ORCID Profile
0000-0002-3733-2717
Current Organisations
University of Sheffield
,
University of Queensland
,
Royal Holloway University of London
,
Sheffield Teaching Hospitals NHS Foundation Trust
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Publisher: Emerald
Date: 16-11-2015
DOI: 10.1108/JHOM-02-2015-0034
Abstract: – Health systems are changing at variable rates. Periods of significant change can create new challenges or lify existing barriers to accreditation program credibility and reliability. The purpose of this paper is to examine, during the transition to a new Australian accreditation scheme and standards, challenges to health service accreditation survey reliability, the salience of the issues and strategies to manage threats to survey reliability. – Across 2013-2014, a two-phase, multi-method study was conducted, involving five research activities (two questionnaire surveys and three group discussions). This paper reports data from the transcribed group discussions involving 100 participants, which was subject to content and thematic analysis. Participants were accreditation survey coordinators employed by the Australian Council on Healthcare Standards. – Six significant issues influencing survey reliability were reported: accreditation program governance and philosophy accrediting agency management of the accreditation process, including the program’s framework survey coordinators survey team dynamics in idual surveyors and healthcare organizations’ approach to accreditation. A change in governance arrangements promoted reliability with an independent authority and a new set of standards, endorsed by Federal and State governments. However, potential reliability threats were introduced by having multiple accrediting agencies approved to survey against the new national standards. Challenges that existed prior to the reformed system remain. – Capturing lessons and challenges from healthcare reforms is necessary if improvements are to be realized. The study provides practical and theoretical strategies to promote reliability in accreditation programs.
Publisher: Wiley
Date: 05-06-2016
DOI: 10.1002/HPM.2301
Abstract: The study aim was to investigate the understandings and concerns of stakeholders regarding the evolution of health service accreditation programs in Australia. Stakeholder representatives from programs in the primary, acute and aged care sectors participated in semi-structured interviews. Across 2011-12 there were 47 group and in idual interviews involving 258 participants. Interviews lasted, on average, 1 h, and were digitally recorded and transcribed. Transcriptions were analysed using textual referencing software. Four significant issues were considered to have directed the evolution of accreditation programs: altering underlying program philosophies shifting of program content focus and details different surveying expectations and experiences and the influence of external contextual factors upon accreditation programs. Three accreditation program models were noted by participants: regulatory compliance continuous quality improvement and a hybrid model, incorporating elements of these two. Respondents noted the compatibility or incommensurability of the first two models. Participation in a program was reportedly experienced as ranging on a survey continuum from "malicious compliance" to "performance audits" to "quality improvement journeys". Wider contextual factors, in particular, political and community expectations, and associated media reporting, were considered significant influences on the operation and evolution of programs. A hybrid accreditation model was noted to have evolved. The hybrid model promotes minimum standards and continuous quality improvement, through examining the structure and processes of organisations and the outcomes of care. The hybrid model appears to be directing organisational and professional attention to enhance their safety cultures. Copyright © 2015 John Wiley & Sons, Ltd.
Publisher: BMJ
Date: 09-2015
Publisher: Oxford University Press (OUP)
Date: 15-07-2016
Abstract: To examine how consumer engagement (CE) can be promoted through Australian accreditation programmes. A nation-wide qualitative study completed in 2012. All eight Australian States and Territories. Two-hundred and fifty-eight healthcare stakeholders from the acute, primary and aged care sectors. Forty-seven in idual and group interviews were undertaken. Questions elicited views on the dimensions and utility of CE promotion by accreditation programmes. Healthcare stakeholders' views on the dimensions and utility of CE promotion by accreditation programmes. Four mechanisms of CE promotion were identified. Two involved requirements for health service organizations to meet CE-related standards related to consumer experience and satisfaction surveys, and consumer participation in organizational governance processes. Two mechanisms for promoting CE through accreditation processes were also identified, concerning consumer participation in the development and revision of standards, and the implementation of accreditation surveys. Accreditation programmes were viewed as important drivers of CE, yet concerns were raised regarding the organizational investments needed to meet programmes' requirements. Accreditation programmes use erse mechanisms as levers for change to promote CE in healthcare. These mechanisms and their inter-relationships require careful consideration by accreditation agencies and health policymakers to maximize their potential benefits, while maintaining stakeholder engagement in programmes.
