Organisational and systems factors impacting on patient safety in acute care organisations: lessons from four multi-site research studies

Background Patient safety is concerned with preventable harm in healthcare, a subject that became a focus for study in the UK in the late 1990s. How to improve patient safety, presented both a practical and a research challenge in the early 2000s, leading to the eleven publications presented in this thesis. Research question The overarching research question was: What are the key organisational and systems factors that impact on patient safety, and how can these best be researched? Methods Research was conducted in over 40 acute care organisations in the UK and Europe between 2006 and 2013. The approaches included surveys, interviews, documentary analysis and non-participant observation. Two studies were longitudinal. Results The findings reveal the nature and extent of poor systems reliability and its effect on patient safety; the factors underpinning cases of patient harm; the cultural issues impacting on safety and quality; and the importance of a common language for quality and safety across an organisation. Across the publications, nine key organisational and systems factors emerged as important for patient safety improvement. These include leadership stability; data infrastructure; measurement capability; standardisation of clinical systems; and creating an open and fair collective culture where poor safety is challenged. Conclusions and contribution to knowledge The research presented in the publications has provided a more complete understanding of the organisation and systems factors underpinning safer healthcare. Lessons are drawn to inform methods for future research, including: how to define success in patient safety improvement studies; how to take into account external influences during longitudinal studies; and how to confirm meaning in multi-language research. Finally, recommendations for future research include assessing the support required to maintain a patient safety focus during periods of major change or austerity; the skills needed by healthcare leaders; and the implications of poor data infrastructure.

Did We Fail? (Counter-)Transference in a Qualitative Media Research Interview

Drawing on Joke Hermes’ (2006) account of a troubling interview, this article reproduces and reflects on passages from a qualitative interview with a user of a social networking site that was experienced as uncomfortable by both interviewee and interviewer (myself). The psychoanalytic concept of (counter-)transference is used to analyse the possible processes that led to the emergence of two narratives by the interviewee and interviewer and resulted in an unsuccessful research encounter. It is suggested that the analysis of the interview narratives may contribute to Wanda S. Pillow’s (2003) notion of an ‘uncomfortable reflexivity’. It may further add to methodological discussions of the interview in media research by placing an emphasis on a complex theory of the subject and intersubjective dynamics.

Good Practice in EU Public Service Media and Contemporary Practice in Jordan: A Comparative Analysis

UNESCO Amman Office Foreword: UNESCO Amman office is pleased to publish a comparative analysis between good Public Service Media (PSM) practices in Europe and the contemporary practice in Jordan. The study is part of the Support to Media in Jordan project, funded by the European Union, aiming to increase media freedom, media independence and journalistic professionalism in Jordan. The state owned broadcaster, Jordan Radio and Television (JRTV), has informed, entertained and educated Jordanians for decades. JRTV reaches almost every corner of the Kingdom and has the potential to serve all Jordanians with balanced, impartial and accurate news and programmes relevant to their day-to-day lives.Based on this potential there has been a long standing ambition to transform the JRTV from a state broadcaster to a public service broadcaster; from a TV and radio that predominately serves the state, to a broadcaster that serves the public and is independent from the Government of the day. This ambition is expressed also in the Support to Media in Jordan project, agreed between the Government an the EU, under which UNESCO has been asked to produce two studies: The comparative PSM analysis and a broader media landscape assessment based on UNESCO’s Media Development Indicators (MDI’s). The Jordanian MDI assessment was carried out by a team of national and international researchers during the first six months of 2015, and builds on the rich flora of recent studies on the Jordanian media landscape, as well as on original research. The study is available in Arabic and English. Professor Naomi Sakr carried out the comparative PSM analysis parallel to the MDI study, and in close cooperation with the MDI research team and UNESCO Amman office.

Media Research and Psychoanalysis: A Suggestion

This short commentary outlines psychoanalysis as a theory and method and its potential value to media research. Following Dahlgren (2013), it is suggested that psychoanalysis may enrich the field because it may offer a complex theory of the human subject, as well as methodological means of doing justice to the richness, ambivalence and contradictions of human experience. The psychoanalytic technique of free association and how it has been adapted in social research (Hollway and Jefferson 2000) is suggested as a means to open up subjective modes of expression and thinking – in researchers and research participants alike – that lie beyond rationality and conscious agency.

