The impact of environment and routines on interactions with patients and relatives in
acute care settings: A video-reflexive ethnography
Staff-patient interactions are a critical aspect of patient experience but commonly arise as problematic. Evidence suggests that features of the physical ward environment, and staff routines, workload, and interruptions, can impact negatively on staff interactions with patients and the time they have available to spend with patients.
The study will explore the key research question: how do features of the environmental context, the work patterns and routines of staff, and conflicting tasks and pressures, impact on the quality of interactions with, and involvement of, patients and relatives? The study will focus on acute care settings (e.g. AMU, ICU), and will use video-reflexive ethnography techniques (VRE).
VRE is an interventionist method which enables researchers to work with participants to foster reflection on their own practices and prompt improvement; this method has been used to study and promote change around patient safety, to improve communication between clinicians, and to improve care for older people.
The study will involve: (i) conducting ethnographic observations and interviews to characterise the environment, routines and task structures of staff in acute care settings in two hospitals, and identifying key points of interaction and engagement with patients; (ii) developing an acceptable
approach to videoing in acute clinical areas; (iii) videoing staff interactions with patients/relatives at key places and times to capture the interaction between environment, routines, tasks and interactions; (iv) feeding back video footage in collaboration with staff to explore their interpretations, and prompt reflexivity and “bottom-up” improvement.
The ethnographic and video data will be analysed and integrated to generate a deep understanding of the relationship between environment, routines, and interactions with patients in ICU and AMU settings. The data will also be used to assess the acceptability of the VRE approach to staff and generate lessons for the future use of VRE in improving the patient experience.
The student would have access to the doctoral research training programme within CSSAH, as well as qualitative methods training through the MRes in Applied Health Research, Department of Health Sciences. We would also provide the student with in-house training in NVivo. The primary training need would be in video data collection methods and analysis of video data, and the student would have the opportunity to attend external courses on these topics.
In order to apply please select Health Sciences Research for a September 2017 intake on the application form linked below. In the Funding section of the online application, please select Studentship and then Select CMBSP in the next dropdown option. Please indicate the name of the project supervisor(s) and the project title in the space provided within the application.
The studentship funding covers:
- Fees – full-time registration covering full UK/EU tuition fees for three years.
Stipend – an annual tax-free stipend equivalent to Research Council rates £14,553pa
(2017/8) - Research Training Support Grant – a research training support grant (including travel allowance) of £1,300pa.
Further details are available here.
Please submit your application using our Online Application System. In order to apply please select Health Sciences Research for a September 2017 intake In the Funding section of the online application indicate Cross College Studentship Please indicate the name of the project supervisor(s) and the project title in the space provided within the application.
Application enquiries to pgradmissions@le.ac.uk Project enquiries to Dr C Tarrant ccp3@le.ac.uk (Health Sciences ) and Prof J Hughes jh528@le.ac.uk (Sociology)
Source: University of Leicester
