scholarly journals Service user engagement and health service reconfiguration: a rapid evidence synthesis

2015 ◽  
Vol 3 (17) ◽  
pp. 1-106 ◽  
Author(s):  
Jane Dalton ◽  
Duncan Chambers ◽  
Melissa Harden ◽  
Andrew Street ◽  
Gillian Parker ◽  
...  
Keyword(s):  
Health Service ◽  
Case Studies ◽  
Systematic Reviews ◽  
Service User ◽  
Evidence Synthesis ◽  
Decision Makers ◽  
User Engagement ◽  
The Public ◽  
Service Change ◽  
Research Studies

BackgroundUK NHS organisations are required to consult patients and the public about proposals for major changes to services. The evidence base for current UK guidance is unclear.ObjectivesTo assess what is known about effective patient and public engagement in reconfiguration processes and to identify implications for further research.DesignRapid evidence synthesis.SettingHealth services affected by reconfiguration proposals in the UK (particularly the English) NHS and similar health systems.ParticipantsMembers of the public and their representatives, patients and patient groups.InterventionsAny intervention to encourage patients and the public and their representatives to be involved in discussions about proposals for major service change.Main outcome measuresAny measure of ‘successful’ engagement as reported by health service decision-makers, patients and public representatives. We were also interested in the outcome of controversial reconfiguration proposals.Data sourcesWe carried out separate searches for systematic reviews, primary research studies and grey literature. Database searches were limited to material published in English from 2000 to March 2014.Review methodsFinal decisions on study inclusion were made by two reviewers independently. We used EPPI-Reviewer 4 (Evidence for Policy and Practice Information and Co-ordinating Centre, University of London, London, UK) to record decisions and for data extraction and quality assessment. We carried out a narrative synthesis using multiple frameworks (including pre-specified research questions and current guidance). In synthesising the case studies, we selected a number of ‘exemplars’ based on quality of reporting and some evaluation of the process of engagement.ResultsEight systematic reviews, seven empirical research studies and 24 case studies (six exemplars) were included. Methods of engagement varied in nature and intensity, and generally involved a mixed methods approach. There was no evidence on the isolated impact of any particular engagement method or collection of methods. In general, engagement was most likely to be successful when the process started at an early stage, offered opportunities for genuine interaction and was led and supported by clinicians involved in delivering the relevant services. The impact of engagement was variably measured and demonstrated. Impact was more frequently defined in terms of process measures than success or failure of reconfiguration. Little was reported on the potential negative impact of service user engagement.ConclusionsPatients and the public could be engaged through a wide variety of methods. In selecting which methods to employ locally, decision-makers should take into account the nature of the local population and of the proposed service changes. Problems often arose because decision-makers paid insufficient attention to issues considered important by the public. NHS England guidance could be a helpful practical framework for future engagement activity.Future workClearly reported evaluations of interventions are needed including those that test the sustainability of methods of engagement and their impact over time. The NHS England guidance on planning and delivering service change may provide a foundation for the design of future research.FundingCommissioned by the National Institute for Health Research Health Service and Delivery Research (HSDR) programme from the University of York HSDR Evidence Synthesis Centre (project no. 13/05/11).

Service user engagement in health service reconfiguration: a rapid evidence synthesis

2015 ◽  
Vol 21 (3) ◽  
pp. 195-205 ◽  
Author(s):  
Jane Dalton ◽  
Duncan Chambers ◽  
Melissa Harden ◽  
Andrew Street ◽  
Gillian Parker ◽  
...  
Keyword(s):  
Health Service ◽  
Service User ◽  
Evidence Synthesis ◽  
User Engagement

DEMOCRACY AND THE ENVIRONMENT IN RUSSIA

2009 ◽  
Vol 11 (02) ◽  
pp. 161-173 ◽  
Author(s):  
NICOLE KOVALEV ◽  
JOHANN KÖPPEL ◽  
ALEXANDER DROZDOV ◽  
ECKHARDT DITTRICH
Keyword(s):  
Decision Making ◽  
Civil Society ◽  
Case Studies ◽  
Decision Makers ◽  
Democratic Deficit ◽  
Approval Process ◽  
The Public ◽  
Environmental Decision Making ◽  
Decision Making Processes ◽  
The Russian Federation

Since 1988, the Russian Federation has required that laws, plans, programs and all kind of projects undergo an environmental assessment. A mandatory component of the EIA in Russia is public participation. In this paper different case studies are used to find out to what extent public could influence environmental decision making processes from the early eighties until 2002. The cases selected include several where the public was passive or where it had limited activities, but also some where the participation was strong and projects were improved or stopped. As far as these case studies highlighted, the civil society in Russia can be described as an organized and sometimes strong factor in the approval process. The behaviour displayed by decision-makers, however, revealed at times a remarkable democratic deficit.

