scholarly journals 38 Improving Access to Outpatient Services for Older People Using A Clinical Microsystems Approach

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i11-i13
Author(s):  
E Tullo ◽  
A Smith ◽  
J Ridden ◽  
R Ross ◽  
R Curless ◽  
...  
Keyword(s):  
Older People ◽  
Emergency Services ◽  
Waiting Times ◽  
Outpatient Services ◽  
North East ◽  
The North ◽  
Team Coaching ◽  
Complex Patients ◽  
Clinical Microsystems ◽  
Main Components

Abstract Background Northumbria Healthcare NHS Foundation Trust provides services to more than 500,000 residents in the North-East of England across multiple sites. Local problem Outpatient services for older people across Northumbria include specialist (eg falls) and generic clinics with differing referral routes, demands and waiting times. Referrals derive from primary care, emergency services and elsewhere; some are complex patients requiring a comprehensive geriatric assessment (CGA). Existing pathways led to variable waits for clinics, duplication and delays. Aim was to improve the timeliness, efficiency and access to appropriate assessment first time. Methods We adopted a Clinical Microsystems approach (Sheffield Microsystems Coaching Academy) for improvement. Main components were team coaching, weekly “Big Room” meeting of involved staff to share understanding of current process, agree change ideas, and test these with multiple plan, do, study, act (PDSA) cycles. Impacts of each PDSA cycle were discussed in Big Room, leading to refinement of the pathway. Interventions Results: PDSA interventions were tested over 6 months: Development of a single triage systemCGA clinic for frail older patients.Development of shared documentation for CGA.Improved cycle and lead times for assessment Conclusions Our quality improvement work supported the development and implementation of a new referral triage process with CGA assessment for complex frail patients. The change has reduced patient wait times, provided early intervention and reduced duplication. Work is ongoing to determine impact on patient satisfaction and time to discharge from clinic. The approach taken by this project could be applied elsewhere to improve outpatient referral processes.

Inequalities in awareness and availability of bereavement services in North-East England

2020 ◽  
pp. bmjspcare-2020-002422
Author(s):  
Donna Wakefield ◽  
Elizabeth Fleming ◽  
Kate Howorth ◽  
Kerry Waterfield ◽  
Emily Kavanagh ◽  
...  
Keyword(s):  
Phase 1 ◽  
Waiting Times ◽  
Financial Strain ◽  
Web Based ◽  
North East ◽  
The North ◽  
Referral Criteria ◽  
National Guidance ◽  
The Uk ◽  
The Impact

ObjectivesNational guidance recommends equality in access to bereavement services; despite this, awareness and availability appears inconsistent. The aim of this study was to explore availability and accessibility of bereavement services across the North-East of England and to highlight issues potentially applicable across the UK, at a time of unprecedented need due to the impact of COVID-19.MethodsPhase 1: an eight item, web-based survey was produced. A survey link was cascaded to all GP practices (General Practitioners) in the region. Phase 2: an email was sent to all services identified in phase 1, requesting details such as referral criteria and waiting times.ResultsAll 392 GP practices in the region were invited to participate. The response rate was 22% (85/392). Twenty-one per cent (18/85) of respondents reported that they do not refer patients, comments included ‘not aware of any services locally’. A total of 36 services were contacted with 72% responding with further information. Most bereavement specific support was reliant on charity-funded services including hospices, this sometimes required a pre-existing link with the hospice. Waiting times were up to 4 months.ConclusionsAlthough multiple different, usually charity-funded services were identified, awareness and accessibility were variable. This survey was conducted prior to the COVID-19 pandemic, where complex situations surrounding death is likely to impact on the usual grieving process and increase the need for bereavement support. Meanwhile, charities providing this support are under severe financial strain. There is an urgent need to bridge the gap between need and access to bereavement services.

Emergency Care Capabilities in North East Haiti: A Cross-sectional Observational Study

2015 ◽  
Vol 30 (6) ◽  
pp. 553-559 ◽  
Author(s):  
Annelies De Wulf ◽  
Adam R. Aluisio ◽  
Dana Muhlfelder ◽  
Christina Bloem
Keyword(s):  
Observational Study ◽  
Emergency Care ◽  
Emergency Services ◽  
Assessment Tools ◽  
World Health ◽  
Cross Sectional ◽  
North East ◽  
The North ◽  
Emergency Medical ◽  
Emergency Equipment

AbstractIntroductionThe North East Department is a resource-limited region of Haiti. Health care is provided by hospitals and community clinics, with no formal Emergency Medical System and undefined emergency services. As a paucity of information exists on available emergency services in the North East Department of Haiti, the objective of this study was to assess systematically the existing emergency care resources in the region.MethodsThis cross-sectional observational study was carried out at all Ministry of Public Health and Population (MSPP)-affiliated hospitals in the North East Department and all clinics within the Fort Liberté district. A modified version of the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care and Generic Essential Emergency Equipment Lists were completed for each facility.ResultsThree MSPP hospitals and five clinics were assessed. Among hospitals, all had a designated emergency ward with 24 hour staffing by a medical doctor. All hospitals had electricity with backup generators and access to running water; however, none had potable water. All hospitals had x-ray and ultrasound capabilities. No computed tomography scanners existed in the region. Invasive airway equipment and associated medications were not present consistently in the hospitals’ emergency care areas, but they were available in the operating rooms. Pulse oximetry was unavailable uniformly. One hospital had intermittently functioning defibrillation equipment, and two hospitals had epinephrine. Basic supplies for managing obstetrical and traumatic emergencies were available at all hospitals. Surgical services were accessible at two hospitals. No critical care services were available in the region. Clinics varied widely in terms of equipment availability. They uniformly had limited emergency medical equipment. The clinics also had inconsistent access to basic assessment tools (sphygmomanometers 20% and stethoscopes 60%). A protocol for transferring patients requiring a higher level of care was present in most (80%) clinics and one of the hospitals. However, no facility had a written protocol for transferring patients to other facilities. One hospital reported intermittent access to an ambulance for transfers.ConclusionsDeficits in the supply of emergency equipment and limited protocols for inter-facility transfers exist in North East Department of Haiti. These essential areas represent appropriate targets for interventions aimed at improving access to emergency care within the North East region of Haiti.De WulfA, AluisioAR, MuhlfelderD, BloemC. Emergency care capabilities in North East Haiti: a cross-sectional observational study. Prehosp Disaster Med. 2015;30(6):553–559.

