Dr. Suzanne M Grant

Lecturer in Medical Anthropology

Understanding and improving the quality and safety of healthcare organisations

Address:

Division of Population Health Sciences
University of Dundee
The Mackenzie Building
Kirsty Semple Way
Dundee
DD2 4BF

Phone Number:

+(44) 01382 388657

Email Address:

smgrant@dundee.ac.uk

Biography

Suzanne studied Social Anthropology at the University of St Andrews (MA (First Class Honours) (1999); PhD (2006)) and Public Health Research at the University of Edinburgh (MSc 2009-10). Her doctoral degree was funded by an Economic and Social Research Council (ESRC) Studentship and an Emslie Horniman/Sutasoma Trust Award from the Royal Anthropological Institute of Great Britain and Northern Ireland. Based on ethnographic fieldwork amongst the Nivaclé indigenous people of the Paraguayan Chaco region of lowland South America from 2001-03, her PhD examined the impact of Mennonite settler colonisation on Nivaclé wellbeing. She has subsequently held research posts at the Universities of Dundee and Glasgow on the impact of financial incentives on UK general practice organisation and culture, before being appointed as Lecturer in Medical Anthropology at the University of Dundee in 2013.

Research interests:

Medical anthropology; anthropology of healthcare safety and quality; wellbeing; dignity; professional, patient and family perspectives on patient safety and quality of care; socio-technical systems; qualitative methods; ethnography; video reflexive ethnography (VRE); meta-ethnography.

Research

Suzanne is a medical anthropologist and her research is located at the interface between anthropology, medicine and healthcare safety and quality. The overarching aim of her work is to improve understandings of safety, risk, wellbeing and dignity within and across healthcare organisational contexts through research that is both methodologically innovative and theoretically engaged. Drawing on insights from social and medical anthropology, her research adopts a novel approach to understanding and improving healthcare safety and quality through the application of innovative ethnographic and video reflexive ethnographic (VRE) methods. Her research focusses on the co-creation of safety, wellbeing and dignity by professionals, patients and their families across different healthcare contexts, and the development of ethnography and VRE as research and improvement methodologies.

Suzanne’s current research is funded by Tenovus Scotland (2017-18) and examines how video reflexive ethnography (VRE) can best be used to understand and improve the safety of inter-professional teamwork in the UK secondary care. This work examines the application of VRE as both a research and improvement methodology amongst professionals, frail older people and their families, and the feasibility and implementation of VRE methods in the UK healthcare context. Her previous research was funded by a Medical Research Council (MRC) Population Health Scientist Postdoctoral Fellowship (2009-13) and focussed on the interrelationship between quality and safety in high-volume organisational routines (e.g. repeat prescribing, laboratory test ordering, document handling) within UK general practice. This research also examined the relationship between formal and informal dimensions of safety, the spatial and temporal dimensions of safety and wellbeing, and the innovative application of long-term and focussed multi-sited ethnographic methods within and across healthcare organisational settings.

Suzanne had previously worked on research projects funded by the Economic and Social Research Council (ESRC) (2005-06) and the National Institute for Health Research (NIHR) Service Delivery and Organisation (SDO) Programme (2006-09). These projects examined the impact of the 2004 General Medical Services (nGMS) contract on general practice organisation and culture, and the governance of general practice professionals. She has conducted consultancy work on the safety of general practice laboratory results handling systems for NHS Education for Scotland (NES) as part of the “Learning from International Networks about Errors and Understanding Safety in Primary Care" (LINNEAUS Euro-PC) funded by the European Union Framework 7 programme. She is currently undertaking consultancy work for NHS Greater Glasgow & Clyde (NHS GGC) comprising an ethnographic evaluation of the Medicines Management Local Enhanced Service (MMLES) for improving the quality and safety of general practice repeat prescribing routines within NHS GGC.

Suzanne co-convenes the British Sociological Association (BSA) Medical Sociology Scottish Regional Group and is a member of the Video Reflexive Ethnography International Association (VREIA).

