Journal articles on the topic 'User and staff experiences'

Purpose – The purpose of this paper is to explore the lived experiences of staff and service-users regarding the introduction of dialectical behaviour therapy (DBT) into an NHS forensic learning disability (LD) service. Design/methodology/approach – Drawing on data from two recent qualitative research studies, the research team used a case-oriented approach to see beyond original findings to capture the shared experiences of the participants’ journeys, thus giving a deeper insight to the commonalities of the participants’ voices which is rarely reported in the literature (Sandelowski, 2011). Findings – A common set of phenomena became apparent when the cases were analysed, these included: trust, intensity and worthwhile. It is intended this paper gives some opportunity for reflection and shared empathetic responses to the similar experiences discussed. Originality/value – The case-orientated analysis adds value to the evidence base by highlighting the importance of the qualitative voice of both the staff and service user. This is important because most available literature reflects the process of setting up a team or DBT service, rather than describing the team experience. Equally, most published literature regarding the effectiveness of DBT is not written from the perspective of the people who receive the therapy.

In the development of sustainable social housing, the residents, operating staff, and administrative staff - as users - face challenges in relation to a lack of involvement. The aim of this research is to contribute with results regarding these challenges. These contributions to the discussion are based on the results of a qualitative evaluation of sustainable social housing. The results suggest that it can be an advantage to utilise user experiences in the development of future sustainable social housing with a view to strengthening the user involvement process. The argument is that a greater degree of user involvement respects people’s experiences as being a contribution to the development of new projects. In addition, the research suggests that the early involvement of residents, operating staff, and administrative staff can strengthen the sense of project ownership and community, as well as the project’s social sustainability. It is claimed that user involvement can promote social sustainability, which is a significant factor, since the intention behind a project’s sustainability is that the residents will later have ownership and an interest in ensuring that it works in accordance with its intentions.

Objectives: This research aimed to examine the role of the corridors in specialist inpatient rehabilitation units to inform future design of these spaces. Background: In healthcare settings, such as rehabilitation units, corridors have often been designed simply as spaces allowing movement between other locations. However, research suggests that corridors may be places where important social and care-related activities take place. How corridors are used and understood by patients and staff in inpatient rehabilitation settings is unclear, and a greater understanding of the role of corridors in these settings could help to inform more supportive design of these spaces. Methods: Independent observations of user activity were conducted at a major metropolitan inpatient spinal injury unit (SIU) and brain injury unit (BIU). Interviews were conducted with SIU patients ( n = 12), and focus groups were conducted with SIU staff ( n = 23), BIU patients ( n = 12), and BIU staff ( n = 10). Results: Results from the observations showed that the corridors were used frequently across the day, particularly by staff. Thematic analysis of staff and patient experiences found three key themes describing how corridors were used: (1) moving around, (2) delivery and experiences of quality care, and (3) a “spillover space.” Conclusions: Results demonstrate that corridors not only have an important role as connective spaces but are also used as flexible, multipurpose spaces for delivery of quality care and patient experiences. Future design should consider how these spaces can more deliberately support and contribute to patient and staff experiences of rehabilitation.

Objectives: This article aims to describe users’ perspectives about the impact of hospital outdoor spaces on the patient experience in a postacute setting. Background: Hospital outdoor space is an important element in healthcare facility design. There is growing evidence that access to green space within hospital outdoor spaces facilitates healing. However, limited studies have explored the users’ perspective regarding how hospital outdoor spaces impact the patient experience. Methods: As part of a hospital preoccupancy evaluation, users (patients, family, and staff) were invited to participate in a semi-structured interview to describe their experiences in the hospital’s outdoor spaces. Data were analyzed using inductive thematic analysis. Results: Seventy-four individuals participated in this study: 24 inpatients, 15 outpatients, 11 family, 23 staff, and one volunteer. Three themes were identified: (1) outdoor space benefits healing by helping patients focus on life beyond their illness, (2) design of healthcare spaces facilitates patients’ access to outdoor space to benefit healing, and (3) programming in the outdoor space promotes healing and recovery. Conclusions: This study describes the users’ perspective regarding the value of outdoor spaces and the design elements that influence the patient experience.

This article reports on service users’ experiences of using digital media to support staff training. A focus group generated a number of themes: potential re-traumatisation, potential therapeutic value in taking part, reflections on the use of the medium and reflections on the value of including serviceuser narratives in staff training.

Purpose The purpose of this paper is to gather the perspectives of individuals accessing an early intervention in psychosis service (EIPS), in order to inform service development. Design/methodology/approach Individual interviews (n=9) and one focus group (n=7) were conducted. Discussions focused on open questions pertaining to service users’ (SU’s) experiences of accessing the EIPS. The results were analysed using inductive thematic analysis. Findings Inductive thematic analysis was used and three main themes were generated: consistency and communication, facilitating therapeutic relationships between EIPS staff and SU’s; pushing boundaries, relating to the importance of services taking a graded approach to developing therapeutic relationships and (re)engaging in activities; and normalising and validating experiences of psychosis. Participants emphasised the importance of relationships with EIPS staff and fellow SUs and highlighted how SUs can feel fearful and vulnerable when staff are not accessible or they view their care as inconsistent. Participants further emphasised the need for practitioners to balance an approach that de-stigmatises psychotic experiences whilst validating distress. Practical implications Consistency of support from EIPSs can be as important as flexibility. Clinicians should carefully consider the balance between validating and normalising distressing experiences associated with psychosis. Offering social activities with other SUs can facilitate therapeutic relationships and recovery but the results suggest that this should be facilitated in a graded way. Originality/value The paper addresses current need in the literature to understand the experiences of people using services in order to improve the quality of the services provided.

AIMS AND METHODThe drug treatment and testing order (DTTO) is a treatment option imposed by courts and the first multi-agency initiative in the treatment of substance misuse in the UK. We used separate focus groups for service users and staff involved with DTTOs in Hertfordshire to qualitatively investigate their experiences of the orders. Interviews were recorded and analysed using grounded theory methods.RESULTSAnalysis highlighted areas of concern related to the central issue of forced treatment, which was more challenging for staff than for service users. The area of most concern was multiagency collaboration.CLINICAL IMPLICATIONSMulti-agency initiatives require extensive liaison across agencies.

AimsLittle is known about the experiences of individuals presenting with complex mental health needs and the provision of care they receive for suicide and self-harm behaviours. There are limited data describing the support individuals receive from services and, where they do, how this support is provided. Research suggests that those presenting with a more complex clinical presentation may have a history of both suicide attempts and self-harm. The aim of the study is to explore the experiences of individuals with complex mental health needs in respect of their self-harm and suicidal behaviours, and experiences of support received from mental health care services.MethodsA semi-structured interview methodology was used to generate qualitative data. Representative participants with complex mental health needs were recruited from across Cheshire and Wirral Partnership NHS Foundation Trust, UK. Ten participants were interviewed for the study. Interviews were audio-recorded and transcribed verbatim. A transcript-based conceptual analysis was conducted to identify and explore emerging themes.ResultsThe following three themes emerged from the service user interviews: (i) Service users discussed suicide attempts following inappropriate discharge; Service users spoke about feeling unsupported and not listened to by care staff, particularly as inpatients; and (ii) Service users expressed a necessity for staff training to improve understanding of self-harm and suicide attempts, having experienced negative consequences of staff handling when they may have self-harmed.ConclusionThis study highlighted the following recommendations for future suicide prevention for mental health services treating service users with complex mental health needs: increasing staff awareness of suicide or self-harm related issues; improving training and risk assessment skills; providing appropriate support for service users following discharge from inpatient settings; improving liaison and collaboration between services to provide better service user outcomes; and increasing awareness in listening to service users’ distress about suicidal or self-harm thoughts for each individual's situational context.

