The English Improving Access to Psychological Therapies (IAPT) Program

2015 ◽  
Author(s):  
David M. Clark
Keyword(s):  
Best Practice ◽  
Stepped Care ◽  
Anxiety And Depression ◽  
Care Model ◽  
Intensive Training ◽  
Practice Recommendations ◽  
Psychological Therapies ◽  
The United Kingdom ◽  
Evidence Based Treatments ◽  
National Effort

Chapter 4 describes the Improving Access to Psychological Therapies Program in the United Kingdom, a sweeping national effort to ensure availability of evidence-based treatments by providing intensive training and utilizing a stepped-care model consistent with best-practice recommendations for the treatment of anxiety and depression.

Implementing a stepped-care psychological pathway for cardiac patients with comorbid anxiety and depression in the UK: a service development project

2021 ◽  
pp. 1-14
Author(s):  
Heather Salt ◽  
Shama El-Salahi ◽  
Angeliki Schiza ◽  
June Dent
Keyword(s):  
Cardiac Rehabilitation ◽  
Secondary Care ◽  
Care Service ◽  
Stepped Care ◽  
Cardiac Patients ◽  
Anxiety And Depression ◽  
Service Development ◽  
Rehabilitation Service ◽  
Comorbid Anxiety ◽  
Psychological Therapies

Background/aims This was a pilot study that was part of a Department of Health and Social Care initiative to improve access to cognitive behavioural therapies for patients with long-term health conditions. The service development work involved integrating an ‘Improving Access to Psychological Therapies’ service with a cardiac rehabilitation service, to treat patients with cardiac disease and comorbid anxiety and/or depression. The aim was to reduce levels of anxiety and depression, urgent care visits, inpatient stays and outpatient appointments, and secondary care service usage. Methods A repeated-measures design was implemented using clinical data collected as part of routine practice. A quasi-control group was used for the economic evaluation, comparing patients who entered into therapy with those who did not. Collaboration between an Improving Access to Psychological Therapies and cardiac rehabilitation service identified 222 cardiac patients (142 males; 80 females) with comorbid anxiety and/or depression to access the pathway over 29 months. Patients accessed psychological therapy using the Improving Access to Psychological Therapies stepped-care model, where therapy intensity and durations varied according to patient need and complexity. Psychological outcomes were measured at three time points: assessment; end of contact; and 3-month follow up. Secondary care service usage was measured for 6 months before and after therapy. Results Significant improvements on all psychological outcomes were found when comparing scores between the three time points. Patients with coronary heart disease and myocardial infarction who received Improving Access to Psychological Therapies treatments had decreased use of secondary care hospital services. Conclusions An integrated Improving Access to Psychological Therapies and cardiac rehabilitation service can provide effective, adapted evidence-based psychological treatments for cardiac patients with comorbid anxiety and depression.

Impacts of Environmental Regulation on Sustainable Economic Growth

2018 ◽  
Vol 9 (9) ◽  
pp. 749-773
Author(s):  
Jonathan Fisher
Keyword(s):  
Economic Growth ◽  
Environmental Regulation ◽  
Technical Change ◽  
Best Practice ◽  
Environmental Regulations ◽  
The European Union ◽  
Porter Hypothesis ◽  
The United Kingdom ◽  
Environment Agency ◽  
Sustainable Economic Growth

There is considerable concern and debate about the economic impacts of environmental regulations. Jonathan Fisher, former Economics Manager at the Environment Agency in England and Wales, reviews the available evidence on this subject. Section 2 presents estimates of the costs and benefits of environmental regulations. Section 3 examines the impacts of environmental regulations on economic growth, innovation and technical change as well as impacts on competitiveness and any movement of businesses to less pollution havens. He questions call for greater certainty regarding future environmental regulations, whereas in fact there should be calls for less uncertainty. This section then suggests how this could be achieved. This section then finishes with an overview of the available evidence. This includes an examination of the Porter Hypothesis that environmental regulations can trigger greater innovation that may partially or more than fully offset the compliance costs. Section 4 then sets out principles for how better environmental regulation can improve its impacts on sustainable economic growth and illustrates how the European Union (EU) Water Framework Directive is a good example of the application of these principles in practice. Section 5 reviews current and recent political perspectives regarding developments in environmental regulations across the EU and shows how the United Kingdom (UK) has successfully positively managed to influence such developments so that EU environmental regulations now incorporate many of these principles to improve their impacts on economic growth. Section 5.1 then examines the implications of Brexit for UK environmental regulations. Finally, Section 6 sets out some best practice principles to improve the impacts of environmental regulation on sustainable economic growth, innovation and technical change.

