Staff Communication Research Articles

Building trust and inclusion with under-served groups: a public involvement project employing a knowledge mobilisation approach.

Certain groups are commonly under-served by health research due to exclusionary models of research design/delivery. Working in partnership with under-served groups is key to improving inclusion. This project aimed to explore the use of a knowledge mobilisation approach to start building partnerships with under-served groups based on trust and mutual understanding. This co-produced public involvement project employed a knowledge mobilisation approach. The project team involved public contributors from four community organisations and staff from two Universities. A series of 'community conversations' were co-produced. These involved open discussions with local people in community settings. The conversations provide an informal space to engage in a multi-directional dialogue about health research and incorporated approaches such as prompt questions, live illustrations, and themed boards. The findings were reviewed collectively. Dissemination/feedback activities and lessons learned for future engagement with community organisations and under-served groups were also co-produced. Over 100 people attended the community conversations. Attendees varied widely in their sociodemographic characteristics (e.g., socioeconomic status and ethnicity) and brought diverse lived experiences (e.g., experiences of homelessness and disability). A strong appetite for change and desire to mobilise public knowledge were evident. Attendees reported wide-ranging barriers to inclusion in health research and suggested ways to address them. Three inter-related take-home messages were identified: ensure relevance, appreciation, and trust; prioritise language and accessibility needs; and maximise flexibility in all research-related activities. Feedback about the community conversations and dissemination activities was largely positive, with all parties planning to continue the partnership building. The lessons learned provide practical suggestions for promoting inclusion in research and highlight the importance of addressing research teams' training/support needs. Knowledge mobilisation was a valuable approach for facilitating multi-directional dialogues and relationship building between local communities and university teams. This approach enabled co-creation of new knowledge related to inclusion and partnership working in health research. The project has provided a firm foundation to build upon. However, creating sustainable, inclusive public partnerships is likely to require systemic changes, such as weighting of fundings schemes to projects that prioritise inclusion of under-served groups throughout the research cycle.

Implementation of an adult life-course vaccine review service, VaxCheck, in community pharmacy: A qualitative analysis

BackgroundCommunity pharmacists are well placed to identify and vaccinate unimmunized or under-immunized individuals who can put themselves and communities at risk of preventable disease. We designed and tested VaxCheck, a novel life-course vaccine review service that can be used to raise awareness and guide personal vaccination action plans, in community pharmacies in Ontario, Canada. ObjectiveTo understand the experiences of community pharmacists and staff directly involved with providing the VaxCheck service as part of initial testing. MethodsSemi-structured interviews were performed with pharmacy staff from nine pharmacies who participated in the study. Interviews were conducted at baseline and following each of three plan-do-study-act quality improvement cycles. Activities undertaken to perform VaxCheck were assessed. An inductive thematic analysis was performed to identify dominant themes and subthemes. Activities and descriptive codes were then correlated to the Consolidated Framework for Implementation Research (CFIR). Results26 interviews were conducted. Pharmacy staff described VaxCheck activities as spanning three stages: (1) Promotion/offering of VaxCheck, (2) Completing the VaxCheck, and (3) Enacting recommendations and follow-up. VaxCheck activities were compatible with workflow related to delivery of other vaccines and medication reviews. Thematic analysis found three considerations guided VaxCheck adoption: (1) Aligning VaxCheck with workflow through flexible integration, (2) Enabling patient-oriented vaccination services, and (3) Contributing to community healthcare provision. Data aligned with all CFIR domains with strengths noted in constructs from the “Innovation characteristics” and “Individuals” domains. Barriers to implementation were identified in “Inner setting”, “Outer setting” and “Process” domains, such as pharmacy workflow capacity, patient knowledge about vaccination, availability of vaccine records, and interactions with other healthcare providers. ConclusionCommunity pharmacists found VaxCheck to be a valuable, accessible service that was well-received by patients and supported adult vaccination reviews and individualized recommendations. VaxCheck was compatible with pharmacy workflow but needed additional resources for sustainability and promotion with stakeholders.

