Adapting stepped care: Changes to service delivery format in the context of high demand.

2021 ◽  
Author(s):  
Russell J. Bailey ◽  
David M. Erekson ◽  
Kara Cattani ◽  
Dallas Jensen ◽  
David M. Simpson ◽  
...  
Keyword(s):  
Service Delivery ◽  
Stepped Care ◽  
High Demand ◽  
Delivery Format

scholarly journals Scoping review of stepped care interventions for mental health and substance use service delivery to youth and young adults

2021 ◽  
Author(s):  
Mai Berger ◽  
Saranee Fernando ◽  
AnnMarie Churchill ◽  
Peter Cornish ◽  
Joanna Henderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Young Adults ◽  
Service Delivery ◽  
Scoping Review ◽  
Stepped Care ◽  
Youth And Young Adults

Developing Services for Patients with Depression or Anxiety in the Context of Long-term Physical Health Conditions and Medically Unexplained Symptoms: Evaluation of an IAPT Pathfinder Site

2016 ◽  
Vol 44 (5) ◽  
pp. 553-567 ◽  
Author(s):  
Stephen Kellett ◽  
Kimberley Webb ◽  
Nic Wilkinson ◽  
Paul Bliss ◽  
Tom Ayers ◽  
...  
Keyword(s):  
Service Delivery ◽  
Care Service ◽  
Medically Unexplained Symptoms ◽  
Psychological Needs ◽  
Stepped Care ◽  
Health Conditions ◽  
Potential Contribution ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Background: There are national policy drivers for mental health services to demonstrate that they are effectively meeting the psychological needs of people with long-term health conditions/medically unexplained symptoms (LTC/MUS). Aims: To evaluate the implementation of a stepped-care service delivery model within an Improving Access to Psychological Therapies (IAPT) service for patients with depression or anxiety in the context of their LTC/MUS. Method: A stepped-care model was designed and implemented. Clinical and organizational impacts were evaluated via analyses of LTC/MUS patient profiles, throughputs and outcomes. Results: The IAPT service treated N = 844 LTC and N = 172 MUS patients, with the majority (81.81%) receiving a low intensity intervention. Dropout across the service steps was low. There were few differences between LTC and MUS outcome rates regardless of step of service, but outcomes were suppressed when compared to generic IAPT patients. Conclusions: The potential contribution of IAPT stepped-care service delivery models in meeting the psychological needs of LTC/MUS patients is debated.

Are wait lists inevitable in subacute ambulatory and community health services? A qualitative analysis

2018 ◽  
Vol 42 (1) ◽  
pp. 93 ◽  
Author(s):  
Katherine E. Harding ◽  
Nicole Robertson ◽  
David A. Snowdon ◽  
Jennifer J. Watts ◽  
Leila Karimi ◽  
...  
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Community Health ◽  
Human Resource ◽  
Service Providers ◽  
Health Service Delivery ◽  
Community Health Services ◽  
Wait Times ◽  
High Demand ◽  
Modifiable Factors

Objectives Wait lists are common in ambulatory and community-based services. The aim of the present study was to explore managers’ perceptions of factors that contribute to wait times. Methods A qualitative study was conducted using semi-structured interviews with managers and team leaders of ambulatory and community health services within a large health network. Interviews were transcribed and coded, and the codes were then grouped into themes and subthemes. Results Representatives from 26 services participated in the project. Four major themes were identified. Three themes related to reasons and factors contributing to increased wait time for services (inefficient intake and scheduling processes; service disruptions due to human resource issues; and high service demand). A fourth theme related to staff attitudes towards wait times and acceptance and acknowledgement of wait lists. Conclusions Service providers perceive high demand to be a key driver of wait times, but a range of other factors also contributes and may represent opportunities for improving access to care. These other factors include improving process efficiencies, greater consistency of service delivery through more efficient management of human resources and shifting to more consumer-centred approaches in measuring wait times in order to drive improvements in patient flow. What is known about the topic? Wait times are common in out-patient and ambulatory services. These services experience high demand, which is likely to continue to grow as health service delivery shifts from hospital to community settings. What does this paper add? Although demand is an important driver of wait times, there are other modifiable factors that also contribute, including process inefficiencies and service disruption related to human resource issues. An underlying staff attitude of acceptance of wait times appears to be an additional barrier to improving access. What are the implications for practitioners? The findings of the present study suggest that there are opportunities for improving access to ambulatory and community health services through more efficient use of existing resources. However, a more consumer-focused approach regarding acceptability of wait times is needed to help drive change.

A Classroom Sign Communication Program for the Severely Handicapped

1981 ◽  
Vol 12 (4) ◽  
pp. 233-239
Author(s):  
Linda Goodman ◽  
Robin Kroc
Keyword(s):  
Service Delivery ◽  
Speech Language Pathologist ◽  
Communication Program ◽  
Severely Handicapped

This article describes a strategy used to teach sign communication to severely handicapped students in the classroom. It recommends that the speech-language pathologist adopt a consultant role in service delivery.

Dimensions of Multiskilling

1999 ◽  
Vol 30 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Carole E. Johnson
Keyword(s):  
Hearing Loss ◽  
Service Delivery ◽  
Monitoring Program ◽  
School Age Children ◽  
School Age ◽  
Support Personnel ◽  
Educational Personnel ◽  
Educational Audiology ◽  
Children With Hearing Loss ◽  
Improve Service Delivery

Educational audiologists often must delegate certain tasks to other educational personnel who function as support personnel and need training in order to perform assigned tasks. Support personnel are people who, after appropriate training, perform tasks that are prescribed, directed, and supervised by a professional such as a certified and licensed audiologist. The training of support personnel to perform tasks that are typically performed by those in other disciplines is calledmultiskilling. This article discusses multiskilling and the use of support personnel in educational audiology in reference to the following principles: guidelines, models of multiskilling, components of successful multiskilling, and "dos and don’ts" for multiskilling. These principles are illustrated through the use of multiskilling in the establishment of a hearing aid monitoring program. Successful multiskilling and the use of support personnel by educational audiologists can improve service delivery to school-age children with hearing loss.

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