Robyn Clay-Williams

Robyn Clay-Williams
Macquarie University · Australian Institute of Health Innovation

BEng, PhD

About

120
Publications
38,752
Reads
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1,848
Citations
Additional affiliations
November 2014 - present
Macquarie University
Position
  • Research Associate
May 2011 - November 2014
University of South Wales
Position
  • PostDoc Position
May 2010 - November 2014
UNSW Sydney
Position
  • Postdoctoral Research Fellow in Human Factors

Publications

Publications (120)
Article
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Background: Reflections on the response to the COVID-19 pandemic often evoke the concept of 'resilience' to describe the way health systems adjusted and adapted their functions to withstand the disturbance of a crisis, and in some cases, improve and transform in its wake. Drawing from this, this study focuses on the role of consumer representative...
Article
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The development and deployment of medical devices, along with most areas of healthcare, has been significantly impacted by the COVID-19 pandemic. This has had variable ethical implications, two of which we will focus on here. First, medical device regulations have been rapidly amended to expedite approvals of devices ranging from face masks to vent...
Article
Emergency Departments (EDs) are highly complex healthcare settings that must be resilient to unpredictable demands. New technologies are regularly introduced into EDs to improve patient care and workflow processes. However, the interaction between social and technical agents can introduce further complexity, making it difficult to identify the fact...
Article
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Introduction Awareness of the benefits of cochlear implants is low, and barriers such as fear of surgery and ongoing rehabilitation have been noted. Perceived stigma associated with hearing loss also plays a key role, with many adults not wanting to appear old or be identified as a person with a disability. In effect, a cochlear implant makes deafn...
Article
Objective: The aim of this study was to develop built environment (BE) design knowledge to support resilient healthcare by systematically reviewing the evidence-based design (EBD) literature. Background: Although the EBD literature is vast, it has not made explicit its contribution to resilient healthcare, which is a key component of the highly...
Article
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Although the COVID pandemic has challenged the resilience of health services in general, this impact has been most visible in intensive care units (ICUs). This paper presents an exploratory study of how ICUs in Brazil have coped with the complexity stemming from the pandemic. Five guidelines for coping with complexity were adopted as analytical fra...
Article
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Background: There is a growing attention on the role of patients and stakeholders in resilience, but there is lack of knowledge and methods on how to support collaborative learning between stakeholders and co-creation of resilient healthcare. The aim of this article was to demonstrate how the methodological process of a consensus process for explo...
Article
People with disabilities are often subject to intersecting layers of social and economic disadvantage and other barriers that drive health inequity. As a result, they frequently experience worse health than people without disabilities, beyond the direct effects of their health condition or impairment. The aim of this overview of systematic reviews...
Article
Background Hip fracture is a major public health concern for older adults, requiring surgical treatment for patients presenting at hospitals across Australia. Although guidelines have been developed to drive appropriate care of hip fracture patients in hospitals, data on health outcomes suggest these are not well-followed. Objective This study aim...
Article
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Objective The aim of this study is to examine the pathways by which work–life balance influences safety climate in hospital settings. Design A national cross-sectional survey on patient safety culture. Settings Healthcare workers from 56 hospitals in Taiwan, covering three work settings: intensive care units, operation rooms and emergency departm...
Article
Patient flow between the emergency department (ED) and hospital wards becomes problematic when bed availability is limited. To better understand the constraints that shape patient flow and everyday work in the ED, we applied Control Task Analysis (i.e., Contextual Activities Template, CAT) and Social Organisational Cooperation Analysis (SOCA) phase...
Article
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A number of Artificial Intelligence (AI) ethics frameworks have been published in the last 6 years in response to the growing concerns posed by the adoption of AI in different sectors, including healthcare. While there is a strong culture of medical ethics in healthcare applications, AI-based Healthcare Applications (AIHA) are challenging the exist...
Article
Background The success of electronic medical records (EMRs) is dependent on implementation features, such as usability and fit with clinical processes. The use of EMRs in mental health settings brings additional and specific challenges owing to the personal, detailed, narrative, and exploratory nature of the assessment, diagnosis, and treatment in...
Article
Purpose The complex and occasionally chaotic nature of health care has been previously described in the literature, as has the broadening recognition that different management approaches are required for different types of problems rather than a “one size fits all” approach. The CYNEFIN framework from Snowden outlines a consistent cognitive approac...
Article
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Objective To identify the risk factors associated with complaints, malpractice claims and impaired performance in medical practitioners. Design Systematic review. Data sources Ovid-Medline, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials were searched from 2011 until March 2020. Reference lists and Google were also handsear...
Poster
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This poster explores current person-centred healthcare in the management of refractory epilepsy, in Australia from the perspectives of people living with refractory epilepsy, general practionners, neurologists and epilepsy specialists. The findings will be outlined in this poster but highlight the need for building models of integrated care. Effect...
Article
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Background: Resilience, a system's ability to maintain a desired level of performance when circumstances disturb its functioning, is an increasingly important concept in healthcare. However, empirical investigations of resilience in healthcare (RiH) remain uncommon, particularly those that examine how government actions contribute to the capacity...
Article