Improving psychological and social support needs after traumatic birth: A qualitative study

IntroductionEmergency deliveries increase maternal risk for postpartum depression (PPD) and post-traumatic stress disorder (PTSD). One in three women describe their birth experience as traumatic, but patient-centered support needs are unclear. We conducted a qualitative study of women with traumatic birth to identify patient-centered priorities to optimize mental health support. MethodsSemi-structured interviews were conducted with women who experienced an emergency during birth, and who self-identified as experiencing traumatic birth. The Stanford Acute Stress Reaction Questionnaire and PTSD Checklist were completed. Interviews included open-ended questions about birth events that improved or worsened their delivery experience, perceptions of mental, physical, and emotional support provided by staff, and patient perspectives about psychological and social support referrals after emergent deliveries. ResultsA majority of participants met positive screening criteria for PTSD at the time of interviews. Birth experiences were affected by prenatal expectations, as well as the style and quality of clinical staff communication during and after delivery. There were four key themes central to their experiences and perceptions: (1) Emotional Impact and Intensity, (2) Factors Influencing Birth Experience, (3) Perceived Lack of Emotional Support, and (4) Desire for Post-Birth Follow-Up and Support. Participants almost unanimously desired to be offered psychosocial services after birth trauma. ConclusionThere are significant gaps in emotional support and communication for patients experiencing traumatic births. Offering structured, in-hospital mental health referrals may address immediate psychological needs, aid in trauma recovery, and potentially mitigate long-term mental health consequences. These findings advocate for a more holistic approach to postpartum care that prioritizes both physical and emotional well-being.

Practices and systems employed by health professionals toward protection and confidentiality of patient health records in Ghana

ObjectivesHealth information relies on a patient's sensory perceptions as well as objective assessments, diagnoses, and test findings. Ghana's current laws governing the confidentiality of patient health data seems a little pertinent in spite of ongoing conversations on the significance of patient health information and the necessity to protect patient information from improper disclosure. The study therefore investigated the extent of patient confidentiality in Ghana by looking into the guidelines, regulations, and rules that govern patient records. MethodsThe interpretive, phenomenological, and narrative methodologies used in qualitative research were employed to study the phenomenon. Twenty (20) participants were interviewed in a semi-structured manner to gather the data needed for the analysis comprising of Doctors, Nurses, Administrative staff, Record Officers, and Information Communication Technology (ICT0 Technicians of five Departments in La General Hospital. The Activity Theory was used as a theoretical foundation for the study ConclusionsThe study revealed that healthcare professionals uphold the moral standards relating to patient confidentiality and trust. Again, the findings of the study showed that medical records are safely stored through the use of Electronic Health Record system in the hospital in a manner that wouldn't compromise patient confidentiality. However, the results establishes that health care workers can potentially serve as a conduit for the leak or breach of patient information through negligence and unprofessional practices. Public interest statementThe study investigated systems and practices that are employed by health workers in Ghana to ensure that patient health records are safeguarded in order to build patients confidence in how their health records are protected. Health workers were interviewed in this study and the findings of the study show that there are practices and systems put in place to safeguard patient health records in the hospitals. Although, it was established that EHR systems help in safeguarding patient health records, the study recommends the need for users of the Health Electronic Records to be fully involved in the implementation process and strict enforcement of policies regarding the use of the EHR system to help prevent negligence and unprofessional application of the system.

