ebook img

The Collaboration Compass PDF

229 Pages·2017·3.33 MB·English
by  
Save to my drive
Quick download
Download
Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.

Preview The Collaboration Compass

Northumbria Research Link Citation: Turnbull, Lindy (2017) The collaboration compass: Using grounded theory to map interactive navigation. Doctoral thesis, Northumbria University. This version was downloaded from Northumbria Research Link: http://nrl.northumbria.ac.uk/36227/ Northumbria University has developed Northumbria Research Link (NRL) to enable users to access the University’s research output. Copyright © and moral rights for items on NRL are retained by the individual author(s) and/or other copyright owners. Single copies of full items can be reproduced, displayed or performed, and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata page. The content must not be changed in any way. Full items must not be sold commercially in any format or medium without formal permission of the copyright holder. The full policy is available online: http://nrl.northumbria.ac.uk/po l i cies.htm l The Collaboration Compass: Using Grounded Theory to Map Interactive Navigation L. L. Turnbull D Nursing 2017 The Collaboration Compass: Using Grounded Theory to Map Interactive Navigation L. L. Turnbull A thesis submitted in partial fulfilment of the requirements of the University of Northumbria at Newcastle for the degree of Professional Doctorate September 2017 2 Abstract Collaboration is central in the transformation and sustainability of future healthcare with a clear place in integrated models of care, but the operationalisation of collaborative working presents challenges in practice. There is a lack of evidence about how collaboration is sustained in the delivery of healthcare, and a deficiency of studies which include patients as part of collaboration. This thesis investigates the meaning and manifestation of collaboration, including the experience of patients and professionals in practice. A social constructionist approach to grounded theory is used to investigate collaboration in an Outpatient Parenteral Antimicrobial Therapy (OPAT) service. The sample consists of staff and patients who have experience of OPAT. Interviews and focus groups are used to generate data, and grounded theory methods are used to progress the study through constant comparative analysis and theoretical sampling to a point of data saturation. Coding, categorising and techniques of situational analysis are used to analyse data and develop theory. The theory of Interactive Navigation conceptualises collaboration as a device used to navigate complex care situations and to direct collaboration with differing consequences for patients and professionals. The factors which influence collaboration are found to be a range of Situational Co-ordinates (Certainty, Uncertainty, Limits, Goals and Power) and interaction takes place through Interactive Mechanisms (Rehearsing, Coordination, Communication and Trust). The Collaboration Compass model is presented as a tool to inform understanding of Developing, Maintaining, Limiting and Disrupting collaboration. Collaboration is differentiated into four distinct areas and is revealed as a social device integral to the situation in which it takes place. This complexity requires recognition if collaborative health and social care developments are to succeed. The theory of Interactive Navigation presents a new way to view collaboration, and the Collaboration Compass offers a tool to navigate situations and map collaboration in practice. 3 Contents Abstract ................................................................................................................................. 3 List of Figures and Tables .................................................................................................. 8 Figures .......................................................................................................................... 8 Tables ........................................................................................................................... 8 Acknowledgements ............................................................................................................. 9 Authors Declaration........................................................................................................... 10 Chapter One – Introduction and Background ................................................................ 11 Introduction ................................................................................................................. 11 Experiences in Professional Practice ..................................................................... 12 Outpatient Parenteral Antimicrobial Therapy ......................................................... 13 Reflection on Practice ............................................................................................... 14 Collaboration as a Concept ...................................................................................... 15 Collaboration in Healthcare ...................................................................................... 16 Policy and Drivers...................................................................................................... 17 Unanswered Questions from Practice .................................................................... 20 Overview of the Study ............................................................................................... 21 Research Questions .................................................................................................. 21 Study Design .............................................................................................................. 22 Personal Influences and a Change of Role ........................................................... 23 Overview of Thesis .................................................................................................... 23 Conclusion .................................................................................................................. 24 Chapter Two - Literature Review .................................................................................... 25 Introduction ................................................................................................................. 25 Approach to Reviewing Literature (Initial Interactions) ......................................... 25 Initial Scoping of the Literature ................................................................................ 27 Learning from the Literature ..................................................................................... 39 Establishing an On-going Relationship with the Literature .................................. 40 Approach to Reviewing Literature (Ongoing Interactions) ................................... 42 Conclusion .................................................................................................................. 43 Chapter Three - Theoretical Orientation ........................................................................ 44 Introduction ................................................................................................................. 44 Ontology and Epistemology ..................................................................................... 44 The Plurality of Practice ............................................................................................ 44 4 Social Constructionism ............................................................................................. 45 Theoretical Orientation to Paradigm and Methodology ........................................ 47 Paradigm and Practice ............................................................................................. 