From the high ground to the swamp: A model for immersive journalism research

This article examines a reflexive, praxis-based methodology for conducting journalism research from a practitioner-academic perspective. Journalism research methods that are interactive, iterative and which rest on a dynamic communicative partnership between academics and practitioners, offer the best way for understanding change in our dynamic field. This permits the researcher to coalesce and strengthen their identity as a practitioner-academic and develop research projects that are mutually beneficial for advancing scholarship and practice. Drawing on reflexive methodologies in the human sciences, such as hermeneutics, cybernetics and constructivism, this article envisions an immersive approach embracing phenomenology and Gestalt as a fully reflexive method of data collection.

Power, Arab media Moguldum & gender rights as entertainment in the Middle East

Discourse is a giant field of research and gender related rights are still a disputed area of thinking. Thus, when Arab transnational satellite televisions produce dialogues, images, stories and narratives about the disputed “universal” gender rights in the Middle East, the big questions remain how and why. According to De Beauvoir (1949), one becomes woman and to Butler (1990) one is not born a gender at all but is “done” and “undone” to become one via discourse. Islamic feminism speaks of a cultural/religious specificity in defending women rights and even gender diversity based on new Quranic interpretations. The gender, “Al-Naw’u”, remains synonym to sex “Al Jins” as gender and queer theories never developed in Arabic in tandem with the European institutions or the theories of the19th century– especially those ideas emerging from studies of the mental asylum. This research tries to understand gender related “rights” and “wrongs” as manifest in the discursive institutions owned by media mogul Prince Al Waleed Ben Talal Al Saud. The trouble of such a study is lexical, ideological and institutional at the same time. Since we lack a critique of the discourses and narratives addressed in the pan-Arab satellite channels, in general it is difficult to understand their significance and influence in everyday life practices. What language is used to speak of gender rights or wrongs? Which ideology is favoured in this practice of legitimisation and/or policing? Using case studies, CDA of social and religious talk shows, narrative analysis of Arabic cinemas, this research adapted triangulation to show the complexity of conversing and narrating gender related content at the micro and macro levels within an institution of power. Using semi-structured interviews from fieldwork in Egypt (2009) and Lebanon (2011), archive research and online ethnography, the research exposes the power structure under which gender discourses evolve. It emerges that gender content is abundant on the Pan Arab satellite space, “manufactured” on talk shows and plotted tactfully in the cinematic “creative-act”. The result is a complex discourse of gender content that scratches the surface calling for interpretation. So how and why do gender rights and wrongs find place on Prince Al Waleed’s Media Empire?

A quarter century of creative chaos: Xinhua News Agency 1980-2005

Chinese media in the context of China's rise have puzzled many scholars who used to understand media and communications phenomena by employing the theories generated from a few affluent Western democracies, notably the US. As a result, a complex but more accurate picture has been ignored. Under numerous theoretical polarizations, the contemporary social world seems little changed but polarized. This thesis aims to propose a different approach endeavoring to 'de-Westernize' or 'internationalize' media and communications studies. As a starting point, this study focuses on the globalization debate, Chinese media and news agency studies. The thesis has investigated the Chinese news agency, Xinhua, by employing Fuzzy Logic which captures the complexity of the change in the agency's business structure and journalistic practices over last 25 years. The change is also examined by scrutinizing the role of journalists in the interrelations of Xinhua with its news sources, media and nonmedia clients, and other news agencies. A combination of archive study and 94 semistructured interviews conducted in Beijing, Shanghai, Guangzhou, Hong Kong, Macau and London provides an inclusive account of the Chinese news institution. The key research findings drawn from the empirical research into Xinhua have justified the central argument of this thesis: Crisp Logic or the 'either/or' approach has failed to explain the dynamics of the change to the media system based in a 'non-Western' society. The numerous theoretical polarizations generated by Crisp Logic to a large extent have distorted the understanding of the contemporary social world by polarizing it. Fuzzy Logic serves better(though it is not the only choice)than the traditional approach to reflect on the set of variables existing between the two poles created by Crisp Logic. This thesis is the first doctorate research in the UK and other English-speaking countries to investigate Xinhua by 'going inside' the news institution's headquarters, local branches and overseas bureaus. This is the first comprehensive academic study of the agency, which not only examines the agency's recent change in business structure and journalistic practices, but also provides a historical account of the agency and its relationship with other social institutions. This is the first media study that employs Fuzzy Logic to understand the globalization theory, Chinese media and news agencies.

