Learning to Improve: challenging context and culture

Research output: Contribution to conferenceOther


This keynote presentation will be drawing on the PARIHS framework (Kirson et al 1998), with its three key elements of evidence, context and facilitation and exploring the concept of psychological safety (Schein 2010) to consider what is required to assist practitioners to make sustainable changes in practice.

It is known that context and culture are intertwined and that cultural change requires effective leadership (Apekey et al. 2011, Dixon-Woods et al. 2013), learning in and from practice (Manley et al. 2009) and teamwork (Wilson et al. 2005). This is easily said, but experience and the literature contest to the reality of integrating these elements is somewhat challenging. The Promoting Action on Research Implementation in Health Services (or PARIHS) framework offers a knowledge transfer model that integrates these elements, guides our thinking and highlights the level of complexity in changing health professionals’ behaviour (Bucknall and Fossum 2015). It is the behaviours that are key.

Kitson et al (1998) who are the originators of PARIHS, argue that successful change occurs when robust evidence, from a variety of sources, matches professional consensus and patient needs (high evidence); the context is receptive to change with sympathetic cultures, effective leadership, and appropriate evaluative systems (high context); and when there is appropriate facilitation of change, with input from skilled external and/or internal facilitators (high facilitation).

Original languageEnglish
Publication statusPublished (in print/issue) - 25 Sept 2018
EventEnhancing Practice Conference 2018: Leading and Facilitating within Practice Development in Healthcare - Switzerland , Basel, Switzerland
Duration: 22 Aug 201825 Aug 2018


ConferenceEnhancing Practice Conference 2018


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