Deborah Swinglehurst

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CONTEXT The extensive research literature on electronic patient records (EPRs) presents challenges to systematic reviewers because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. METHODS Using the meta-narrative method and searching beyond the Medline-indexed literature, this review(More)
Information and communications technologies (ICTs) in healthcare are often introduced with expectations of higher-quality, more efficient, and safer care. Many fail to meet these expectations. We argue here that the well-documented failures of ICTs in healthcare are partly attributable to the philosophical foundations of much health informatics research.(More)
OBJECTIVES To develop and evaluate an information service in which a "clinical informaticist" (a GP with training in evidence-based medicine) provided evidence-based answers to questions posed by GPs and nurse practitioners. DESIGN Descriptive pilot study with systematic recording of the process involved in searching for and critically appraising(More)
OBJECTIVE To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. DESIGN Ethnographic case study. SETTING Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of(More)
OBJECTIVE To explore general practitioners' (GP) perspectives on the meaning of 'timeliness' in dementia diagnosis. DESIGN Narrative interview study. SETTING UK academic department of primary care. PARTICIPANTS Seven practising GPs with experience of conveying a diagnosis of dementia. METHODS GPs' narrative commentaries of encounters with patients(More)
Trisha Greenhalgh professor of primary care health sciences, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK, Ellen Annandale professor, Sociology, University of York, UK, Richard Ashcroft professor of bioethics, Queen Mary University London, UK, James Barlow professor of technology and innovation management–healthcare,(More)
This paper reviews and critiques the different approaches to the use of narrative in quality improvement research. The defining characteristics of narrative are chronology (unfolding over time); emplotment (the literary juxtaposing of actions and events in an implicitly causal sequence); trouble (that is, harm or the risk of harm); and embeddedness (the(More)
Objectives To describe and evaluate two different models of a clinical informaticist service. Design A case study approach, using various qualitative methods to illuminate the complexity of the project groups’ experiences. Setting UK primary health care. Interventions Two informaticist projects to provide evidence based answers to questions arising in(More)
OBJECTIVE To investigate how electronic templates shape, enable and constrain consultations about chronic diseases. DESIGN Ethnographic case study, combining field notes, video-recording, screen capture with a microanalysis of talk, body language and data entry-an approach called linguistic ethnography. SETTING Two general practices in England. (More)
BACKGROUND Health informatics research has traditionally been dominated by experimental and quasi-experimental designs. An emerging area of study in organisational sociology is routinisation (how collaborative work practices become business-as-usual). There is growing interest in the use of ethnography and other in-depth qualitative approaches to explore(More)