scholarly journals Modelling length of stay and patient flows: methodological case studies from the UK neonatal care services

2014 ◽  
Vol 65 (4) ◽  
pp. 532-545 ◽  
Author(s):  
Eren Demir ◽  
Reda Lebcir ◽  
Shola Adeyemi
Keyword(s):  
Length Of Stay ◽  
Case Studies ◽  
Neonatal Care ◽  
Care Services ◽  
The Uk

Organizing across borders

2005 ◽  
Vol 48 (5) ◽  
pp. 643-653 ◽  
Author(s):  
Chris Holden
Keyword(s):  
Case Studies ◽  
Long Term Care ◽  
Care Work ◽  
Term Care ◽  
User Choice ◽  
Care Services ◽  
Organization Of Care ◽  
The Uk

Internationalized providers of care services face competing incentives and pressures relating to profit and quality. Case studies of corporate providers of long-term care in the UK demonstrate that their mode of organization has important implications for both user choice and the organization of care work. French Les fournisseurs internationalisés sont soumis à des pressions et à des incitatifs concurrentiels pour produire des profits et de la qualité. Des études de cas portant sur les fournisseurs institutionnels d'assistance à long terme au Royaume-Uni révèlent que leur mode d'organisation a d'importantes répercussions tant au niveau du choix des bénéficiaires qu'au niveau de l'organisation du travail d'assistance. Spanish Los prestadores transnacionales de servicios se enfrentan con incentivos que compiten entre sí y con la tensión entre calidad y ganancia. Se estudian unoscasos de prestadores de cuidados de larga duración en el Reino Unido. Estos demuestran que el modo de organización tiene consecuencias importantes, tanto para opciones abiertas al usuario como para la organización de los cuidados.

scholarly journals Adapting primary care for new migrants: a formative assessment

BJGP Open ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. bjgpopen17X100701 ◽  
Author(s):  
Elizabeth Such ◽  
Elizabeth Walton ◽  
Brigitte Delaney ◽  
Janet Harris ◽  
Sarah Salway
Keyword(s):  
Primary Care ◽  
Case Studies ◽  
Online Survey ◽  
Resource Constraints ◽  
Sample Survey ◽  
Service Development ◽  
Care Provision ◽  
Care Services ◽  
Primary Care Services ◽  
The Uk

BackgroundImmigration rates have increased recently in the UK. Migrant patients may have particular needs that are inadequately met by existing primary care provision. In the absence of national guidance, local adaptations are emerging in response to these new demands.AimTo formatively assess the primary care services offered to new migrants and the ways in which practitioners and practices are adapting to meet need.Design & settingOnline survey and case studies of current practice across primary care in the UK. Case studies were selected from mainstream and specialist general practice as well as primary care provision in the third sector.MethodNon-probability sample survey of primary care practitioners (n = 70) with descriptive statistical analysis. Qualitative case studies (n = 8) selected purposively; in-depth exploration of organisational and practitioner adaptations to services. Analysis is structured around the principles of equitable care.ResultsSurvey results indicated that practitioners focused on working with communities and external agencies and adapting processes of, for example, screening, vaccination, and health checks. Lack of funding was cited most frequently as a barrier to service development (n = 51; 73%). Case studies highlighted the prominence partnership working and of an organisational and practitioner focus on equitable care. Adaptations centred on addressing wider social determinants, trauma, and violence, and additional individual needs; and on delivering culturally-competent care.ConclusionDespite significant resource constraints, some primary care services are adapting to the needs of new migrants. Many adapted approaches can be characterised as equity-oriented.

