Implementation of patient-focused care: before-after effects

2014 ◽  
Vol 27 (7) ◽  
pp. 594-604 ◽  
Author(s):  
Bodil Wilde-Larsson ◽  
Marianne Inde ◽  
Annika Carlson ◽  
Gun Nordström ◽  
Gerry Larsson ◽  
...  
Keyword(s):  
Large Scale ◽  
Healthcare Providers ◽  
Work Climate ◽  
Care Quality ◽  
Content Type ◽  
After Effects ◽  
Quality Ratings ◽  
Health And Social Care ◽  
Before And After ◽  
Post Assessment

Purpose – The purpose of this paper is to evaluate an organizationally oriented, patient-focused care (PFC) model's effects on care quality and work climate. Design/methodology/approach – The study has a before-after (PFC implementation) design. The sample included 1,474 patients and 458 healthcare providers in six participating wards before and after PFC implementation, plus five additional randomly chosen wards, which only featured in the post-assessment. Findings – No pre-post differences were found regarding care perceptions or provider work climate evaluations. Statistically significant improvements were noted among provider care evaluations. Using aggregate-level ward data, multiple regression analyses showed that high adherence to PFC principles and a positive work climate contributed significantly to variance among care quality ratings. Research limitations/implications – Among healthcare providers, questions related to specific PFC aspects during evenings, nights and weekends had to be dropped owing to a low response rate. Practical implications – An important requirement for both practice and research is to tailor PFC to various health and social care contexts. Originality/value – The study is large-scale before-after PFC model review, where patient and provider data were collected using well-established measurements.

A logic model of the implementation of a regional workforce strategy in positive behavioural support

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Noone ◽  
Alison Branch ◽  
Melissa Sherring
Keyword(s):  
Large Scale ◽  
Social Care ◽  
Building Blocks ◽  
Logic Model ◽  
Competency Framework ◽  
Health Staff ◽  
Content Type ◽  
Behavioural Support ◽  
Health And Social Care ◽  
Wide Range

Purpose Positive behavioural support (PBS) as a framework for delivering quality services is recognised in important policy documents (CQC, 2020; NICE, 2018), yet there is an absence in the literature on how this could be implemented on a large scale. The purpose of this paper is to describe a recent implementation of a workforce strategy to develop PBS across social care and health staff and family carers, within the footprint of a large integrated care system. Design/methodology/approach A logic model describes how an initial scoping exercise led to the production of a regional workforce strategy based on the PBS Competence Framework (2015). It shows how the creation of a regional steering group was able to coordinate important developmental stages and integrate multiple agencies into a single strategy to implement teaching and education in PBS. It describes the number of people who received teaching and education in PBS and the regional impact of the project in promoting cultural change within services. Findings This paper demonstrates a proof of concept that it is possible to translate the PBS Competency Framework (2015) into accredited courses. Initial scoping work highlighted the ineffectiveness of traditional training in PBS. Using blended learning and competency-based supervision and assessment, it was possible to create a new way to promote large-scale service developments in PBS supported by the governance of a new organisational structure. This also included family training delivered by family trainers. This builds on the ideas by Denne et al. (2020) that many of the necessary building blocks of implementation already exist within a system. Social implications A co-ordinated teaching and education strategy in PBS may help a wide range of carers to become more effective in supporting the people they care for. Originality/value This is the first attempt to describe the implementation of a framework for PBS within a defined geographical location. It describes the collaboration of health and social care planners and a local university to create a suite of courses built around the PBS coalition competency framework.

The factors of consumer confidence recovery after scandals in food supply chain safety

2018 ◽  
Vol 30 (5) ◽  
pp. 1379-1400 ◽  
Author(s):  
Shuhui Wang ◽  
Paul Alexander
Keyword(s):  
Decision Making ◽  
Food Safety ◽  
Supply Chains ◽  
Large Scale ◽  
Deductive Reasoning ◽  
Consumer Confidence ◽  
Milk Formula ◽  
Extended Model ◽  
Content Type ◽  
Before And After