Background Implementation science (IS) should contribute to maintaining high standards of care across healthcare systems and enhancing care practices. However, despite the evident need for greater and more rapid uptake and integration of evidence in practice, IS design and methodology fall short of the needs of effective translation. Aim In this p...
Article
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Background A key characteristic of healthcare systems that deliver high quality and cost performance in a sustainable way is a systematic approach to capacity and capability building for quality improvement. The aim of this research was to explore the factors that lead to successful implementation of a program of quality improvement projects and a...
Article
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Objective In 2014, an escalation plan and morning handover meetings were implemented in an intensive care unit (ICU) to reduce access block for post-operative care. In this study, the improvement intervention is revisited 5 years on with the objective to see if the changes are sustained and to understand factors contributing to sustainability. Des...
Preprint
BACKGROUND The success of electronic medical records (EMRs) is dependent on implementation features, such as usability and fit with clinical processes. The use of EMRs in mental health settings brings additional and specific challenges, due to the personal, detailed, narrative, and exploratory nature of assessment, diagnosis, and treatment in this...
Article
Background Emergency departments (EDs) are complex socio-technical work systems that require staff to manage patients in an environment of fluctuating resources and demands. To better understand the purpose, and pressures and constraints for designing new ED facilities, we developed an abstraction hierarchy model as part of a work domain analysis (...
Chapter
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Over the past two decades, prominent researchers such as Greenhalgh [1], Plsek [2], Leykum [3], Lanham [4], Petticrew [5] and Hawe [6, 7] and their colleagues and teams have promoted using complexity theory to describe and analyse the various dimensions of healthcare organisation [8–12]. Internationally, in parallel, governments have recognised the...
Article
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Background: Over the last two decades, Emergency Department (ED) crowding has become an increasingly common occurrence worldwide. Crowding is a complex and challenging issue that affects EDs' capacity to provide safe, timely and quality care. This review aims to map the research evidence provided by reviews to improve ED performance. Methods and...
Article
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Introduction Value-based healthcare delivery models have emerged to address the unprecedented pressure on long-term health system performance and sustainability and to respond to the changing needs and expectations of patients. Implementing and scaling the benefits from these care delivery models to achieve large-system transformation are challengi...
Article
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Background Studies of clinical effectiveness have demonstrated the many benefits of programmes that avoid unnecessary hospitalisations. Therefore, it is imperative to examine the factors influencing implementation of these programmes to ensure these benefits are realised across different healthcare contexts and settings. Numerous factors may act as...
Article
Residents in Australian aged care facilities can suffer serious preventable harm from incidents (‘adverse events’ (AEs)). An inadequate response to AEs by aged care facilities can compound distress to residents and their families/carers. Facilities have an obligation to respond to and investigate AEs involving residents, learn from them, and take a...
Article
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Background: High-risk patients presenting for surgery require complex decision-making and perioperative management. However, given there is no gold standard for identifying high-risk patients, doing so may be challenging for clinicians in practice. Before a gold standard can be established, the state of current practice must be determined. This st...
Article
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To the disbenefit of qualitative health services research, the generation of study design is too often implied as a logical consequence of aims or questions. Limited space is afforded to describing the critical processes we go through to devise our research for the ever-complex services we seek to understand. This article offers an in-depth examina...
Article
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Objectives Diabetic eye disease is a leading cause of blindness but can be mitigated by regular eye assessment. A framework of issues, developed from the literature of barriers to eye assessment, was used to structure an examination of perceptions of a new model of care for diabetic retinopathy from the perspective of staff using the model, and hea...
Article
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Accident models and theoretical foundations underpinning safety investigations are key to understanding how investigators construct causality and make recommendations. Safety science has devoted large efforts to investigating and theorizing about accidents. Why doesn't healthcare pay more interest to these theories when investigating healthcare acc...
Article
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Objective: Little is known about the influence that hospital quality systems have on quality at department level, in Australia and elsewhere. This study assessed the relationships between organizational-level quality management systems, and the extent to which hospital-level quality management systems and department-level quality management strate...
Article
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Objective: We aimed to examine whether Emergency Department (ED) quality strategies, safety culture and leadership were associated with patient-level outcomes, after controlling for other organization-level factors, in 32 large Australian hospitals. Design: Quantitative observational study, using linear and multi-level modelling to identify rela...
Article
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Healthcare organisations vary in the degree to which they implement quality and safety systems and strategies. Large-scale cross-sectional studies have been implemented to explore whether this variation is associated with outcomes relevant at the patient level. The Deepening our Understanding of Quality in Australia (DUQuA) study draws from earlier...
Article
This paper examines the principles of benchmarking in healthcare and how benchmarking can contribute to practice improvement and improved health outcomes for patients. It uses the Deepening our Understanding of Quality in Australia (DUQuA) study published in this Supplement and DUQuA's predecessor in Europe, the Deepening our Understanding of Quali...
Article
Objective: Healthcare accreditation surveyors are well positioned to gain access to hospitals and apply their existing data collection skills to research. Consequently, we contracted and trained a surveyor cohort to collect research data for the Deepening our Understanding of Quality in Australia (DUQuA) project. The aim of this study is to explor...
