scholarly journals Sustaining Transformation by Evidence Mobilisation (STEM)Club in the North East of England

2020 ◽  
Vol 43 (127) ◽  
Author(s):  
Shona Haining ◽  
Joanne Naughton ◽  
Mark Lambert
Keyword(s):  
Cultural Change ◽  
Decision Makers ◽  
Local Health ◽  
Healthcare Decision ◽  
Care Providers ◽  
North East ◽  
The North ◽  
Healthcare Decision Making ◽  
Health And Social Care ◽  
Personal Connections

In 2016 Sustainability and Transformation Partnerships were formed across the whole of England, bringing together care providers with commissioners and local authorities to plan local delivery of health and social care. Within this context, a small group of leaders working in broadly “evidence roles” within healthcare in the North East and North Cumbria (NENC), began discussing how those with the skills to support evidence-based practice might be able to better support healthcare decision-making at the system-wide level. The group focussed on the need for cultural change and making personal connections. Rather than provide “evidence products”, our aim was to build relationships between policy and decision makers and those in evidence roles. We agreed that we needed to: Develop a network of local people working in evidence roles in the healthcare field (STEMClub). Link local health library and knowledge services staff (LKS) into the work streams of the Sustainability and Transformation Partnership (now the Integrated Care System). Raise awareness and gain support among senior stakeholders in the ICS, NHS England (NHSE), Public Health England (PHE) and Health Education England (HEE) of the aims of STEMClub. This case study describes our progress to date in developing the network and supporting the work of healthcare decision-makers and policy makers in the North East and North Cumbria.

To dictate or collaborate? A phenomenological exploration of physiotherapists’ leadership styles

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000403
Author(s):  
Victoria Smith ◽  
Claire Maxwell ◽  
Lisa Robinson
Keyword(s):  
Leadership Styles ◽  
Well Being ◽  
Leadership Role ◽  
Future Research ◽  
Semistructured Interview ◽  
Team Leaders ◽  
Framework Analysis ◽  
North East ◽  
The North ◽  
Health And Social Care

ObjectivesSelection of effective leadership styles within healthcare is linked to high quality, safe care for patients. Within the literature attention has been given to medical and nursing professions, failing to acknowledge the contribution made by physiotherapy leaders. This study aims to consider the leadership styles used by physiotherapists in a designated leadership role, specifically exploring the barriers they face and the strategies employed to overcome current leadership dilemmas.DesignA qualitative, phenomenological design was used. Consent was obtained from each participant for one semistructured interview which was audio recorded and transcribed verbatim. Framework analysis was used to analyse the data.SettingA large National Health Service Foundation Trust within the North East of England.ParticipantsA purposive sample of ten physiotherapy team leaders.ResultsThe theoretical leadership framework that emerged demonstrated the daily tensions experienced by physiotherapy team leaders in regard to being a transactional or transformational leader. Within this, three superordinate themes exist: the individual, the team and the organisation and beyond. Each theme contained barriers and enablers which related to transactional and transformational leadership styles, respectively.ConclusionsThe framework identified gives insight into a group of clinical leaders not yet explored and provides a foundation for the development of leadership behaviours throughout physiotherapy. These clinicians should be supported by senior leaders to develop more transformational styles which have the potential to impact on staff well-being and patient care. Future research should compare these findings with studies involving larger sample sizes that span the health and social care system.

scholarly journals Sharing a vision. Do participants in integrated care programmes have the same goals and objectives?

2019 ◽  
Vol 33 (3) ◽  
pp. 122-129
Author(s):  
Axel Kaehne
Keyword(s):  
Integrated Care ◽  
Social Care ◽  
Care Delivery ◽  
Shared Vision ◽  
Window Of Opportunity ◽  
Care Providers ◽  
Care Services ◽  
The North ◽  
Health And Social Care ◽  
Goals And Objectives

Integrating health and social care services remains one of the most difficult undertakings in the field of care delivery. One of the key requirements for success in integration programmes is a shared vision amongst care providers. Shared visions may contain views as to what the new services should look like, how it should operate and what it should be able to achieve. The paper reports findings of an evaluation of a service integration programme in the North of England. It confirms that a programme consensus on issues such as aims and objectives and programme logics is seen by participants as a key to success. Yet, the study also found that there is a specific window of opportunity in integration programmes when participating organisations start on relatively high levels of commitment and enthusiasm which tend to tail off relatively quickly. The paper closes with a discussion about the implications of the findings for programme designers and service planners.

