Dr Aled Jones
Reader: Patient Safety & Healthcare Quality
My research focuses on two specific dimensions of healthcare quality, namely patient centeredness and patient safety. In particular, employee “speaking up” (also referred to as whistle-blowing/raising concerns) about poor patient care and other breaches to patient safety and safe nurse staffing levels.
“Speaking up” about safety concerns and poor care
Healthcare organisations internationally have a poor track record of supporting staff to speak up about poor care, or of not responding adequately and helpfully when staff do speak up. I am interested in understanding more about how workplace cultures restrict or enhance the act of speaking up by employees. A further question of interest is what interventions can be designed and implemented to help employees to speak up and to respond to speaking up by colleagues. I mostly use qualitative research and sociological approaches and theories to better understand speaking up in the workplace. Practical application of research findings to improve practices is currently underway at various NHS sites (for example see here).
Safe nurse staffing
Nursing is by far the largest professional group within the NHS and in healthcare systems internationally. There is a clear association between registered nursing staff levels and patient safety outcomes. However, important questions remain about the effective deployment of nurse staffing and associated resources. Research into nurse staffing for Welsh Government (see here) has been completed and I am a member of the NHS Wales Nurse Staffing Group, see here for further details of key note address at the 2017 Nurse Staffing Conference in Cardiff.
Patient Safety and Healthcare Quality - more generally I have also published widely on patient safety communication and aspects of patient centred care in areas such as midwifery, primary care, mental health and children's care.
Module leader: Critical perspectives on healthcare quality and safety (Profesional Doctorate module) - NRT 172; Health Policy and Health Economics (Masters module) - NRT 177
Other Teaching commitments: Patient Safety & Clinical Risk (Masters module) - NRT 073; Research methods (Masters module) HCT 118; Pre-registration nursing and midwifery Quality and Safety Teaching.
I lead the Masters Module in Health Policy and Health Economics (NRT177) which runs January to April and do sessional lectures on advanced practice modules such as documentation and clinical assessment; team working and complex systems; patient safety and risk; research methods. In addition I supervise Masters students’ dissertations.
I also lead the Professional Doctorate Module “Critical Perspectives on Patient Safety and Quality), next running January 2018.
I teach patient safety and quality improvement as well as research methods on a range of courses from undergraduate to doctoral level. I am a faculty member of NHS Wales 1000 Lives Improvement and of the UK & Ireland IHI Open School. As faculty member I advise on how best to design, deliver and support education programmes to improve healthcare
Employees “speaking up”, raising concerns and whistleblowing (funded by the Older People’s Commissioner for Wales and the General Nursing Council Trust)
Employees who “speak-up” or “raise concerns” about problems with healthcare services are often referred to as “whistleblowers”. Although whistleblowing makes an important contribution to patient safety in the NHS, whistleblowers have not always been treated well, often suffering professional and person reprisals from colleagues and the public for their efforts. The Francis Report in 2013 into serious patient care failures at Stafford Hospital is one of many inquiries into poor practice in the NHS which describe how whistleblowers were often ignored and mistreated by colleagues to the detriment of safe patient care.
Our research has explored the influence of workplace culture on employee speaking up. We want to better understand how the conditions and circumstances within organisations can encourage or deter staff from speaking up. Related to this, we also want to better understand the organisational response to concerns when raised –why is it that so many organisations respond so badly when employees speak up, even though organisations encourage this behaviour?
We have used qualitative social science approaches to better understand some of these questions. Our studies have been undertaken with staff from a range of professions and at different levels within the organisational hierarchy, from students and junior workers to executive level nurses.
Research impact: Freedom to speak up safely with Cardiff and Vale University Health Board (funded by ESRC/Cardiff University Impact Acceleration Award).
In the summer of 2016 Cardiff and Vale University Health Board launched their Freedom to Speak Up Safely (F2SUS) initiative. The initiative is designed to support employees to raise and respond to concerns about any issue that deflects from the organisation’s aim to deliver consistently excellent care. Our research and expertise in this area of practice contributed directly to the design and implementation of the F2SUS initiative
Please see the following links for further information.
More information available at the following website:
Related ongoing project and areas of interest:
- Development of a “Speak up” Survey (led by David Schwappach, Swiss Patient Safety Foundation)
- Speaking up about poor care: the role of students, educators and HEIs (with Robin Ion and Richard Craven)
- Daniel Kelly, Tricia Brown, Davina Allen (Cardiff University)
- Jill Maben (University of Surrey)
- Mary Adams (King’s College London)
- Russel Mannion (University of Birmingham)
- David Schwappach (Swiss Patient Safety Foundation)
- Robin Ion, Richard Craven (Abertay University)
I am interested in supervising PhD students who would like to explore patient safety and quality improvement in health and social care contexts. Applications are particularly welcomed that focus on
- Raising concerns/speaking-up/whistleblowing by staff about failures in care - for example, what are the barriers and facilitators to effective "speaking up" by staff? What interventions/initiatives can be developed to promote speaking up culture in the workplace?
- Workplace culture and patient safety - for example, how does workplace culture affect healthcare workers understanding of patient safety and their safety practices?
- Optimal deployment of staffing levels - for example, projects that consider nurse staffing levels and the effects on patient outcomes (e.g. safety outcomes) and staff outcomes (e.g. retention of staff, staff well-being).
Current research students
Tricia Brown PhD studentship - The mentor-student dynamic in raising concerns in clinical practice. A grounded theory study.
Judith Benbow PhD studentship - The resilience of front-line registered nurses working in Wales.
Rene Mifsud PhD studentship - Exploring professional practice of Occupational Therapists in Malta.
Iain Harbison Professional Doctorate studentship - An exploration of the strategies and experiences of senior clinicians and the implementation and management of Emergency Department waiting time targets.
Ian Willliams Professional Doctorate studentship - How do children aged six to eleven years old living in Wales experience their quality of life following a moderate head injury?
Marianne Maraj Professional Doctorate studentship - Exploring well-being in hybrid managers in an NHS Trust