The New Instantaneity: How Social Media are Helping us Privilege the (Politically) Correct over the True

The recent sacking of the eminent scientist Tim Hunt from one of the UK’s leading research institutions is only the latest in a series of cases where public individuals have been derided for comments made in jest on social media, with serious consequences for their professional and personal lives. This article discusses the case of Tim Hunt as an example of the extent to which the privileging of the correct over the true which has long pervaded media discourse is taken to the extreme by the instant-response culture of social media. It points to the emergence of a new form of instantaneity enabled by these networked forms of communication that serves to reinforce systemic inaction rather than the change widely associated with these technologies. It draws on philosophy and Critical Theory as useful conceptual frameworks for highlighting the ways in which Twitter & co. increasingly call us to action but crowd out thought, thereby passing over opportunities for real social change.

Strategies of newsroom convergence: comparing UK and Chinese newspaper groups

This research examines media integration in China, choosing two Chinese newspaper groups as cases for comparative study. The study analyses the convergence strategies of these Chinese groups by reference to an Role Model of convergence developed from a literature review of studies of cases of media convergence in the UK – in particular the Guardian (GNM), Telegraph Media Group (TMG), the Daily Mail and the Times. UK cases serve to establish the characteristics, causes and consequences of different forms of convergence and formulate a model of convergence. The model will specify the levels of newsroom convergence and the sub-units of analysis which will be used to collect empirical data from Chinese News Organisations and compare their strategies, practices and results with the UK experience. The literature review shows that there is a need for more comparative studies of media convergence strategy in general, and particularly in relation to Chinese media. Therefore, the study will address a gap in the understanding of media convergence in China. For this reason, my innovations have three folds: Firstly, to develop a new and comprehensive model of media convergence and a detailed understanding of the reasons why media companies pursue differing strategies in managing convergence across a wide range of units of analysis. Secondly, this study tries to compare the multimedia strategies of media groups under radically different political systems. Since, there is no standard research method or systematic theoretical framework for the study of Newsroom Convergence, this study develops an integrated perspective. The research will use the triangulation analysis of textual, field observation and interviews to explain systematically what was the newsroom structure like in the past and how did the copy flow change and why. Finally, this case study of media groups can provide an industrial model or framework for the other media groups.

Gold, power, protest: Digital and social media and protests against large-scale mining projects in Colombia

Colombia’s Internet connectivity has increased immensely. Colombia has also ‘opened for business’, leading to an influx of extractive projects to which social movements object heavily. Studies on the role of digital media in political mobilisation in developing countries are still scarce. Using surveys, interviews, and reviews of literature, policy papers, website and social media content, this study examines the role of digital and social media in social movement organisations and asks how increased digital connectivity can help spread knowledge and mobilise mining protests. Results show that the use of new media in Colombia is hindered by socioeconomic constraints, fear of oppression, the constraints of keyboard activism and strong hierarchical power structures within social movements. Hence, effects on political mobilisation are still limited. Social media do not spontaneously produce non-hierarchical knowledge structures. Attention to both internal and external knowledge sharing is therefore conditional to optimising digital and social media use.

Internet Surveillance after Snowden: A Critical Empirical Study of Computer Experts' Attitudes on Commercial and State Surveillance of the Internet and Social Media post-Edward Snowden

Acknowledgement: The research presented in this paper was conducted as part of the EU FP7 research project PACT (http://www.projectpact.eu), grant agreement number 285635.

Managing Vietnamese newsrooms: the role of internal communication

There have been many studies on news production but little has been found about newsroom efficiency despite the fact that this is journalists’ main concern. The very few (mostly foreign) researchers who study Vietnamese media usually look at them from policy making and political-social perspectives, and with an outsider’s eye. They have little physical access, if any, to the media houses, which surely limits their view. Their approach implicitly over-emphasizes the influence of political forces and neglects the media’s own dynamics. This research takes a different approach: from insiders’ point of view. Using two daily newspapers as case studies, this multi-disciplinary ethnographic research seeks to understand the strategies Vietnamese news media employ to cope with the subsidy cuts and increasing competition while still under close political control. A particular focus is on the newsroom operational strategies to improve efficiency. It is found that organizational structure and culture, work climate, motivation and employee satisfaction, leadership and management styles, personnel policies (task requirements vs personal abilities and skills), systems/policies and procedures, and most importantly, communication are the factors that affect the newsroom efficiency, as well as newsroom strategy implementation and results.