Adapting, expanding and embedding community and culture into health ecosystems

Abstract Background Community anchor organisations (CAOs) work with communities who experience health inequalities and disadvantage, providing a range of activities and services to meet individuals’ needs in an integrated way. This study explored how CAOs use art, cultural and nature-based activities as part of their work to respond to the needs of people facing inequalities and considered how activities can be scaled in this health setting. Methods This study used community-based participatory research within a case study approach to work with four purposively sampled CAOs. Participants were community members, volunteers, staff, trustees, partner organisations and commissioners. Data collection methods included: document analysis, interviews (n = 45), workshops (n = 5) and focus groups (n = 11). This study was also supported by data collected by trained community researchers (n = 18). Framework analysis was conducted for within- and cross-case analysis. Results In the context of CAOs, the delivery of art, cultural and nature-based activities were found to be an important mechanism for developing trusted relationships with marginalised groups, who may lack trust in statutory services and health focused activities. Other facilitators to community engagement were the CAOs’ longevity, localness and co-location of services within a trusted and familiar place that connect people to personalised support. Barriers to scaling up included funding models as well as insufficient dialogue and understanding between CAOs and the local public health ecosystem. Conclusions CAOs have long term trusted relationships with disadvantaged communities and are influential in connecting individuals with projects and services. Findings suggest that the effectiveness of action to address inequality through art, cultural and nature-based activities could be improved if the role of CAOs was recognised more coherently in place-based public health plans. Key messages • Creative activities enable meaningful engagement with disadvantaged groups within place-based settings. • CAOs must be recognised more coherently in place-based strategies to reduce health inequalities.

Creating Collaborative Spaces for Community College Faculty and Staff to Discuss Pedagogy

ABSTRACT Research from undergraduate and K-12 environments suggests that providing meaningful support for Community College students requires faculty and staff to engage in ongoing self-reflection, peer support, and a commitment to research-based pedagogical shifts. Currently, California Community College (CCC) faculty and staff get very few of these opportunities. This study aims to address this issue through an intervention designed to provide opportunities for CCC faculty and staff to be part of a flexible, coherent professional learning community. The intervention is part of an NSF-funded research and development project at a community college in central California designated as a Hispanic Serving Institution (HSI), with the goal of providing faculty and staff with tools and processes to support students toward higher retention and success in STEM by facilitating “micro-internships.” Micro-internships are designed to reduce inequalities inherent in the traditional internship paradigm by providing access to professional and research skills for students who do not have the opportunities and/or confidence to participate in a more traditional full-length internship. Conversations with participants showed how they embraced the design principles that were negotiated as a project team, and how one or more of the study interventions had played a powerful role in supporting their learning and development toward certain pedagogical shifts. Our results highlight the power of providing spaces such as summer workshops and ongoing “community of practice” meetings for collaboration, professional learning, and peer-to-peer mentorship.

Beyond Empathy: Examining the Complexities of Outpatient Satisfaction in a Resource-Constrained Setting

Patient satisfaction is a critical indicator of healthcare quality, particularly in resource-constrained settings where efficient and effective care is paramount. This study aimed to explore the multifaceted nature of outpatient satisfaction at a private Indonesian hospital, moving beyond the traditional focus on empathy to understand the interplay of various service quality dimensions. A mixed-methods sequential explanatory design was employed. The quantitative phase involved a survey of 400 outpatients, measuring their satisfaction with five service quality dimensions: tangibles, reliability, responsiveness, empathy, and assurance. Data were analyzed using descriptive statistics, Importance-Performance Analysis (IPA), and gap analysis (suitability index). The qualitative phase utilized in-depth interviews and focus group discussions with patients, staff, and management to provide context and depth to the quantitative findings. While overall patient satisfaction was 82.9%, a gap analysis revealed substantial discrepancies between patient expectations and perceptions across several service quality dimensions. Tangibles, reliability, and responsiveness emerged as key areas requiring improvement. Qualitative findings highlighted extended wait times, inconsistent staff communication, and concerns about the physical environment as significant contributors to patient dissatisfaction. Achieving high levels of patient satisfaction in resource-constrained environments necessitates a comprehensive approach that addresses systemic inefficiencies and communication gaps alongside interpersonal factors like empathy. These findings underscore the need for targeted interventions to optimize resource allocation, streamline processes, and enhance staff communication skills to improve the patient experience.