scholarly journals THE ETHICAL PROBLEMS OF ARCHITECTURAL RECONSTRUCTION – HUNGARIAN CASE STUDIES

2019 ◽  
pp. 1-8
Author(s):  
Ádám Arnóth
Keyword(s):  
Case Studies ◽  
Decision Makers ◽  
Ethical Problems ◽  
The Public ◽  
Hungarian Case ◽  
Architectural Reconstruction

Modernist practice, the modernist way of conservation and restoration, is against historicism, against reconstruction. The main rule is: deceit, forgery, falsification is forbidden. Despite this, some reconstructions were undertaken in Hungary, and recently the pressure for reconstructions has become even greater. Unfortunately, the categories of listed buildings, open-air museums and Disneyland are sometimes mixed up by the public and even by decision makers.

scholarly journals Synthesis for health services and policy: case studies in the scoping of reviews

2021 ◽  
Vol 9 (15) ◽  
pp. 1-84
Author(s):  
Rob Anderson ◽  
Andrew Booth ◽  
Alison Eastwood ◽  
Mark Rodgers ◽  
Liz Shaw ◽  
...  
Keyword(s):  
Health Services ◽  
Case Studies ◽  
Systematic Reviews ◽  
Information Exchange ◽  
Social Care ◽  
Evidence Synthesis ◽  
Synthesis Methods ◽  
Health And Social Care ◽  
Review Team ◽  
The University

Background For systematic reviews to be rigorous, deliverable and useful, they need a well-defined review question. Scoping for a review also requires the specification of clear inclusion criteria and planned synthesis methods. Guidance is lacking on how to develop these, especially in the context of undertaking rapid and responsive systematic reviews to inform health services and health policy. Objective This report describes and discusses the experiences of review scoping of three commissioned research centres that conducted evidence syntheses to inform health and social care organisation, delivery and policy in the UK, between 2017 and 2020. Data sources Sources included researcher recollection, project meeting minutes, e-mail correspondence with stakeholders and scoping searches, from allocation of a review topic through to review protocol agreement. Methods We produced eight descriptive case studies of selected reviews from the three teams. From case studies, we identified key issues that shape the processes of scoping and question formulation for evidence synthesis. The issues were then discussed and lessons drawn. Findings Across the eight diverse case studies, we identified 14 recurrent issues that were important in shaping the scoping processes and formulating a review’s questions. There were ‘consultative issues’ that related to securing input from review commissioners, policy customers, experts, patients and other stakeholders. These included managing and deciding priorities, reconciling different priorities/perspectives, achieving buy-in and engagement, educating the end-user about synthesis processes and products, and managing stakeholder expectations. There were ‘interface issues’ that related to the interaction between the review team and potential review users. These included identifying the niche/gap and optimising value, assuring and balancing rigour/reliability/relevance, and assuring the transferability/applicability of study evidence to specific policy/service user contexts. There were also ‘technical issues’ that were associated with the methods and conduct of the review. These were choosing the method(s) of synthesis, balancing fixed and fluid review questions/components/definitions, taking stock of what research already exists, mapping versus scoping versus reviewing, scoping/relevance as a continuous process and not just an initial stage, and calibrating general compared with specific and broad compared with deep coverage of topics. Limitations As a retrospective joint reflection by review teams on their experiences of scoping processes, this report is not based on prospectively collected research data. In addition, our evaluations were not externally validated by, for example, policy and service evidence users or patients and the public. Conclusions We have summarised our reflections on scoping from this programme of reviews as 14 common issues and 28 practical ‘lessons learned’. Effective scoping of rapid, responsive reviews extends beyond information exchange and technical procedures for specifying a ‘gap’ in the evidence. These considerations work alongside social processes, in particular the building of relationships and shared understanding between reviewers, research commissioners and potential review users that may be reflective of consultancy, negotiation and co-production models of research and information use. Funding This report has been based on work commissioned by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HSDR) programme as three university-based evidence synthesis centres to inform the organisation, delivery and commissioning of health and social care; at the University of Exeter (NIHR 16/47/22), the University of Sheffield (NIHR 16/47/17) and the University of York (NIHR 16/47/11). This report was commissioned by the NIHR HSDR programme as a review project (NIHR132708) within the NIHR HSDR programme. This project was funded by the NIHR HSDR programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 15. See the NIHR Journals Library website for further project information.

