scholarly journals Study protocol for a national retrospective review of femoral periprosthetic fracture management. Is there variation in practice?

Author(s):  
Ahmed A H Nasser ◽  
Govind Chauhan ◽  
Khabab Osman ◽  
Saroop Nandra ◽  
Rajpal Nandra ◽  
...  

Abstract Introduction The incidence of femoral periprosthetic fractures (PPFs) in the UK is on the rise. This rising incidence presents a clinical and an economic burden on the national health care services. There is also uncertainty about the most effective treatment modality for femoral PPFs, as well as a lack of evidence for a standardized management approach. We aimed to identify the true incidence and any variation in the management of femoral PPFs nationally. Methods and analysis This multicentre national collaborative study has been designed by a trainee led research network in collaboration with a well-established university research organization. Data will be collected from participating centres over a period of 10 years (2010–2019). All adults presenting with a femoral PPF will be identified, and the mode of treatment for each fracture subtype will be recorded. Other measures will evaluate patient and treatment variables, objective and subjective outcome measures. Univariate and multivariate regression analyses will be used, as well as the coefficient of determination (R) in an attempt to measure the degree to which the models could explain the variation in management. Ethics and dissemination This multicentre national project was approved by the local clinical governance department at each participating hospital site. The results of this study will be submitted to international peer reviewed journals and appropriate national and international conferences.

Author(s):  
Mark Jewell ◽  
Derek H.T. Walker

This chapter provides insights from a large UK construction organisation case study where communities of practice have been supported through use of a software tool and management approach that encourages their spread across the organisation. We provide a descriptive characterisation of what the community of practice (COP) software tool does, how it evolved, and anecdotal evidence from interviews with its users of its value to the UK case study organisation. We recognise the need to investigate COP value generation more formally, and we have developed a research proposal to undertake further work in a collaborative study with industry to provide useful COP performance measures to be undertaken. This chapter provides valuable insights from several years’ reflection upon the tool’s use and application, and we highlight both drivers and barriers to its deployment. The objective was to provide a practical example of what COP management tools could and should address.


Curationis ◽  
1995 ◽  
Vol 18 (1) ◽  
Author(s):  
M. Muller

The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.


2013 ◽  
Vol 21 (8) ◽  
pp. 571-577 ◽  
Author(s):  
Eman Alshawish ◽  
Janet Marsden ◽  
Gill Yeowell ◽  
Christopher Wibberley

2021 ◽  
Vol 27 (7) ◽  
pp. 176-181
Author(s):  
Anne Holdoway

Malnutrition represents a significant health burden in the UK, affecting patient outcomes and costing health care services over £20 billion. Anne Holdoway discusses opportunities for early intervention and explains how healthcare managers can help to address this issue.


2020 ◽  
Vol 14 (12) ◽  
pp. 1769-1776 ◽  
Author(s):  
Nurulamin M Noor ◽  
Ailsa L Hart ◽  
Peter M Irving ◽  
Subrata Ghosh ◽  
Miles Parkes ◽  
...  

Abstract There have been immediate and profound impacts of SARS-CoV-2 and COVID-19 on health care services worldwide, with major consequences for non COVID-19 related health care. Alongside efforts to reconfigure services and enable continued delivery of safe clinical care for patients with IBD, consideration must also be given to management of IBD research activity. In many centres there has been an effective shutdown of IBD clinical trial activity as research sites have switched focus to either COVID-19 related research or clinical care only. As a result, the early termination of trial programmes, and loss of potentially effective therapeutic options for IBD, has become a real and worrying prospect. Moreover, in many countries research activity has become embedded into clinical care—with clinical trials often providing access to new therapies or strategies—which would otherwise not have been available in standard clinical pathways. This pandemic has significant implications for the design, conduct, analysis, and reporting of clinical trials in IBD. In this Viewpoint, we share our experiences from a clinical and academic perspective in the UK, highlighting the early challenges encountered, and consider implications for patients and staff at research sites, sponsors, research ethics committees, funders, and regulators. We also offer potential solutions both for now and for when we enter a recovery phase from the pandemic.


2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii14-ii18
Author(s):  
A Gomez ◽  
A Capon-Saez ◽  
A Gomez-Mosquera ◽  
Y Parada-DeFreitas ◽  
J J Arechaderra-Calderon ◽  
...  

Abstract Introduction The United Kingdom and Spain run government-funded social and health care services, free for the user at the point of delivery. Acute Geriatric Units (AGU) carrying out Comprehensive Geriatric Assessments improve the clinical outcomes of older patients. Little is known about the similarities and differences between countries, and how these may impact on clinical outcomes. Methods Prospective observational study of consecutive patients admitted to AGU of 2 hospitals in the UK and 4 hospitals in Spain between the 1st to the 30th of October 2019 and from the 1st to the 29th of February 2020. We followed up the patients for a 90 day period. Conclusions Frailty, multimorbidity and polypharmacy were prevalent in both cohorts. English patients were younger, with shorter hospital stay, mortality and use of antipsychotic medication but higher readmission rates. Involvement from Allied health care professionals was higher in UK hospitals.


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