Research Funding

Grant S (PI), Guthrie B, Mesman J. “Improving the safety of inter-professional collaboration in an Acute Medical Unit: an examination of the feasibility and implementation of video reflexive ethnography (VRE) in UK healthcare” Tenovus Scotland Major Research Grant. £57,430

Grant S (PI) “Ethnographic evaluation of the Medicines Management Local Enhanced Service (MMLES) for improving the quality and safety of general practice repeat prescribing routines in NHS Greater Glasgow and Clyde”. NHS Greater Glasgow & Clyde. £12,663

Witham M (PI), Grant S, Kroll T, Atherton I. “Evidencing the role of social care for people with multi-morbidities: an ethnographic study”. Economic and Social Research Council (ESRC) - Scottish Government Co-funded Postgraduate Studentship. £56,068

Guthrie B (PI), Donan P, Grant S, Mellon N, Dreischulte T. “Enhanced Medication Summaries to reduce high-risk prescribing in people with polypharmacy in primary care: a cluster randomised trial (POEMS Chief Scientist Office (CSO) Research Grant. £224,992

Publications

Grant S, Guthrie B. (2018) Between demarcation and discretion: the medical-administrative boundary as a locus of safety in high-volume organisational routines, Social Science and Medicine, 203, 43-50. DOI: 10.1016/j.socscimed.2018.03.005

Goodwin D, Mesman J, Verkerk M, Grant S (2018) The dynamics of dignity and safety: a discussion, BMJ Quality and Safety, DOI: 10.1136/bmjqs-2017-007159

Grant S, Guthrie B. (2018) Efficiency and thoroughness trade-offs in high-volume organisational routines: an ethnographic study of prescribing safety in primary care, BMJ Quality and Safety, 27, 199-206. DOI: 10.1136/bmjqs-2017-006917

Scott D, Grant S. (2017) A meta-ethnography of the facilitators and barriers to the successful implementation of patient complaints processes in healthcare settings, Health Expectations, DOI: 10.1111/hex.12645

Grant S, Checkland K, Bowie P, Guthrie B. (2017) The role of informal dimensions of safety in high-volume organisational routines: an ethnographic study of test results handling in UK general practice, Implementation Science, 12, 56, DOI 10.1186/s13012-017-0586-8.

Grant S, Mesman J, Guthrie B. (2016) Spatio-temporal elements of articulation work in the achievement of repeat prescribing safety in UK general practice, Sociology of Health and Illness, 38, 2, 306-324.

Fioratou E, Chatzimichailidou M, Grant S, Glavin R, Flin R, Trotter C. (2015) Beyond monitors: distributed situated awareness in the anaesthetic management of Major Obstetric Haemorrhage, Theoretical Issues in Ergonomics Science, 17, 1, 104-124.

Bowie P, Forrest E, Price J, Verstappen W, Cunningham D, Halley L, Grant S, Kelly M, McKay J. (2015) Good practice statements on safe laboratory testing: a mixed methods approach by the Linneaus Collaboration on patient safety in primary care. European Journal of General Practice, 21, 19-25.

Grant, S., Ring, A., McLean, G., Guthrie, B., Gabbay, M., Mair, F., Watt, G., Heaney, D., O’Donnell, C.A. Soft governance, restratification and the 2004 general medical services contract: the case of UK primary care organisations and general practice teams. Sociology of Health and Illness, 37 (1), 30-51.

Grant, S.Guthrie, B., Entwistle, V.A., Williams, B. (2014) A meta-ethnography of organisational culture in primary care medical practice, Journal of Health Organization and Management, 28(1), 28-40.

Grant, S. (2012) Fences, pathways, and a peripatetic sense of community: kinship and residence amongst the Nivacle of the Paraguayan Chaco. In J. Vergunst, A. Árnason, N. Ellison and A. Whitehouse (eds.) Landscapes Beyond Land: Routes, Aesthetics, Narratives. New York: Berghahn. European Association of Social Anthropologists Series (19). ISBN: 978-0857456717.

Huby, G., Harries, J., Grant, S. (2011) Contributions of ethnography to the study of public services management: Past and present realities, Public Management Review, 13, 2, 209-226.

Grant, S., Huby, G., Watkins, F., Checkland, K., McDonald, R., Davies, H., Guthrie, B. (2009) The impact of pay-for-performance on professional boundaries in UK general practice: An ethnographic study, Sociology of Health and Illness, 31, 2, 229-245.

