scholarly journals Decreasing Barriers to Care: Voices of Riders, Drivers, and Staff of a Rural Transportation Program

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 780-780
Author(s):  
Abby Schwartz ◽  
Alice Richman ◽  
Mallary Scott ◽  
Haiyong Liu ◽  
Weyling White ◽  
...  
Keyword(s):  
Qualitative Interviews ◽  
Case Manager ◽  
Access To Healthcare ◽  
Case Managers ◽  
Poverty Level ◽  
Phase Study ◽  
Holistic Understanding ◽  
Health Project ◽  
No Wait ◽  
Transportation Program

Abstract Eastern North Carolina (eNC) is a rural, poor, and underserved region of the state with 1 in 5 adults living below the poverty level. Residents experience health disparities driven by limited access to healthcare and inequitable distribution of social determinants of health. Project TRIP (Transporting Residents with Innovative Practices) is a potential solution to barriers in accessing care in eNC. Results presented include the first phase of a multi-phase study evaluating and replicating TRIP’s effectiveness. Data from qualitative interviews with TRIP riders, drivers, and staff (e.g., case managers) will be presented (n= 20). As a result of the COVID-19 pandemic, interviews were conducted by telephone with the goal of understanding both strengths and weaknesses of the transportation program from riders, drivers, and staff to gain a holistic understanding of TRIP. Of the riders interviewed, the majority (91%) were age 50 and over and African American. Themes that emerged from the data that highlighted strengths of the program included: improved health outcomes, no wait times for pick up or drop offs, cost free, and accommodating service. Themes related to areas of weaknesses or improvement included: needing more transportation vendors and a dedicated TRIP case manager and scheduling concerns. The presentation will conclude with considerations in translating the findings into a pilot and expansion of TRIP in another eNC county (study phases 2 & 3), and how the data can inform the development of transportation interventions in other states, with the goal of increasing access to healthcare for vulnerable rural populations.

scholarly journals The specific needs of patients following sepsis: a nested qualitative interview study

BJGP Open ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. bjgpopen17X100725
Author(s):  
Sabine Gehrke-Beck ◽  
Mareike Bänfer ◽  
Nina Schilling ◽  
Konrad Schmidt ◽  
Jochen Gensichen ◽  
...  
Keyword(s):  
Patient Education ◽  
Qualitative Content Analysis ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Case Manager ◽  
Clinical Information ◽  
Case Managers ◽  
Structured Interviews ◽  
Serious Illness ◽  
Qualitative Interview Study

BackgroundSurvivors of sepsis suffer from multiple critical disease sequelae when discharged to primary care. There is a lack of structured aftercare programmes and case managers may be helpful in caring for patients with chronic critical disease.AimTo gain insight into the functioning of a structured aftercare programme for post-sepsis patients in general practice.Design & settingA qualitative study using semi-structured interviews with patients and GPs across Germany who participated in an randomised controlled trial of a structured aftercare programme for post-sepsis patients, which included patient education and case manager monitoring.MethodQualitative interviews with 19 patients and 13 GPs were audiorecorded, transcribed verbatim, and analysed using qualitative content analysis.ResultsPatients appreciated the information given in the patient education session, but some disliked it because it reminded them of their serious illness. GPs appreciated patient education because well-informed patients are more likely to participate in follow-up. Patients appreciated the case monitoring because it made them feel safer and more cared for and helped them reflect on their health issues. However, some patients felt uncomfortable with the regular questioning. GPs appreciated the case management programme because they received regular clinical information. However some GPs were wary of the clinical relevance of the information, the delegation of the patient to the nurse, and efficiency of time. Both patients and GPs requested more clinical support, such as easier access to psychotherapists.ConclusionIn general, both patients and their GPs appreciated patient education and monitoring following sepsis. Patients’ retrospections and worries about their serious illness need to be considered.

Case Management in Occupational Rehabilitation: Would the Real Case Manager Please Stand Up?

1995 ◽  
Vol 1 (2) ◽  
pp. 104-117 ◽  
Author(s):  
Dianna T. Kenny
Keyword(s):  
Case Management ◽  
Case Manager ◽  
Occupational Rehabilitation ◽  
Case Managers ◽  
Injured Workers ◽  
Policy And Practice ◽  
Post Injury ◽  
Proper Role ◽  
Key Stakeholders ◽  
Successful Case

Key stakeholders (injured workers, rehabilitation co-ordinators, rehabilitation providers, treating doctors and insurers) in the occupational rehabilitation process were interviewed to gain their perspective concerning the degree to which case management was viewed as the organising principle of post-injury management and to whom this role was most frequently assigned. Findings indicated that there were differences in stakeholder perceptions about who should fill this role for the injured worker, with the majority of each group claiming case management as their proper role. In contrast, 35% of the injured workers interviewed stated that they either did not have a case manager or that they case managed themselves. Although it was argued that rehabilitation co-ordinators are suitably placed to act as case managers, they were nominated least by injured workers. Three vignettes of successful case management were presented and recommendations for policy and practice were made.

