World, vol. 107 no. 3/4
Type: Research Article
ISSN: 0307-4803

Keywords

1 – 10 of 352