Checkland, K.; Harrison, S.; McDonald, R.; Grant, S.; Campbell, S.; Guthrie, B. (2008) Biomedicine, holism and general medical practice: Responses to the 2004 General Practitioner contract, Sociology of Health and Illness, 30, 5, 788-803.

Huby, G.; Guthrie, B.Grant, S.; Watkins, F.; McDonald, R.; Checkland, K.; Davies, H. (2008) Whither British general practice after the 2004 GMS contract? Stories and realities of change in four UK general practices, Journal of Health, Organization and Management, 22, 1, 63-78.

Consultancy Reports:

Grant, S. (2012) An Ethnographic Study of Primary Care Results Handling: Research Findings. Report prepared for NHS Education for Scotland (NES) and Learning from International Networks about Errors and Understanding Safety in Primary Care (LINNEAUS Euro-PC).

Research Reports:

O'Donnell, C.A., Ring, A., McLean, G., Grant, S.Guthrie, B., Gabbay, M., Mair, F.S., Carlisle, C., Heaney, D., Sutton, M. and Watt, G.C.M. (2010) The new GMS contract in primary care: The impact of governance and incentives on care. Final report. NIHR Service Delivery and Organisation programme.

Guthrie, B., Huby, G., Davies, H., Grant, S., Watkins, F. (2006) Public services: What changes when incentives change in primary medical care? Final Report. ESRC Public Services Programme. ESRC Award Reference Number: RES-153-25-0043.

Teaching

Suzanne has completed the Postgraduate Certificate in Academic Practice in Higher Education (PGCAPHE) and has the following teaching responsibilities:

  • Module Leader, Ethnographic Methods in Healthcare Research, BMSc in Healthcare Improvement, University of Dundee.
  • Module Leader, Behavioural and Social Science, Master of Public Health (MPH), University of Dundee
  • BMSc in Healthcare Improvement supervising the following dissertation projects:

·         2015-16: “An ethnographic study of communication of medicines reconciliation from secondary care to primary care at discharge”. Student: Danielle Cunningham

·         2014-15: “An ethnographic study of multidisciplinary team meetings within the community mental health setting”. Student: Marianne Inglis (Awarded with Distinction)

  • Honorary Fellow and Visiting Lecturer, Master of Public Health, University of Edinburgh. Delivery of lecture and tutorials to postgraduate students on the application of ethnographic methods in healthcare organisational research on the ‘Qualitative Research in Health’ module.

PhD Supervision

Nov 2014-present: “Evidencing the role of social care for people with multi-morbidities – a mixed methods project to understand and successfully analyse linked health and social care data on older people”. Student: Anne Canny (ESRC-Scottish Government Co-funded Postgraduate Studentship, co-supervised with Witham, M., Kroll, T. and Atherton, I).

Oct 2014-present: “Polypharmacy reviews for patients with multiple morbidities: professional experiences, boundaries and identities”. Student: Alpana Mair (Principal supervisor of part-time PhD funded by the Scottish Government, co-supervised with Guthrie, B.)

Conferences

Conference Presentations:

1)      ‘Opening the ‘black box’ of patient safety: The application of long-term and focussed multi-sited ethnography for understanding healthcare organisational complexity’ BSA Medical Sociology Group Conference, Birmingham (8th September 2016)

2)      ‘Opening the ‘black box’ of patient safety: The application of long-term and focussed multi-sited ethnography for understanding healthcare organisational complexity’ Association of Social Anthropologists Conference, Durham (5th July 2016)

3)      ‘The role of ethnography in understanding and improving safety in healthcare organisations: the case of high-volume routines in UK general practice’ 15th Annual Qualitative Methods (QM) Conference, Glasgow (4th May 2016)

4)      ‘The everyday negotiation of the clinical-administrative boundary: the case of high-volume ‘backstage’ work in primary care’, Poster Presentation, School of Medicine Research Symposium, Crieff (25th February 2016)

5)      ‘The everyday negotiation of the clinical-administrative boundary in UK general practice: an ethnographic study’, BSA Medical Sociology Group Conference, York (11th September 2015)