Financial media, globalisation, and China’s economic integration: comparing narrative construction of the Economist and Caijing

In June 2015, legal frameworks of the Asian Infrastructural Investment Bank were signed by its 57 founding members. Proposed and initiated by China, this multilateral development bank is considered to be an Asian counterpart to break the monopoly of the World Bank and the International Monetary Fund. In October 2015, China’s Central Bank announced a benchmark interest rate cut to combat the economic slowdown. The easing policy coincides with the European Central Bank’s announcement of doubts over US Fed’s commitment to raise interest rates. Global stock markets responded positively to China’s move, with the exception of the indexes from Wall Street (Bland, 2015; Elliott, 2015). In the meantime, China’s ‘One Belt, One Road’ (or New Silk Road Economic Belt) became atopic of discourse in relation to its growing global economy, as China pledged $40 billion to trade and infrastructure projects (Bermingham, 2015). The foreign policy aims to reinforce the economic belt from western China through Central Asia towards Europe, as well as to construct maritime trading routes from coastal China through the South China Sea (Summers, 2015). In 2012, The Economist launched a new China section, to reveal the complexity of the‘meteoric rise’ of China. John Micklethwait, who was then the chief editor of the magazine, said that China’s emergence as a global power justified giving it a section of its own(Roush, 2012). In July 2015, Hu Shuli, the former chief editor of Caijing, announced the launch of a think tank and financial data service division called Caixin Insight Group, which encompasses the new Caixin China Purchasing Managers Index (PMI). Incooperation with with Markit Group, a principal global provider of PMI, the index soon became a widely cited economic indicator. One anecdote from November’s Caixin shows how much has changed: in a high-profile dialogue between Hu Shuli and Kevin Rudd, Hu insisted on asking questions in English; interestingly, the former Prime Minister of Australia insisted on replying in Chinese. These recent developments point to one thing: the economic ascent of China and its increasing influence on the power play between economics and politics in world markets. China has begun to take a more active role in rule making and enforcement under neoliberal frameworks. However, due to the country’s size and the scale of its economy in comparison to other countries, China’s version of globalisation has unique characteristics. The ‘Capitalist-socialist’ paradox is vital to China’s market-oriented transformation. In order to comprehend how such unique features are articulated and understood, there are several questions worth investigating in the realms of media and communication studies,such as how China’s neoliberal restructuring is portrayed and perceived by different types of interested parties, and how these portrayals are de-contextualised and re-contextualised in global or Anglo-American narratives. Therefore, based on a combination of the themes of globalisation, financial media and China’s economic integration, this thesis attempts to explore how financial media construct the narratives of China’s economic globalisation through the deployment of comparative and multi-disciplinary approaches. Two outstanding elite financial magazines, Britain’s The Economist, which has a global readership and influence, and Caijing, China’s leading financial magazine, are chosen as case studies to exemplify differing media discourses, representing, respectively, Anglo-American and Chinese socio-economic and political backgrounds, as well as their own journalistic cultures. This thesis tries to answer the questions of how and why China’s neoliberal restructuring is constructed from a globally-oriented perspective. The construction primarily involves people who are influential in business and policymaking. Hence, the analysis falls into the paradigm of elite-elite communication, which is an important but relatively less developed perspective in studying China and its globalisation. The comparing of characteristics of narrative construction are the result of the textual analysis of articles published over a ten-year period (mid-1998 to mid-2008). The corpus of samples come from the two media outlets’ coverage of three selected events:China becoming a member of the World Trade Organization, its outward direct investment, and the listing of stocks of Chinese companies in overseas exchanges, which are mutually exclusive in sample collection and collectively exhaustive in the inclusion of articles regarding China’s economic globalisation. The findings help to understand that, despite language, socio-economic and political differences, elite financial media with globally-oriented readerships share similar methods of and approaches to agenda setting, the evaluation of news prominence, the selection of frame, and the advocacy of deeply rooted neoliberal ideas. The comparison of their distinctive features reflects the different phases of building up the sense of identity in their readers as global elites, as well as the different economic interests that are aligned with the corresponding readerships. However, textual analysis is only relevant in terms of exploring how the narratives are constructed and the elements they include; textual analysis alone prevents us from seeing the obstacles and the constrains of the journalistic practices of construction. Therefore, this thesis provides a brief discussion of interviews with practitioners from the two media, in order to understand how similar or different narratives are manifested and perceived, how the concept of neoliberalism deviates from and is justified in the Chinese context, and how and for what purpose deviations arise from Western to Chinese contexts. The thesis also contributes to defining financial media in the domain of elite communication. The relevant and closely interlocking concepts of globalisation, elitism and neoliberalism are discussed, and are used as a theoretical bedrock in the analysis of texts and contexts. It is important to address the agenda-setting and ideological role of elite financial media, because of its narrative formula of infusing business facts with opinions,which is important in constructing the global elite identity as well as influencing neoliberal policy-making. On the other hand, ‘journalistic professionalism’ has been redefined, in that the elite identity is shared by the content producer, reader and the actors in the news stories emerging from the much-compressed news cycle. The professionalism of elite financial media requires a dual definition, that of being professional in the understanding of business facts and statistics, and that of being professional in the making sense of stories by deploying economic logic.