What makes communication work and for whom? Examining interprofessional collaboration among home care staff using structural equation modeling

ABSTRACT Up to 175 conditions influencing interprofessional practices have been identified. Still, little is known about to what extent these conditions interact, influence communication, and vary across professional groups and settings. We explored these knowledge gaps by examining communication among staff in home care and home nursing units in two Danish municipalities, Herning and Holstebro. Conditions were categorized into two types (programme and context) and two levels (professional and organizational). Structural Equation Modeling was used with a sample of 395 staff and 21 managers to analyze the condition categories’ interactions, influences on communication, and variations by unit type and municipality. Context conditions strongly influenced programme conditions on the professional and organizational levels. Organizational-level context conditions had no significant influence, organizational-level programme conditions had a weak influence, and professional-level programme and context conditions had moderate influences on communication. Lastly, professional-level programme conditions had the biggest influence on communication for staff in home care units and in Holstebro. In contrast, professional-level context conditions had the biggest influence on communication for staff in home nursing units and in Herning. These findings offer unique insights into conditions’ interactions, influences, and variances, contributing to our understanding of what makes communication work and for whom.

Effect of Paraprofessional AAC Training Package on Staff and Student Communication

Effect of Paraprofessional AAC Training Package on Staff and Student Communication

Need for Human Interaction and Acknowledging Communication-An Interview Study With Patients With Aphasia Following Stroke.

To explore stroke patients' experiences of the communicative practice during their hospitalisation and describe strategies and supporting communication techniques applied by patients and nursing staff from the patient's perspective. A qualitative descriptive study was undertaken. A qualitative approach was chosen; through a purposeful sample strategy, 13 semi-structed interviews with 12 patients who had aphasia following stroke, and one patient had dysarthria. The interviews were video-recorded and partially transcribed. Data were analysed according to Graneheim and Lundman's content analysis. Interview data were collected in 2022. The analysis generated one overarching theme; Being acknowledged as an equal human being as it appeared to be a pervasive and underlying trait across the four categories; Waking up to a new communicative reality, A task-oriented communicative agenda, Misunderstandings as a communicative dead end and Establishing a communication-friendly environment: peace, patience and supporting techniques, describing the immediate and descriptive level. The patients did not seem to encounter a systematic approach to communication. They perceived the health care staff's communication as primarily task and purpose-oriented, lacking deeper conversations, which seemed to leave several with unmet emotional and psychological needs. Emotional, relational and existential aspects seemed interwoven in communication. These findings contribute by illuminating an important patient perspective and ultimately, raising the point that from the perspective of patients the nursing staff's communication was primarily task and purpose oriented, and they lacked deeper conversations. Hence also raises the point that the use of supportive communication strategies alone will allow nursing staff to meet the existential needs of patients with aphasia. Supported communication needs to address compassionate and acknowledging aspects of communication. No Patient or Public Contribution in this paper.

Organizational health literacy in German hospitals: a cross-sectional survey among hospital managers

BackgroundOrganizational health literacy (OHL) describes conditions and measures in healthcare institutions to enable patients to make good health-related decisions. By providing easy access to and appropriate communication of understandable information to use and navigate the facility, healthcare organizations can contribute to strengthening patients’ health literacy and self-management. The extent of OHL implementation in German hospitals remains largely unknown. This study aims to fill this gap in our knowledge by investigating OHL-related activities reported by hospital managers.MethodsBetween November and December 2022, we conducted a national online survey among medical, nursing and administrative hospital managers with hospitals that operate more than 50 beds. The data were collected via the health literate health care organization ten item questionnaire (HLHO-10) and supplemented by sociodemographic questions and an open-ended question. We applied variance and correlation analyses to investigate the data.ResultsOf 3,301 invited hospital managers, 371 participated in the survey (response rate 11%). The overall mean score for HLHO-10 was 4.6 (SD = 1.1) on a 7-point Likert scale, indicating a moderate level of OHL implementation. Hospital managers stated that hospitals concentrate on helping patients find their way around and communicating the costs of treatment transparently and clearly; conversely, that active patient participation in the design and evaluation of health information is rare in care settings, and that health information is seldom provided to patients through a range of media. For the practical implementation of the OHL, most hospital managers mentioned activities regarding communication standards, such as providing information materials.ConclusionsGiven their unique position as hubs of human interaction, hospitals provide an ideal opportunity to promote the adoption of OHL. By actively involving patients, hospitals can better tailor their approaches to meet patient needs and preferences. Compared to studies from oncology centres in Germany and 20 Italian hospitals, the average HLHO-10 score of this study is lower. While some aspects of OHL are already embedded in inpatient care, it is imperative that OHL is thoroughly embedded in the hospitals’ organizational culture and plays a fundamental role in the daily operations of the institution. This could be done, for instance, by more explicitly addressing the topic of health literacy in staff communication training.