Purpose Democratic Therapeutic Communities (TCs) provide an environment for offenders to work on longstanding emotional and relational problems and address their offending behaviour. The purpose of this paper is to explore the experience of making psychological changes on a TC from the perspective of residents. Design/methodology/approach Interpretative Phenomenological Analysis was used to explore the experience of five former residents of the TC at HMP Gartree. Findings Four main themes emerged, each with two sub-themes: Motivation to Change (sub-themes: Engagement, Determination); Environment (sub-themes: Boundaries, Experience of care); Removal of Masks (sub-themes: Embracing vulnerability, Emerging authenticity) and Relationships (sub-themes: Re-enacting the past, Challenge from peers). Findings are discussed in relation to existing literature. Research limitations/implications Understanding service users perspectives on what helps facilitate change can help staff empathise with their experiences and strengthen their relationships. The importance of clear and consistent boundaries that are perceived as fair and the development of meaningful relationships with staff in creating an atmosphere that enables change has implications for other therapeutic or supportive environments. This research represents the experiences of five participants who were motivated to take part and comfortable to speak to a professional about their experiences. As such, generalisations about the wider TC population should be made cautiously and further research would be beneficial. Originality/value The research adds to the underrepresented area of service user perspectives in a forensic TC. It contributes a rich account of the experience of psychological change that can help staff working in TCs understand and relate to their residents experiences.

Background The prominence of telemental health, including providing care by video call and telephone, has greatly increased during the COVID-19 pandemic. However, there are clear variations in uptake and acceptability, and concerns that digital exclusion may exacerbate previous inequalities in access to good quality care. Greater understanding is needed of how service users experience telemental health, and what determines whether they engage and find it acceptable. Methods We conducted a collaborative framework analysis of data from semi-structured interviews with a sample of people already experiencing mental health problems prior to the pandemic. Data relevant to participants’ experiences and views regarding telemental health during the pandemic were identified and extracted. Data collection and analysis used a participatory, coproduction approach where researchers with relevant lived experience, contributed to all stages of data collection, analysis and interpretation of findings alongside clinical and academic researchers. Findings The experiences and preferences regarding telemental health care of the forty-four participants were dynamic and varied across time and settings, as well as between individuals. Participants’ preferences were shaped by reasons for contacting services, their relationship with care providers, and both parties’ access to technology and their individual preferences. While face-to-face care tended to be the preferred option, participants identified benefits of remote care including making care more accessible for some populations and improved efficiency for functional appointments such as prescription reviews. Participants highlighted important challenges related to safety and privacy in online settings, and gave examples of good remote care strategies they had experienced, including services scheduling regular phone calls and developing guidelines about how to access remote care tools. Discussion Participants in our study have highlighted advantages of telemental health care, as well as significant limitations that risk hindering mental health support and exacerbate inequalities in access to services. Some of these limitations are seen as potentially removable, for example through staff training or better digital access for staff or service users. Others indicate a need to maintain traditional face-to-face contact at least for some appointments. There is a clear need for care to be flexible and individualised to service user circumstances and preferences. Further research is needed on ways of minimising digital exclusion and of supporting staff in making effective and collaborative use of relevant technologies.

Purpose: The aim of this study was to improve the overall experience for patients using chronic pain services at a large teaching hospital in England. Experience-based co-design methodology was used to gain a greater understanding of patients’ experiences and to produce a list of priorities for change when improving the patient experience. Method: A total of seven video-recorded patient interviews were conducted to capture a range of patient experiences of using the chronic pain service. The interviews were analysed to identify ‘touchpoints’ which are areas in which patients experienced a heightened emotional response to their interaction with the service or staff. A short trigger film was compiled to illustrate these touchpoints to staff and gain their commitment to improve patients’ experiences when using the service. A patient experience event was held at which patients discussed the touchpoints and identified the most significant areas for change that would improve their experiences of using the chronic pain service. Results: A wide range of touchpoints were identified. The lack of information provided before arriving for a procedure and the need for a short debrief after clinic were prioritised for improvement. Patients valued the development of good relationships with clinic staff and feeling properly listened to for the first time. The patient experience event allowed the key points patients would like to know before a procedure, to be drawn up in a list, which could be passed onto staff. Conclusion: This study featured collaboration between patients and staff to improve patients’ experiences of using chronic pain services. Through patient participation, a comprehensive list of recommendations for service improvement was produced, and possible solutions were identified. The involvement of patients in driving change and re-designing services is shaping a more patient-centred chronic pain clinic and improving the experience for all the patients who use the service.

The objective was to explore the efficacy of a dual diagnosis resource—the Reasons For Use Package (RFUP)—to build staff capacity to work with service users and explore service user experiences. A two-state case comparison evaluation was conducted employing a mixed methods action research design, utilizing staff and service user surveys combined with focus groups involving staff trained and mentored in use of the RFUP. Results were that both staff and service users responded positively to the RFUP. Staff self-reported improvements in knowledge and confidence, and service users reported the RFUP assisted them with reflecting on interactions between their mental health and substance use; this assisted them with goal planning and improved their working relationship with staff. Implications were that training and mentoring in the RFUP can contribute to building staff knowledge and confidence in dual diagnosis interventions in mental health community services, and benefit service users.

Purpose This paper aims to explore the impact of stressors and the strategies staff use to cope with these at a detention facility. It documents through case studies some of the triggers of trauma, possible coping mechanisms that might assist in navigating the associated stressors in a workplace and recommendations as to what might assist staff. Design/methodology/approach A naturalist approach was used in this research, using an ethnographic qualitative methodology. Grounded theory assisted in the analysis of the data to capture naturalistically the subjective experience of the participants of the study. Conversations occurred with staff who had worked in a detention facility using face to face semi-structured interviews. The structure was open-ended to allow the staff to discuss and share their experiences freely. Findings Stressors that impacted staff working in a detention facility resulted from areas such as heightened reactions from detainees because of the length of their detainment, detainee self-harm, dealing with the effects of an increase of substance abuse through detainees obtaining contraband and the associated violent reactions that can occur as a result. Adverse symptoms noted within the lives of staff included acute anxiety, sleeplessness, depression and tension within impersonal relationships, including family. What compounded the issue was staffs’ reluctance to talk about work stressors. Research limitations/implications The research used nine participants for case studies of staff who had formerly experienced various adverse impacts of stressors. This is not a comprehensive study, however, of the broader experiences of staff at an Australian detention facility. It does provide, however, a snapshot of the experiences of a small group who had significantly been impacted by the stressors of the workplace. Practical implications This paper provides fresh perspectives or initiatives that are needed to assist staff to navigate the changing environment of working in a detention facility. In particular, some support mechanisms and protective factors that could be put in place to curb the negative impact of stressors in the workplace and to mitigate against long term stress disorders developing in the personal lives of staff. Social implications Many staff are not getting the help they need to cope with the emotional distress they experience in their workplace. However, there are practical interventions to support staff in managing the stressors they face. These will be outlined in this article. Originality/value This study was carried out with the goal of giving staff a voice and to capture their former experiences in their vocational responsibilities in a venue that has had very limited research attention. This study has presented the challenges staff faced in a unique venue of working in a detention facility. It has documented some of the common stressors staff faced, the impact of such and some coping mechanisms used to handle them.

Purpose The purpose of this paper is to describe a small scale pilot study undertaken in Northern Ireland to gather service user feedback from individuals who have been subject to adult safeguarding procedures. Design/methodology/approach The aims, methods and findings of the “Adult Safeguarding: 10,000 Voices” pilot project are presented. Findings The pilot project highlighted how an initiative which captures the experiences of patients, service users, carers and staff in the health and social care sector (10,000 Voices) could be successfully adapted for use in adult safeguarding, facilitating the collation of complex experiences and enabling insights to be gleaned and shared. Research limitations/implications The pilot study is limited by the small number of participants. The findings are preliminary. Practical implications For the first time in Northern Ireland the 10,000 Voices model was utilised in the context of a non-health related service, namely, adult safeguarding. Social implications This outline of the model and methodology for obtaining service user feedback can inform user involvement in other contexts. Originality/value This paper provides an accessible overview of an innovative approach to engaging service users in adult safeguarding, such approaches, to date have been limited.