Article
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Objective: This study aimed to explore the associations between the organization-level quality arrangements, improvement and implementation and department-level safety culture and leadership measures across 32 large Australian hospitals. Design: Quantitative observational study, using linear and multi-level modelling to identify relationships be...
Article
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Objective: The aim of this study was to develop and refine indices to measure organization and care pathway-level quality management systems in Australian hospitals. Design: A questionnaire survey and audit tools were derived from instruments validated as part of the Deepening Our Understanding of Quality improvement in Europe (DUQuE) study, ada...
Article
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Background: Good workspace design is key to the quality of work, safety, and wellbeing for workers, yet we lack vital knowledge about optimal hospital design to meet healthcare workforce needs. This study used novel mobile methods to examine the concept of Work-as-Done and the effect of workspace-use on healthcare professional practice, productivi...
Article
This study aimed to operationalise and use the World Health Organisation's International Classification for Patient Safety (ICPS) to identify incident characteristics and contributing factors of deaths involving complications of medical or surgical care in Australia. A sample of 500 coronial findings related to patient deaths following complication...
Preprint
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Background: System resilience describes the performance or capacity of a system to absorb and adapt in response to stressors and perturbations. This protocol outlines the search strategy to identify indicators or metrics of system resilience from across diverse fields and examine the methods/processes for developing these indicators or metrics. Met...
Article
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With this paper, we initiate the Supplement on Deepening our Understanding of Quality in Australia (DUQuA). DUQuA is an at-scale, cross-sectional research programme examining the quality activities in 32 large hospitals across Australia. It is based on, with suitable modifications and extensions, the Deepening our Understanding of Quality improveme...
Article
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Objective: The Deepening our Understanding of Quality in Australia (DUQuA) project is a multisite, multilevel, cross-sectional study of 32 of the largest hospitals in Australia. This overview examines relationships between (i) organization-level quality management systems and department-level quality management strategies and (ii) patient-level me...
Article
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Objective: This study aimed to refine and validate a tool to measure safety culture and leadership in Australian hospitals. Design: The clinician safety culture and leadership questionnaire was constructed by combining and refining following two previously validated scales: Safety Attitudes Questionnaire and the Leadership Effectiveness Survey....
Article
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Objective: Patients can provide a unique perspective on the safety of care in hospitals. Understanding that the extent to which the way hospitals are organized for quality and safety is associated with patient perceptions of care is becoming increasingly valued and necessary for the direction of targeted interventions across healthcare systems. Th...
Article
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This final article in our 12-part series articulating a suite of quality improvement studies completes our report on the Deepening our Understanding of Quality in Australia (DUQuA) program of work. Here, we bring the Supplement's key findings and contributions together, tying up loose ends. Traversing the DUQuA articles, we first argued the case fo...
Article
Following its emergence from the field of resilience engineering in 2012, resilient health care has grown to underpin a new paradigm of safety that leverages an understanding of what goes right to improve patient care. The aim of this paper was to review the resilient health care literature via multiple analyses, in order to examine growth and glob...
Article
This chapter presents an overview of Resilient Health Care (RHC), introducing two aspects of RHC that are important for designing sustainable digital health systems and for considering implementation outcomes: (1) understanding how normal variation in everyday work can affect implementation of digital health interventions, and (2) the role of infor...
Article
Aim: Acute otitis media (AOM) is the most common infectious disease for which antibiotics are prescribed; its management is costly and has the potential to increase the antimicrobial resistance of this infection. This study measured the levels of adherence to the clinical practice guidelines (CPGs) of AOM and otitis media with effusion (OME) manag...
Article
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Introduction Workspaces are socially constructed environments where social relationships are produced, reproduced, challenged and transformed. Their primary function is to support high-quality service delivery to the benefit of ‘patients’. They are also settings where employees can work effectively, in a safe and healthy environment, delivering a h...
Article
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This paper offers a new way of understanding the course of a chronic, neurological condition through a comprehensive model of patient-reported determinants of health and wellbeing: The Patient Reported ImpleMentation sciEnce (PRIME) model is the first model of its kind to be based on patient-driven insights for the design and implementation of init...
Article
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Objective To evaluate the implementation of an intensive care unit (ICU) intervention designed to establish rules for making ICU decisions about postsurgery beds. Design Preintervention/postintervention case study using a multimethod approach, involving two phases of staff interviews, process mapping and collection of administrative data. Setting...
Article
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Objectives: Effective researcher assessment is key to decisions about funding allocations, promotion and tenure. We aimed to identify what is known about methods for assessing researcher achievements, leading to a new composite assessment model. Design: We systematically reviewed the literature via the Preferred Reporting Items for Systematic Re...
Article
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Objectives The objective of this study is to investigate whether papers reporting research on Chinese transplant recipients comply with international professional standards aimed at excluding publication of research that: (1) involves any biological material from executed prisoners; (2) lacks Institutional Review Board (IRB) approval and (3) lacks...