A qualitative study of organisational resilience in care homes in Scotland
Providing care for the dependent older person is complex and there have been persistent concerns about care quality as well as a growing recognition of the need for systems approaches to improvement. The I-SCOPE (Improving Systems of Care for the Older person) project employed Resilient Healthcare (...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767361/?tool=EBI |
| _version_ | 1797977696639123456 |
|---|---|
| author | Alastair Ross Janet E. Anderson Santhani Selveindran Tamsin MacBride Paul Bowie Andrea Sherriff Linda Young Evie Fioratou Edel Roddy Heather Edwards Belinda Dewar Lorna M. Macpherson |
| author_facet | Alastair Ross Janet E. Anderson Santhani Selveindran Tamsin MacBride Paul Bowie Andrea Sherriff Linda Young Evie Fioratou Edel Roddy Heather Edwards Belinda Dewar Lorna M. Macpherson |
| author_sort | Alastair Ross |
| collection | DOAJ |
| description | Providing care for the dependent older person is complex and there have been persistent concerns about care quality as well as a growing recognition of the need for systems approaches to improvement. The I-SCOPE (Improving Systems of Care for the Older person) project employed Resilient Healthcare (RHC) theory and the CARE (Concepts for Applying Resilience) Model to study how care organisations adapt to complexity in everyday work, with the aim of exploring how to support resilient performance. The project was an in-depth qualitative study across multiple sites over 24 months. There were: 68 hours of non-participant observation, shadowing care staff at work and starting broad before narrowing to observe care domains of interest; n = 33 recorded one-to-one interviews (32 care staff and one senior inspector); three focus groups (n = 19; two with inspectors and one multi-disciplinary group); and five round table discussions on emergent results at a final project workshop (n = 31). All interviews and discussion groups were recorded and transcribed verbatim. Resident and family interviews (n = 8) were facilitated through use of emotional touchpoints. Analysis using QSR NVivo 12.0 focused on a) capturing everyday work in terms of the interplay between demand and capacity, adaptations and intended and unintended outcomes and b) a higher-level thematic description (care planning and use of information; coordination of everyday care activity; providing person-centred care) which gives an overview of resilient performance and how it might be enhanced. This gives important new insight for improvement. Conclusions are that resilience can be supported through more efficient use of information, supporting flexible adaptation, coordination across care domains, design of the physical environment, and family involvement based on realistic conversations about quality of life. |
| first_indexed | 2024-04-11T05:12:14Z |
| format | Article |
| id | doaj.art-bd09eac96ae443788239ed93bd82d708 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T05:12:14Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-bd09eac96ae443788239ed93bd82d7082022-12-25T05:31:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011712A qualitative study of organisational resilience in care homes in ScotlandAlastair RossJanet E. AndersonSanthani SelveindranTamsin MacBridePaul BowieAndrea SherriffLinda YoungEvie FioratouEdel RoddyHeather EdwardsBelinda DewarLorna M. MacphersonProviding care for the dependent older person is complex and there have been persistent concerns about care quality as well as a growing recognition of the need for systems approaches to improvement. The I-SCOPE (Improving Systems of Care for the Older person) project employed Resilient Healthcare (RHC) theory and the CARE (Concepts for Applying Resilience) Model to study how care organisations adapt to complexity in everyday work, with the aim of exploring how to support resilient performance. The project was an in-depth qualitative study across multiple sites over 24 months. There were: 68 hours of non-participant observation, shadowing care staff at work and starting broad before narrowing to observe care domains of interest; n = 33 recorded one-to-one interviews (32 care staff and one senior inspector); three focus groups (n = 19; two with inspectors and one multi-disciplinary group); and five round table discussions on emergent results at a final project workshop (n = 31). All interviews and discussion groups were recorded and transcribed verbatim. Resident and family interviews (n = 8) were facilitated through use of emotional touchpoints. Analysis using QSR NVivo 12.0 focused on a) capturing everyday work in terms of the interplay between demand and capacity, adaptations and intended and unintended outcomes and b) a higher-level thematic description (care planning and use of information; coordination of everyday care activity; providing person-centred care) which gives an overview of resilient performance and how it might be enhanced. This gives important new insight for improvement. Conclusions are that resilience can be supported through more efficient use of information, supporting flexible adaptation, coordination across care domains, design of the physical environment, and family involvement based on realistic conversations about quality of life.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767361/?tool=EBI |
| spellingShingle | Alastair Ross Janet E. Anderson Santhani Selveindran Tamsin MacBride Paul Bowie Andrea Sherriff Linda Young Evie Fioratou Edel Roddy Heather Edwards Belinda Dewar Lorna M. Macpherson A qualitative study of organisational resilience in care homes in Scotland PLoS ONE |
| title | A qualitative study of organisational resilience in care homes in Scotland |
| title_full | A qualitative study of organisational resilience in care homes in Scotland |
| title_fullStr | A qualitative study of organisational resilience in care homes in Scotland |
| title_full_unstemmed | A qualitative study of organisational resilience in care homes in Scotland |
| title_short | A qualitative study of organisational resilience in care homes in Scotland |
| title_sort | qualitative study of organisational resilience in care homes in scotland |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767361/?tool=EBI |
| work_keys_str_mv | AT alastairross aqualitativestudyoforganisationalresilienceincarehomesinscotland AT janeteanderson aqualitativestudyoforganisationalresilienceincarehomesinscotland AT santhaniselveindran aqualitativestudyoforganisationalresilienceincarehomesinscotland AT tamsinmacbride aqualitativestudyoforganisationalresilienceincarehomesinscotland AT paulbowie aqualitativestudyoforganisationalresilienceincarehomesinscotland AT andreasherriff aqualitativestudyoforganisationalresilienceincarehomesinscotland AT lindayoung aqualitativestudyoforganisationalresilienceincarehomesinscotland AT eviefioratou aqualitativestudyoforganisationalresilienceincarehomesinscotland AT edelroddy aqualitativestudyoforganisationalresilienceincarehomesinscotland AT heatheredwards aqualitativestudyoforganisationalresilienceincarehomesinscotland AT belindadewar aqualitativestudyoforganisationalresilienceincarehomesinscotland AT lornammacpherson aqualitativestudyoforganisationalresilienceincarehomesinscotland AT alastairross qualitativestudyoforganisationalresilienceincarehomesinscotland AT janeteanderson qualitativestudyoforganisationalresilienceincarehomesinscotland AT santhaniselveindran qualitativestudyoforganisationalresilienceincarehomesinscotland AT tamsinmacbride qualitativestudyoforganisationalresilienceincarehomesinscotland AT paulbowie qualitativestudyoforganisationalresilienceincarehomesinscotland AT andreasherriff qualitativestudyoforganisationalresilienceincarehomesinscotland AT lindayoung qualitativestudyoforganisationalresilienceincarehomesinscotland AT eviefioratou qualitativestudyoforganisationalresilienceincarehomesinscotland AT edelroddy qualitativestudyoforganisationalresilienceincarehomesinscotland AT heatheredwards qualitativestudyoforganisationalresilienceincarehomesinscotland AT belindadewar qualitativestudyoforganisationalresilienceincarehomesinscotland AT lornammacpherson qualitativestudyoforganisationalresilienceincarehomesinscotland |