This paper explores service user and staff experiences of a diagnostic trauma assessment within an emotionally unstable personality disorder inpatient population. Findings highlight strengthened therapeutic relationships with minimal adverse effects and support the implementation of trauma-diagnostic assessments within inpatient settings.

This study assessed user experiences of a public library in Namibia and non-user attitudes to it. A convenience sample of 586 was employed. Participants in the study were 207 (35.3%) registered librarymembers and 379 (64.7%) non-users. Needs assessment questionnaires, suggestion box forms, interviews and observations were the tools used for the collection of data. The results indicated that thepublic library is well known to the local community and is mostly accessed by learners from local schools, teachers, and distance-learners from various tertiary educational institutions. Users from different occupations also accessed the library. The library was used for study purposes, research, access to computers and reprographic services. The results also revealed that, although services, resources and usage were found to be satisfactory, some users were not satisfied with the services because of inadequate space, irrelevant resources, attitudes of staff members, untidiness, location, poor internet connectivity, poor ventilation, and noise. The findings of this study can inform policymakers on how information access and services need to be improved.

Since August 2015, a large range of sexual health and reproductive health services have been provided in more than 120 pharmacies across Birmingham (England). Our study aimed to explore how pharmacy staff and pharmacy users experience delivering or being provided with sexual health and reproductive health services. Between March and September 2019, semi-structured interviews were conducted with 15 pharmacy staff delivering sexual and reproductive health services and 15 people who had used a sexual and reproductive health service at the pharmacy. Interviews were analysed thematically. Pharmacy users found services convenient to use and were largely satisfied with pharmacy staff consultation skills. Staff were motivated to deliver the services, although some felt that they did not receive sufficient recognition for their work. Barriers to pharmacy-based sexual and reproductive health services were identified, including lack of privacy for users, lack of staff and user awareness of the services, lack of trained staff to deliver services and lack of capacity for copper coil insertions in females presenting for emergency contraception. The identification of barriers to effective service provision can be used to improve the delivery of sexual and reproductive health services in pharmacies and lead to a greater uptake.

This case study describes the consolidation and migration of the University of New Mexico’s University Libraries’ database A-Z lists. A subject librarian lead the nine-month project that included most subject librarians, the electronic resources team, the Director of Collections, and the web & discovery librarian. The project also provided the UL the opportunity to review all the resources in the lists, and update all descriptions, and create new workflows for adding and managing a single list.

BackgroundThe search for causal links between human resource management (HRM) and organisational performance has dominated academic and practitioner debates for many years. However, much of this work comes from contexts outside health care and/or the UK.ObjectivesThis study tested the later stages of a well-established HRM model, testing whether or not there was evidence of causal links between staff experience and intermediate (staff) and final (patient and organisational) outcomes, and whether or not these differed in parts of the NHS. We used large-scale longitudinal secondary data sets in order to answer these questions in a thorough way.Data sourcesSearches were conducted using Health Management Information Consortium, MEDLINE, PsycINFO, Social Sciences Citation Index and EBSCOhost(from inception to May 2012).MethodsStaff experience data came from the national NHS staff surveys of 2009, 2010 and 2011, with trust-level measures of staff absenteeism, turnover, patient satisfaction, mortality and infection rates gathered from the same NHS years. Several analytical methods were used, including multilevel analysis, mediated regression, latent growth curve modelling and cross-lagged correlation analysis.ResultsIn general, the pattern was that better staff experiences are associated with better outcomes for employees and patients. Multilevel analysis found that the positive effects of staff perceiving equal opportunities on employee outcomes were especially strong, as were the negative effects of aggression and discrimination. Organisational-level analysis showed that better staff experiences (particularly those associated with better well-being and better job design, and more positive attitudes about the organisation generally) were linked to lower levels of absenteeism and greater patient satisfaction. There was some evidence that the relationship with absenteeism is causal, although the causal link with patient satisfaction was less clear-cut. Some relationships between staff experience and turnover, and some between staff experience and patient mortality, were also found (and a few with infection rates), with longitudinal analysis comparatively unclear about the direction of causality. Although many staff experiences were associated with absenteeism and patient satisfaction, these effects were not mediated and the reason staff experiences are linked to patient satisfaction appears to be separate from the link with absenteeism. In general, there is no single group of staff (or geographical region) for which staff experiences are the most important. However, nurses’ experiences generally had the strongest effects on absenteeism, followed by medical/dental staff. Few clear or explainable patterns for other staff group effects were found. Absenteeism was most readily predicted by staff experience in the West Midlands. Two Action Learning Sets of managers, and patient and public involvement representatives broadly supported the emerging findings of the factors that seemed to be important indicators of staff satisfaction and organisational outcomes.LimitationsThe relatively blunt nature of the data used meant that conclusions about the direction of causality were less clear. More specific limitations included that we had to limit outcome variables to those that were available already, that many variables were available for acute trusts, and that we could not break down data further within trusts or years.ConclusionsOverall, the research confirmed many expected links between staff experiences and outcomes, providing support for that part of the overall HRM model in the NHS. However, conclusions about the direction of causality were less clear (except for absenteeism). This is probably due in part to the relatively blunt nature of the data used. Future research may involve the careful evaluation of interventions designed to improve staff experience on more specific groups of staff, and the continued use of secondary data sources, such as those used in this report, to answer more specific, theoretically driven questions.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Background: Increasing access to evidence-based talking therapies for people with psychosis is a national health priority. We have piloted a new, “low intensity” (LI) CBT intervention specifically designed to be delivered by frontline mental health staff, following brief training, and with ongoing supervision and support. A pilot feasibility study has demonstrated significant improvement in service user outcomes. This study is a qualitative analysis of the experiences of the staff and service users taking part in the evaluation. Aims: To evaluate the acceptability of the training protocol and the therapy, and to examine the factors promoting and restraining implementation. Method: All trained staff and service users completed a semi-structured interview that was transcribed and subjected to thematic analysis. Results: Service users spoke about learning new skills and achieving their goals. Staff spoke about being able to use a brief, structured intervention to achieve positive outcomes for their clients. Both groups felt that longer, more sophisticated interventions were required to address more complex problems. The positive clinical outcomes motivated therapists to continue using the approach, despite organizational barriers. Conclusions: For both trained staff and service users, taking part in the study was a positive experience. Staff members’ perceived skill development and positive reaction to seeing their clients improve should help to promote implementation. Work is needed to clarify whether and how more complex difficulties should be addressed by frontline staff.

Background: User participation is advocated on the basis that consumers know their own needs better than anyone else. Photovoice is a participatory research method that empowers the grass-root population to give voice on concerned issues for eliciting social change. Aim: This study explores the experience and impact of user participation in mental health services (MHS) in Hong Kong through photovoice. It also examines the effects of this method in studying user participation. Method: In this qualitative inquiry, authors, two peer researchers and three participants were involved in the various stages of research design, data collection and data analysis. Participants took photos showing their perception and experiences of being involved in different MHS systems. They shared their narratives through these images and reflected on the participatory experience of photovoice. Results: User participation was experienced as a gradual process of assuming control that involved personal responsibility, connection with peers, collaboration with staff, redefinition of boundaries and social inclusion. Meaningful participation gave rise to a sense of contribution, interpersonal connection and self-worth and transformed one’s identity. Participants enjoyed the mutual interaction and derived benefit from the photovoice process. Issues such as consent and confidentiality arose in implementation. Conclusion: Participation entails partnership among service users, providers and peers. Photovoice opens up new space for unfolding expert knowledge. Further application of this participatory approach with the local community is suggested in order to develop person-centered care.

