'They don't actually join the dots': An exploration of organizational change in Irish opiate community treatment services

dc.check.date2022-07-09
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorKelly, Peter
dc.contributor.authorHegarty, J.
dc.contributor.authorDyer, Kyle R.
dc.contributor.authorO'Donovan, A.
dc.date.accessioned2021-08-19T08:09:48Z
dc.date.available2021-08-19T08:09:48Z
dc.date.issued2021-07-09
dc.date.updated2021-08-19T07:58:46Z
dc.description.abstractPeople who use community-based drug treatment services spend a considerable amount of their time in treatment in direct contact with frontline staff. These staff are also fundamental to supporting the implementation of change to meet service user needs. Yet, very little is known about staff perspectives on the process and internal dynamics of drug treatment services, their views about what makes services work effectively, and how services can more effectively adopt to changes in practice. Conducted across Irish community opiate prescribing services and drawing on data from 12 in-depth qualitative interviews with frontline staff. This paper examines the narratives of staff about the factors which influence the dynamics and process of treatment services, particularly in relation to the implantation of change. Change itself was described both in respect of how a service responded to immediate service user needs or supported planned change. Little distinction was made in respect of service attributes which facilitated a response in either context. Overwhelmingly, staff contextualised current service effectiveness, historical change, and desired change in how effectively their services met service user needs, which was also viewed as a significant motivation for change. Differences in operational standards across services in terms of practices, policy implementation, job roles, divisions between professional groups, and recruitment and retention of staff inhibited change adoption. Factors which were identified in terms of inhibiting or facilitating planned change were consistent with the wider literature on change implementation but provided unique insights in the context of substance misuse services. A range of interdependent factors which influence an 'eco-system' of service delivery were identified. Effective policy implementation in Ireland remains aspirational, but findings reported in this paper have important implications for future planning and design of services for people who use drugs, and provide a good basis for further investigation.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationKelly, P., Hegarty, J.; Dyer, K. R. and O'Donovan, A. (2021) ''They don't actually join the dots': An exploration of organizational change in Irish opiate community treatment services', Journal of Substance Abuse Treatment, 108557 (10pp). doi: 10.1016/j.jsat.2021.108557en
dc.identifier.doi10.1016/j.jsat.2021.108557en
dc.identifier.endpage10en
dc.identifier.issn1873-6483
dc.identifier.issn0740-5472
dc.identifier.journaltitleJournal of Substance Abuse Treatmenten
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/11756
dc.language.isoenen
dc.publisherElsevier Inc.en
dc.rights© 2021, Elsevier Inc. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectSubstance misuseen
dc.subjectOrganizational changeen
dc.subjectImplementationen
dc.subjectDrug policyen
dc.title'They don't actually join the dots': An exploration of organizational change in Irish opiate community treatment servicesen
dc.typeArticle (peer-reviewed)en
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