3. Emergent themes and practice guidelines

3.10. Organisational parameters

The three field visits offered participants opportunities to learn about Irish organisational practices in participation (youth, health and addictions services) to explore the opportunities and challenges in participatory practices. The feedback from these visits helped raise several questions and debates about how organisational culture can enhance or prevent participation as follows: contexts:

  • It is essential to understand the historical and contemporary drivers that led to participatory approaches in terms of institutional, financial, professional and service user factors.
  • One must counteract the tendency to view service user problems and identities as homogenous rather than consider, for example, issues of ethnicity, race, gender and class.
  • Where services were located in geographical areas which local communities were distrustful of, then community-based interventions maybe be necessary.
  • It was crucial, in interdisciplinary settings and other settings that there are leadership and organisational commitments to authentic and not tokenistic forms of participation.
  • More engaged practice and educational organisations build participation into higher levels of decision making and policymaking in the organization’s system of management and service delivery.

Theme 10) Case Study Example: Organisational culture and participation

In the Czech case study, a new team was created specifically for the research project. The process enabled the team to explore a range of organisational obstacles in the university and there was a decision to involve and reward non-academic participants in the project. This had the effect of creating more space and equal access in the non-profit organisation that supported the empowerment of minorities.

In another case study, in a cardiological intensive care unit, it was found that the opportunities for accommodating participative approaches can be hindered by the demands of time and energy experienced by workers. The organisation provided the IP participant with the opportunity for several weeks to exclusively focus on working closely with patients after myocardial infarction. This was part of an early discharge project taking place in the clinic. During the time with the patients, it was possible to gain many insights into their lives through conversation. Time spent with patients enabled forms of education to take place about their health condition. By actively asking them questions and answering theirs, they opened up and showed interest in managing their health condition. There were limitations to this approach given that the time and energy was consuming, so a question remained about how these advances could be achieved in a busy workload. One solution would be to fund dedicated nurses or healthcare social workers only for this task, which would enable a better discharge planning process where the patients’ specific needs can be met. The patients appreciated the time and interest dedicated to them and benefitted from learning the most about their disease as the knowledge of their condition in participatory ways. Unfortunately, systematic discharge planning or systematic routine social worker visits are not very common in Czech Republic, as the social interventions are usually carried out and planned by doctors and are mostly dedicated to serious cases. It was argued that staffing resources issues often prevent such positive participatory practice.