50 Twenty First Century Grounded Theory Methodology ......................................... 51 Situational Analysis ................................................................................................... 52 Developing and Expanding the Theoretical Orientation ....................................... 54 Symbolic Interactionism ............................................................................................ 55 Evaluating Symbolic Interactionism ........................................................................ 57 Action, Agency and Structure .................................................................................. 60 The Iowa and Indiana School of Symbolic interactionism.................................... 61 Structuration Theory .................................................................................................. 62 Conclusion .................................................................................................................. 63 Chapter Four - Research Design .................................................................................... 64 Introduction ................................................................................................................. 64 Study Design .............................................................................................................. 64 Consideration of the Research Situation ................................................................ 64 Reflexive Methods ..................................................................................................... 65 Tools of Reflexivity .................................................................................................... 67 Accessing the Research Situation: the Role of the Gatekeeper ......................... 68 Sampling ..................................................................................................................... 69 Sampling Strategy ..................................................................................................... 70 Data generation ......................................................................................................... 75 Methods of Data Analysis ......................................................................................... 80 Theoretical Sensitivity ............................................................................................... 84 Ethical Issues ............................................................................................................. 85 Conclusion .................................................................................................................. 87 Chapter Five - Data Analysis ........................................................................................... 89 Introduction ................................................................................................................. 89 Stages of Analysis ..................................................................................................... 89 Coding ......................................................................................................................... 90 Relational Maps ......................................................................................................... 91 Categorising ............................................................................................................... 93 Constant Comparison and Reflexivity..................................................................... 95 Situational Analysis ................................................................................................... 97 5 Abductive Reasoning, Agency and Structure ...................................................... 102 Social World Mapping ............................................................................................. 104 Integrating Categories............................................................................................. 107 Positional Mapping .................................................................................................. 109 Developing Theoretical Concepts and Abstracting Theory ................................ 111 Conclusion ................................................................................................................ 113 Chapter Six - Findings .................................................................................................... 115 The Collaboration Compass and Interactive Navigation ........................................ 115 Introduction ............................................................................................................... 115 The Collaboration Compass: A Conceptual Model ............................................. 115 Orientation using Situational Co-ordinates .......................................................... 117 Interactive Mechanisms .......................................................................................... 122 Interactive Navigation using the Collaboration Compass .................................. 125 Silences in the Data ................................................................................................ 140 Conclusion ................................................................................................................ 141 Chapter Seven – Discussion ......................................................................................... 142 Introduction ............................................................................................................... 142 The Challenge of Representing Complex Collaboration .................................... 142 The Complexity of Collaboration in Practice Situations ..................................... 143 The Role of Structure and Agency in Collaboration ............................................ 144 Navigating the Situation .......................................................................................... 146 Finding Collaborative Direction .............................................................................. 150 Interactive Navigation and Power.......................................................................... 156 The Collaboration Compass and Interactive Navigation in Theoretical Context ................................................................................................................................... 162 Conclusion ................................................................................................................ 166 Chapter Eight – Summary and Implications for Future Collaborative Practice ....... 168 Introduction ............................................................................................................... 168 Summary of Key Findings ...................................................................................... 168 Implications for National and Local Policy............................................................ 170 Implications for Collaborative Practice ................................................................. 174 Implications for Research ....................................................................................... 177 From Reflection to Reflexivity and Back Again ................................................... 179 Conclusion ................................................................................................................ 182 6 References ....................................................................................................................... 184 Appendix A ....................................................................................................................... 