Purpose The purpose of this paper is to report the training of college librarians, academic and management staff, IT managers and students on how to organise, manage and use a user-friendly library. In Uganda, as in many countries, the problem is that school and/or college libraries are managed by librarians who may have good cataloguing and management skills, but who do not have the pedagogic skills and knowledge of the school curricula that are necessary for librarians to be able to guide and mentor both teachers and students or organise curriculum-related activities or facilitate research. The development of user-friendly libraries contributes in improving education quality through nurturing the interest of students and teachers in literacy activities and active search for knowledge. Under the stewardship of the Belgium Technical Cooperation and the Ministry of Education in Uganda, library stakeholders were trained on how to put users – rather than themselves – in the centre of the library’s operations and introduced to active teaching and learning methodologies and activities with emphasis on getting engaged in transforming spaces, services, outreach to users and collections. Several measures, short and long term were taken to address the gaps limiting the performance of the librarians. Given the disparities in the trainees’ education level and work experience, the training was delivered in seven modules divided into three units for over eight months in 2015. By the end of the training, trainees developed unique library strategic plan, library policies and procedures, capacity to use library systems, physical design and maintenance systems, partnerships, library structure and staff job descriptions. Design/methodology/approach To effectively engage the participants each topic was conducted using active teaching and learning (ATL) methodologies, including: lecture with slides and hands-on practice – each topic was introduced in a lecture form with slides and hands-on exercises. The main goal was to introduce the participants to the concepts discussed, offer opportunities to explore alternative approaches, as well define boundaries for discussion through brainstorming. The question-answer approach kept the participants alert and to start thinking critically on the topic discussed – brainstorming sessions allowed thinking beyond the presentation room, drawing from personal experiences to provide alternatives to anticipated challenges. The goal here was for the participants to provide individual choices and approaches for real life problems; group discussions: case study/ scenario and participant presentations – participants were provided with a scenario and asked to provide alternative approaches that could solve the problem based on their personal experience at their colleges. By the end of the group discussion, participants presented a draft of the deliverable as per the topic under discussion. More so, group discussions were an excellent approach to test participant’s teamwork skills and ability to compromise, as well as respecting team decisions. It was an opportunity to see how librarians will work with the library committees. Group discussions further initiated and cemented the much-needed librarian–academic staff – college management relationship. During the group discussion, librarians, teaching staff, ICT staff and college management staff, specifically the Principals and Deputy Principals interacted freely thus starting and cultivating a new era of work relationship between them. Individual presentation: prior to the workshop, participants were sent instructions to prepare a presentation on a topic. For example, participants were asked to provide their views of what a “user-friendly library” would look like or what would constitute a “user-friendly library”; the college library of HTC-Mulago was asked to talk about their experience working with book reserves, challenges faced and plans they have to address the challenges, while the college librarian from NTC-Kaliro was asked to describe a situation where they were able to assist a patron, the limitations they faced and how they addressed them. Doing so did not only assist to emotionally prepare the participants for the training but also helped to make them start thinking about the training in relation to their libraries and work. Take-home assignment: at the end of each session, participants were given home assignments to not only revise the training material but also prepare for the next day training. Further the take-home assignments provided time for the participants to discuss with their colleagues outside of the training room so as to have a common ground/ understanding on some of the very sensitive issues. Most interesting assignment was when participants were asked to review an article and to make a presentation in relation to their library experiences. Participant reports: participant reports resulted from the take-home assignments and participants were asked to make submission on a given topic. For example, participants were asked to review IFLA section on library management and write a two-page report on how such information provided supported their own work, as well as a participant report came from their own observation after a library visit. Invited talks with library expert: two invited talks by library experts from Consortium of Uganda University Libraries and Uganda Library and Information Science Association with the goal to share their experience, motivate the participants to strive higher and achieve great things for their libraries. Library visitation: there were two library visits conducted on three separate days – International Hospital Kampala (IHK) Library, Makerere University Library and Aga Khan University Hospital Library. Each of these library visits provided unique opportunities for the participants to explore best practices and implement similar practices in their libraries. Visual aids – videos, building plans and still photos: these were visual learning aids to supplement text during the lectures because they carried lot of information while initiating different thoughts best on the participants’ past experience and expertise. The training advocated for the use of ATL methodologies and likewise similar methodologies were used to encourage participants do so in their classrooms. Findings Addressing Key Concerns: Several measures, both long and short term, were taken to address the gaps limiting the performance of the librarians. The measures taken included: selected representative sample of participants including all college stakeholders as discussed above; active teaching and learning methodologies applied in the training and blended in the content of the training materials; initiated and formulated approaches to collaborations, networks and partnerships; visited different libraries to benchmark library practices and encourage future job shadowing opportunities; and encouraged participants to relate freely, understand and value each other’s work to change their mindsets. College librarians were encouraged to ensure library priorities remain on the agenda through advocacy campaigns. Short-term measures: The UFL training was designed as a practical and hands-on training blended with individual and group tasks, discussions, take-home assignments and presentations by participants. This allowed participates to engage with the material and take responsibility for their own work. Further, the training material was prepared with a view that librarians support the academic life of teaching staff and students. Participants were tasked to develop and later fine-tune materials designed to support their work. For example, developing a subject bibliography and posting it on the library website designed using open source tools such as Google website, Wikis, blogs. The developed library manual includes user-friendly policies and procedures referred to as “dos and don’ts in the library” that promote equitable open access to information; drafting book selection memos; new book arrivals lists; subscribing to open access journals; current awareness services and selective dissemination of information service displays and electronic bulletins. Based on their library needs and semester calendar, participants developed action points and timelines to implement tasks in their libraries at the end of each unit training. Librarians were encouraged to share their experiences through library websites, Facebook page, group e-mail/listserv and Instagram; however, they were challenged with intimate internet access. College libraries were rewarded for their extraordinary job. Given their pivotal role in the management and administration of financial and material resources, on top of librarians, the participants in this training were college administrators/ management, teaching and ICT staff, researchers and student leadership. Participants were selected to address the current and future needs of the college library. These are individuals that are perceived to have a great impact towards furthering the college library agenda. The practical nature of this training warranted conducting the workshops from developed but similar library spaces, for example, Aga Khan University Library and Kampala Capital City, Makerere University Library, International Hospital Kampala Library and Uganda Christian University Library. Participants observed orientation sessions, reference desk management and interviews, collection management practices, preservation and conservation, secretarial bureau management, etc. Long-term measures: Changing the mindset of librarians, college administrators and teaching staff is a long-term commitment which continues to demand for innovative interventions. For example: job shadowing allowed college librarian short-term attachments to Makerere University Library, Uganda Christian University Library, Aga Khan Hospital University Library and International Hospital Kampala Library – these libraries were selected because of their comparable practices and size. The mentorship programme lasted between two-three weeks; on-spot supervision and follow-up visits to assess progress with the action plan by the librarians and college administration and college library committee; ensuring that all library documents – library strategic plan, library manual, library organogram, etc are approved by the College Governing Council and are part of the college wide governing documents; and establishing the library committee with a job description for each member – this has strengthened the library most especially as an advocacy tool, planning and budgeting mechanism, awareness channel for library practices, while bringing the library to the agenda – reemphasizing the library’s agenda. To bridge the widened gap between librarians and the rest of the stakeholders, i.e. teaching staff, ICT staff, college administration and students, a college library committee structure and its mandate were established comprising: Library Committee Chairperson – member of the teaching staff; Library Committee Secretary – College Librarian; Student Representative – must be a member of the student Guild with library work experience; and Representative from each college academic department. A library consortium was formed involving all the four project supported colleges to participate in resource sharing practices, shared work practices like shared cataloguing, information literacy training, reference interview and referral services as well a platform for sharing experiences. A library consortium further demanded for automating library functions to facilitate collaboration and shared work. Plans are in place to install Koha integrated library system that will cultivate a strong working relationship between librarians and students, academic staff, college administration and IT managers. This was achieved by ensuring that librarians innovatively implement library practices and skills acquired from the workshop as well as show their relevance to the academic life of the academic staff. Cultivating relationships takes a great deal of time, thus college librarians were coached on: creating inclusive library committees, timely response to user needs, design library programmes that address user needs, keeping with changing technology to suite changing user needs, seeking customer feedback and collecting user statistics to support their requests, strengthening the library’s financial based by starting a secretarial bureau and conducting user surveys to understand users’ information-seeking behaviour. To improve the awareness of new developments in the library world, college librarians were introduced to library networks at national, regional and international levels, as a result they participated in conferences, workshops, seminars at local, regional and international level. For example, for the first time and with funding from Belgium Technical Cooperation, college librarians attended 81st IFLA World Library and Information Congress in South African in 2015. College libraries are now members of the Consortium of Uganda University Libraries and Uganda Library and Information Science Association and have attended meetings of these two very important library organisations in Uganda’s LIS profession. The college librarians have attended meetings and workshops organized by these two organisations. Originality/value At the end of the three units training, participants were able to develop: a strategic plan for their libraries; an organogram with staffing needs and job description matching staff functions; a Library Committee for each library and with a structure unifying all the four project-support Colleges; a library action plan with due dates including deliverables and responsibilities for implementation; workflow plan and organisation of key sections of the library such as reserved and public spaces; furniture and equipment inventory (assets); a library manual and collection development policy; partnerships with KCCA Library and Consortium of Uganda University Libraries; skills to use Koha ILMS for performing library functions including: cataloguing, circulation, acquisitions, serials management, reporting and statistics; skills in searching library databases and information literacy skills; skills in designing simple and intuitive websites using Google Sites tools; and improved working relationship between the stakeholders was visible. To further the user-friendly libraries principle of putting users in the centre of the library’s operations, support ATL methodologies and activities with emphasis on getting engaged in transforming spaces, services, outreach to users and collections the following initiatives are currently implemented in the colleges: getting approval of all library policy documents by College Governing Council, initiating job shadowing opportunities, conducting on-spot supervision, guide libraries to set up college library committees and their job description, design library websites, develop dissemination sessions for all library policies, incorporate user-friendly language in all library documents, initiate income generation activities for libraries, set terms of reference for library staff and staffing as per college organogram, procurement of library tools like DDC and library of congress subject headings (LCSH), encourage attendance to webinars and space planning for the new libraries.