Publisher: Informa UK Limited
Date: 09-10-2014
DOI: 10.1080/17441692.2014.959541
Abstract: Gender mainstreaming developed as the global strategy for gender equality nearly two decades ago. Since then it has faced criticism for its technocratic application, and its role in the de-politicisation and neutralisation of the women's movement in gender policy-making. In the health sector, this incongruity is exacerbated by a traditional bio-medical approach to women's issues. In this paper, we ask whether gender mainstreaming can be made to work in the health sectors of developing countries where these challenges, as well as women's poor health status, are further complicated by a raft of local traditional, cultural, political and socioeconomic barriers. To answer these questions, we present a case study of Papua New Guinea (PNG), one of the world's most disadvantaged and politically challenging countries. We review data on women's health in PNG and analyse PNG's aspirational and actual performance on gender mainstreaming, looking at: international commitments political will and capacity national policies and programmes and the women's movement along with civil society's participation. We find numerous paradoxes between the aims of gender mainstreaming and the necessary conditions for its success.
Publisher: Wiley
Date: 04-11-2015
DOI: 10.1111/HEX.12300
Publisher: Springer International Publishing
Date: 12-10-2018
Publisher: Wiley
Date: 23-12-2015
DOI: 10.1111/HEX.12169
Publisher: Springer Science and Business Media LLC
Date: 21-11-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2014
DOI: 10.1002/CHP.21218
Abstract: Evidence suggests that Crew Resource Management (CRM), a form of team training, is beneficial. In CRM training, participants learn in idual portable team skills such as communication and decision making through group discussion and activities. However, the usual 1-day course format is not always compatible with health care organizational routines. A modular training format, while theoretically sound, is untested for interprofessional team training. The aim of this study was to explore the potential for modularized CRM training to be delivered to a group of interprofessional learners. Modularized CRM training, consisting of two 2-hour workshops, was delivered to health care workers in an Australian tertiary hospital. Kirkpatrick's evaluation model provided a framework for the study. Baseline attitude surveys were conducted prior to each workshop. Participants completed a written questionnaire at the end of each workshop that examined their motivations, reactions to the training, and learner demographics. An additional survey, administered 6 weeks post training, captured self-assessed behavior data. Twenty-three in iduals from a range of professions and clinical streams participated. One in 5 participants (22%) reported that they translated teamwork skills to the workplace. While positive about the workshop format and content, many respondents identified personal, team, and organizational barriers to the application of the workshop techniques. CRM training when delivered in a modular format has positive outcomes. Following the training, some respondents overcame workplace barriers to attempt to change negative workplace behavior. This progress provides cautious optimism for the potential for modular CRM training to benefit groups of interprofessional health staff.
Publisher: American Physical Society (APS)
Date: 10-07-2019
Publisher: Oxford University Press (OUP)
Date: 29-09-2015
Abstract: To test our hypothesis that hospitals with higher accreditation scores, specifically in infection control, would be associated with lower Staphylococcus aureus bacteraemia (SAB) rates. A retrospective cohort study. Acute public hospitals (n = 77) in New South Wales, Australia, with reported SAB rates, results from two accreditation surveys and results from at least four hand hygiene audits. We linked three separate data sets comprising SAB rates, accreditation scores and hand hygiene rates. SAB rates were regressed against accreditation scores, hand hygiene audit rates and hospital demographics using a generalized linear model to account for the non-linear nature of our outcome variable. Significant (P < 0.05) findings included the following: SAB rates across all hospitals fell from 1.34 per 10 000 bed days in 2009 to 0.77 per 10 000 bed days in 2012 mean SAB rates in small hospitals (0.62/10 000 bed days) over the study period were lower than those for principal referral hospitals (1.52/10 000 bed days) smaller hospitals with higher accreditation scores had lower SAB rates, but larger hospitals with higher overall accreditation scores had higher SAB rates, although the effect size was small (<2%). There is a strong evidence base for using SAB rates to measure the impact of infection control programs that are assessed during accreditation. However, there is less evidence to support whether accreditation scores accurately reflect implementation of the infection control accreditation standards. This impacts identification of indicators to measure patient safety and quality of care, especially in ensuring these are appropriate across a range of hospital size and activities.
