Research Projects (selection)
Australian Research council Discovery Grant: "Examining organistation complexity and clinical rish to enhance hospital patients' safety. (2008-2010) $475,000.
This project will investigate how complexity and space enable and constrain the work of hospital clinicians.
Australian Commission for Safety and Quality in Health Care: The National Clinical Handover Initiative. (2007) $202,000.
This project focuses on designing a clinical handover monitoring tool using video-based simulation technologies.
Institute for Medical Education and Training, The Sax Institute and North Coast Area Health Service: 'What is the experience of rural junior doctors and their supervisors with clinical supervision?' (2007) $30,000.
This project investigates junior doctors' experiences of educational supervision with the aim of producing advice for clinical supervisors. The research method used is diary keeping, requiring participants to reflect on a regular basis about training and support processes.
Australian Commission for Safety and Quality in Health Care: Australia-Wide Evaluation of the Open Disclosure Standard (2007) $158,000.
This project evaluates the progress that 42 organizations around Australia are making with implementing the Australian council for Safety and Quality in Health Care Open Disclosure Standard (2003). Contact has been established with pilot organizations and interviewing of staff and patients has begun. Interim report is due 30 June 2007. Final report is due 30 September 2007.
UNSW Gold Star Award (2006) $30,000
This Award was given following a near-hit ARC-Discovery application. The award was not accepted due to relocation to UTS.
UNSW Faculty Research Grant (2006), $29,000, 'A project to resolved the clinical practical and ethical challenges of disseminating and implementing hospital-based Root Casue Analysis (RCA) recommendations'.
Aims and objectives of the project
This project has three aims. First, targeting the safety and qualityo f the care provided, the project describes and analyses how care organization and care enactment relate in two paediatric sites. Second, the project engages clinicians in 'participative sense-making' of the analytical findings produced under the first aim. Third, the project evaluates the degree to which and maps how clinicians are able to achieve 'positive learning' form negotiating problems and clinical incidents; it arranges co-authorship with clinicians about these issues, and it communicates the learning thus articulated to managers and policy makers.
Presentations
Hunter, C., & Iedema, R. (2006). Researching learning in everyday paediatric practice, Paediatric Research Seminar "Creating a future for Children and Families". Westmead Hospital. July 2006.
Long, D., Hunter., & (conveners) (2006). When the Field is a Ward or a Clinic: Hospital Ethnography (conference session), Beyond Science and Art: Anthropology and the Unification of Knowledge AAS (Australian Anthropology Society) Annual Conference, Cairns, Australia.
Long, D., Hunter, C., & (conveners) (2006), Culture Writing: The Art and Science of Ethnography (conference session) ACSPRI Social Science Methodology Conference. Sydney.
Australian Council for Safety and Quality in Health Care: An Australia-Wide Evaluation of the Open Disclosure Standard (2007) $158,000.
This project evaluates the progress that 42 organizations around Australia are making with implementing the Australian Council for Safety and Quality in Health Care Open Disclosure Standard (2003). Contact has been established with pilot site organizations and interviewing of staff and patients has begun. Interim report is due 30 June 2007. Final report is due 30 September 2007.
Australian Research Council Discovery Grant DP0450773: 2004-2006, $360,000: "Preventive Health Care - Are clinicians' identity and practices attuned to the requirments of health care reform?"
Original aims and objectives of the report
This project has three over-arching aims. First, the study seeks to examine and assess the extent to which health care workers are prepared for the intensification of organizational participation inherent in the reforms with which they are being confronted by policy makers, health organization managers and patients. Second, the study seeks to explore ways for staff to reflect on the substance of their work through their review of video data about their work. Third, the study seeks to refine video-taping as a method of organizational and work practice research.
Progress to date
Ethics clearance was obtained mid-2004; a research fellow and PhD researcher were appointed mid-2004/early 2005, access to two research sites was negotiated and participant consent obtained. Site 1 observations were undertaken from August 2004, and video data collection occurred between December 2004 and June 2005. Site 2 observations and video data collection commenced in April 2005. Data collection at complete at site 1, and is due to be completed at site 2 by June 2006. Medical, nursing and allied health staff at both sites have engaged in the research process to an unanticipated extent, including reflective interviews. This supports one of the central aims of the project that is to evaluate the potential effectiveness of reeflective video ethnography as an organizational tool for health care teams. Major areas of interest which are emerging from the data collected to date include:
- Issues that facilitate and hinder work and communication flows in multidisciplinary health teams.
- Ways in which a mutlidisciplinary health team negotiate a constand input of new protocols, and changes to excisting protocols, raising tensions for clinicians required to offer high-quality evidence-based medicine as well as appropriately introduce new innovations.
- Dissonances and convergences between various health care workers definitions of"good outcome", as well as patients' own definitions of a "good outcome".
These emergent themes provide excellent material with which to explore the two aims of the project, namely to examine (1) The preparedness of clinicians for new types of organizational relationships and (2) The process of change of professional identity. In addition, the clinical team at site 1 are engaging in a process of evaluating and implementing infection control procedures, and this process will be monitored and fed back to staff using the video reflective methodology designed for this project, providing a major case study for the above.
Publications
Iedema, R., Long, D., Forsyth, R., & Lee, B. (2006). 'Visibilizing clinical work: Video ethnography in the contemporary hospital'. Heath Sociology Review. 15(2): 156-168.
Iedema, R., Long, D., Carroll, K., Stenglin, M. and Braithwaite, J. (2006) Corridor work: how 'liminal' space can be a focal resource for handling complexities of multi-disciplinary health care. Proceedings of the 11th International Colloquium of the Asia-Pacific Researchers in Organization Studies (APROS). 4-6 December 2005, M. Muetzelfeld (ed), Melbourne, pp238-247.
Long, D., Lee, B., & Braithwaite, J. (forthcoming). Attempting Clinical Democracy: Enhancing multivocality in a multidisciplinary clinical team. In C. Caldas-Coulthard, & R. Iedema (Eds.), Identity trouble: Critical discourse and contestations of identification. Basingstoke: Plagrave-Macmillan.
Long, D., Forsyth, R., Carroll, K., & Iedema, R. (2006). The (Im)possibility of clinical democracy. Health Sociology Review, 15(5): 506-519.
Long, D., R. Iedema and B.B. Lee (2007) 'Corridor conversations: Clinical communication in casual spaces'. In Discourses of Hospital Communication: Tracing complexities in contemporary health organizations. R. Idema (ed.), 182-200. Basingstoke: Palgrave-Macmillan.
Iedema, R. (2006). (Post-)bureaucratizing Medicine: Health Reform and the Reconfiguration of Contemporary Clinical Work. In F. Meyer, & M. Gotti (Eds.), Advances in medical discourse analysis: Oral and written contexts. Gottingen: Peter Lang. Pp.111-131.
Information about further projects available on request: Rick.Iedema@uts.edu.au