Digital Public Defence: Monica Stolt Pedersen
MSc Monica Stolt Pedersen at Institute of Clinical Medicine will be defending the thesis “The use and experience of an audit & feedback cycle when implementing a clinical practice guideline in specialist mental health care in Norway. A qualitative case study” for the degree of PhD (Philosophiae Doctor).
Photo: Tor-Arne Isene
The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Digital Trial Lecture – time and place
- First opponent: Professor Gunilla Borglin, Karlstad University, Sweden
- Second opponent: Professor Frederik Alkier Gildberg, University of Southern Denmark
- Third member and chair of the evaluation committee: Associate Professor Øistein Hovde, University of Oslo
Chair of the Defence
Professor Emeritus Ulrik Fredrik Malt, University of Oslo
Researcher Lars Lien, University of Oslo
Implementation research in health services is needed to optimise use of clinical practice guidelines (CPGs). Audit and feedback (A&F) is a circular process measuring practice against CPGs, were reflecting on results, agreeing on improvement and developing improvement plans is essential.
The aim was to add to the knowledge of the use and experience of A&F in specialist mental health care in Norway. This was done by exploring an A&F cycle over a year from different angles: by observing team meetings at the outset and focus group interviews of staff and individual interviews of first-line managers at the end of the cycle.
A key message is that A&F is experienced as useful, confirmed good practice and brought forth competencies hidden in everyday practice. A&F contributed to clarify the patients’ needs in a local context and at a micro level as it illuminated consequences for each unit, for individuals’ everyday work and in relation to the broader system with which the staff cooperates. Discussions on lack and sources of knowledge exposed insufficient information competency.
Staff and first-line managers felt being flooded with initiatives (such as CPGs and procedures) from superior authorities and saw them more as directives than as decision aids. No one took full responsibility for follow-up on decided actions and insufficient organisational support limited accomplishment and impact of the full A&F cycle. Despite first-line managers having a positive attitude and declared responsibility, administrative daily tasks and lack of support caused focus to fade slowly. Additionally, the roles of the first-line managers and the psychiatrist could be complex regarding decisions.
Stronger links between evidence-based practice, information competency and A&F could lead to better understanding and ownership of the full A&F cycle, and thus its effect as an implementation strategy to increase use of CPGs in mental health care, suggesting stronger focus on implementation leadership.
Contact the research support staff.