Author: Stephen Yu
Yu, Stephen, 2023 Exploring the influence of an Australian healthcare organisation-initiated education program, Flinders University, College of Nursing and Health Sciences
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Background: Reports of suboptimal care from an Australian healthcare organisation raised concerns about a disconnect between the practices of healthcare professionals and the organisation’s values for patient care. These concerns led to the conception and development of the Exceptional Care Education Program (ECEP), a one-day workshop focused on three components of healthcare (essentials of care, escalation of care, and minimising restrictive practices). The ECEP workshop aimed to inform the participants of the organisation’s vision and values to encourage a positive culture focused on effective healthcare.
Methods: The aim of the study was to explore the influence of the ECEP on its participants’ approaches to healthcare. The research questions were: Were the ECEP outcomes observed in the practices of the participants? Were the goals of the ECEP reflected in the culture of the patient care delivered by the participants? A focused ethnographic methodology was utilised in this study. Two phases of data collection occurred: direct observation of ECEP participants’ patient care, along with interviews, and semi-structured interviews with the ECEP participants, facilitators and executive leaders. Thirty-four ECEP-attendee clinical administrative and healthcare professionals volunteered to participate. Data collected encompassed 97 observational hours with 23 ECEP participants, as well as interviews with 33 ECEP participants. Interviews were also undertaken with two facilitators and three executive leaders. The analytical framework utilised observation field notes and memos as well as verbatim interview transcripts.
Findings: The outcomes are related to the participants’ perspectives, the facilitators’ experiences and the intentions of the executive leaders. Participants indicated that their deeply held values were not influenced by the ECEP; rather, it had reinforced their own values. They saw barriers to effective care as not solvable by education. Rather, they sought action from the executive team to address care delivery issues such as staff workload, excessive documentation, unpleasant or toxic work cultures, and inadequate organisational support of staff. The facilitators, who had nursing backgrounds, were challenged by engaging the diverse participants, who included nurses, midwives, medical officers (doctors), allied health professionals and administrative staff. They experienced mental stress from running multiple workshops each week while constantly being questioned about the workshop’s relevance. The executive leaders were committed to improving care through the values presented in the ECEP. However, participants were not consulted about the content and felt their existing professional values were disregarded.
Conclusions: The findings indicate that the values presented in the ECEP aligned with many of the participants’ existing healthcare values. However, the approach taken to develop and deliver the ECEP did not influence their clinical practices. The original contribution to knowledge is to show that educational workshops such as the ECEP require close collaboration, during development, between the leadership team and the prospective participants. Investments in resources such as research into program development and support for facilitators could also enhance educational outcomes.
Keywords: Healthcare education program; healthcare initiative; healthcare improvement, healthcare organisation
Subject: Health Education thesis
Thesis type: Doctor of Philosophy
Completed: 2023
School: College of Nursing and Health Sciences
Supervisor: Dr Lindy King