scholarly journals Improving the accuracy of admitted subacute clinical costing: an action research approach

2017 ◽  
Vol 41 (4) ◽  
pp. 443
Author(s):  
Sharon Hakkennes ◽  
Ross Arblaster ◽  
Kim Lim
Keyword(s):  
Action Research ◽  
Health Services ◽  
Healthcare Services ◽  
Mandatory Reporting ◽  
Research Approach ◽  
Rehabilitation Centre ◽  
Research Framework ◽  
Action Research Approach ◽  
Health Services Need ◽  
Additional Value

Objective The aim of the present study was to determine whether action research could be used to improve the breadth and accuracy of clinical costing data in an admitted subacute setting Methods The setting was a 100-bed in-patient rehabilitation centre. Using a pre-post study design all admitted subacute separations during the 2011–12 financial year were eligible for inclusion. An action research framework aimed at improving clinical costing methodology was developed and implemented. Results In all, 1499 separations were included in the study. A medical record audit of a random selection of 80 separations demonstrated that the use of an action research framework was effective in improving the breadth and accuracy of the costing data. This was evidenced by a significant increase in the average number of activities costed, a reduction in the average number of activities incorrectly costed and a reduction in the average number of activities missing from the costing, per episode of care. Conclusions Engaging clinicians and cost centre managers was effective in facilitating the development of robust clinical costing data in an admitted subacute setting. Further investigation into the value of this approach across other care types and healthcare services is warranted. What is known about this topic? Accurate clinical costing data is essential for informing price models used in activity-based funding. In Australia, there is currently a lack of robust admitted subacute cost data to inform the price model for this care type. What does this paper add? The action research framework presented in this study was effective in improving the breadth and accuracy of clinical costing data in an admitted subacute setting. What are the implications for practitioners? To improve clinical costing practices, health services should consider engaging key stakeholders, including clinicians and cost centre managers, in reviewing clinical costing methodology. Robust clinical costing data has the potential to be used beyond mandatory reporting requirements; however, health services need to balance the cost of improving their costing data with the additional value obtained from that data.

scholarly journals Patient involvement 2.0: Experience-based co-design supported by action research

2017 ◽  
Vol 17 (4) ◽  
pp. 469-491 ◽  
Author(s):  
Susanne MK Gustavsson ◽  
Thomas Andersson
Keyword(s):  
Action Research ◽  
Patient Involvement ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
Care Patient ◽  
Pediatric Care ◽  
Research Approach ◽  
Quality Improvements ◽  
Healthcare Organizations ◽  
Action Research Approach

Strong professionals who influence the development of healthcare services have dominated healthcare organizations for many years. However, this dominance has been challenged recently through patient involvement. One method of achieving patient involvement is experience-based co-design (EBCD), in which patients and healthcare professionals work together to improve care. Patient involvement has considerable potential, but also presents certain challenges. This article addresses these challenges using experiences from patients and healthcare professionals who participated in two action research projects that aimed to improve patient experienced quality using EBCD in pediatric care. The paper shows that patient involvement in quality improvements can challenge the traditional roles of professionals and patients by new roles as co-designers. The role as co-designer embraces new perspectives for healthcare professionals that force them to step out of their comfort zone. Accordingly, healthcare professionals are able to view patients as equal partners in improvement work. Reflecting dialogues during the projects offered eye-opening stories for patients and healthcare professionals that enabled them to construct a common picture of care. The contribution of this study is strengthening earlier research that argues that an action research approach can strengthen important values for successful EBCD projects: equal partnerships, new roles, and dialogue. The findings show that the combination of EBCD and action research is a promising approach to address the challenges of patient involvement in healthcare improvement.

scholarly journals The process of transprofessional collaboration: how caregivers integrated the perspectives of rehabilitation through working with a physical therapist