When the decision is what to decide: Using evidence inventory reports to focus health technology assessments

2011 ◽  
Vol 27 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Matthew D. Mitchell ◽  
Kendal Williams ◽  
Gretchen Kuntz ◽  
Craig A. Umscheid
Keyword(s):  
Systematic Reviews ◽  
Randomized Trials ◽  
Clinical Evidence ◽  
New Technologies ◽  
Health Technology ◽  
Decision Makers ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Literature Searches ◽  
Primary Literature

Objectives: Health systems frequently make decisions regarding acquisition and use of new technologies. It is desirable to base these decisions on clinical evidence, but often these technologies are used for multiple indications and evidence of effectiveness for one indication does not prove effectiveness for all. Here, we describe two examples of evidence inventory reports that were performed for the purposes of identifying how much and what type of published clinical evidence was available for a given technology, and the contexts in which those technologies were studied.Methods: The evidence inventory reports included literature searches for systematic reviews and health technology assessment (HTA) reports, and systematic searches of the primary literature intended to count and categorize published clinical studies. The reports did not include analysis of the primary literature.Results: The inventory reports were completed in 3 to 4 days each and were approximately ten pages in length, including references. Reports included tables listing the number of reported studies by specific indication for use, and whether or not there were randomized trials. Reports also summarized findings of existing systematic reviews and HTA reports, when available. Committees used the inventory reports to decide for which indications they wanted a full HTA report.Conclusions: Evidence inventory reports are a form of rapid HTA that can give decision makers a timely understanding of the available evidence upon which they can base a decision. They can help HTA providers focus subsequent reports on topics that will have the most influence on healthcare decision making.

scholarly journals A scabies outbreak in the North East Region of Ghana: The necessity for prompt intervention

2020 ◽  
Vol 14 (12) ◽  
pp. e0008902
Author(s):  
Yaw Ampem Amoako ◽  
Richard Odame Phillips ◽  
Joshua Arthur ◽  
Mark Ayaaba Abugri ◽  
Emmanuel Akowuah ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
The Body ◽  
Northern Ghana ◽  
Individual Treatment ◽  
Local Health ◽  
Cross Sectional ◽  
North East ◽  
The North ◽  
Resource Limited ◽  
International Alliance

Background There is a dearth of data on scabies from Ghana. In September 2019, local health authorities in the East Mamprusi district of northern Ghana received reports of scabies from many parts of the district. Due to on-going reports of more cases, an assessment team visited the communities to assess the effect of the earlier individual treatment on the outbreak. The assessment team furthermore aimed to contribute to the data on scabies burden in Ghana and to demonstrate the use of the International Alliance for the Control of Scabies (IACS) diagnostic tool in a field survey in a resource limited setting. Methodology/Principal findings This was a cross sectional study. Demographic information and medical history was collected on all participants using a REDCap questionnaire. A standardised skin examination of exposed regions of the body was performed on all participants. Scabies was diagnosed based on the criteria of the International Alliance for the Control of Scabies (IACS). Participants were mostly female (61.5%) and had a median age of 18.8 years (IQR 13–25). Two hundred out of 283 (71%) of participants had scabies with most (47%) presenting with moderate disease. Impetigo was found in 22% of participants with scabies and 10.8% of those without scabies [RR 2.27 (95% CI 1.21–4.27)]. 119 participants who received scabies treatment in the past months still had clinical evidence of the disease. 97% of participants reported a recent scabies contact. Scabies was commoner in participants ≤16 years compared to those >16 years [RR 3.06 (95% CI 1.73–5.45)]. Conclusion/Significance The prevalence of scabies was extremely high. The lack of a systematic approach to scabies treatment led to recurrence and ongoing community spread. The IACS criteria was useful in this outbreak assessment in Ghana. Alternative strategies such as Mass drug administration may be required to contain outbreaks early in such settings.

Dementia, Healthcare Decision Making, and Disability Law

2019 ◽  
Vol 47 (S4) ◽  
pp. 25-33 ◽  
Author(s):  
Megan S. Wright
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Moderate Dementia ◽  
Disability Law ◽  
Surrogate Decision Makers ◽  
Surrogate Decision ◽  
Alternative Decision ◽  
Made In

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions.