scholarly journals Risk Factors for First-Ever Stroke in Older People in the North East of England

Stroke ◽  
2004 ◽  
Vol 35 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Helen Rodgers ◽  
Jane Greenaway ◽  
Tina Davies ◽  
Ruth Wood ◽  
Nicholas Steen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older People ◽  
North East ◽  
The North

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.

scholarly journals The Impact on Older People’s Wellbeing of Leaving Heritage Volunteering and the Challenges of Managing this Process

2021 ◽  
Author(s):  
Bruce Davenport ◽  
Andrew Newman ◽  
Suzanne Moffatt
Keyword(s):  
Older People ◽  
Cultural Heritage ◽  
Personal Agency ◽  
Structured Interviews ◽  
Older Volunteers ◽  
North East ◽  
The North ◽  
Age Related ◽  
The Impact

The benefits of volunteering for older volunteers and for the organisations who host them is well-documented. The impact of being obliged to leave volunteering due to age-related conditions, and any challenges that this creates for volunteer managers, are under-researched. This study explored how volunteers and volunteer managers experienced this point in the volunteering lifecycle and whether the topic warranted further research. Semi-structured interviews were carried out with fourteen older people, who were (or had been) volunteers at one of three cultural heritage organisations in the north-east of England alongside seven volunteer managers from those organisations. These represented the diversity of heritage organisations in the region. Volunteers discussed leaving volunteering in terms of loss but also indicated that forms of personal appraisal and agency were possible, ameliorating the impact of leaving. Volunteer managers discussed how organisational frameworks and the relationships they formed with volunteers shaped their practices. These relationships created a sense of organisational reciprocity which led some managers to exceed the rules in order to sustain people in their volunteering. The results suggest that supporting personal agency could ameliorate the impact of leaving volunteering but that organisations would benefit from articulating the extent and the limits of that support.

scholarly journals Computer-based laboratory simulation: evaluations of student perceptions

2011 ◽  
Vol 4 (3) ◽  
Author(s):  
Norrie S. Edward
Keyword(s):  
Student Perceptions ◽  
Laboratory Simulation ◽  
North East ◽  
The North ◽  
Predicting Performance ◽  
Hands On ◽  
Part Time ◽  
Computer Based ◽  
Main Components ◽  
Design And Manufacture

Laboratory experimentation in engineering is an essential part of the three main components in an engineer's formation. The theoretical constructs and models are imparted in lectures and tutorials. Workshop hands-on activity allows the student to acquire an understanding of the interaction of design and manufacture, and the constraints both impose. Characteristics of plant are investigated through experiment, and this aids the learner's understanding of the limitation of models in predicting performance. The learner also gains an appreciation of the nature of errors and of the construction of plant. But while the oil industry has brought prosperity to the North- East, it has also brought unique educational demands: the working arrangements place severe restrictions on part-time student attendance. Technicians work a block of two to four weeks offshore, followed by a similar period of leave. Different companies have different arrangements, and shift-change days.DOI:10.1080/0968776960040306

scholarly journals The use of NHS accident and emergency services by commercial sea fishermen in the North East of Scotland

2005 ◽  
Vol 55 (2) ◽  
pp. 96-98 ◽  
Author(s):  
Catriona Matheson ◽  
Sarah Morrison ◽  
Elizabeth Murphy ◽  
Lewis Ritchie ◽  
Christine Bond ◽  
...  
Keyword(s):  
Emergency Services ◽  
North East ◽  
The North ◽  
Accident And Emergency

Ras al Khaimah: further archaeological discoveries

Antiquity ◽  
1976 ◽  
Vol 50 (200) ◽  
pp. 216-222
Author(s):  
Beatrice De Cardi
Keyword(s):  
United Arab Emirates ◽  
The State ◽  
Focused Attention ◽  
North East ◽  
The North ◽  
History Of ◽  
The City

Ras a1 Khaimah is the most northerly of the seven states comprising the United Arab Emirates and its Ruler, H. H. Sheikh Saqr bin Mohammad al-Qasimi, is keenly interested in the history of the state and its people. Survey carried out there jointly with Dr D. B. Doe in 1968 had focused attention on the site of JuIfar which lies just north of the present town of Ras a1 Khaimah (de Cardi, 1971, 230-2). Julfar was in existence in Abbasid times and its importance as an entrep6t during the sixteenth and seventeenth centuries-the Portuguese Period-is reflected by the quantity and variety of imported wares to be found among the ruins of the city. Most of the sites discovered during the survey dated from that period but a group of cairns near Ghalilah and some long gabled graves in the Shimal area to the north-east of the date-groves behind Ras a1 Khaimah (map, FIG. I) clearly represented a more distant past.

Lichens in the North-East regions of Cyprus

1999 ◽  
Vol 110 (5-6) ◽  
pp. 455-463 ◽  
Author(s):  
S. Güvenç ◽  
Ş Öztürk
Keyword(s):  
North East ◽  
The North
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