Aims and methodTo investigate the complementarities of staff and service users' experiences of shame in psychiatric in-patient settings. Qualitative methods were used by means of focus group interviews in two compositions – staff and service users. Data were transcribed and thematically analysed.ResultsService user group transcripts revealed four prominent themes: ‘loss of value’, ‘loss of adulthood and autonomy’, ‘loss of subjectivity’ and ‘shaming or blaming of others’. Staff group transcripts also revealed two themes one of which overlapped with service users (‘shaming or blaming of others’) and one of which was distinct (‘entrapment’).Clinical implicationsShame processes may be elicited by caregiving and impede treatment. Staff find themselves in the predicament of provoking the problems they intend to address. Suggestions are made as to how to respond to this dilemma and practically improve aspects of the in-patient care process to reduce shame.

Cellar doors provide retail sales for wineries, providing higher returns than wholesale to domestic and export markets. Customer-based research has established enjoyable cellar door experiences are essential to building brand attachment, creating enduring customers, and increasing on-site and post-visit sales. However, customers co-create cellar door experiences with staff, as each approach the experience with unique realities guiding their expectations. Scarce literature includes experiences from staff perspectives. Constructivist grounded theory and adopting Charmaz’s approach to analysis were used to explore data from semi-structured, in-depth interviews with 33 wine consumers ranging in wine involvement, from wine novices to highly involved enthusiasts and winemakers. Twenty-two of the consumers were cellar door staff with experiences ranging from a few months to owners of long-established family wineries. Cognitive dissonance theory helped us to understand how tensions may arise for individuals approaching each experience and where to avert perceived risks. Findings show convivial connection respecting all actors creates enjoyable experiences. The warmth of greeting, further strengthened by staff–customer rapport, developed via knowledgeable conversation throughout the experience, increases brand attachment. Co-created connection becomes the conduit through which positive experiences are created and where brand attachment is forged. A framework based on emerging categories guides professional development models and human resources strategies for wineries, thereby maximizing profitability through cellar door sales.

ObjectiveTo detail how hospital staff with differing personal and professional caregiving experiences approach the care of patients with dementia, in order to make practical recommendations for practice.DesignCross-sectional qualitative interviews.SettingA UK hospital ward providing dementia care.ParticipantsA complete hospital ward staff team, constituting 47 hospital staff from 10 professions.MethodsHospital staff were asked to list their approaches to emotion-focused care in individual, ethnographic freelisting interviews. Cultural consensus analysis was used to detail variations in approaches to dementia care between staff subgroups.Main outcome measuresThe most salient listed descriptions of care emphasised by staff members with personal experience of dementia caregiving when compared with staff members without such experience, and descriptions from staff newer to the profession compared with staff with more years of professional dementia caregiving experience.ResultsSubgroups of hospital staff showed different patterns of responses both in how they noticed the emotional distress of patients with dementia, and in prioritised responses that they deemed to work. Hospital staff with professional experience of dementia caregiving and staff with fewer years of professional experience prioritised mutual communication and getting to know each patient.ConclusionsSubgroups of hospital staff with personal caregiving experiences and fewer years of professional care experience were more likely to describe person-centred care as their routine ways of working with patients with dementia. It is recommended that personal experience and the novice curiosity of hospital staff be considered as valuable resources that exist within multidisciplinary staff teams that could enhance staff training to improve the hospital care for patients with dementia.

Aim To understand violence on acute mental health units according to staff and service user perspectives and experiences. Background The collateral damage of violence in acute inpatient mental health settings is wide-ranging, impacting on the health and wellbeing of staff and service users, and detrimental to public perceptions of people who are mentally unwell. Despite international research on the topic, few studies have examined psychiatric unit violence from both staff and service user perspectives. Methods We conducted in-depth interviews with 85 people (42 staff, 43 service users) in four adult acute mental health inpatient units in New Zealand. We undertook a thematic analysis of perspectives on the contributing factors and consequences of violence on the unit. Results Both staff and service users indicated violence was a frequent problem in acute inpatient units. Four themes regarding the causes of violence emerged: individual service user factors, the built environment, organisational factors, and the overall social milieu of the unit. Staff often highlighted complexities of the system as causal factors. These included the difficulties of managing diverse service user illnesses within an inadequate and unsafe built environment whilst having to contend with staffing issues and idiosyncrasies relating to rule enforcement. In contrast, service users talked of their needs for care and autonomy not being met in an atmosphere of paternalism, boredom due to restrictions and lack of meaningful activities, enforced medication, and physical confinement as precipitants to violence. Two broader themes also emerged, both relating to empathy. Both staff and service users exhibited ‘othering’ (characterised by a profound lack of empathy) in relation to acutely unwell individuals. Explanations for violent behaviour on the unit differed between groups, with service users being more likely to attribute unwanted behaviour to contextual factors and staff more likely to ‘blame’ mental illness. The consequences of violence included stress, physical injury, and a culture of fear and stigma. Conclusion Violence in acute inpatient mental health units in New Zealand is a significant, complex, and unresolved problem negatively impacting the therapeutic mission of these settings. Further in-depth qualitative investigations are urgently required into what is experienced as violence by service users, their view of how violence occurs, the role of fear and power relations, and the contributions of the built and organisational environment to all forms of violence to all unit users. A core function of the acute mental health unit is to offer a therapeutic environment for individuals at their most vulnerable. For this to happen, the unit must be a rewarding place to work, and a safe place to be.

