A commentary on “Consensus recommendations on balancing educational opportunities and service provision in surgical training: Association of surgeons in Training Delphi qualitative study” [Int. J. Surg. (2020) Epub ahead of Print]

Background American educational legislation suggests culturally competent speech and language services should be provided in a child's native language, but the number of multilingual speech-language pathologists (SLPs) is negligible. Consequently, many monolingual English-speaking practitioners are being tasked with providing services to these populations. This requires that SLPs are educated about cultural and linguistic diversity as well as the legislation that concerns service provision to non-English or limited English proficiency speakers. Purpose This qualitative study explored the experiences of monolingual, American, English-speaking SLPs and clinical fellows who have worked with immigrant and refugee families within a preschool context. It investigated what training SLPs received to serve this population and what knowledge these SLPs possessed with regard to federal legislation governing the provision of services to culturally and linguistically diverse (CLD) communities. Method Ten American clinicians with experience treating CLD children of refugee and immigrant families in the context of preschool service provision participated in the study. Semistructured interviews were utilized to better understand the type of training clinicians received prior to and during their service delivery for CLD populations. Additionally, questions were asked to explore the degree to which practitioners understood federal mandates for ethical and effective service provision. The data collected from these interviews were coded and analyzed using the principles of grounded theory. Findings The results of this study revealed that there was a general sense of unpreparedness when working with CLD clients. This lack of training also attributed to a deficiency of knowledge surrounding legislation governing service provision to CLD populations.

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Challenges to the Practice of Evidence-Based Medicine during Residents’ Surgical Training: A Qualitative Study Using Grounded Theory

Academic Medicine ◽

10.1097/00001888-200311000-00022 ◽

2003 ◽

Vol 78 (11) ◽

pp. 1183-1190 ◽

Cited By ~ 65

Author(s):

Mohit Bhandari ◽

Victor Montori ◽

P J. Devereaux ◽

Sonia Dosanjh ◽

Sheila Sprague ◽

...

Keyword(s):

Grounded Theory ◽

Qualitative Study ◽

Surgical Training ◽

Evidence Based Medicine ◽

Evidence Based ◽

Based Medicine

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Facilitating integrated delivery of services across organisational boundaries: Essential enablers to integration

British Journal of Occupational Therapy ◽

10.1177/0308022616688019 ◽

2017 ◽

Vol 80 (5) ◽

pp. 302-309

Author(s):

Stephanie Best

Keyword(s):

United Kingdom ◽

Qualitative Study ◽

Service Provision ◽

Social Care ◽

Occupational Therapists ◽

Leadership Communication ◽

The United Kingdom ◽

Health And Social Care ◽

Integration Of Services ◽

Integrated Delivery

Introduction Integrating services is a key tenet to developing services across the United Kingdom. While many aspects of integration have been explored, how to facilitate integration of services remains unclear. Method An exploratory qualitative study was undertaken in 2015 to explore occupational therapists’ perceptions on integrating service provision across health and social care organisational boundaries. The views of practitioners who had experienced integration were sought on a range of aspects of integrating services. This paper focuses on the facilitators for delivering integration and the essential enablers are identified. Findings Numerous factors were noted to facilitate integration and three essential enablers were highlighted. Leadership, communication and joint education were recognised as playing a central role in integrating services across organisational boundaries; without these three essential enablers, integration is liable to fail. Conclusion Integration is a process rather than an event; continued emphasis will be required on leadership, communication and joint education to progress integration achievements made to date.

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Community Perception Regarding Maternity Service Provision in Public Health Institutions in 2018 and 2019: A Qualitative Study

International Journal of Women s Health ◽

10.2147/ijwh.s250044 ◽

2020 ◽

Vol Volume 12 ◽

pp. 773-783

Author(s):

Meklit Girma ◽

Carmen Robles ◽

Mekdes Asrat ◽

Hadgay Hagos ◽

Measho G/slassie ◽

...

Keyword(s):

Public Health ◽

Qualitative Study ◽

Service Provision ◽

Maternity Service ◽

Community Perception ◽

Public Health Institutions ◽

Health Institutions

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Recognition and response to life-threatening situations among women with perinatal mental illness: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2018-025872 ◽

2019 ◽

Vol 9 (3) ◽

pp. e025872 ◽

Cited By ~ 2

Author(s):

Abigail Easter ◽

Louise Michelle Howard ◽

Jane Sandall

Keyword(s):

Mental Health ◽

Mental Illness ◽

Qualitative Study ◽

Service Provision ◽

Healthcare Professionals ◽

Perinatal Period ◽

Professional Culture ◽

Near Miss ◽

Prescribe Medication ◽

Life Threatening

ObjectiveMental illness has persistently been found to be a leading cause of death during pregnancy and the year after birth (the perinatal period). This study aims to explore barriers to detection, response and escalation of mental health-related life-threatening near miss events among women with perinatal mental illness.DesignQualitative study.ParticipantsHealthcare professionals (HCP) working in psychiatry, maternity and primary care (n=15) across community and hospital maternity and perinatal services within the UK.MethodsIn-depth semistructured interviews were conducted with a range of healthcare professionals working with women during the perinatal period. An iterative process of inductive and deductive thematic analysis, informed by systems theories of healthcare and the Three Delays model, was employed to analyse the data.ResultsThree overarching themes were identified: recognition of severity, communication of risk and service provision and access to treatment. Differing perspectives of mental illness severity influenced how life-threatening situations among women with perinatal mental illness were described, recognised and communicated between teams. Under-resourced mental health service provision, particularly within emergency and specialist perinatal mental health services, unclear thresholds for escalating care and poor infrastructure for sharing information all contributed to delays in a timely response to crisis situations. Reluctance to prescribe medication or admit women to psychiatric hospital, stigma and missed appointments created further delays.ConclusionsResponse and escalation of care for life threatening near miss events among women with mental illness is strongly influenced by professional culture and understandings of mental illness embedded within different healthcare disciplines. Focusing on how differences in organisational and professional culture contribute to the recognition of severe mental illness and interdisciplinary communication may help facilitate clearer co-ordination between teams.

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