scholarly journals Assessments of stress of conscience, burnout and social support amongst care providers in home care and residential care for older people

2021 ◽  
Author(s):  
Johan Åhlin ◽  
Eva Ericson‐Lidman ◽  
Gunilla Strandberg
Keyword(s):  
Social Support ◽  
Home Care ◽  
Older People ◽  
Residential Care ◽  
Care Providers ◽  
Stress Of Conscience ◽  
Care For Older People

scholarly journals The challenges of commissioning home care for older people in England: commissioners’ perspectives

2020 ◽  
pp. 1-20 ◽  
Author(s):  
Karen Davies ◽  
Elizabeth Dalgarno ◽  
Susan Davies ◽  
Amy Roberts ◽  
Jane Hughes ◽  
...  
Keyword(s):  
Home Care ◽  
Older People ◽  
Home Care Services ◽  
Market Model ◽  
Local Context ◽  
Care Providers ◽  
Local Authorities ◽  
Telephone Interviews ◽  
Care Services ◽  
Care For Older People

Abstract Home care for older people in England is commissioned through local authorities working predominantly with independent providers of care. Commissioners operate in a market model, planning and procuring home care services for local populations. Their role involves ‘managing’ and ‘shaping’ the market to ensure an adequate supply of care providers. Another imperative, emerging from the principles of personalisation, is the drive to achieve user outcomes rather than ‘time and task’ objectives. Little formal research has investigated the way commissioners reconcile these different requirements and organise commissioning. This study investigated commissioning approaches using qualitative telephone interviews with ten commissioners from different local authorities in England. The characteristics of commissioning were analysed thematically. Findings indicated (a) commissioning involved complex systems and processes, uniquely shaped for the local context, but frequently changed, suggesting a constant need for reframing commissioning arrangements; (b) partnerships with providers were mainly transactional, with occasional examples of collaborative models, that were considered to facilitate flexible services more appropriate for commissioning for personalised outcomes; and (c) only a small number of commissioners had attempted to reconcile the competing and incompatible goals of tightly prescribed contracting and working collaboratively with providers. A better understanding of flexible contracting arrangements and the hallmarks of a trusting collaboration is required to move beyond the procedural elements of contracting and commissioning.

Using a developed participatory action research process in practice to help care providers deal with troubled conscience in residential care of older people

2016 ◽  
Vol 16 (2) ◽  
pp. 190-206 ◽  
Author(s):  
Eva Ericson-Lidman ◽  
Gunilla Strandberg
Keyword(s):  
Quality Of Care ◽  
Action Research ◽  
Older People ◽  
Participatory Action Research ◽  
Residential Care ◽  
Research Process ◽  
Care Providers ◽  
Participatory Action ◽  
Care For Older People

Stress of conscience seriously influence the quality of care and the wellbeing of the care providers in care for older people. It is therefore of great importance to take measures to address, and relieve but preferably prevent stress related to troubled conscience. In our participatory action research studies, we have used troubled conscience as a driving force to relieve care providers’ burden and to increase quality of care. The aim with this paper is to present our experiences of using a further developed participatory action research process in practice to deal with care providers' troubled conscience in residential care for older people. The contribution to participatory action research practice in our studies is a support to the participatory action research process through using a modified model of problem processing, an approach which we found fruitful. In the paper, we describe our experiences and discuss them in relation to relevant literature and theory. Our experiences are that in participatory action research it is crucial to build a trusting relationship and striving to create a fruitful dialogue between the researchers and the participants. In our studies, we found that participatory action research is an easy approach to adapt as a problem-solving process in clinical practice and in nursing research.

Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People

2021 ◽  
pp. 104973232110038
Author(s):  
Cecilie Fromholt Olsen ◽  
Astrid Bergland ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Anne Gudrun Langaas
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Transitional Care ◽  
Care Pathway ◽  
Patient Flow ◽  
Care Pathways ◽  
Care Providers ◽  
Patient Centered ◽  
Care For Older People

Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.

scholarly journals Change agents’ experiences of implementing a new organizational culture in residential care for older people: A qualitative study

2021 ◽  
pp. 205715852199599
Author(s):  
Eva Ericson-Lidman ◽  
Gunilla Strandberg
Keyword(s):  
Content Analysis ◽  
Older People ◽  
Residential Care ◽  
Change Process ◽  
Change Agent ◽  
Change Agents ◽  
Culture Transformation ◽  
Conflicting Demands ◽  
Great Responsibility ◽  
Care For Older People

Culture change in organizations may affect employees and change agents are often a forgotten resource; their perspective is often overlooked in research. The aim of the study was to illuminate experiences of being a change agent in order to improve residential care of older people. Interviews were performed with 15 change agents who participated in a large culture transformation in residential care for older people. The study followed COREQ guidelines and content analysis was used to interpret the text. The analysis revealed that the change agents felt chosen when they accepted the challenge to become a change agent, but they also felt that transferring the message to co-workers was demanding. Conflicting demands about measuring care and aggravating circumstances to implement change were described. The results indicate that change agents benefit from preparation for the role itself as they have a great responsibility on their shoulders. In making the process more successful, all co-workers should be involved in the change process from the beginning.

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