ACTION FOR SUSTAINABILITY: NORTHWEST ENGLAND'S TOOL FOR REGIONAL STRATEGIC SUSTAINABILITY APPRAISAL

2001 ◽  
Vol 03 (03) ◽  
pp. 413-430 ◽  
Author(s):  
PHILIP JAMES ◽  
STUART DONALDSON
Keyword(s):  
Sustainable Development ◽  
Case Studies ◽  
Regional Planning ◽  
Decision Makers ◽  
Regional Sustainability ◽  
Wide Audience ◽  
The Public ◽  
The Uk ◽  
Sustainability Framework ◽  
Sustainability Appraisal

A requirement of the UK Government's strategy for sustainable development, published in 1999, was that all English regions would produce a sustainability framework by the end of 2000. In the Northwest, the framework has been produced under the title Action for Sustainability. The framework is addressed at a wide audience of strategists and key decision-makers, including elected members and those in the public, private and voluntary sectors. One of the framework's main uses is to be a tool for regional sustainability appraisal. The work undertaken to produce the framework is described by one of those involved in the process. The published framework is evaluated using current concepts of sustainable development. The way in which the framework is already beginning to influence development in the Northwest is illustrated by two case studies involving appraisals of the Regional Planning Guidance and applications for funding from the Single Regeneration Budget.

The Cassel Hospital, London

1996 ◽  
Vol 30 (5) ◽  
pp. 672-680 ◽  
Author(s):  
Paul Coombe
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Case Studies ◽  
Complex Network ◽  
Nursing Care ◽  
Historical Development ◽  
Public Hospital ◽  
Structure And Function ◽  
The Public ◽  
And Function

This paper is an account of the principles and practices of treatment offered at the Cassel Hospital, London, with a particular focus on the Inpatient Families Unit. The Cassel Hospital is an internationally renowned therapeutic community, the operation of which is based on psychoanalytic principles and which has operated within the British National Health Service for nearly 50 years. An account of the historical development of the hospital is given as well as a description of its structure and function. The following three innovative structures are elaborated: a complex network within which patients can develop, Cassel-style nursing care, and nurse-therapist supervision. Theoretical underpinnings are outlined, which together with two case studies facilitate an appreciation of the capacity of the therapeutic network to foster the successful treatment of a range of severely disordered individuals and families. Such treatment may approach a level perhaps otherwise unattainable and which is widely applicable in the public hospital and clinic settings in Australia.

scholarly journals Institutional change of cloud ERP implementation in the public sector

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nizar Mohammad Alsharari
Keyword(s):  
Public Sector ◽  
Case Studies ◽  
Enterprise Resource Planning ◽  
Resource Planning ◽  
Transformation Process ◽  
Decision Makers ◽  
Erp Implementation ◽  
Content Type ◽  
Erp System ◽  
The Public

Purpose This study aims to explain the transformation process from using regular enterprise resource planning (ERP) system into implementing Cloud ERP system in the UAE public sector. Design/methodology/approach The study uses a qualitative case study and analyzes the primary evidences from in-depth interviews with the case organization’s personnel. It conducts a thematic analysis of the interviews’ findings. Furthermore, the study uses secondary and tertiary resources from published sources comprising the case organization’s website and previous studies. Findings The findings demonstrated that the transformation process to Cloud ERP could result in different practical benefits in an organization’s controlling system, cost reduction and profitability. Conversely, results revealed that the effectiveness of implementing cloud ERP is dependable on the provider’s professionalism; hence resulting in issues related to minimized organizational independence. In addition, the paper’s findings provide evidenced clarifications about the controversial misconceptions of Cloud ERP’s privacy issues. Research limitations/implications The paper is exposed to the regular case studies limitations, as the study is a qualitative research studying one case company. Thus, the study findings should be strengthened by future quantitative researches on more companies with implying more statistical analysis. Practical implications The paper has important implications for practitioners and decision-makers, as it presents significant and reality-based information about Cloud ERP implementation’s benefits and drawbacks. It thus enhances decision-makers’ ability to make an appropriate and suitable decision about adopting the Cloud ERP in the public sector. Originality/value As Cloud ERP is still emerging, this study is one of the very few case studies that discuss and present some experienced benefits and issues related to Cloud ERP implementation in UAE Government. This study also uses transformation theory to analyze the data.

scholarly journals Improving the Utility of Evidence Synthesis for Decision Makers in the Face of Insufficient Evidence