6)      ‘Spatio-temporal elements of articulation work in the achievement of repeat prescribing safety in UK general practice: an ethnographic study’, BSA Sociology Group Annual Conference, Glasgow (16th April 2015)

7)      ‘The role of ethnography in healthcare quality and safety: the case of high-volume, safety-critical routines in UK general practice’, BSA Medical Sociology Group Conference, Birmingham (10th September 2014)

8)      ‘The role of organisational routines in the safety of laboratory results handling in UK general practice: an ethnographic study’, BSA Medical Sociology Group Conference, York (11th September 2013)

9)      ‘Understanding socio-technical collaborative work routines in UK family practice through ethnographic enquiry’, Advances in Qualitative Methods, Edmonton, Canada (23rd June 2013)

10)   ‘Role of organisational context in the quality and safety of results handling routines in general practice: an ethnographic case study’, Scottish Departments of General Practice Annual Conference (NADEGS), Dundee (24th January 2013)

11)   ‘A systematic literature search and meta-ethnography of qualitative research on organizational culture in general medical practice’, Scottish Departments of General Practice Annual Conference (NADEGS), Dundee (19th-20th January 2012)

12)   ‘Conducting a meta-ethnography of qualitative research on organizational culture in primary care teams: methodological considerations’, 17th Qualitative Health Research (QHR) Conference, Vancouver, Canada (25th-27th October 2011)

13)   ‘A systematic literature search and meta-ethnography of qualitative research on organizational culture in general medical practice’, 40th Annual Scientific Meeting  of the Society for Academic Primary Care (SAPC), University of Bristol (6th-8th July 2011)

14)   ‘A systematic literature search and meta-ethnography of qualitative research on organizational culture in general medical practice’, Scottish School of Primary Care (SSPC) Annual Conference, Edinburgh (19th April 2011)

15)   ‘Ethnography in the study of new public management’, The 5th Annual Joint University of Liverpool Management School and Keele University Institute for Public Policy and Management Symposium on Current Developments in Ethnographic Research in the Social and Management Sciences, Queen Mary University, London (1st-2nd September 2010)

16)   ‘The new GMS Contract in Primary Care: The Impact of Governance and Incentives on Care’, Health Policy Panel, Society for Academic Primary Care (SAPC) 38th Annual Scientific Meeting, University of Dundee (July 2009)

17)    ‘”I think I can be firm, but I have a heart”: Implementing the 2004 GMS contract in UK primary care’, Annual Meeting of the University Departments of General Practice of Scotland (ADEGS) Conference (January 2009)

18)   ‘”I think I can be firm but I have a heart”: Implementing the 2004 GMS contract in UK primary care’, European Network Primary Care Conference: The Future of Primary Care, University of Southampton.  ‘”I think I can be firm but I have a heart”: Implementing the 2004 GMS contract in UK primary care’ (September 2008)

19)   ‘”It’s about leadership rather than management”: The impact of the 2004 GMS contract on governance in UK primary care’, British Sociological Association Medical Sociology Group 40th Annual Conference, University of Sussex (September 2008)

20)   ‘Impact of the GMS contract on governance: Qualitative case studies comparing England and Scotland’, Society for Academic Primary Care (SAPC) 37th Annual Scientific Meeting, National University of Ireland, Galway (July 2008)

21)   ‘The Impact of the GMS Contract on Governance: Preliminary Findings Comparing Scotland and England’, Annual Meeting of the University Departments of General Practice of Scotland (ADEG Conference) (January 2008) 

22)   ‘”Like a Spider in the Middle of a Web”: The Impact of the 2004 GMS Contract on Governance in Primary Medical Care’, British Sociological Association Medical Sociology Group 39th Annual Conference, Britannia Adelphi Hotel, Liverpool.  (September 2007)

23)   ‘”Core” QOF Teams: An Ethnographic Study of the Impact of the 2004 GMS Contract on the Clinical-Managerial Boundary in UK General Practice’, Society for Academic Primary Care (SAPC) 36th Annual Scientific Meeting, University of London (July 2007)

24)   Plus Ça Change…: An ethnographic exploration of the impact of the new GMS contract on inter-professional relations in UK general practice’, British Sociological Association Medical Sociology Group 38th Annual Conference, Heriot-Watt University, Edinburgh (September 2006)