PATIENT-CENTERED DECISION MAKING: LESSONS FROM MULTI-CRITERIA DECISION ANALYSIS FOR QUANTIFYING PATIENT PREFERENCES

2017 ◽  
Vol 34 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Kevin Marsh ◽  
J. Jaime Caro ◽  
Erica Zaiser ◽  
James Heywood ◽  
Alaa Hamed
Keyword(s):  
Decision Making ◽  
Decision Analysis ◽  
Patient Preferences ◽  
Good Practice ◽  
Decision Makers ◽  
Healthcare Decision ◽  
Patient Centered ◽  
Multi Criteria Decision Analysis ◽  
Healthcare Decision Making ◽  
Decision Making Processes

Objectives: Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered.Methods: This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences.Results: The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported.Conclusions: The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.

scholarly journals Burnout and its Influencing Factors among Primary Health Care Providers in the North East of Iran

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0167648 ◽  
Author(s):  
Mohammad Amiri ◽  
Ahmad Khosravi ◽  
Ahmad Reza Eghtesadi ◽  
Zakieh Sadeghi ◽  
Ghasem Abedi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Influencing Factors ◽  
Health Care Providers ◽  
Care Providers ◽  
North East ◽  
The North ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
East Of Iran

scholarly journals Housing voices: using theatre and film to engage people in later life housing and health conversations

2019 ◽  
Vol 22 (4) ◽  
pp. 181-192
Author(s):  
Cathy Bailey ◽  
Natalie Forster ◽  
Barbara Douglas ◽  
Claire Webster Saaremets ◽  
Esther Salamon
Keyword(s):  
Older People ◽  
Social Care ◽  
Later Life ◽  
Select Committee ◽  
Content Type ◽  
North East ◽  
The North ◽  
Primary Responsibility ◽  
Health And Social Care ◽  
Types Of Information

Purpose Quality, accessible and appropriate housing is key to older people’s ability to live independently. The purpose of this paper is to understand older people’s housing aspirations and whether these are currently being met. Evidence suggests one in five households occupied by older people in England does not meet the standard of a decent home. The Building Research Establishment has calculated that poor housing costs the English National Health Service £1,4bn annually (Roys et al., 2016). Design/methodology/approach This paper reports on the findings of a participatory theatre approach to engaging with those not often heard from – notably, those ageing without children and older people with primary responsibility for ageing relatives – about planning for housing decisions in later life. The project was led by an older people’s forum, Elders Council, with Skimstone Arts organisation and Northumbria University, in the north east of England. Findings Findings suggest there is an urgent need to listen to and engage with people about their later life housing aspirations. There is also a need to use this evidence to inform housing, health and social care policy makers, practitioners, service commissioners and providers and product and service designers, to encourage older people to become informed and plan ahead. Research limitations/implications Use of a participatory theatre approach facilitated people to explore their own decision making and identify the types of information and support they need to make critical decisions about their housing in later life. Such insights can generate evidence for future housing, social care and health needs. Findings endorse the recent Communities and Local Government (2018) Select Committee Inquiry and report on Housing for Older People and the need for a national strategy for older people’s housing. Originality/value Although this call is evidenced through an English national case study, from within the context of global population ageing, it has international relevance.

Multi-Criteria Decision Analysis (MCDA) in Healthcare Decision-Making

2019 ◽  
Author(s):  
Paul Hansen ◽  
Nancy Devlin
Keyword(s):  
Decision Making ◽  
Decision Analysis ◽  
Decision Makers ◽  
Healthcare Decision ◽  
Main Subject ◽  
Health Technologies ◽  
Multi Criteria Decision Analysis ◽  
Healthcare Decision Making ◽  
Repeated Applications ◽  
Additive Equation

Multi-criteria decision analysis (MCDA) is increasingly used to support healthcare decision-making. MCDA involves decision makers evaluating the alternatives under consideration based on the explicit weighting of criteria relevant to the overarching decision—in order to, depending on the application, rank (or prioritize) or choose between the alternatives. A prominent example of MCDA applied to healthcare decision-making that has received a lot of attention in recent years and is the main subject of this article is choosing which health “technologies” (i.e., drugs, devices, procedures, etc.) to fund—a process known as health technology assessment (HTA). Other applications include prioritizing patients for surgery, prioritizing diseases for R&D, and decision-making about licensing treatments. Most applications are based on weighted-sum models. Such models involve explicitly weighting the criteria and rating the alternatives on the criteria, with each alternative’s “performance” on the criteria aggregated using a linear (i.e., additive) equation to produce the alternative’s “total score,” by which the alternatives are ranked. The steps involved in a MCDA process are explained, including an overview of methods for scoring alternatives on the criteria and weighting the criteria. The steps are: structuring the decision problem being addressed, specifying criteria, measuring alternatives’ performance, scoring alternatives on the criteria and weighting the criteria, applying the scores and weights to rank the alternatives, and presenting the MCDA results, including sensitivity analysis, to decision makers to support their decision-making. Arguments recently advanced against using MCDA for HTA and counterarguments are also considered. Finally, five questions associated with how MCDA for HTA is operationalized are discussed: Whose preferences are relevant for MCDA? Should criteria and weights be decision-specific or identical for repeated applications? How should cost or cost-effectiveness be included in MCDA? How can the opportunity cost of decisions be captured in MCDA? How can uncertainty be incorporated into MCDA?

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