Procedural Justice in Practice: A Comprehensive Study of its During the Implementation of the Criminal and Civil Procedure in the Basic Court of Gjilan and its Branches

Propose: This study aims to analyze the implementation of the core principles of procedural justice Understanding, Neutrality, Respect, and Voice in the Basic Court of Gjilan and its branches. Method: The perceptions and experiences of individuals involved in judicial processes will be evaluated through statistical, qualitative and quantitative methods, structured questionnaires, interviews, direct observation of court sessions (including communication, physical and emotional behavior of judicial staff), and analysis of audio/video recordings and official documentation, such as court decisions and communications. Results: The study will assess the level of dignity and respect experienced by individuals, investigate opportunities to voice opinions and concerns, evaluate the perceived neutrality of decision-makers, and assess their trustworthiness.

OPTIMUM DESIGN OF INTENSIVE CARE UNIT- AN EVIDENCE- BASED HEALING ENVIRONMENT

Successfully designing a new ICU requires clarity of vision and purpose and the recognition that the patient room is the core of the ICU experience for patients, staff, and visitors. The ICU canbe conceptualised into three components: the patient room, central areas, and universal support services. Each patient room should be designed for single patient use and be similarly configured and equipped. The design of the room should focus upon functionality, ease of use, healing, safety, infection control, communications, and connectivity. All aspects of the room, including itsinfrastructure; zones for work, care, and visiting; environment, medical devices, and approaches to privacy; logistics; and waste management, are important elements in the design process. Since most medical devices used at the ICU bedside are really sophisticated equipments, the ICU needs to be capable of supporting the full scope of medical informatics. The patient rooms, the central ICU areas (central stations, corridors, supply rooms, pharmacy, laboratory, staff lounge, visitor waiting room,) and the universal support services (infection prevention, finishings & and flooring, staff communications, signage & wayfinding, security and fire & safety) work best when fully interwoven. This coordination helps establish efficient and safe patient throughput and care and fosters physical and social cohesiveness within the ICU. Synchronisation of the universal support services in the ICU with the hospital’s existing systems maintains unity of purpose and continuity across the enterprise and avoids unnecessary duplication of efforts.

Exploring the Well-being Experiences of Patients Following Heart Valve Replacement Surgery through the Biopsychosocial-spiritual Model: A Qualitative Content Analysis.

Heart valve replacement (HVR) surgery represents a significant life event that can potentially impact the well-being (WB) of patients; however, there is a shortage of research on the understanding of WB in HVR patients. This study aims to elucidate the WB experiences of patients who have undergone HVR surgery. A qualitative directed content analysis approach was employed, focusing on patients who had undergone HVR surgery at hospitals affiliated with Mashhad University of Medical Sciences in Iran from March 2021 to June 2022. Data collection involved conducting 23 face-to-face, semi-structured, in-depth interviews with HVR patients until data saturation was reached. Data analysis was performed using the Elo and Kyngäs approach in MAXQDA software version 10. The analysis revealed 11 generic categories based on the Biopsychosocial-Spiritual (BPSS) model, encompassing the WB experiences of HVR patients. These categories included physical improvements, facilitated treatment compliance, personal and environmental mastery, optimism in life, resilience, healing therapeutic communication of medical staff, a positive supportive atmosphere, job and financial assurance, faith in a higher power, optimism regarding a purposeful future, and gratitude mixed with generosity. The findings of the current study revealed that the experience of WB in HVR patients was influenced by various conditions. By recognizing these conditions, healthcare providers can develop targeted interventions to improve the WB experience in these patients. Also, the findings provide a foundation for future research on WB in medical contexts.