‘About Being’: An interdisciplinary and collaborative arts and health project supporting the ongoing recovery of stroke survivors

2021 ◽  
Vol 00 (00) ◽  
pp. 1-15
Author(s):  
Laura Snell ◽  
Vicki Goodwin ◽  
Tom Grimwood
Keyword(s):  
Unique Feature ◽  
Qualitative Interviews ◽  
Stroke Survivors ◽  
Valuable Contribution ◽  
Community Project ◽  
Arts And Health ◽  
Health Initiatives ◽  
Student Volunteers ◽  
Health Project ◽  
Model Of Practice

Arts and health initiatives can make a valuable contribution to the ongoing recovery of stroke survivors. This article focuses on a study of the ‘About Being’ project, which provides dance and movement sessions for stroke survivors in the Cumbrian city of Carlisle, United Kingdom. The study evaluated the model of practice applied to the community project and how the sessions supported the ongoing recovery of stroke survivors. The methodology involved observations of the sessions and qualitative interviews. A unique feature of this project is that it brings together the fields of education, arts and health by engaging practitioners, academics and student volunteers, along with the stroke survivors who participate in the sessions. It is proposed that the success of the ‘About Being’ project is attributed to its interdisciplinary and collaborative practice, person-centred approach and multidirectional learning environment, which is beneficial for all those involved.

Preparing Nurses for the Acute Care Case Manager Role: Educational Needs Identified by Existing Case Managers

1998 ◽  
Vol 29 (3) ◽  
pp. 130-134
Author(s):  
Marie T Nolan ◽  
Alexandra Harris ◽  
Amanda Kufta ◽  
Nancy Opfer ◽  
Holley Turner
Keyword(s):  
Acute Care ◽  
Case Manager ◽  
Educational Needs ◽  
Case Managers ◽  
Manager Role

scholarly journals “We Want to Build a Network”: Professional Experiences of Case Managers Working With Military Families

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986978 ◽  
Author(s):  
Robyn Englert ◽  
Renee Dell’Acqua ◽  
Shannon Fitzmaurice ◽  
Abigail Marter Yablonsky
Keyword(s):  
Military Families ◽  
Qualitative Content Analysis ◽  
Qualitative Interviews ◽  
Well Being ◽  
Case Managers ◽  
Military Health ◽  
Professional Experiences ◽  
Treatment Facilities ◽  
The Military

Optimizing case management (CM) services increases service member readiness at home and abroad. However, little research has been conducted on the experiences of case managers providing services to military families within the Military Health System. Semistructured qualitative interviews were conducted to explore the professional experiences of case managers to identify factors that may affect care to military families. A total of 53 case managers from military medical treatment facilities (MTFs) varying in size, location, and branch of service were interviewed by telephone to explore their perspectives. Qualitative content analysis was performed. Case managers serve a variety of functions, but specific roles vary between MTFs. Factors that affect CM services for military families were identified: (1) need for pediatric specialization, (2) heavy workload, (3) appropriate staff, (4) patient handoffs, and (5) the role of CM. Recommendations for improving CM services to facilitate the well-being of military families are discussed.

scholarly journals WHEN NETWORKS FAIL: ISOLATION AND INDEPENDENCE AMONG OLDER ADULTS IN PUBLIC HOUSING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S180-S180
Author(s):  
Brooke Wagen ◽  
Whitney Williams ◽  
Jan Bennett ◽  
Elizabeth A Jacobs
Keyword(s):  
Older Adults ◽  
Problem Solving ◽  
Public Housing ◽  
Affordable Housing ◽  
Qualitative Interviews ◽  
Well Being ◽  
Poverty Level ◽  
Cultural Perceptions ◽  
Health Aging ◽  
Problematic Experiences

Abstract In the coming decades, the population of adults over 65 in the US will increase dramatically. Many older adults live at or below the poverty level, and the growing lack of affordable housing combined with fixed incomes promises to increase the number of older adults facing combined housing and health challenges. Despite their vulnerability, little is known about the lived experiences of older adults aging in place in public housing. We conducted semi-structured qualitative interviews with 27 older adults at two public housing sites in Austin, Texas to gain an understanding of their thoughts on health, aging, home, community, and problem solving. We conducted interviews in Spanish (n=10) and English (n=17) with 16 female and 11 male interviewees with a mean age of 71.7 years (range 65-85 years). We systematically coded transcribed interviews and used grounded theory to analyze the data. Participants described feeling isolated due to language barriers, cultural perceptions about neighbors, and previous problematic experiences with neighbors leading to intentional isolation for safety. Some, however, spoke of how they acted as community connectors or responded to connectors in the community in ways that reduced their isolation. Participants framed individual problem-solving and personal choices as central to health and wellness. Our findings suggest a way forward for housing authorities, communities, and health systems working together to provide services to these adults. Incorporating their points of view and even co-creating interventions to enhance their health and well-being will make these interventions more successful and welcome.

scholarly journals Perceptions of Power Mobility Use and Safety within Residential Facilities