Ethnic Differences in Self-Poisoning Across South London

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 268-272
Author(s):  
Sean Cross ◽  
Dinesh Bhugra ◽  
Paul I. Dargan ◽  
David M. Wood ◽  
Shaun L. Greene ◽  
...  
Keyword(s):  
Black Women ◽  
Data Collection ◽  
White Women ◽  
Population Based ◽  
Care Services ◽  
Self Harm ◽  
Managing Risk ◽  
The Uk ◽  
Incident Cases ◽  
Minority Ethnic

Background: Self-poisoning (overdose) is the commonest form of self-harm cases presenting to acute secondary care services in the UK, where there has been limited investigation of self-harm in black and minority ethnic communities. London has the UK’s most ethnically diverse areas but presents challenges in resident-based data collection due to the large number of hospitals. Aims: To investigate the rates and characteristics of self-poisoning presentations in two central London boroughs. Method: All incident cases of self-poisoning presentations of residents of Lambeth and Southwark were identified over a 12-month period through comprehensive acute and mental health trust data collection systems at multiple hospitals. Analysis was done using STATA 12.1. Results: A rate of 121.4/100,000 was recorded across a population of more than half a million residents. Women exceeded men in all measured ethnic groups. Black women presented 1.5 times more than white women. Gender ratios within ethnicities were marked. Among those aged younger than 24 years, black women were almost 7 times more likely to present than black men were. Conclusion: Self-poisoning is the commonest form of self-harm presentation to UK hospitals but population-based rates are rare. These results have implications for formulating and managing risk in clinical services for both minority ethnic women and men.

Asylum-seekers falsely implicating themselves in international crimes: Should they be informed of the existence of Article 1F of the Refugee Convention?

2014 ◽  
Vol 12 (1) ◽  
pp. 91-101
Author(s):  
Brian Moore ◽  
Joris van Wijk
Keyword(s):  
The Netherlands ◽  
Case Studies ◽  
Asylum Seekers ◽  
Refugee Convention ◽  
International Crimes ◽  
Refugee Claim ◽  
The Uk ◽  
National Governments

Case studies in the Netherlands and the UK of asylum applicants excluded or under consideration of exclusion pursuant to Article 1Fa of the Refugee Convention reveal that some applicants falsely implicated themselves in serious crimes or behaviours in order to enhance their refugee claim. This may have serious consequences for the excluded persons themselves, as well as for national governments dealing with them. For this reason we suggest immigration authorities could consider forewarning asylum applicants i.e. before their interview, about the existence, purpose and possible consequences of exclusion on the basis of Article 1F.

Emergent and Adaptive Spiritualities in the Twentieth Century

2018 ◽  
Author(s):  
Andy Lord
Keyword(s):  
Twentieth Century ◽  
Case Studies ◽  
Church Life ◽  
The Usa ◽  
The Uk

This chapter points to the ‘pluralization of the lifeworld’ involved in globalization as a key context for changing dissenting spiritualities through the twentieth century. These have included a remarkable upsurge in Spirit-movements that fall under categories such as Pentecostal, charismatic, neo-charismatic, ‘renewalist’, and indigenous Churches. Spirit language is not only adaptive to globalized settings, but brings with it eschatological assumptions. New spiritualities emerge to disrupt existing assumptions with prophetic and often critical voices that condemn aspects of the existing culture, state, and church life. This chapter outlines this process of disruption of the mainstream in case studies drawn from the USA, the UK, India, Africa, and Indonesia, where charismaticized Christianity has emerged and grown strongly in often quite resistant broader cultures.

Volunteering in hospice and palliative care in the United Kingdom

2018 ◽  
Author(s):  
Ros Scott
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Care Services ◽  
The United Kingdom ◽  
Strategic Direction ◽  
Palliative Care Services ◽  
History Of ◽  
The Uk ◽  
Hospice And Palliative Care ◽  
Changing Role

This chapter explores the history of volunteers in the founding and development of United Kingdom (UK) hospice services. It considers the changing role and influences of volunteering on services at different stages of development. Evidence suggests that voluntary sector hospice and palliative care services are dependent on volunteers for the range and quality of services delivered. Within such services, volunteer trustees carry significant responsibility for the strategic direction of the organiszation. Others are engaged in diverse roles ranging from the direct support of patient and families to public education and fundraising. The scope of these different roles is explored before considering the range of management models and approaches to training. This chapter also considers the direct and indirect impact on volunteering of changing palliative care, societal, political, and legislative contexts. It concludes by exploring how and why the sector is changing in the UK and considering the growing autonomy of volunteers within the sector.

