Understanding perspectives on major system change: A comparative case study of public engagement and the implementation of urgent and emergency care system reconfiguration

التفاصيل البيبلوغرافية
العنوان: Understanding perspectives on major system change: A comparative case study of public engagement and the implementation of urgent and emergency care system reconfiguration
المؤلفون: Orla Healy, Sheena McHugh, Conor Foley, Elsa Droog, John Browne, Claire M. Buckley
المصدر: Health Policy. 121:800-808
بيانات النشر: Elsevier BV, 2017.
سنة النشر: 2017
مصطلحات موضوعية: Economic growth, Process management, Process (engineering), 030503 health policy & services, Health Policy, Comparative case, Health services research, Stakeholder, Control reconfiguration, Care provision, 03 medical and health sciences, 0302 clinical medicine, Political science, 030212 general & internal medicine, Public engagement, 0305 other medical science, Qualitative research
الوصف: Objectives Major changes have been made to how emergency care services are configured in several regions in the Republic of Ireland. This study investigated the hypothesis that engagement activities undertaken prior to these changes influenced stakeholder perspectives on the proposed changes and impacted on the success of implementation. Methods A comparative case-study approach was used to explore the changes in three regions. These regions were chosen for the case study as the nature of the proposals to reconfigure care provision were broadly similar but implementation outcomes varied considerably. Documentary analysis of reconfiguration planning reports was used to identify planned public engagement activities. Semi-structured interviews with 74 purposively-sampled stakeholders explored their perspectives on reconfiguration, engagement activities and public responses to reconfiguration. Framework analysis was used, integrating inductive and deductive approaches. Results Approaches to public engagement and success of implementation differed considerably across the three cases. Regions that presented the public with the reconfiguration plan alone reported greater public opposition and difficulty in implementing changes. Engagement activities that included a range of stakeholders and continued throughout the reconfiguration process appeared to largely address public concerns, contributing to smoother implementation. Conclusions The presentation of reconfiguration reports alone is not enough to convince communities of the case for change. Genuine, ongoing and inclusive engagement offers the best opportunity to address community concerns about reconfiguration.
وصف الملف: application/pdf
تدمد: 0168-8510
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a02de0bb93498f160a3434e3e050a1c8
https://doi.org/10.1016/j.healthpol.2017.05.009
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....a02de0bb93498f160a3434e3e050a1c8
قاعدة البيانات: OpenAIRE