Stroke service delivery in rural areas in Australia lacks evidence-based, best practice care protocols as a result of limited resources and opportunity. Healthcare redesign is an approach to improving health services by understanding barriers and enablers to service provision and work with users to develop solutions for improvement. This research aimed to qualitatively evaluate stroke care in rural Tasmania using a person-centered approach, as part of a larger healthcare redesign initiative to improve acute stroke care. Semi-structured interviews, aimed at gaining insight into experiences of healthcare staff and users, were conducted. Thematic analysis revealed three global themes (communication, holistic care, and resourcing) that demonstrated some consistency between healthcare staff and user experience, highlighting that some needs and expectations were not being met. Results of this experiential study provide important perspectives for delivering needs-based improvements in service provision for acute stroke care. Overall, this study showed that systems of stroke care in rural areas could be improved by utilizing a redesign approach including healthcare staff and users in the development of solutions for health service improvement.

Aim: This systematic review aimed to provide new insights into how pharmacy spaces, or the architecture of pharmacies, are experienced by pharmacy service users and staff. The review sought to identify environmental factors which may influence service users’ and staff participation in community-based pharmacy health services. Method: Ten databases were searched for English language publications, using a combination of search terms relating to pharmacy service users and staff; pharmacy spaces; and health and social care outcomes. Data from the final selected studies were extracted, thematically analysed using a narrative approach and the quality of each study assessed using the Integrated quality Criteria for the Review of Multiple Study designs (ICROMS). Results: 80 articles reporting 80 studies published between 1994 and 2020 were identified; they were from 28 countries, involving around 3234 community pharmacies, 13,615 pharmacy service users, 5056 pharmacists and 78 pharmacy health staff. Most studies (94%) met the ICROMS minimum score, and half did not meet the mandatory quality criteria. Four themes likely to influence service users’ and staff experiences of pharmacy health services were identified: (1) privacy; (2) experience of the physical environment; (3) professional image; and (4) risk of error. Conclusion: To optimise the delivery and experience of pharmacy health services, these spaces should be made more engaging. Future applied research could focus on optimising inclusive pharmacy design features.

AbstractAims. To examine the relationship between nursing students’ exposure to various forms of incivility in acute care practice settings and their experience of burnout. Background. Given that staff nurses and new nurse graduates are experiencing incivility and burnout in the workplace, it is plausible that nursing students share similar experiences in professional practice settings. Design and sample. A cross-sectional survey design was used to assess Year 4 nursing students’ (n=126) perceptions of their experiences of incivility and burnout in the clinical learning environment. Methods. Students completed instruments to assess frequency of uncivil behaviors experienced during the past six months from nursing staff, clinical instructors, and other health professionals in the acute care practice setting and to measure student burnout. Results. Reported incidences of incivility in the practice setting were related to burnout. Higher rates of incivility, particularly from staff nurses, were associated with higher levels of both components of burnout (emotional exhaustion and cynicism).

BackgroundSelf-harm is increasingly common in many countries, is often repeated and may have other negative outcomes.AimsTo systematically review people's attitudes towards clinical services following self-harm in order to inform service design and improvement.MethodA search of electronic databases was conducted and experts in the field were contacted in order to identify relevant worldwide qualitative or quantitative studies. Data were extracted independently by two reviewers with more weight given to studies of greater quality and relevance.ResultsThirty-one studies met the inclusion criteria. Despite variations in healthcare systems and setting, participants' experiences were remarkably similar. Poor communication between patients and staff and a perceived lack of staff knowledge with regard to self-harm were common themes. Many participants suggested that psychosocial assessments and access to after-care needed to be improved.ConclusionsSpecific aspects of care that might increase service user satisfaction and treatment adherence include staff knowledge, communication and better after-care arrangements. A standard protocol could aid regular audits of users' experiences of services.

IntroductionIn the literature, service users and informal caregivers have been critical towards psychiatric inpatient care. However, little is known about their fears related to hospital care.ObjectivesWe describe service users’ and informal caregivers’ experiences of fear in psychiatric hospital settings.MethodsThe data were collected from seven mental health associations located in six Finnish cities. Focus group interviews (f=8) were conducted (2015–2016) with service users (n=20) and informal caregivers (n=15), and were guided to focus on violence and challenging situations in psychiatric care. In a secondary analysis, experiences of fear were extracted from the transcriptions and analyzed using inductive content analysis.ResultsBoth groups’ experiences of fear focused on themes related to staff, treatment and fellow patients. Additionally, service users had experiences of fear related to the hospital environment. Fears related to staff involved intimidating personnel using force or acting in threatening ways. Participants also described staff seemingly being afraid of patients and care givers. Three types of fears related to treatment were described: fear of not being admitted to hospital even if needed, fear of being admitted to hospital, and fear of coercive methods used in care. Fear of fellow patients involved being afraid of aggressive, unpredictable behaviors, which could cause, e.g., a lack of sleep at night for service users. Fears related to the environment itself were also discussed.ConclusionsBeing hospitalized can be a difficult experience for service users and informal caregivers. These results can help psychiatric healthcare staff acknowledge areas in care that may potentially cause feelings of fear.DisclosureNo significant relationships.

Virtual reality provides a powerful way to visualize the three-dimensional, atomic-level structures of molecules and materials. We present new virtual reality software for molecular modeling and for testing the use of virtual reality in organic chemistry education. The open-source software, named VRChem, was developed primarily for building, visualizing and manipulating organic molecules using a head-mounted virtual reality system. The design goal of the VRChem software was to create an easy-to-use and entertaining user experience for molecular modeling in virtual reality. We discuss the design and implementation of VRChem, together with real-life user experiences collected from students and academic research staff.

Background/Aims A female acute inpatient mental health ward developed a care pathway to support women who self-harm during their admission. This service evaluation was the first to explore staff and patients' experiences of the care pathway using qualitative methods. Methods Semi-structured interviews were completed with eight staff members and five patients. Thematic analysis was used to analyse the interview data. Results Themes that developed from staff interviews were about effects on staff and staff support, enabling patients to manage self-harm autonomously and the ward environment. Themes developed from patient interviews included enabling engagement, putting skills into practice and least restrictive practice. Staff and patients viewed the pathway as effective in reducing self-harm incidents and levels of restriction on the ward. Conclusions The pathway was viewed positively by staff and patients, although improvements could be considered to increase its efficacy.

Purpose Research suggests that individuals with autistic spectrum disorder (ASD) are inconsistently supported throughout the criminal justice system (CJS) in the UK. Bradley (2009) recommended the introduction of criminal justice liaison and diversion (L&D) teams to bridge the gap between the CJS and mental health services and provide a more consistent and improved quality of support for individuals with vulnerabilities, including those with autism. This study aims to explore the experiences of staff working in L&D teams who encounter individuals with ASD. Design/methodology/approach Interviews were conducted with ten L&D team members. Interpretative phenomenological analysis was used to gain insight into their lived experiences of working with autism in the CJS. Findings Interpretation of individual transcripts resulted in three super-ordinate themes: “feeling helpless and helpful in the system”, “transition to knowing” and “impact on self”. Each theme encapsulated a number of sub-themes depicting the limitations of services, difficult environments, making a difference, lack of understanding, developing understanding and the impact of these experiences on staff’s confidence, attitudes and well-being. Practical implications Criminal justice services are limited for people with autism. There is a lack of autism awareness by staff. Lack of awareness impacts staff attitudes and confidence. Training in autism should be provided to criminal justice staff. Originality/value This research highlights the limitations of services available for individuals with autism and the widespread lack of autism awareness. These concerns directly impacted participants’ confidence, attitudes and well-being. Recommendations are proposed to guide future practice and research including increasing availability of access to ASD services, enforcing mandatory autism-specific training for staff and routinely collecting service-user feedback.

