Multidisciplinary Care Planning using a Developmental Work Research Approach

  • Julian Pugh

Student thesis: Doctoral ThesisDoctor of Health (DHealth)


This research addressed change management and learning in a multidisciplinary addictions chronic care environment in order to prepare for shared care planning within an electronic health record. It used a Developmental Work Research approach and was able to use insights from Bernstein’s theory of knowledge structures, Bakhtin’s work on social language and a Critical Realism approach to address weaknesses in the base Activity Theory approach. In these ways problems concerning fragmented, demarcated silo working across clinical and non-clinical addictions services could be examined. The objective of the study was to identify tensions and contradictions in working environments and to engage multidisciplinary workers in a collaborative change laboratory environment via the use of co-configuration and expansive learning. The working group examined past and current practice and were able to formulate new forms of practice, based on the use of a shared care plan tool, to address identified problems and national policy aims. It was able to use the aforementioned theoretical insights to illuminate the multiple utility of the shared care plan tool as a pedagogic device. This enabled the production of new practice possibilities, paradigms and planning to be undertaken, and the consideration of these within the context of ‘real time’ multidisciplinary activity within a forthcoming national IT system. This research has explored, identified and formulated new practice to improve multidisciplinary working between clinical and non-clinical workers across diverse sectors. This will have significant health and cost benefit gains for clients, workers and organisations as well as translating policy aims into effective practice. The next stage will be to manage the roll-out of the forthcoming IT system using the theoretical and methodological developments crafted in this research endeavour.
Date of Award31 Dec 2012
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorHarry Daniels (Supervisor)


  • care planning
  • drug treatment
  • multidisciplinary
  • Developmental work research

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