Policy Solutions and International Perspectives on the Funding of Public Service Media Content for Children: A Report for Stakeholders

This project on Policy Solutions and International Perspectives on the Funding of Public Service Media Content for Children began on 8 February 2016 and concludes on 31 May 2016. Its outcomes contribute to the policy-making process around BBC Charter Review, which has raised concerns about the financial sustainability of UK-produced children’s screen content. The aim of this project is to evaluate different funding possibilities for public service children’s content in a more challenging and competitive multiplatform media environment, drawing on experiences outside the UK. The project addresses the following questions: • What forms of alternative funding exist to support public service content for children in a transforming multiplatform media environment? • What can we learn from the types of funding and support for children’s screen content that are available elsewhere in the world – in terms of regulatory foundations, administration, accountability, levels of funding, amounts and types of content supported? • How effective are these funding systems and funding sources for supporting domestically produced content (range and numbers of projects supported; audience reach)? This stakeholder report constitutes the main outcome of the project and provides an overview and analysis of alternatives for supporting and funding home-grown children’s screen content across both traditional broadcasting outlets and emerging digital platforms. The report has been made publicly available, so that it can inform policy work and responses to the UK Government White Paper, A BBC for the Future, published by the Department of Culture, Media and Sport in May 2016.

From Underground to Elite: Egyptian Bloggers before and after the 2011 Uprising

This research looks at how the shift in the status of Egyptian bloggers from underground dissident voices to mainstream political and media players affected the plurality they add to the public space for discourse in Egypt’s authoritarian settings. The role of the internet – and more recently social media and bloggers – in democratic transition has been studied by various media scholars since the introduction of the worldwide web and especially after the Egyptian and Tunisian uprisings of 2011. But no work has been done to study how bringing those once-underground bloggers into the public and media spotlight affected the nature of the blogosphere and the bloggers themselves. Star bloggers were not only covered by the media after January 25th, 2011, they also started joining the media as column writers; a move that had various effects on them and the blogosphere but was never examined in media studies. The plurality the blogosphere adds to the Egyptian public space for discourse in light of those changes as well as in light of the financial and practical sustainability of blogging was hence never looked at in a context similar to Egypt’s. Guided by modified theories of the public sphere and theories of hegemony and manufacturing consent, I look at whether bloggers have been co-opted into the historical bloc in the process of renewing the social order and how this affects them and the online sphere. Also, guided by theories of power and media elites, I look at bloggers’ backgrounds to assess whether they come from power elites and are transforming into media elites, thus limiting the plurality of the online sphere. Finally, guided by theoretical works on institutionalizing and commercializing the internet, I look at how those shifts into mainstream affect the independence and freedom of the blogs and microblogs. The research uses a comparative study to assess how those changes affect prominent versus less prominent bloggers and compare their backgrounds. The study uses quantitative content analysis and framing analysis of chosen media outlets and interviews with bloggers, marketeers and media professionals. The findings trace an increase in media coverage of bloggers post January 25th, 2011, especially in the prominent bloggers category, and an overall positive framing of bloggers post the uprising. This led to the mainstreaming of bloggers into the media as well as public work, which had various implications on the freedom they had over their content and voice, both online and offline. It also points to a dramatic decrease in bloggers’ activity on their blogs in favour of mainstream and social media and due to star bloggers becoming more career-oriented and their failure to make blogs financially sustainable. The findings also indicate that more prominent bloggers seem to come from more elite backgrounds than others and enjoy luxuries that allow them the time, technology and security to post online. This research concludes that the shifts in bloggers’ status post-January 25th have limited the plurality they add to the discourse in Egypt.