Purpose Viewing consumer confidence as a set of static factors has informed previous research and underpinned strategies used in recovering from food safety quality failures, but this approach has not delivered reliable and quick recovery from large-scale food safety scandals. The purpose of this paper is to examine extant models and the factors they are composed of, and suggest an extended model that has a better potential for consumer confidence. The paper focuses on food products where supply chains are visible, and use these features to group the findings. Design/methodology/approach In this study principal components and logit analyses are used to assess the role of 30 variables operating in a consumer confidence model constructed from several existing in the literature. This combined model considers emotional, cognitive, trust and sociodemographic factors. In total, 14 independent factors are identified. The authors examine the factors, and from these, the decision-making mechanisms before and after the Sanlu Infant Milk Formula (IMF) scandal of 2008. Findings The authors find that the factors considered by consumers are different for different IMF supply chains, and different again before and after the scandal. The authors develop the argument for an extension to the existing models, incorporating a dynamic consumer confidence system. Research limitations/implications The paper uses a single survey after the focus event to establish “before” and “after” decision-making factors. Since the IMF scandal is recent and of very high profile, this is likely valid even if it carries memory bias effects. The study is directly applicable to food safety scandals in a Chinese context. Deductive reasoning extends our assertions to a wider context. They are logically validated but have not been formally tested. Practical implications Using this system as a framework a checklist for recovery from a similar food safety scandal is suggested. The authors also suggest more general use for use where supply chains features are visible to consumers. Originality/value Models for food safety consumer confidence recovery have previously focused on identifying models and the static factors they consist of. These do represent a reflection of how this phenomenon operates, but using the principals of this model nevertheless does not result in good recovery from extreme food safety failures. This paper contributes by extending these models to one that can be applied for better recovery.

scholarly journals The Digital House of Care: information solutions for integrated care

2016 ◽  
Vol 24 (5/6) ◽  
pp. 237-248 ◽  
Author(s):  
Andrew Muirhead ◽  
Derek George Ward ◽  
Brenda Howard
Keyword(s):  
Large Scale ◽  
Social Care ◽  
Care Delivery ◽  
Service Planning ◽  
Recent Experience ◽  
Organisational Development ◽  
Digital Tool ◽  
Content Type ◽  
Health And Social Care ◽  
Care Information

Purpose The purpose of this paper is to describe the development of a digital tool in an English county striving towards a vision of integrated information that is used to underpin an increasingly integrated future of health and social care delivery. Design/methodology/approach It discusses the policy context nationally, the origins and implementation of the initiative, the authors’ experiences and viewpoint highlighting key challenges and learning, as well as examples of new work undertaken. Findings In all, 12 health and care organisations have participated in this project. The ability for local commissioners and providers of services to now understand “flow” both between and within services at a granular level is unique. Costs are modest, and the opportunities for refining and better targeting as well as validating services are significant, thus demonstrating a return on investment. Key learning includes how organisational development was equally as important as the implementation of innovative new software, that change management from grass roots to strategic leaders is vital, and that the whole system is greater than the sum of its otherwise in-silo parts. Practical implications Data linkage initiatives, whether local, regional or national in scale, need to be programme managed. A robust governance and accountability framework must be in place to realise the benefits of such as a solution, and IT infrastructure is paramount. Social implications Organisational development, collaborative as well as distributed leadership, and managing a change in culture towards health and care information is critical in order to create a supportive environment that fosters learning across organisational boundaries. Originality/value This paper draws on the recent experience of achieving large-scale data integration across the boundaries of health and social care, to help plan and commission services more effectively. This rich, multi-agency intelligence has already begun to change the way in which the system considers service planning, and learning from this county’s approach may assist others considering similar initiatives.

Using HCAHPS data to improve hospital care quality

2016 ◽  
Vol 28 (6) ◽  
pp. 974-990 ◽  
Author(s):  
John C. Carter ◽  
Fred N. Silverman
Keyword(s):  
Patient Satisfaction ◽  
Survey Data ◽  
Healthcare Providers ◽  
Hospital Management ◽  
Care Quality ◽  
Future Research ◽  
Content Type ◽  
Pareto Analysis ◽  
Hospital Administrators ◽  
Patient Satisfaction Scores

Purpose The purpose of this paper is twofold: to enable hospital administrators to increase reimbursement rates under value-based purchasing (VBP) by understanding the process by which the Centers for Medicare and Medicaid Services (CMS) calculate and use performance scores from the Hospital Consumer Assessment of Healthcare Providers and Systems survey of patient experience; to apply statistical methods to determine what dimensions of patient care have the greatest impact on overall satisfaction scores and thus reimbursement. Design/methodology/approach The expository purpose was met by locating, analyzing and interpreting published CMS documentation related to VBP to explain the complex methods used to convert raw survey data to total patient satisfaction scores on seven dimensions. The raw data on 2,984 hospitals were cleaned and correlation and regression analysis used to measure the relationship between raw survey scores and overall patient satisfaction scores. Finally, Pareto analysis was used to show the relative influence of each dimension on satisfaction performance scores. Findings Nursing communications accounted for 75 percent of the variance in the patient satisfaction domain score in a stepwise regression. Research limitations/implications This research focusses only on the patient satisfaction component of VBP, over which hospital administrators have significant control. Future research could explore how hospital management can improve scores on clinical outcomes, process and efficiency. Practical implications Shows hospital management the most influential methods for improving their patient satisfaction scores and reimbursement under VBP. Originality/value Offers a managerially focussed explanation of how patient satisfaction scores are computed from raw survey data and how statistical analysis of the data can be used to improve quality.