Illuminating the decision-making strategies of anesthesia providers in challenging cases

2020 ◽  
Vol 64 (1) ◽  
pp. 653-657
Author(s):  
Joshua Biro ◽  
David M. Neyens ◽  
Candace Jaruzel ◽  
Catherine D. Tobin ◽  
Myrtede Alfred ◽  
...  
Keyword(s):  
Decision Making ◽  
Work Environment ◽  
Medication Errors ◽  
Information Seeking ◽  
Best Practice ◽  
Practice Recommendations ◽  
Medication Delivery ◽  
Anesthesia Providers ◽  
Healthcare Work ◽  
Realistic View

Medication errors and error-related scenarios in anesthesia remain an important area of research. Interventions and best practice recommendations in anesthesia are often based in the work-as-imagined healthcare system, remaining under-used due to a range of unforeseen complexities in healthcare work-as- done. In order to design adaptable anesthesia medication delivery systems, a better understanding of clinical cognition within the context of anesthesia work is needed. Fourteen interviews probing anesthesia providers’ decision making were performed. The results revealed three overarching themes: (1) anesthesia providers find cases challenging when they have incomplete information, (2) decision-making begins with information seeking, and (3) attributes such as expertise, experience, and work environment influence anesthesia providers’ information seeking and synthesis of tasks. These themes and the context within this data help create a more realistic view of work-as-done and generate insights into what potential medication error reducing interventions should look to avoid and what they could help facilitate.

scholarly journals Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Update 2020

2021 ◽  
pp. 1-69
Author(s):  
David J. Gladstone ◽  
M. Patrice Lindsay ◽  
James Douketis ◽  
Eric E Smith ◽  
Dar Dowlatshahi ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Best Practice ◽  
Practice Recommendations

Best Practice Recommendations for Optimizing Care in Structural Heart Programs: Planning Efficient and Resource Leveraging Systems (PEARLS)

2021 ◽  
Author(s):  
Elizabeth M. Perpetua ◽  
Kimberly A. Guibone ◽  
Patricia A. Keegan ◽  
Roseanne Palmer ◽  
Martina K. Speight ◽  
...  
Keyword(s):  
Best Practice ◽  
Practice Recommendations ◽  
Resource Leveraging

scholarly journals Commentary: Quality nutrition care is integral to the Oncology Care Model

2021 ◽  
Author(s):  
Mary Beth Arensberg ◽  
Beth Besecker ◽  
Laura Weldishofer ◽  
Susan Drawert
Keyword(s):  
Best Practice ◽  
Treatment Guidelines ◽  
Nutrition Therapy ◽  
Care Model ◽  
Nutrition Care ◽  
Ambulatory Oncology ◽  
Oncology Care ◽  
Improvement Programs ◽  
And Performance ◽  
Registered Dietitian Nutritionists

AbstractThe Oncology Care Model (OCM) is a US Centers for Medicare & Medicaid Services (CMS) specialty model implemented in 2016, to provide higher quality, more highly coordinated oncology care at the same or lower costs. Under the OCM, oncology clinics enter into payment arrangements that include financial and performance accountability for patients receiving chemotherapy treatment. In addition, OCM clinics commit to providing enhanced services to Medicare beneficiaries, including care coordination, navigation, and following national treatment guidelines. Nutrition is a component of best-practice cancer care, yet it may not be addressed by OCM providers even though up to 80% of patients with cancer develop malnutrition and poor nutrition has a profound impact on cancer treatment and survivorship. Only about half of US ambulatory oncology settings screen for malnutrition, registered dietitian nutritionists (RDNs) are not routinely employed by oncology clinics, and the medical nutrition therapy they provide is often not reimbursed. Thus, adequate nutrition care in US oncology clinics remains a gap area. Some oncology clinics are addressing this gap through implementation of nutrition-focused quality improvement programs (QIPs) but many are not. What is needed is a change of perspective. This paper outlines how and why quality nutrition care is integral to the OCM and can benefit patient health and provider outcomes.

The Welsh Eating Disorder Service Review 2018, Scottish Eating Disorder Service Review 2021 and recommendations of best practice in comorbid eating disorders and diabetes

2021 ◽  
pp. 135910452110138
Author(s):  
Jacinta Tan ◽  
Gemma Johns
Keyword(s):  
Eating Disorders ◽  
United Kingdom ◽  
Eating Disorder ◽  
High Mortality ◽  
Best Practice ◽  
Service Development ◽  
The United Kingdom ◽  
Scottish Government ◽  
The Relationship ◽  
Service Change

Background: Diabetes and eating disorders are frequently comorbid. This particular comorbidity is not only often poorly recognised, but is difficult to treat and has a high mortality. Method: In this article, we will briefly review the relationship between diabetes and eating disorders. We will review the current NICE and other guidance and reports concerning both diabetes and eating disorders in the United Kingdom. We will then describe the recommendations of the 2018 Welsh Government Eating Disorder Service Review and the 2021 the Scottish Government Eating Disorder Service Review regarding diabetes and eating disorders, which will lead to service change. Conclusions: We conclude that this is a relatively underdeveloped but important area where there needs to be further service development and more collaboration between diabetes and eating disorder services.

scholarly journals Best Practice Standards for the delivery of NHS Infection Services in the United Kingdom

2021 ◽  
pp. 100095
Author(s):  
Natasha VDV Ratnaraja ◽  
Angharad P Davies ◽  
Bridget L Atkins ◽  
Rishi Dhillon ◽  
Nikunj Mahida ◽  
...  
Keyword(s):  
United Kingdom ◽  
Best Practice ◽  
The United Kingdom ◽  
Practice Standards
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