The emphasis on schools to promote pupils’ emotional well-being (EWB) has taken prominence in Government initiatives over the last 10 years. Initially focused within primary education, more recent publications have drawn attention to pupils’ EWB within secondary education, as well as the promotion of teaching staffs’ EWB. The prevalence of occupational stress and its negative impact upon teaching staffs’ EWB is increasing. There has been little exploration into the views of teaching staff and pupils concerning the implementation of EWB initiatives and the associated impact on teaching staffs’ daily practice and their own EWB.This paper is based on, and includes, extracts from research carried out during initial Educational Psychology doctoral training at the University of Sheffield (Salter, 2010). This research used a grounded theory (GT) methodological approach. Category themes emerged that outlined psychosocial processes involved in the whole school promotion of pupils and teaching staffs’ EWB in one secondary school. This paper presents a summary of themes arising from the research: the stressors teaching staff face and the impact on their EWB; benefits and barriers that staff experience when promoting pupils’ EWB; examples of current practice which promote teaching staffs’ EWB; and the role of the Educational Psychologist (EP) in supporting teaching staff EWB. All of these are grounded within the sampled views and experiences of pupils, teaching staff and EPs.Recommendations are made for EPs and secondary schools regarding the implementation and implications of associated systems which promote the EWB of teaching staff.

Purpose This study aims to assess international customers’ experiences in the leading hotels of the iconic city of Shanghai. Design/methodology/approach Leximancer, a qualitative analysis software program, was used to examine over 2,000 reviews appraising Shanghai’s superior hotels. The reviews were posted on Agoda.com. Findings Overall, the international tourists were actually quite satisfied with the superior Shanghai hotels. This study highlighted the continuing importance of the attentive and professional “staff”, physical attributes of the “hotel”, comfort of the “room”, “location”, proximity to a “shopping” area and co-creation possibilities to deliver some “beautiful” experiences. Segments of the market based on tourists’ origins, travel style and hotel management styles emphasized different expressive and instrumental features. Some strong commonalities were identified. The most satisfied customers, no matter what their backgrounds, were those who were more impressed with the expressive and intangible elements in the hotel, especially their interaction with and the service qualities of the hotels’ professional and attentive staff. Practical implications The work offers a potential range of insights and emphases for individual properties in Shanghai and other locations to help market and co-create experiences in their properties in distinctive ways. Originality/value The work is framed within the wider theoretical concerns of extending the meaning of co-creation in the experience economy. The work argues that co-creation is not limited to the on-site experience but rather that post-visit appraisals through user-generated contents constitute an extended form of interaction which may assist in understanding the full trajectory of the hotel experience.

Hospitalisation at Home (HaH) is a new model providing hospital-level care at home as a substitute for traditional care. Biometric monitoring and digital communication are crucial, but little is known about user perspectives. We aim to explore how in-patients with severe COVID-19 infection and clinicians engage with and experience communication and self-monitoring activities following the HaH model. A qualitative study based on semi-structured interviews of patients and clinicians participating in the early development phase of HaH were conducted. We interviewed eight clinicians and six patients. Five themes emerged from clinicians: (1) staff fear and concerns, (2) workflow, (3) virtual closeness, (4) patient relatives, and (5) future HaH models; four themes emerged from patients: (1) transition to home, (2) joint responsibility, (3) acceptability of technologies, and (4) relatives. Despite technical problems, both patients and clinicians were enthusiastic about the conceptual HaH idea. If appropriately introduced, treatment based on self-monitoring and remote communication was perceived acceptable for the patients; however, obtaining vitals at night was an overwhelming challenge. HaH is generally acceptable, perceived patient-centred, influencing routine clinical workflow, role and job satisfaction. Therefore, it calls for educational programs including more perspective than issues related to technical devices.

Objective: The purpose of the research was to describe nursing and medical staff’s knowledge of simulated learning and their experiences of the usefulness of simulation education in one hospital district in Finland. The research aimed at producing user-oriented knowledge to be used in the development of multiprofessional simulation pedagogical continuing education. The study is part of a larger research project, whose purpose is to build up a multiprofessional simulated learning environment for a network of partners. They involve a university of applied sciences, a vocational education center, a health technology development center and a hospital district.Methods: Data were collected using aWeb-based survey tool between December 1, 2016 and January 13, 2017. The questionnaire contained both quantitative (n = 24) and qualitative (n = 3) items. This article deals with quantitative data only. Data was analyzed using SPSS Statistics for Windows 23. The response rate was 28% (n = 125).Results: Both nursing and medical staff found that simulation education had been useful for the development of their theoretical and practical competence. Some statistically significant differences were discovered between various age and professional groups.Conclusions: As a conclusion, nursing and medical staff in this hospital district need more information about simulation education and simulated learning environments. The knowledge produced in this study can be used in planning multiprofessional simulation pedagogical continuing education. Simulation pedagogy can be especially useful when practicing teamwork and interaction in acute, recurring and infrequent care situations.

Purpose – The purpose of this paper is to gain insight into the experiences of staff working with transgendered sex offenders in a prison setting. Design/methodology/approach – The study utilised a qualitative approach, with semi-structured interviews used to explore the experiences of staff working with transgendered sexual offenders (n=6). Data were analysed using thematic analysis. Findings – Three themes were identified in the data. The first relates to how staff become educated on transgender issues and the content of this information. The second describes situations in which boundaries are overstepped by both transgender offenders and others in the prison. The third relates to the ways in which staff manage change, such as tailoring treatment to specific needs and being mindful of what adaptations may be required. Research limitations/implications – The main drawback of this research was the limited sample; female prison staff. Future research should expand this sample to encompass male staff and staff working in alternate category prisons. Practical implications – The research illustrates the utility of staff collaboration with transgendered sex offenders on transgender issues but also suggests some additional guidance is required when it comes to determining the boundaries. Staff may also benefit from more education on the possible ways in which a transgendered identity can impact on criminogenic needs. Originality/value – The present research offers insight into the current state of care and management of transgendered offenders in custody and the nature of interactions between staff and this minority group. At present, there is limited research in this area.

Purpose This study aims to gain an understanding of hotel experiences during the pandemic by examining sentiments of guests posted online. Design/methodology/approach This paper incorporates the balance theory, in a dyadic system to analyze the ways in which guests were motivated to restore a position of balance during the unprecedented COVID-19 crisis. Qualitative content analysis was used to detect thematic patterns of hotel experiences based on examining online reviews shared by actual guests of two major hotel brands – one more closely associated with convenience-driven automation (high-tech) and the other known for providing more guest–employee interaction (high-touch). Findings The analysis of the reviews yielded six main themes: “purpose of visit,” “COVID safety concerns,” “technology adoption,” “COVID limitations,” “exceeded expectation” and “hospitality of staff.” Staff displaying a welcoming attitude was the main factor in creating a convivial experience for guests at both hotel brands, but the technology was not highlighted as much in guests’ reviews. Despite the pandemic, guests of both hotel brands had similar levels of enjoyment regarding their hotel experiences regardless of the high-touch or high-tech nature of the operations. Research limitations/implications User-generated content often reflects the opinions of those who are very satisfied or not satisfied at all. Different data collection techniques could be used to get a “big picture” view of the balance between high-touch and high-tech experiences. Practical implications The findings offer support to researchers and practitioners who advocate that high-touch and high-tech can indeed co-exist, and that these distinct service delivery modes do not have to be mutually exclusive. Originality/value This paper provides new trajectories that can broaden the approaches undertaken by hospitality/tourism scholars and practitioners based on user-generated content. This study is one of the first to adopt the lens of the balance theory, in a dyadic system, to investigate how guests may be psychologically motivated to balance their perceptions and expectations during a time of crisis.