25)   ‘Exploring in Depth the Effects of New Incentives in Primary Care: The Impact of the New GMS Contract on Professional Boundaries’, Society for Academic Primary Care (SAPC) 35th Annual Scientific Meeting, University of Keele (July 2006)

26)   ‘The Changing Face of Patient Care: An Exploration of the Impact of the New GMS Contract on Inter-Professional Boundaries’, Scottish School of Primary Care (SSPC) Annual Conference, Perth (April 2006)

27)   ‘The impact of Mennonite missionisation and development on Nivaclé cosmology’, First Workshop on Indigenous Theology, Filadelfia, Central Chaco, Paraguay (October 2002)

28)   ‘The economic, social and political situation of the Nivacle of the Paraguayan Chaco’, Second Three-Nations Encounter of the Indigenous Peoples and Communities of the South American Chaco, Mariscal Estigarribia, Chaco, Paraguay (September 2001).

 

Invited Presentations:

1)      ‘Trajectories of safety in collaborative actions: an ethnographic study of repeat prescribing in UK general practice’, Greater Manchester Primary Care Patient Safety Translational Research Centre, University of Manchester (18th March 2014)

2)      ‘Spatio-temporal dimensions of repeat prescribing safety in UK general practice: an ethnographic study’, Division of Population Health Sciences Seminar (12th March 2014)

3)      ‘Spatial dimensions of repeat prescribing safety in UK general practice: an ethnographic study’, Social Dimensions of Health Institute (SDHI) Webinar, Universities of Dundee and St Andrews (28th November 2013)

4)      ‘Understanding healthcare organisations through ethnography: the struggle to keep laboratory results management safe in general practice’, Population Health Sciences Seminar Series, Medical Research Institute, University of Dundee (5th December 2012)

5)      ‘Evaluating meta-ethnography: a synthesis of qualitative research on organisational culture in general medical practice organisations’, Invited guest seminar, Qualitative Health Research Group Seminar Series, School of Medicine and Health, University of Durham (3rd April 2012)

6)      ‘Ethnographic approaches to qualitative research and their application to primary care settings’ co-presented with Dr Al Dowie (University of Glasgow), Invited guest seminar, Qualitative Research Forum, University of Glasgow (31st May 2011)

7)      ‘Mixing ethnographic and quantitative methods in health services research: methodological issues’, organization and delivery of half-day workshop for staff, researchers and students as part of the Delivery of Care Programme, Health Services Research Unit (HSRU), University of Aberdeen (12th April 2011)

8)      ‘Mixed ethnographic and quantitative methods to understand and measure organizational culture in UK general practice’, Invited speaker, National Institute for Health Research (NIHR)/Medical Research Council (MRC) Research Methods Programme Fellows’ Workshop, London (9th February 2011)

9)      ‘Ethnography in the study of public management’, Invited speaker, International Research Symposium on Public Management (IRSPM), University of Berne, Switzerland (8th April 2010)

10)   ‘Methodological reflections on conducting ethnography in ‘traditional’ and ‘non-traditional’ contexts’, Invited guest seminar, Departmental Seminar, Department of Social Anthropology, University of St. Andrews (March 2008)

11)   ‘”This side” and “the other side”: landscape, residence and relatedness amongst the Nivacle of the Paraguayan Chaco’, Invited speaker, ‘Landscape and Narrative: New Ethnographies of Landscape and Environment’ invited workshop, Department of Social Anthropology, University of Aberdeen (June 2007)

12)   ‘The application of the concept of ‘mythscapes’ to transnational culture-broker Jet-Li’, Socrates Intensive Programme, Department of Social and Cultural Anthropology, University of Vienna, Austria. Workshop Title: ‘Lifeworlds: Transitions between Plural Social Milieus’. One of two UK Delegates on 2-week programme financed by the European Union and the Federal Ministry of Science and Culture (August 2005)

13)   ‘The impact of transnational development projects in kinship and cosmology amongst the Nivacle of the Paraguayan Chaco’, invited presentation in Spanish to the National Scientific and Technical Research Council (CONICET), University of Buenos Aires, Argentina (16th April 2003)