Building the Reflective Healthcare Organisation Book

Acknowledgements     vii
Dedication     viii
Preface     ix
Introduction: Mapping out the 'rough ground'     1
Building the reflective healthcare organisation: asking a question     2
The power of the positive question     4
Opening up the book's central question     5
Re-framing reflective practice as reflective learning     9
What is a frame?     9
How framing works in practice     10
What is r-learning?     14
The book's basic action steps     17
What is an action pathway?     18
Is it enough to know an action's path?     20
Scaling up reflective learning: some challenges in taking action     20
RAISE     24
Mapping out the 'rough ground'     25
References     27
Action step 1: developing an appreciation of reflective learning     29
Some conceptions of reflective practice     30
The evidence-base for action step 1     30
Some conceptions of reflection     32
Are definitions of reflective practices important?     41
Reflections on the failure-to-success spectrum     42
Some kinds of reflection     44
Reflection and the complexities of practice     49
The centrality of the individual     51
Some aspects of critical kinds of reflection     53
Linking reflection with learning and practice     57
Linking reflection with good practice     59
What are some of the habits of reflection?     60
Some frameworks for action     61
The reflective practitioner     63
Why are reflective practices important?     67
Getting organised for engaging in reflective practices     68
Reflective practices and workplace cultures     69
Re-framing reflective practices     74
Moving on and building a new positive core     77
References     86
Action step 2: r-learning as an innovation     91
Coverage and uptake of innovations     92
Framing r-learning as an innovation     94
What makes an innovation successful?     96
Reflecting on patient safety     100
Facilitating r-learning at the centre of a cancer care network     116
What do we know about scaling up?     125
What are some of the challenges to scaling up?     126
Adoption as a staged process: the work of Rogers     127
Adopting an innovation: the case of an English primary care trust     129
Innovation as a non-linear dynamic system     132
The work of Greenhalgh et al. (2004) and a multidisciplinary view     135
References     138
Action step 3: journeying along action pathways-to-scale     142
What is a pathway-to-scale?     143
Action pathway: values     145
Action pathway: conversation     161
Action pathway: user     172
Action pathway: leadership     190
Action pathway: team     199
Action pathway: network     208
Summary     214
References     215
Action step 4: a force for change     220
RAISE     220
Illustrating RAISE in practice     221
References     234
Summary     235
Useful metaphors     235
The central question     235
R-learning     235
Action pathways-to-scale     235
A force for change     236
Towards a full-stop     237
Index     239