The aim of this paper is to investigate how an increasing fraction of the Danish libraries over the last years has experimented with lending of non-traditional materials. The main purpose is to examine how library staff can develop non-traditional lending initiatives that support a user-to-user exchange of experiences. The paper’s main contribution is the presentation of a model, “Erfaringsudlånsmodellen” (“The model of Experience Lending”), which describes how the cultural communication strategy of co-creation can be combined with the lending of non-traditional materials, which will result in an extension of the library collection that in the future can contain not only the materials, but the patrons’ experiences with the materials as well. A number of Danish and foreign examples of the lending of non-traditional materials are reviewed. Afterwards, two specific Danish alternative lending initiatives are investigated further. These are Valby’s Library’s “FrøLab” (“SeedLab”) and Risskov Library’s “Man Bliver Glad af Surdej!” (“Sourdough makes you happy!”) The lending design of these initiatives is discussed, and it is stated that the initiatives combine knowledge sharing tools with co-creation to facilitate an exchange of experience between users. This lending design is formalized in the model of Experience Lending, which is presented and discussed.

Purpose This study aims to examine nature-based tourists’ experiences in tree houses using user-generated content in Web reviews. The research objectives were to identify the main dimensions of tree house experiences and test whether these dimensions vary according to different traveller-type market segments. Design/methodology/approach A sample of 722 Web reviews was analysed using mixed content analysis methods. Leximancer software provided computer-assisted qualitative data analysis that identified the main themes, after which further qualitative analysis identified the key narratives associated with experiences. Findings The results reveal that tourists are extremely satisfied with their stays in tree houses. The main themes that encompass the dominant narratives are tree house, Costa Rica, staff, morning, walk, wildlife, rainforest, opportunity to learn, trip, experience and recommendation. The narratives vary according to type of traveller. Originality/value The valuable insights gained emphasise the advantages of using user-generated content in tourism studies. The results also offer a better understanding of the key dimensions of this type of nature-based tourism, including a graphic representation of the main themes and concepts in guests’ narratives. In addition, the findings emphasise that nature-based tourists are not a homogeneous group and that they can be segmented according to type of traveller.

ObjectivesTo explore staff experiences of working with a digital communication platform implemented throughout several primary healthcare centres in Sweden.DesignA descriptive qualitative approach using focus group interviews. Qualitative content analysis was used to code, categorise and thematise data.SettingPrimary healthcare centres across Sweden, in both rural and urban settings.ParticipantsA total of three mixed focus groups, comprising 19 general practitioners and nurses with experience using a specific digital communication platform.ResultsFive categories emerged: ‘Fears and Benefits of Digital Communication’, ‘Altered Practice Workflow’, ‘Accepting the Digital Society’, ‘Safe and Secure for Patients’ and ‘Doesn't Suit Everyone and Everything’. These were abstracted into two comprehensive themes: ‘Adjusting to a novel medium of communication’ and ‘Digitally filtered primary care’, describing how staff experienced integrating the software as a useful tool for certain clinical contexts while managing the communication challenges associated with written communication.ConclusionsFamily medicine staff were ambivalent concerning the use of digital communication but, after a period of adjustment, it was seen as a useful communication tool especially when combined with continuity of care. Staff acknowledged limitations regarding use by inappropriate patient populations, information overload and misinterpretation of text by both staff and patients.

Purpose This paper aims to explore inpatient staff experiences of seeking to meet the religious and cultural needs of Black, Asian and Minority Ethnic (BAME) inpatients on mental health wards. Design/methodology/approach Nine semi-structured interviews were undertaken with inpatient staff in one NHS Trust in England to explore their views and experiences of supporting BAME inpatients to meet their religious and cultural needs. Anonymised transcripts were analysed thematically. Findings Inpatient staff reported lacking the confidence and knowledge to identify and meet BAME inpatients’ religious and cultural needs, especially inpatients from smaller ethnic groups and newly emerging communities. There was no specific assessment used to identify religious and cultural needs and not all inpatient staff received training on meeting these needs. Concerns were raised about difficulties for staff in differentiating whether unusual beliefs and practices were expressions of religiosity or delusions. Staff identified the potential role of inpatients’ family members in identifying and meeting needs, explaining religious and cultural beliefs and practices, and psychoeducation to encourage treatment or medication adherence. Practical implications Potential ways to address this gap in the knowledge and confidence of inpatient staff to meet the religious and cultural needs of BAME patients include training for inpatient staff; the production and updating of a directory of common religious and cultural practices and needs; local resources which can help to support those needs; and religious and cultural practices and needs being documented by mental health practitioners in community teams such that this information is readily available for inpatient staff if a service user is admitted. Originality/value This is the first study to consider inpatient staff views on meeting the religious and cultural needs of BAME informal patients and patients detained under the Mental Health Act 1983.

Purpose Audit and feedback (A&F) often underlie implementation projects, described as a circular process; i.e. an A&F cycle. They are widely used, but effect varies with no apparent explanation. We need to understand how A&F work in real-life situations. The purpose of this paper, therefore, is to describe and explore mental healthcare full A&F cycle experiences. Design/methodology/approach This is a naturalistic qualitative study that uses four focus groups and qualitative content analysis. Findings Staff accepted the initial A&F stages, perceiving it to enhance awareness and reassure them about good practice. They were willing to participate in the full cycle and implement changes, but experienced poor follow-up and prioritization, not giving them a chance to own to the process. An important finding is the need for an A&F cycle facilitator. Practical implications Research teams cannot be expected to be involved in implementing clinical care. Guidelines will keep being produced to improve service quality and will be expected to be practiced. This study gives insights into planning and tailoring A&F cycles. Originality/value Tools to ease implementation are not enough, and the key seems to lie with facilitating a process using A&F. This study underscores leadership, designated responsibility and facilitation throughout a full audit cycle.

ObjectiveThe aim of this study was to identify barriers and enablers from the perspectives of stroke survivors, carers and staff to understand the experiences of care.DesignThe study used a qualitative descriptive methodology and employed semistructured interview technique.SettingA metropolitan stroke rehabilitation unit in Western Australia providing rehabilitation services for inpatients and outpatients.ParticipantsOverall, 10 participants (four staff, four stroke survivors and two primary carers) were interviewed. Transcripts were analysed using thematic analysis.ResultsExperiences of care focused on lack of time, urgency to regain mobility, postshock recovery, uncertainty about the future and the importance of accepting help once home. There was a degree of mismatch between staff experiences of the reality of what can be provided and the experiences and expectations of stroke survivors and families. However, the benefits of a specialised rehabilitation unit were found to contribute to a positive patient experience overall. The specialised unit demonstrated that services must optimise staff time with patients and carers in the poststroke rehabilitation journey to ensure benefits for the long-term well-being for both.ConclusionSeeking patient, family and staff experiences of care can provide valuable insights into facilitating better patient, family and staff engagement for preparation for home-based rehabilitation for stroke survivors and their caregivers. Further research with a larger sample across diverse hospital settings would provide even greater insight into strategies to best address the reality of rehabilitation care and readiness of patients when returning home to the community.

Introduction: A positive patient experience is a key component of good quality of care. Post-pandemic healthcare systems face the challenge of addressing burnout among healthcare staff, who are directly involved in the delivery of healthcare, which has implications for the patient experience. There is an established association between staff and patient experience; exploring the experience of staff may give insights into factors that negatively impact the patient experience. Experience-based design (EBD) is a quality improvement approach that uses the experience of service users to derive improvements. The purpose of this study is to design, validate, and test an EBD tool that may be used to capture the staff experience. Methods: A focus group of clinical and nonclinical staff (identified through the NHS Elect networks) and the development team coproduced an EBD survey based on nine “touch-points” of a typical working day. Once the survey questionnaire was tested and agreed with it was distributed to 1300 members of NHS networks. Results: A total of 377 NHS staff responded to the questionnaire. Analysis revealed effective teamwork had a positive psychological impact on staff. However, increased workload, missed meal breaks, and an increased administrative/IT burden were associated with the greatest negative responses by clinical and nonclinical staff. Conclusion: Overall, factors impacting staff well-being are multifaceted and varied between trusts. However, leaders in healthcare can use EBD to identify targeted improvements for the day-to-day experiences of staff.