scholarly journals Referrals to Urgent Dental Centres During the COVID-19 Pandemic: A Multi-Site Analysis Research Project

2021 ◽  
Vol 10 (1) ◽  
pp. 40-45
Author(s):  
Adam Shathur ◽  
Samuel Reeves ◽  
Faizal Sameja ◽  
Vishal Patel ◽  
Allan Jones
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Easy Access ◽  
Dental Services ◽  
Care Services ◽  
Dental Practitioners ◽  
Consultation And Referral ◽  
Care Systems ◽  
Access To Primary Care ◽  
The Uk

Introduction: The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems. Aims: To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes. Methods: 110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were. Results: At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include ‘advice, analgesia and antimicrobial’ from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment. Conclusion: Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.

Increasing Pediatric Audiology Services via Telehealth

2021 ◽  
Vol 42 (02) ◽  
pp. 136-151
Author(s):  
Tommy Evans ◽  
Timothy Nejman ◽  
Erin Stewart ◽  
Ian Windmill
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Case Studies ◽  
Health Care Services ◽  
Medical Center ◽  
Access To Healthcare ◽  
Hospital Medical ◽  
Care Services ◽  
Telehealth Service ◽  
Pediatric Audiology

AbstractTelehealth as a means to deliver health care services has been used by physicians for many years, but the use of telehealth in audiology, specifically in pediatrics, has been minimal. Barriers such as licensure, reimbursement, technology, and equipment have been cited as reasons for audiologists not participating in telehealth. However, the COVID-19 pandemic created the need for telehealth services to be widely used to safely increase access to healthcare, and emergent orders helped reduce previous barriers so that audiologists could participate in telehealth service delivery. This article details three cases where audiologists delivered telehealth services to children. These case studies demonstrate portions of the Division of Audiology Telehealth Program of the Cincinnati Children's Hospital Medical Center and how they increased access to hearing healthcare in response to the COVID-19 pandemic.

Effect of a Reduced Postpartum Length of Stay Program on Primary Care Services Use by Mothers and Infants

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 937-941
Author(s):  
Kenneth D. Mandl ◽  
Charles J. Homer ◽  
Oren Harary ◽  
Jonathan A. Finkelstein
Keyword(s):  
Primary Care ◽  
Length Of Stay ◽  
Early Discharge ◽  
Urgent Care ◽  
Care Utilization ◽  
Care Services ◽  
Primary Care Services ◽  
Ambulatory Services ◽  
The Impact ◽  
Services Use

Objective. To determine the impact of reduced postpartum length of stay (LOS) on primary care services use. Methods. Design: Retrospective quasiexperimental study, comparing 3 periods before and 1 period after introducing an intervention and adjusting for time trends.Setting: A managed care plan.Intervention: A reduced obstetrical LOS program (ROLOS), offering enhanced education and services.Participants: mother-infant dyads, delivered during 4 time periods: February through May 1992, 1993, and 1994, before ROLOS, and 1995, while ROLOS was in effect.Independent Measures: Pre-ROLOS or the post-ROLOS year.Outcome Measures: Telephone calls, visits, and urgent care events during the first 3 weeks postpartum summed as total utilization events. Results. Before ROLOS, LOS decreased gradually (from 51.6 to 44.3 hours) and after, sharply to 36.5 hours. Although primary care use did not increase before ROLOS, utilization for dyads increased during ROLOS. Before ROLOS, there were between 2.37 and 2.72 utilization events per dyad; after, there were 4.60. Well-child visits increased slightly to .98 visits per dyad, but urgent visits did not. Conclusion. This program resulted in shortened stays and more primary care use. There was no increase in infant urgent primary care utilization. Early discharge programs that incorporate and reimburse for enhanced ambulatory services may be safe for infants; these findings should not be extrapolated to mandatory reduced LOS initiatives without enhancement of care.

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