2021 ◽  
Author(s):  
M. Hassan Murad ◽  
Stephanie M. Chang ◽  
Celia Fiordalisi ◽  
Jennifer S. Lin ◽  
Timothy J. Wilt ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Indirect Evidence ◽  
Evidence Base ◽  
Healthcare Research ◽  
Decision Makers ◽  
Healthcare Decision ◽  
Insufficient Evidence ◽  
Convenience Sample

Background: Healthcare decision makers strive to operate on the best available evidence. The Agency for Healthcare Research and Quality Evidence-based Practice Center (EPC) Program aims to support healthcare decision makers by producing evidence reviews that rate the strength of evidence. However, the evidence base is often sparse or heterogeneous, or otherwise results in a high degree of uncertainty and insufficient evidence ratings. Objective: To identify and suggest strategies to make insufficient ratings in systematic reviews more actionable. Methods: A workgroup comprising EPC Program members convened throughout 2020. We conducted interative discussions considering information from three data sources: a literature review for relevant publications and frameworks, a review of a convenience sample of past systematic reviews conducted by the EPCs, and an audit of methods used in past EPC technical briefs. Results: Several themes emerged across the literature review, review of systematic reviews, and review of technical brief methods. In the purposive sample of 43 systematic reviews, the use of the term “insufficient” covered both instances of no evidence and instances of evidence being present but insufficient to estimate an effect. The results of the literature review and review of the EPC Program systematic reviews illustrated the importance of clearly stating the reasons for insufficient evidence. Results of both the literature review and review of systematic reviews highlighted the factors decision makers consider when making decisions when evidence of benefits or harms is insufficient, such as costs, values, preferences, and equity. We identified five strategies for supplementing systematic review findings when evidence on benefit or harms is expected to be or found to be insufficient, including: reconsidering eligible study designs, summarizing indirect evidence, summarizing contextual and implementation evidence, modelling, and incorporating unpublished health system data. Conclusion: Throughout early scoping, protocol development, review conduct, and review presentation, authors should consider five possible strategies to supplement potential insufficient findings of benefit or harms. When there is no evidence available for a specific outcome, reviewers should use a statement such as “no studies” instead of “insufficient.” The main reasons for insufficient evidence rating should be explicitly described.

Factors affecting the performance of public out-patient services

2019 ◽  
Vol 43 (3) ◽  
pp. 294
Author(s):  
Ugenthiri Naiker ◽  
Gerry FitzGerald ◽  
Joel M. Dulhunty ◽  
Michael Rosemann
Keyword(s):  
Qualitative Research ◽  
Health Service ◽  
Conceptual Framework ◽  
Case Studies ◽  
Waiting Times ◽  
Hospital Setting ◽  
Essential Element ◽  
System Reform ◽  
The Public ◽  
Sustainable Improvement

Objective The delivery of public out-patient services is an essential part of complex healthcare systems, but the contribution of public out-patient services is often ill defined and poorly evaluated. The aim of this study was to identify and better understand those factors that may affect the performance of out-patient services to provide health service managers, clinicians and executives with a conceptual framework for future decision-making processes. Methods The present qualitative research involved five exploratory case studies. These case studies were conducted across two specialties at hospitals in the Metro North Hospital and Health Service in Queensland. Data were obtained from 38 interviews and 15 focus groups, and were analysed to identify common themes. Further analysis helped identify the most significant factors and build a conceptual framework for understanding the relationships between those factors and their effect on performance. Results Across both specialties there were 10 factors (scheduling, performance, service framework, categorisation or prioritisation of patients, internal and external stakeholders, resources, service demand, culture, system challenges and medical stakeholders) identified that may affect the performance of out-patient services. These factors were condensed into five core domains: culture, stakeholders, resources, demand and system reform. Conclusion Strategies to address the five core domains identified may provide a framework for sustainable improvement in the delivery of out-patient services. What is known about the topic? The provision of specialist out-patient services is an essential element of health service delivery. Access to specialist services in the public sector is challenging because of the escalating demand associated with an increasing and aging demographic. The factors that may affect the delivery of out-patient services need to be addressed for long-term sustainable improvement. What does this paper add? This paper provides a conceptual framework grounded in rigorous qualitative data analysis for understanding the internal and external factors that affect waiting times for specialist out-patient services. The results of this qualitative research indicate that there are five core domains that may influence waiting times in the public out-patient setting. When these domains are addressed at the strategic, tactical and operational levels, they have the potential to provide significant improvement in the delivery of out-patient services. What are the implications for practitioners? This paper guides the attention of relevant stakeholders towards the five core domains identified (culture, stakeholders, resources, demand and system reform) that influence the performance of waiting times at the operational, tactical and strategic levels within the public hospital setting.

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