The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme

This study explores the views of a network of healthcare professionals who, in addition to their main clinical roles and related professional training duties, are also trained patient educators (Educators) delivering a structured education (SE) programme to adults with diabetes. The author engages w...

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Main Author: Go Jefferies, Josephine K. W.
Format: Thesis (University of Nottingham only)
Language:English
Published: 2012
Subjects:
Online Access:https://eprints.nottingham.ac.uk/12942/
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author Go Jefferies, Josephine K. W.
author_facet Go Jefferies, Josephine K. W.
author_sort Go Jefferies, Josephine K. W.
building Nottingham Research Data Repository
collection Online Access
description This study explores the views of a network of healthcare professionals who, in addition to their main clinical roles and related professional training duties, are also trained patient educators (Educators) delivering a structured education (SE) programme to adults with diabetes. The author engages with literature on self-management and institutional change in healthcare and closely considers factors affecting implementation of self-management and structured education. The research aims to show the mental framing that Educators use when considering self-management, and the implications for the spread of self-management diffusion at the micro-organisational level. It does this by analysing Educators’ beliefs and attitudes to diabetes self-management and SE, and then situates their responses using theoretical frameworks to identify and explain institutional change processes taking place. Echoing Coulter’s (2012) findings from her study into leadership and patient engagement, my study shows that healthcare professionals hold positive views about being an Educator chiefly as it allows them to acquire new knowledge and skills, which allows them to improve professional effectiveness and patient outcomes. This can be interpreted as new cultural-cognitive and normative elements creating a new institutional logic at the micro-organisational level. Being an Educator also allows them to mitigate effects of poor practice elsewhere in the diabetes care network resulting in better patient outcomes; they do this through exploiting micro-institutional affordances in a highly structured institution like the NHS. This enactment can be interpreted as forming new regulative elements. The study makes a novel contribution to the literature on self-management by addressing the views of healthcare professionals and healthcare innovation by showing how their engagement means self-management is becoming institutionalised.
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spelling nottingham-129422025-02-28T11:22:14Z https://eprints.nottingham.ac.uk/12942/ The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme Go Jefferies, Josephine K. W. This study explores the views of a network of healthcare professionals who, in addition to their main clinical roles and related professional training duties, are also trained patient educators (Educators) delivering a structured education (SE) programme to adults with diabetes. The author engages with literature on self-management and institutional change in healthcare and closely considers factors affecting implementation of self-management and structured education. The research aims to show the mental framing that Educators use when considering self-management, and the implications for the spread of self-management diffusion at the micro-organisational level. It does this by analysing Educators’ beliefs and attitudes to diabetes self-management and SE, and then situates their responses using theoretical frameworks to identify and explain institutional change processes taking place. Echoing Coulter’s (2012) findings from her study into leadership and patient engagement, my study shows that healthcare professionals hold positive views about being an Educator chiefly as it allows them to acquire new knowledge and skills, which allows them to improve professional effectiveness and patient outcomes. This can be interpreted as new cultural-cognitive and normative elements creating a new institutional logic at the micro-organisational level. Being an Educator also allows them to mitigate effects of poor practice elsewhere in the diabetes care network resulting in better patient outcomes; they do this through exploiting micro-institutional affordances in a highly structured institution like the NHS. This enactment can be interpreted as forming new regulative elements. The study makes a novel contribution to the literature on self-management by addressing the views of healthcare professionals and healthcare innovation by showing how their engagement means self-management is becoming institutionalised. 2012-12-13 Thesis (University of Nottingham only) NonPeerReviewed application/pdf en arr https://eprints.nottingham.ac.uk/12942/1/J_Go_Jefferies_MRes_Dissertation_Sep_2012_FINAL%282%29%5B1%5D.pdf Go Jefferies, Josephine K. W. (2012) The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme. MRes thesis, University of Nottingham. diabetes self-management institutionalisation professional agency spread of innovation structured patient education X-PERT Programme
spellingShingle diabetes self-management
institutionalisation
professional agency
spread of innovation
structured patient education
X-PERT Programme
Go Jefferies, Josephine K. W.
The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme
title The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme
title_full The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme
title_fullStr The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme
title_full_unstemmed The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme
title_short The role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the X-PERT Programme
title_sort role of context and professional agency in the spread of healthcare innovation: an exploratory study of healthcare professionals' views of diabetes self-management and the x-pert programme
topic diabetes self-management
institutionalisation
professional agency
spread of innovation
structured patient education
X-PERT Programme
url https://eprints.nottingham.ac.uk/12942/