2005 ◽  
Vol 72 (3) ◽  
pp. 142-152 ◽  
Author(s):  
William B. Mortenson ◽  
William C. Miller ◽  
Jeanette Boily ◽  
Barbara Steele ◽  
Leslie Odell ◽  
...  
Keyword(s):  
Qualitative Interviews ◽  
Self Esteem ◽  
Residential Facilities ◽  
Two Phase ◽  
Safety Measures ◽  
The Road ◽  
Phase Study ◽  
Power Wheelchairs ◽  
No Gold Standard

Background. Power wheelchairs enhance quality of life by enabling occupation, improving self-esteem and facilitating social interaction. Despite these benefits, the risks associated with power mobility use raise serious concerns in residential facilities. Purpose. As there is no gold standard to assess when a client is unsafe, a two-phase study was conducted to develop client-centred guidelines for power mobility use. Method. In the first phase of the study, presented here, 18 in-depth, qualitative interviews were conducted with a variety of stakeholders, including power mobility users, other residents, staff and family members. Results. A thematic analysis of the interviews revealed four main themes: 1) the meaning of power mobility, 2) learning the rules of the road, 3) red flags: concerns about safety, and 4) solutions. Practice Implications. Given the importance of power mobility, safety measures need to address issues of mobility and safety for power mobility drivers and those around them.

scholarly journals Weighing up Work Willingness in Social Assistance: A Balancing Act on Multiple Levels

2019 ◽  
Vol 35 (5) ◽  
pp. 718-737 ◽  
Author(s):  
Marjolijn De Wilde ◽  
Sarah Marchal
Keyword(s):  
Political Ideology ◽  
Social Assistance ◽  
Case Manager ◽  
Individual Case ◽  
Case Managers ◽  
Unintended Consequences ◽  
Organizational Setting ◽  
Multiple Levels ◽  
Vignette Experiment ◽  
Welfare Agencies

Abstract In all European countries, social assistance legislation specifies that the receipt of benefits is conditional upon the willingness to work. Nevertheless, the manner in which such policies are implemented in practice has remained a black box. From the literature on social policy, social work, and social administration, we know that implementation is the result of decisions at multiple levels. To our knowledge, however, this study is the first quantitative attempt to bring together the insights from these various strands of literature into a combined assessment of factors that determine willingness-to-work assessments. We build on an innovative and purpose-designed survey of social workers in Belgium. We identified factors determining the perceptions of 584 case managers, clustered in 89 municipalities, with regard to sanction decisions upon job refusal, based on almost 5,000 experimentally varied client cases (vignette experiment). These unique data make it possible to distinguish between the effects of case managers who assess individual cases and characteristics of the local welfare agencies and municipalities in which they operate. The results reveal relatively little variation between municipalities, which can be largely explained by characteristics of the municipalities (e.g. political ideology and organizational setting). Surprisingly, however, we find extensive variation at the case-manager level. Although some of this variation remains unexplained, a substantial share can be explained by characteristics of individual case managers (e.g. age and attitudes concerning the welfare state). This finding raises concerns about the unintended consequences of the broad discretion granted to case managers within contemporary social assistance schemes.

Case Manager Work and Workload: Uncovering a Wicked Problem—A Secondary Analysis Using Interpretive Description

2018 ◽  
Vol 31 (2) ◽  
pp. 83-91
Author(s):  
K. D. Fraser ◽  
L. Garland Baird ◽  
S. Labonte ◽  
H. O’Rourke ◽  
N. S. Punjani
Keyword(s):  
Home Care ◽  
Secondary Analysis ◽  
Case Manager ◽  
Home Care Services ◽  
Case Managers ◽  
Wicked Problem ◽  
Interpretive Description ◽  
Care Services ◽  
Workload Measurement ◽  
Measurement Tools

Canada’s population is aging, and by 2027, it is expected that 22 million people will be older than 65 years. Home care services were used by 2.2 million individuals, or 8% of Canadians 15 years of age and older in 2012. Home care programs are continually expanding to meet the needs of the growing number of clients, and goals include keeping people in their homes for as long as possible, delaying the need for institutional care, and maintaining quality of life. Case managers are the gatekeepers to home care in Canada. They collaborate with families to plan care, coordinate home care services and community supports, as well as monitor client progress and evaluate outcomes. The aim of our study was to conduct a qualitative secondary analysis to understand the factors that influence case manager work and workload in home care. We completed a secondary analysis of four data sets from four primary studies of related concepts that occurred between 2006 and 2013. Our study design was inductively driven using the tenets of interpretive description. Case managers’ work and workloads are messy and affected by interrelated complex structures of home care programs within health care systems. The concept of a wicked problem, which describes a problem that is complex and intractable, is a useful construct we use to gain some clarity around the work and workload problems that case managers face. Case managers aim to make a positive difference in their client’s lives, but are constantly dealing with change, and can experience feelings of being their client’s last resort with the resulting pressure ultimately impacting their workload. In addition, case managers reported health system failures, including a lack of capacity and structural integration within home care programs that increase their work and workload. Case manager work and workload requires further research including the development and refinement of accurate workload measurement tools that consider the multiple aspects of professional responsibilities and case management activities. Workload and workload measurement tools are needed to account for the unplanned and unpredictable nature of case management work and assist with the distribution of more equitable caseloads among case managers and home care teams.

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