PHASE | ACTIVITY | PURPOSE | LOGISTICS | PARTICIPANTS | OUTPUTS |
---|---|---|---|---|---|
1. Max. 5 × 8 hour shifts | Initial unstructured observations | • Familiarisation with space and use of space • Familiarisation with rhythm of setting • Starting to build relationships and trust • Determine who is amenable to shadowing • Identify key locations for stationary observations • Identify key policy/guideline documents | • Background observation of activity (potentially accompanying key initial contact in the setting) • Introductions with staff members • 5 shifts on different days of the week (over 2 weeks) (= max 40 hours) | All staff | • Map of settings • Timetable of key regular events • List of 6-8 key informants • Collected documents for later analysis (e.g. policies, guidelines) • Fieldnotes |
2. Max. 8 × 8 hour shifts | Shadowing staff members | • Observe mechanics of interactional construction of safe practice • Observe interactions newcomers/old-timers • Observe use of tools/artefacts/environment • Identifying key practices to follow in later stage | • Shadow each staff member for 1 shift/part shift • Audio recording of key meetings attended by staff member • Field notes of informal talk • Field interviews | 2 doctors 2 nurses 2 allied health 2 managers | • Map of practices of each key informant - how they construe patient safety and how they go about trying to maintain it • Fieldnotes • Transcriptions of meetings |
3. Max. 2 × 8 hour shifts | Stationary observations in key locations | • Observe role of key artefacts in constitution of safety (e.g. phone in nurse's station; filing cabinet etc). • Observe patterns of movement of staff | • 2 locations, 1 shift each (max. 16 hours) | All staff | • Fieldnote account of how artefacts and space play a role in the constitution of safety • Actor-artefact network map |
4. Max. 4 × 8 hour shifts | Tracing key practices | • Observe the unfolding of specific practices previously identified as key to preservation of safety • Observe differences in activity when practice is in the course of the everyday (e.g. admission/ discharge) and, if appropriate, when it follows breakdown in order (e.g. incident review) | • 1 'everyday' practice over the course of 2 shifts • 1 practice dealing with deviation from the normal (i.e. when safe practice has broken down in some way) | Staff involved in practices chosen | • Map of 'practice nets' involved in practices key to preservation of safety • How practice nets change when safety breaks down |
5. Approx. 1 hr per interview | Interviews | • Elicit narrative accounts of safety preservation • Observe how the meaning of safety is constructed by different professionals - what 'rules and resources' do they draw on? • Test emerging findings/maps of practices | • 6-8 interviews - audio recordings | 6-8 key informants from phase 2 | • Transcripts for analysis |
6. Approx. 30 mins per survey | •Social network survey | • Provide triangulation of observation and interview data • Map overall patterns of communication about safety issues within and between the two settings under study | • Administer a social network questionnaire to all staff in the inpatient team and community team under study. | All staff | • Social network diagrams providing visual representation of patterns of safety communication |