Quality improvement at East London NHS Foundation Trust: the pathway to embedding lasting change

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Owen P. O'Sullivan ◽  
Nynn Hui Chang ◽  
Philip Baker ◽  
Amar Shah
Keyword(s):  
Quality Improvement ◽  
Large Scale ◽  
Planning Process ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Organisational Change ◽  
Community Health Services ◽  
Current Status ◽  
Content Type ◽  
Qualitative Feedback

PurposeEast London NHS Foundation Trust (ELFT) is a major provider of mental healthcare and community health services. Quality improvement (QI) has become central to its organisational policy and goals for which it has received national and international attention.Design/methodology/approachThis piece reflects on the Trust's transformation and its approach. It provides many examples and discusses several of the associated challenges in building and sustaining QI momentum. It is the result of a range of perspectives from staff involved in planning and building large-scale QI capability. It contextualises QI's current status in UK mental healthcare.FindingsSeveral key factors were identified: board-led commitment to organisational transformation; investment in training and resources to support staff motivation; clear and realistic project goals in line with the service's over-arching strategic direction; support for service users and staff at all levels to get involved to address issues that matter to them; and, finally, placement of a high value on service user and staff qualitative feedback.Practical implicationsBuilding QI capability represents a significant challenge faced by all large healthcare providers. Sharing experiences of change can assist other organisations achieve the necessary buy-in and support the planning process.Originality/valueAchieving and sustaining lasting organisational change in healthcare is challenging. This article provides a background on QI at ELFT and reflects on the pathway to its present position at the forefront of the application of QI within healthcare.

Integrated care communities: putting change theory into practice

2014 ◽  
Vol 22 (4) ◽  
pp. 132-141 ◽  
Author(s):  
Elizabeth Bradbury
Keyword(s):  
Integrated Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Large Scale ◽  
Social Care ◽  
Content Type ◽  
North West ◽  
Health And Social Care ◽  
Capability Building ◽  
Complex Adaptive

Purpose – The purpose of this paper is to reflect on the experience of the Advancing Quality Alliance's (AQuA) regional Integrated Care Discovery Community created to translate integrated care theory into practice at scale and to test ways to address the system enablers of integrated care. Design/methodology/approach – Principles of flexibility, agility, credibility and scale influenced Community design. The theoretical framework drew on relevant complexity, learning community and change management theories. Co-designed with stakeholders, the discovery-based Community model incorporated emergent learning from change in complex adaptive environments and focused bespoke support on leadership capability building. Findings – In total, 19 health and social care economies participated. Kotter's eight-step change model proved flexible in conjunction with large-scale change theories. The tension between programme management, learning communities and the emergent nature of change in complex adaptive systems can be harnessed to inject pace and urgency. Mental models and simple rules were helpful in managing participant's desire for a directive approach in the context of a discovery programme. Research limitations/implications – This is a viewpoint from a regional improvement organisation in North West England. Social implications – The Discovery Community was a useful construct through which to rapidly develop multiple integrated health and social care economies. Flexible design and bespoke delivery is crucial in a complex adaptive environment. Capability building needs to be agile enough to meet the emergent needs of a changing workforce. Collaborative leadership has emerged as an area requiring particular attention. Originality/value – Learning from AQuA's approach may assist others in structuring large-scale integrated care or complex change initiatives.

Patient perceptions of quality: analyzing patient satisfaction surveys

2015 ◽  
Vol 35 (8) ◽  
pp. 1158-1181 ◽  
Author(s):  
Roberta S. Russell ◽  
Dana M. Johnson ◽  
Sheneeta W White
Keyword(s):  
Patient Satisfaction ◽  
Care Provider ◽  
Healthcare Providers ◽  
Academic Research ◽  
Quality Of Healthcare ◽  
Care Quality ◽  
Patient Perceptions ◽  
Medical Specialties ◽  
Content Type

Purpose – Healthcare facilities are entering an era of increased oversight and heightened expectations concerning both reduced costs and measureable quality. The US Affordable Care Act requires healthcare organizations to collect certain metrics, including patient assessments of quality, in order to monitor and improve the quality of healthcare. These metrics are used as a basis for graduated insurance reimbursements, and are available to consumers as an aid in selecting healthcare providers and insurance plans. The purpose of this paper is to provide healthcare providers with the analytic capabilities to better understand quality of care from the patient’s point of view. Design/methodology/approach – This research examines patient satisfaction data from a multi-specialty Medical Practice Group, and uses regression analysis and paired comparisons to provide insight into patient perceptions of care quality. Findings – Results show that variables related to Access, Moving Through the Visit, Nurse/Assistant, Care Provider and Personal Issues significantly impact overall assessments of care quality. In addition, while gender and type of care provider do not appear to have an impact on overall patient satisfaction, significant differences do exist based on age group, specialty of the physician and clinic type. Originality/value – This study differs from most academic research as it focusses on medical practices, rather than hospitals, and includes multiple clinic types, medical specialties and physician types in the analysis. The study demonstrates how analytics and patient perceptions of quality can inform policy decisions.