Publisher: Springer International Publishing
Date: 12-10-2017
Publisher: Springer Science and Business Media LLC
Date: 24-08-2023
DOI: 10.1245/S10434-023-14192-X
Abstract: Recently, the number of prehabilitation trials has increased significantly. The identification of key research priorities is vital in guiding future research directions. Thus, the aim of this collaborative study was to define key research priorities in prehabilitation for patients undergoing cancer surgery. The Delphi methodology was implemented over three rounds of surveys distributed to prehabilitation experts from across multiple specialties, tumour streams and countries via a secure online platform. In the first round, participants were asked to provide baseline demographics and to identify five top prehabilitation research priorities. In successive rounds, participants were asked to rank research priorities on a 5-point Likert scale. Consensus was considered if 70% of participants indicated agreement on each research priority. A total of 165 prehabilitation experts participated, including medical doctors, physiotherapists, dieticians, nurses, and academics across four continents. The first round identified 446 research priorities, collated within 75 unique research questions. Over two successive rounds, a list of 10 research priorities reached international consensus of importance. These included the efficacy of prehabilitation on varied postoperative outcomes, benefit to specific patient groups, ideal programme composition, cost efficacy, enhancing compliance and adherence, effect during neoadjuvant therapies, and modes of delivery. This collaborative international study identified the top 10 research priorities in prehabilitation for patients undergoing cancer surgery. The identified priorities inform research strategies, provide future directions for prehabilitation research, support resource allocation and enhance the prehabilitation evidence base in cancer patients undergoing surgery.
Publisher: Informa UK Limited
Date: 03-02-2015
DOI: 10.3109/13561820.2015.1004039
Abstract: Collaborative practice among early career staff is at the bedrock of interprofessional care. This study investigated factors influencing the enactment of interprofessional practice by using the day-to-day role of six junior doctors in three teaching hospitals as a gateway to understand the various professions' interactive behaviours. The contextual framework used for the study was Strauss' theory of negotiated order. Ethnographic techniques were applied to observe the actions and interactions of participants on typical working days in their hospital environments. Field notes were created and thematic analysis was applied to the data. Three themes explored were culture, communication, and collaboration. Issues identified highlight the bounded organisational and professional cultures within which junior doctors work, and systemic problems in interprofessional interaction and communication in the wards of hospitals. There are indications that early career doctors are interprofessional isolates. The constraints of short training terms and pressure from multi-faceted demands on junior doctors can interfere with the establishment of meaningful relationships with nurses and other health professionals. The realisation of sustained interprofessional practice is, therefore, practically and structurally difficult. Enabling factors supporting the sharing of expertise are outweighed by barriers associated with professional and hospital organisational cultures, poor interprofessional communication, and the pressure of competing in idual task demands in the course of daily practice.
Publisher: BMJ
Date: 04-2016
Publisher: Emerald
Date: 12-06-2017
DOI: 10.1108/QAOA-07-2016-0028
Abstract: Quality of care in the residential aged sector has changed over the past decade. The purpose of this paper is to examine these changes from the perspectives of staff to identify factors influencing quality of residential aged care, and the role and influence of an aged care accreditation programme. Focus groups were held with 66 aged care staff from 11 Australian aged care facilities. Data from semi-structured interviews were analysed to capture categories representing participant views. Participants reported two factors stimulating change: developments in the aged care regulatory and policy framework, and rising consumer expectations. Four corresponding effects on service quality were identified: increasing complexity of resident care, renewed built environments of aged care facilities, growing focus on resident-centred care and the influence of accreditation on resident quality of life. The accreditation programme was viewed as maintaining minimum standards of quality throughout regulatory and social change, yet was considered to lack capacity of itself to explicitly promote or improve resident quality of life. For an increasingly complex aged care population, regulatory and societal change has led to a shift in service provision from institutional care models to one that is becoming more responsive to consumer expectations. The capacity of long-established and relatively static accreditation standards to better accommodate changing consumer needs comes into question. This is the first study to examine the relationship between accreditation and residential aged care service quality from the perspectives of staff, and offers a nuanced view of “quality” in this setting.
Publisher: Oxford University Press (OUP)
Date: 10-02-2014
Abstract: Multi-Stakeholder Health Services Research Collaborations (M-SHSRCs) are increasingly pursued internationally to undertake complex implementation research that aims to directly improve the organisation and delivery of health care. Yet the empirical evidence supporting M-SHSRCs' capacity to achieve such goals is limited, and significant impediments to effective implementation are identified in the literature. This dichotomy raises the question, 'is it worth engaging in M-SHSRCs?' In this paper, we contribute to the narrative evidence-base by outlining key issues emerging from our substantial collaborative experience in Australia. Key benefits, challenges and mechanisms that may enable effective implementation of M-SHSRCs in other contexts are highlighted. We conclude that M-SHSRCs are worthwhile and succeed through significant financial, temporal and emotional investments.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: Mexico
Location: Germany
Location: Iran (Islamic Republic of)
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Diana Greenfield.