2020 ◽  
Vol 8 (4) ◽  
pp. e000378
Author(s):  
Ryohei Goto ◽  
Junji Haruta
Keyword(s):  
Nursing Home ◽  
Action Research ◽  
Physical Therapist ◽  
Nursing Home Residents ◽  
Research Approach ◽  
Action Research Approach ◽  
Informal Interview ◽  
Trial Basis ◽  
Field Notes

ObjectivesTo clarify the process of how caregivers in a nursing home integrate the perspectives of rehabilitation into their responsibilities through working with a physical therapist.DesignThis study was conducted under an action research approach.SettingThe target facility was a nursing home located in Japan. The researcher, a physical therapist, worked at the nursing home once a week from April 2016 to March 2017. During the study period, he created field notes focused on the dialogue and action of caregivers regarding care, responses of caregivers to the physical therapist and reflections as a physical therapist. Caregivers were also given a short informal interview about their relationship with the nursing home residents. For data analysis, two researchers discussed the content based on the field notes, consolidating the findings.ParticipantsThe participants were caregivers who worked at the target facility. Thirty-eight caregivers agreed to participate. Average age was 39.6±11.1 years, 14 (37%) were male and average caregiver experience was 9.8 years.ResultsTwo cycles of action research were conducted during the study period. There were four stages in the process of how caregivers in the nursing home integrated the perspectives of rehabilitation through their work with the physical therapist. First, caregivers resisted having the rehabilitation programme carried out in the unit because they perceived that rehabilitation performed by a physical therapist was a special process and not under their responsibility. However, the caregivers were given a shared perspective on rehabilitation by the physical therapist, which helped them to understand the meaning of care to adapt the residents’ abilities to their daily life. They practised resident-centred care on a trial basis, although with a sense of conflict between their new and previous role, which emphasised the safety of residents’ lives and personhood. The caregivers increased their self-efficacy as their knowledge and skills were supplemented by the physical therapist and his approval of their attempted care. They were then able to commit to their newly conceived specialty of care as a means of supporting the lives of residents.ConclusionsThe process of working with a physical therapist led to a change in caregivers’ perception and behaviours, which occurred in four stages: resistance to incorporation, recapture of other perspectives, conflicts and trials in the role of caregiver and transformation to a resident-centred perspective.

scholarly journals Use of participatory action research approach to develop a self-management resource for persons living with dementia

Dementia ◽  
2021 ◽  
pp. 147130122199728
Author(s):  
Sherry Dupuis ◽  
Carrie McAiney ◽  
Lisa Loiselle ◽  
Brenda Hounam ◽  
Jim Mann ◽  
...  
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Primary Care Providers ◽  
Self Management ◽  
Research Approach ◽  
Care Providers ◽  
Participatory Action ◽  
Action Research Approach ◽  
Care Partners ◽  
Essential Components

This article describes the use of a participatory action research (PAR) approach to developing a self-management resource for persons living with dementia and care partners. Despite growing evidence that persons with dementia are able to contribute in meaningful ways to decision-making about their care and life preferences, few opportunities exist for them to participate in the design of resources and services meant for them. There is also a need to support the self-management of persons living with dementia with the provision of accurate, high quality, user-friendly information. The Living Well with Dementia resource was developed through a partnership with persons with dementia, family members, Alzheimer Society representatives, primary care providers, and researchers. The methods used in the development of this resource are outlined in six steps employed in this process, from establishment of a PAR team to final resource creation. Informed by a whole systems approach, the resource brings together essential components of self-management into a comprehensive system of care and support for living. It empowers users to be active participants in the application of new knowledge to their lives. Better self-management has important implications for access to health care and quality of life for persons with dementia and care partners.

Community Participatory Action Research Approach as an Effective Tool Towards Adoption of Corn-Based Farming System Technologies by Libona, Bukidnon Farmers

2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Lorena Duna ◽  
◽  
Juanita Salvani ◽  
Marivic Paday ◽  
Joy Daproza ◽  
...  
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Farming System ◽  
Research Approach ◽  
Participatory Action ◽  
Action Research Approach

participatory, community, technologies, adoption, sustainability

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