211 University Ethics Committee Letter ....................................................................... 211 Appendix B ....................................................................................................................... 212 NHS Ethics Committee Letter ................................................................................ 212 Appendix C ....................................................................................................................... 216 NHS Trust Research and Development Department Letter .............................. 216 Appendix D ....................................................................................................................... 218 Letter of Invitation to Participants .......................................................................... 218 Appendix E ....................................................................................................................... 219 Patient Participant Information Sheet Appendix .................................................. 219 Appendix F ....................................................................................................................... 221 Staff Participant Information Sheet ....................................................................... 221 Appendix G....................................................................................................................... 223 Consent Form .......................................................................................................... 223 Appendix H ....................................................................................................................... 224 Semi-structured Interview Protocol ....................................................................... 224 Appendix I ........................................................................................................................ 226 Focus Group Protocol ............................................................................................. 226 Appendix J ........................................................................................................................ 229 Coordinating Category Map ................................................................................... 229 7 List of Figures and Tables Figures Figure 1: Timeline of Research Journey ....................................................................... 21 Figure 2: Collaborative Links .......................................................................................... 74 Figure 3: Theoretical Sampling ...................................................................................... 74 Figure 4: Word Cards ....................................................................................................... 79 Figure 5: Situational Map and Relational Analysis....................................................... 81 Figure 6: Social World Map ............................................................................................. 82 Figure 7: Positional Map .................................................................................................. 83 Figure 8: Participant A Data: Messy Relational Map (Coordinating) ......................... 92 Figure 9: Participant A Map: Category (Coordinating) ................................................ 94 Figure 10: Participant D Data: Colour Coded D ........................................................... 94 Figure 11: Participant D Map: Colour Coded Categories ............................................ 95 Figure 12: First Situational Map ...................................................................................... 98 Figure 13: Situational Map: Coordinating/Facilitating Category and Sub-categories ........................................................................................................................................... 100 Figure 14: Situational Map: Trusting Category and Sub-categories ........................ 100 Figure 15: Situational Map: Rehearsing Category and Sub Categories ................. 101 Figure 16: Situational Map: Power Category and Sub-categories ........................... 101 Figure 17: Situational Map: Nine Situational Categories .......................................... 102 Figure 18: Social World Map 1 ..................................................................................... 105 Figure 19: Social World Map 2 ..................................................................................... 106 Figure 21: Conceptual Diagram 2 ................................................................................ 108 Figure 22: Positional Maps 1 ........................................................................................ 110 Figure 23: Positional Maps 2 ........................................................................................ 112 Figure 24: Final Situational Map: Theoretical Categories and Sub-categories. ..... 112 Figure 25: Conceptual Diagram 3 ................................................................................ 113 Figure 26: Interactive Navigation: Underpinning Categories and Sub-categories . 116 Figure 27: The Collaboration Compass Model ........................................................... 116 Figure 28: Situational Co-ordinates ............................................................................. 117 Figure 29: Interactive Mechanisms .............................................................................. 123 Figure 30: Positional Map for Developing Collaboration ........................................... 126 Figure 31: Positional Map for Maintaining Collaboration........................................... 132 Figure 32: Positional Map for Limiting Collaboration ................................................. 134 Figure 33: Positional Map for Disrupting Collaboration ............................................. 137 Figure 34: The Collaboration Compass Model ........................................................... 170 Tables Table 1: Participant Details .............................................................................................. 72 Table 2: Itinerary of Interviews and Focus Groups....................................................... 76 Table 3: Stages of Analysis ............................................................................................. 90 8 Acknowledgements Many people have helped me during my studies, and there are too many to name individually, but I would like to acknowledge and express particular thanks to the following: Professor Susan Carr for her support, encouragement and excellent supervision, and Carol Wills for her support during the early part of my doctoral journey. I am grateful to Northumbria University and County Durham and Darlington NHS Foundation Trust for their support. My friends and family have been stalwart in their understanding, support and encouragement. I’m so grateful to my husband Paul for his confidence in my ability, and for reading every word. To my daughter Emma for sharing in the doctoral highs and lows, my son David for his assurance that everything would get done, and to my sister Gillian, for keeping track of my reading and for providing regular email encouragement. Thank you also to my amazing friends Liz and Dot, who led the way and who remained sure that I would follow. I am particularly grateful to all the participants in my study who gave me their time and insight. It was a great pleasure to interview all of them. This thesis is in memory of Participant B, who was so generous in sharing his very precious time. It was an honour. 9

See more

The list of books you might like

Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.