The role of champions in health system and practice change: an examination of Emergency Department Intimate Partner Violence (IPV) interventions in a regional Local Health District
Creators: name: Saberi, Ellie
Publisher: name: Southern Cross University
Year: 2024
Subjects: Champion
Domestic Violence
Intimate Partner Violence
Practice Change
Quality Improvement
Emergency Department
Change Agent
Rural Health
Screening
Innovation
Emergency Nursing

description: Background
description: Intimate Partner Violence (IPV) results in profound and long-lasting harm that disproportionately impacts women and children. Individuals affected by IPV are more frequent users of health services, particularly Emergency Departments (EDs) (Alshammari et al., 2018; Briones‐Vozmediano et al., 2022; Caetano et al., 2020; Dawson et al., 2019). Frontline ED staff are in a critical position to identify and respond to IPV, yet it remains challenging for clinicians to enquire about IPV. In Australia, screening for IPV within EDs has been trialled in New South Wales (Spangaro et al., 2020). It is not, however, routinely carried out in all EDs. Although the topic of champions has been examined extensively within management research, the role of champions remains underexplored in the healthcare context. In the field of IPV, no study to date has explicitly examined the role of champions in increasing enquiry about IPV and fostering required health system and practice change.
description: Aim
description: This study aimed to explore and further conceptualise the role, attributes, and motivations of champions implementing routine nurse screening for IPV. In so doing, the exploration sought to understand the strategies these champions employed and the barriers and enablers they experienced when fostering the adoption and maintenance of routine screening by nurses.
description: Method
description: Adopting a longitudinal interpretive qualitative approach, guided by social constructionist underpinnings, the study involved qualitative semi-structured interviews (undertaken between 2017 and 2019) with 24 champion participants in two EDs.
description: Findings
description: This study found that champions contributed significantly to IPV practice change, identifying three key motivators for champion efforts and five critical strategies that champions used to change IPV practice and sustain IPV screening within their sites. The study also identified a number of structural and systemic barriers that impacted the efforts of champions, along with enablers that sustained champion efforts. Distilled from the study is a set of principles that provide a framework for the future effective use of champions in health service practice change efforts. These findings offer new insights into how health services can identify, prepare, and support champions.
description: Conclusion
description: The findings of this research have international relevance, highlighting the important role that champions play in enacting IPV practice change within EDs. Practice change within this area of health is not easily achieved or sustained. This study fills an important gap in the knowledge about efforts to sustain IPV responses in healthcare. The findings will assist in developing strategies to overcome barriers faced by champions and increase awareness of their place in practice and policy change in healthcare settings. The study provides clinicians, managers and policymakers with clarity of the role, motivations, strategies and characteristics of champions and the enabling factors and barriers that they face.