Partnership in action: forging a new approach

2018 ◽  
Vol 21 (3/4) ◽  
pp. 99-107 ◽  
Author(s):  
Sarah Roxby
Keyword(s):  
Healthcare Providers ◽  
Health Sector ◽  
New Approach ◽  
Content Type ◽  
Language And Culture ◽  
Health And Wellbeing ◽  
Time Commitment ◽  
Health And Social Care ◽  
Working Together ◽  
Two Sectors

Purpose Professional partnerships between housing and health are not impossible, but they take time, commitment and dedicated strategic leadership. The language and culture of the two sectors are sometimes complex and do not always match. There can be issues understanding each other’s motivation, ethics and terminology which can cause a barrier when working together. The purpose of this paper is to share the journey of how Wakefield District Housing (WDH) is working with the care and health sector to create sustainable partnerships that benefit both parties, getting to a stage where they could successfully integrate with healthcare providers in the Wakefield district. Design/methodology/approach The paper offers the reader an overview of how WDH’s membership of the Wakefield Health and Wellbeing Board enabled improved partnership working with NHS and other members, including the establishment of a Housing, Health and Social Care Partnership, the employment of dedicated senior staff, co-located multi-disciplinary teams and joint design of new services. Findings WDH has demonstrated that the organisation understands the challenges facing NHS colleagues, has acknowledged the complexities of the system that their partners work in and looked for solutions alongside them. The opportunities within partnership working are boundless and, if successful, the outcomes for tenants and the wider Wakefield population could be in excess of those envisaged in planning the project. Partnerships will almost inevitably encounter challenges along the way but if all partners keep their own and shared visions in mind, further success is within reach and all parties will get there faster by not going alone. Practical implications The paper offers useful guidance and ideas for other housing organisations aiming to improve their contribution to local integrated healthcare. Originality/value This paper provides an original perspective from inside the programme, offering practical, comprehensive and deliverable initiatives to improve health outcomes for local communities.

Library and information services: impact on patient care quality

2014 ◽  
Vol 27 (8) ◽  
pp. 672-683 ◽  
Author(s):  
Joanne Gard Marshall ◽  
Jennifer Craft Morgan ◽  
Cheryl A. Thompson ◽  
Amber L. Wells
Keyword(s):  
Patient Care ◽  
Critical Incident ◽  
Large Scale ◽  
Positive Impact ◽  
Information Access ◽  
Care Quality ◽  
Access Methods ◽  
Content Type ◽  
Library Resources ◽  
Patient Care Quality

Purpose – The purpose of this paper is to explore library and information service impact on patient care quality. Design/methodology/approach – A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. Findings – Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. Originality/value – Electronic collections and services provided by the library and the librarian contribute to patient care quality.

scholarly journals Quality and legal aspects in public care procurement

2016 ◽  
Vol 28 (4) ◽  
pp. 648-663 ◽  
Author(s):  
Jan Bröchner ◽  
Carolina Camén ◽  
Henrik Eriksson ◽  
Rickard Garvare
Keyword(s):  
Social Care ◽  
Public Procurement ◽  
Public Awareness ◽  
Legal Aspects ◽  
Care Quality ◽  
Equal Treatment ◽  
Care Providers ◽  
Content Type ◽  
Legal Principles ◽  
Health And Social Care

Purpose – The purpose of this paper is to assess the applicability of care quality concepts as contract award criteria for public procurement of health and social care, using the case of Sweden. Design/methodology/approach – Based on a literature review, European and Swedish legal texts, government regulations as well as 26 Swedish court review cases concerning care procurement have been analysed. Findings – Methods used for assessing care quality are seldom useful for predicting the quality to be delivered by a potential contractor. Legal principles of transparency and equal treatment of tenderers make it necessary to apply strict requirements for verification. Research limitations/implications – Results refer primarily to a Swedish context but could be applicable throughout the EU. Further studies of relations between award criteria and public/private collaborative practices for improving care quality during contractual periods are desirable. Practical implications – Local and regional procurement officials should benefit from a better understanding of how quality criteria should be designed and applied to the award procedures for care contracts. Care providers in the private sector would also be able to develop their quality strategies and present their abilities more efficiently when tendering for public contracts. Social implications – Issues of quality of health and social care are of obvious importance for social sustainability. Public awareness of care quality problems is evident and often a cause of media concern. Originality/value – This investigation pinpoints the difference between traditional care quality thinking and the legal principles underlying contract award in public procurement of care services.

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