Strategy Implementation in Conflict Management to Prevent Violence in Transportation Education Institutions

Education is a fundamental basis for building national civilization. Educational institutions in the transportation sector continue to transform to enhance the quality of education. In connection with the violence in the educational environment, it is vital to carry out this study to provide an overview for the community, teaching, and education staff, and educational policymakers, especially in the transportation sector. The study was carried out using a method in the form of a literature study also called a literature review. The results of this study include: 1) Conflicts in educational institutions usually occur between individuals, groups, or between parts of the environment; 2) Conflict management in educational institutions can be conducted by mediating promptly to prevent conflicts from escalating.; and 3) Implementation of conflict management strategies can be done by creating professional code of ethics learning policies and routine activities to increase team collaboration outdoors (outbound).

A "Whole Child Approach": Parent Experiences with Acute Care Hospitalizations for Children with Autism Spectrum Disorder and Behavioral Health Needs.

Children with Autism Spectrum Disorder (ASD) experience increased hospitalizations as compared to the general population, particularly in the context of mental health crises. Given the unique needs of children with ASD and behavioral health needs that can either lead to or emerge during hospitalization, an understanding of hospital experiences is critical. To date, research on caregiver experiences in acute care medical hospital settings is limited. Therefore, the purpose of this qualitative study was to investigate caregiver experiences with inpatient care for children with ASD and behavioral health needs, including factors and practices that impacted or were desirable for care. Two focus groups were conducted with a total of 12 parents of children with ASD admitted to a large pediatric hospital. Data were analyzed using interpretive description. Emerging themes pointed to the child, family, and staff factors and practices that intersect to influence hospitalization experiences. Child factors included the child's communication, sensory, behavioral, medical, and safety needs. Family factors included the family's relationship with the healthcare team, own needs, and advocacy experiences. Staff factors included staff communication practices, comfort, and knowledge when providing care. Overall, this research demonstrates the complexity of factors and practices that impact the behavioral health hospitalization experience for children with ASD and their caregivers. Experiences varied widely and were guided by the unique needs of each child. Findings point to care practices that can be adopted to best meet the needs of all stakeholders during hospitalization and offer implications for future educational initiatives.

Creating group work-integrated learning experiences for non-clinical health degrees: A practitioner reflection

Work-Integrated Learning (WIL) experiences, integral for equipping students with the skills and knowledge crucial for employment and success in their chosen careers, have traditionally been associated with accreditation requirements in professional programs. More recently, acknowledging the importance of WIL experiences in non-professional programs has grown. In this reflective paper, the experiences of the practitioner tasked with developing a new WIL capstone course for students in Health and Biomedical Science degrees are described. Grounded in social exchange theory, where interactions are viewed as exchanges aimed at maximising rewards while minimising costs, the intent was for student groups to engage with a range of authentic project experiences offered by industry, community, and academic staff (the WIL partners). Critical elements were the active involvement of a diverse array of partners and the importance of relationship building for the long-term sustainability of the project experiences. I discuss and reflect on the specific strategies employed to engage the WIL partners, inspiring them to collaborate and develop meaningful projects suitable for students pursuing various career paths. Additionally, I reflect on the invaluable experiences and feedback provided by our partners.

Implementation and Evaluation of APOTECAchemo in a Community Cancer Center: A Comparative Study of Robotic Versus Manual Antineoplastic Preparation.

