This research briefing paper was prepared in collaboration with the Institutional Rhythms and Energy Demand Working Group and presented to the Northern England Sustainability and Health Network. It provides ideas and suggests potential opportunities for energy and mobility demand management in the NHS.
The paper examines two examples of ordinary working arrangements that hold in place particular patterns of demand for energy and travel: the first is the discharge process and the second patient transport.
It describes the sequences and synchronisations of the ordinary working activities involved that result in energy-intensive pinch points in ways of working and the boundaries of responsibility that hold them in place. Potential opportunities are identified in reconfigurations that are already taking place in hospitals, that might be adapted and adjusted, to shape patterns and profiles of demand for energy and travel and reduce associated carbon emissions.
My article titled ‘Institutional Rhythms: Combining Practice Theory and Rhythmanalysis to Conceptualise Processes of Institutionalisation’ is out now and is Open Access in Time and Society.
This article examines various ways that practice theorists have drawn on theories of time and about temporal rhythms to describe how practices are organised in everyday life. It does so to argue that Lefebvre’s work on rhythmanalysis provides important ideas for understanding how practices become temporally connected and societal rhythms become institutionalised.
On the 7th February 2017, we held the second working group meeting for the Institutional Rhythms project. This time the working group met at Airedale General Hospital and began to develop outputs based on conceptual contributions taken from the project and two practical case examples presented by working group members.
Jo Davy and Frank Swinton presenting Rapid Improvement work on discharge at Airedale Hospital.
Alexis Keech, Head of Environmental Sustainability for the Yorkshire Ambulance Service, presented on some of the issues resulting from increasing demand for patient transport and on how the service was responding to these increasing pressures. Jo Davy, Head of Quality Improvement at Airedale, presented on work at Airedale to improve patient discharge and flow.
The working group used concepts developed in the first meeting about temporal sequences, cycles, and institutional rhythms to work through potential new opportunities for shifting temporal arrangements to manage and steer demand for hospital services and patient transport.
Working group members enjoying floorball on a narrow and obstacle filled pitch. But at least it wasn’t forty degrees this time!
As aways there was, of course, time for a (slightly unorthodox) game of floorball!
The third and final meeting of the working group will take place in Leeds on the 23rd May where the group will work on developing further example cases and strategies for disseminating outputs from the project across the NHS.
Click here for more information on the Institutional Rhythms and Energy Demand Working Group process and outputs.
While I was visiting Beyond Behaviour Change and the Centre for Urban Research at RMIT I was asked to write something from the Institutional Rhythms project for the Australian Hospital and Healthcare Bulletin magazine.
This short piece is about the potential opportunities that arise for the future sustainability of NHS hospitals when demand for resources including, energy, transport, and goods are considered as the outcomes of critical intersections in the timings of working arrangements.
The full article is available here.
Nicola Spurling and I have a chapter in The Nexus of Practices: Connections, Constellations, Practitioners which is edited by Allison Hui, Elizabeth Shove, and Theodore Schatzki and was published in December 2016. The accepted manuscript version of this chapter is available here.
Our chapter calls for a practice theory which begins with complexes of practice and not ‘a practice’, and for one that focuses on the relationships between connections (interconnections). Through examples of hospital life, we develop the concept of connective tissue which both holds complexes of practice together and that is itself an essential feature of practices. The chapter argues that connective tissue has multiple qualities. We argue that studying the interconnections between these qualities is the key to understanding change in hospital life, and other complexes of practice, over time.
Panel at TASA. #thatleantho
The Australian Sociological Association’s Annual Conference was held in Melbourne this year, just as I was there visiting Beyond Behaviour Change and the Centre for Urban Research at RMIT. So it was great timing to join the Environment and Society stream. I presented some more of the work from the Institutional Rhythms project and joined in a short question panel on practice theory and sustainability.
The title of my talk was ‘Fixity and Flexibility in Hospital Discharge: Temporal Rhythms and How to Entrain Them‘.
The lens of practice theory. Designed and produced by Sarah Royston.
It was great to see lots of new projects presented in the Environment and Society stream that were taking a practice theory approach to investigating interesting empirical cases. There was some more discussion before and after the session about ‘using’ the ‘lens’ of practice theory. See Elizabeth Shove’s contribution in a collection of Responses to the PBES Thinking Notes for more on this.
I gave a seminar at the Centre for Urban Research at RMIT. Here are links to the abstract and the slides. My talk was recorded and you can listen to it below.