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      Creating safer cancer care with ethnic minority patients: A qualitative analysis of the experiences of cancer service staff

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          Abstract

          Introduction

          Effective consumer engagement practices can enhance patient safety. This is important for consumers from ethnic minority backgrounds who are exposed to increased risk of patient safety events. Using the Systems Engineering Initiative for Patient Safety model, this study explored staff experiences of creating opportunities for engagement with consumers from ethnic minority backgrounds to contribute to their cancer care safety.

          Method

          A qualitative study was conducted using semistructured interviews with cancer service staff from four cancer services across two states in Australia. Purposive sampling was used to recruit healthcare staff from a diverse range of professions. Data were analysed using the Framework Analysis method.

          Results

          Fifty‐four interviews were conducted with healthcare staff. Analysis of the qualitative interview data identified enablers and associated challenges that contributed to creating a shared understanding between consumers and staff of the information, processes, expectations and problems arising in care. Enablers and challenges are reported in relation to four themes: (1) co‐creating safety through shared understanding of care processes; (2) tools and technologies support planned communication; (3) organisational policy levers exist but lack implementation in direct care and (4) formal tasks incorporate consumer engagement more readily than informal interactions.

          Conclusion

          The availability of infrastructure and resources to support communication with consumers from ethnic minority backgrounds was limited to specific tasks across the cancer care continuum. Strategies implemented by health services to foster effective communication during formal interactions now require expansion to support and create conditions for effective consumer engagement during informal and everyday care tasks. The use of innovative language support tools and cultural considerations are required at the service and system level to support consumer engagement in all types of care interactions.

          Public and Patient Involvement

          The study was embedded within a larger project that included a consumer investigator and was guided by a consumer advisory group (CAG). These consumer team members have lived experience of cancer and are from diverse ethnic backgrounds. CAG members provided feedback on the draft interview guide and participant information for this study.

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          Most cited references48

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Using the framework method for the analysis of qualitative data in multi-disciplinary health research

            Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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              SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients.

              Healthcare practitioners, patient safety leaders, educators and researchers increasingly recognise the value of human factors/ergonomics and make use of the discipline's person-centred models of sociotechnical systems. This paper first reviews one of the most widely used healthcare human factors systems models, the Systems Engineering Initiative for Patient Safety (SEIPS) model, and then introduces an extended model, 'SEIPS 2.0'. SEIPS 2.0 incorporates three novel concepts into the original model: configuration, engagement and adaptation. The concept of configuration highlights the dynamic, hierarchical and interactive properties of sociotechnical systems, making it possible to depict how health-related performance is shaped at 'a moment in time'. Engagement conveys that various individuals and teams can perform health-related activities separately and collaboratively. Engaged individuals often include patients, family caregivers and other non-professionals. Adaptation is introduced as a feedback mechanism that explains how dynamic systems evolve in planned and unplanned ways. Key implications and future directions for human factors research in healthcare are discussed.
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                Author and article information

                Contributors
                Role: Postdoctoral Research Fellowashfaq.chauhan@mq.edu.au
                Role: Research Fellow
                Role: Professor
                Role: Research Fellow
                Role: Multicultural Health Team Leader
                Role: Associate Professor
                Role: Associate Professor
                Role: Associate Professor
                Role: Professor
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                30 January 2024
                February 2024
                : 27
                : 1 ( doiID: 10.1111/hex.v27.1 )
                : e13979
                Affiliations
                [ 1 ] Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Macquarie University Macquarie Park New South Wales Australia
                [ 2 ] School of Nursing and Midwifery Monash University Clayton Victoria Australia
                [ 3 ] Multicultural Health Services Western Sydney Local Health District North Parramatta New South Wales Australia
                [ 4 ] School of Health Sciences UNSW Sydney Kensington New South Wales Australia
                [ 5 ] School of Population Health UNSW Sydney Kensington New South Wales Australia
                [ 6 ] The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW Camperdown New South Wales Australia
                [ 7 ] Ingham Institute for Applied Medical Research Liverpool UK
                Author notes
                [*] [* ] Correspondence Ashfaq Chauhan, PhD, Postdoctoral Research Fellow, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW 2109, Australia.

                Email: ashfaq.chauhan@ 123456mq.edu.au

                Author information
                http://orcid.org/0000-0003-2762-510X
                http://orcid.org/0000-0002-5147-7381
                http://orcid.org/0000-0002-3747-0087
                Article
                HEX13979
                10.1111/hex.13979
                10825879
                4e5820f0-e60c-4d8c-93ac-5bb8c32b64fb
                © 2024 The Authors. Health Expectations published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 December 2023
                : 21 August 2023
                : 12 January 2024
                Page count
                Figures: 0, Tables: 0, Pages: 11, Words: 7910
                Funding
                Funded by: Cancer Australia , doi 10.13039/501100001111;
                Award ID: CA‐ITA1819/01
                Funded by: National Health and Medical Research Council , doi 10.13039/501100000925;
                Award ID: 1180925
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                February 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.6 mode:remove_FC converted:30.01.2024

                Health & Social care
                cancer care,consumer engagement,patient safety,seips
                Health & Social care
                cancer care, consumer engagement, patient safety, seips

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