Background: The ever-increasing complexity and demand for antineoplastic therapy necessitates innovative solutions to improve the accuracy and safety of drug preparation. Objective: To evaluate the utilization of an advanced robotic chemotherapy drug compounding system (APOTECAchemo) at a Community Cancer Center (CCC), examining accuracy, efficiency, and staff perceptions. Methods: This single-center, retrospective study evaluated the preparation of 7 intravenous (IV) antineoplastics at a CCC over a 1-year period. We compared manual methods with the APOTECAchemo system. The primary measure of accuracy was the absolute drug error percentage, with a comparison of pass and fail rates. Secondary endpoints included the overall use of APOTECAchemo for all IV antineoplastic preparations and average preparation times. An end-user satisfaction survey gathered feedback from pharmacists and pharmacy technicians. Results: A total of 8210 doses were prepared at the CCC, with 52.1% compounded by APOTECAchemo and 47.9% manually. Of these, the CCC prepared 5526 doses of the 7 routinely compounded antineoplastics. APOTECAchemo prepared 3851 (69.7%) doses, while manual compounding accounted for 1675 (30.3%) doses. The average absolute drug error was 1.44% (95% CI, 1.35-1.53) with robot compounding versus 1.17% (95% CI, 1.03-1.32) with manual (P < 0.001). The overall failure rate was 0.72%. There were 25 failed doses (0.45%), with 8 (0.2%) failures attributed to APOTECAchemo and 17 (1%) to manual compounding (P < 0.001). The average dose preparation time was longer with APOTECAchemo compared with manual methods. The end-user satisfaction survey indicated a positive reception toward APOTECAchemo. Conclusions: Our study demonstrates the successful implementation, extensive utilization, and high accuracy of both APOTECAchemo and manual compounding methods in the preparation of routinely administered antineoplastics at a CCC.

Staff perspectives on fall prevention activities in long-term care facilities for older residents: "Brief but often" staff education is key.

Falls are a serious health problem in long-term care facilities (LTCFs), affecting more than 50% of residents. A key role of LTCF staff is to assess fall risks and implement fall prevention activities. Understanding the barriers and facilitators is key to successful implementation. This descriptive qualitative study involving four LTCF facilities (varied provider types and sizes) in southwest Ireland. We recruited a convenience sample of 17 LTCF staff, who participated in semi-structured online 1:1 interviews (n = 7) or small group interviews (n = 10). The data were analysed using Braun and Clarke's reflective thematic analysis. The participants included two directors of nursing, three therapists, one ward manager, one general practitioner, five nurses and five healthcare assistants. Six main themes were identified, reflecting factors that influenced fall prevention: a need for sufficient staff and appropriate skill mix; fall policy, documentation and leadership; equipment and safe environments; person-centred care; staff knowledge, skills and awareness in falls prevention; and staff communication and collaborative working. A wide range of approaches that supported LTCF staff to overcome barriers were identified, including audits and feedback, falls champions, fall prevention leaders, daily communication (e.g., safety pauses) and staff collaboration. Formal multidisciplinary meetings and identification systems to highlight residents at high risk of falling were not considered helpful. Staff suggested that education should be briefer, ongoing and practice-based ("brief but often") to promote ownership and responsibility. LTCF staff identified several approaches to prevent falls in LTCFs as part of usual care, rather than lengthy, formal meetings and training. The potential role of families in fall prevention was under-appreciated and should be investigated further.

Perceptions of organization, job attitudes, challenges, and solutions among medical school administrative staff.

Staff is essential to the university's efficient administrative operations, which are critical for education, research, and service. Medical schools, often independent, need specialized administrative elements. This study explores how medical school staff perceives the organization using the Six-Box model and evaluates their perceived organizational support, job satisfaction, and organizational commitment based on the concept of job attitudes. This study employs a mixed-methods approach, integrating quantitative and qualitative data via a convergent parallel design. It simultaneously collects and analyzes data from a survey and consensus workshop for medical school staff. The survey data were statistically analyzed (IBM SPSS ver. 25.0; IBM Corp., USA), and the workshop discussions were subjected to content analysis. The findings combined provide a comprehensive understanding of the medical school administrative system. Quantitative analysis revealed purpose (3.80) as the highest-rated organizational perception and rewards (2.72) as the lowest. Similarly, job satisfaction was highest (3.63) in job attitudes, while perceived organizational support (2.96) was the lowest. Group differences were observed by gender, enrollment capacity, and contract type (p&lt;0.05). In qualitative research, keywords appeared in relation to their experiences within the medical school organization, encompassing doctor training, emotional responses, administrative features, personal attributes, and cultural influences. Overload, faculty issues, and communication gaps are obstacles. Strategies for overcoming these challenges focus on improving staff treatment, resource allocation, training, and communication channels. This study was conducted to explore a broad understanding of the administration of medical schools. Findings suggest challenges with workload, communication, and organizational support. We propose a dedicated medical school administrative system, improved work conditions, and enhanced communication.