Insights from staff nurses and managers on unit-specific nursing performance dashboards: a qualitative study – BMJ Quality and Safety
This article highlights how unit-specific dashboards are being used to monitor performance and drive quality improvement efforts from the perspectives of nurses and unit managers.
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Creating spaces in intensive care for safe communication: a video-reflexive ethnographic study – BMJ Quality and Safety
The built environment in acute care settings is a new focus in patient safety research. This article reports on an interventionist video-reflexive ethnographic (VRE) study that explored how clinicians used the built environment to achieve safe communication in an intensive care unit (ICU) in a metropolitan Sydney hospital.
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Designing quality improvement initiatives: the action effect method, a structured approach to identifying and articulating programme theory – BMJ Quality and Safety
This paper outlines the approach used in a research and improvement programme to support QI initiatives in identifying and articulating programme theory: the action effect method.
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Why Lean doesn’t work for everyone – BMJ Quality and Safety
Popularisation of Lean in healthcare has led to emphasis on Lean quality improvement tools in isolation, with inconsistent results. This article argues that to successfully facilitate system transformation toward higher quality care at lower cost, Lean tools must be part of a comprehensive management system, within a supportive institutional culture, and with committed leadership.
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The problem with quality: A tale of two audits – British Journal of Healthcare Management article
This article reflects on the impact of the present day audit culture on NHS staff. By examining the facts of two very different audit processes, some of the unintended consequences of increased auditing and monitoring are illustrated; the issue of trust within the organisation seems particularly vulnerable to such processes. Various perspectives are considered, and are drawn from economic theory and organisational theory. Finally, an alternative method of improving quality within an organisation is proposed, using the paradigm of complexity theory.
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