A qualitative study of organisational resilience in care homes in Scotland

Ross, A. et al. (2022) A qualitative study of organisational resilience in care homes in Scotland. PLoS ONE, 17(12), e0279376. (doi: 10.1371/journal.pone.0279376) (PMID:36538564) (PMCID:PMC9767361)

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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.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Sherriff, Professor Andrea and Selveindran, Dr Santhani and Bowie, Dr Paul and Macpherson, Professor Lorna and Ross, Dr Alastair
Creator Roles:
Ross, A.Conceptualization, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Writing – original draft, Writing – review and editing
Selveindran, S.Data curation, Formal analysis, Investigation, Project administration, Writing – review and editing
Bowie, P.Funding acquisition, Methodology, Writing – review and editing
Sherriff, A.Funding acquisition, Methodology, Writing – review and editing
Macpherson, L. M.Funding acquisition, Supervision, Writing – review and editing
Authors: Ross, A., Anderson, J. E., Selveindran, S., MacBride, T., Bowie, P., Sherriff, A., Young, L., Fioratou, E., Roddy, E., Edwards, H., Dewar, B., and Macpherson, L. M.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
Research Group:Community Oral Health
Journal Name:PLoS ONE
Publisher:Public Library of Science
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2022 Ross et al.
First Published:First published in PLoS ONE 17(12): e0279376
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
173114Improving Systems of Care for the Older PErson (I-SCOPE)Alastair RossDunhill Medical Trust (DUNHILLM)R462/0216Med - Dental School