Community frailty team workforce development – a personal reflection

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Eleanor Corbett ◽  
Lucy Lewis
Keyword(s):  
Workforce Development ◽  
Geographical Area ◽  
Community Health Services ◽  
Community Services ◽  
Community Response ◽  
Rapid Review ◽  
Team Approach ◽  
Personal View ◽  
Content Type ◽  
Complex Needs

PurposeThis paper represents a personal view of a newly appointed consultant practitioner trainee in frailty. This role was created as a result of a rapid workforce review of a Frailty Support Team (FST) in response to the COVID-19 pandemic.Design/methodology/approachThe FST traditionally worked alongside other community services. A “One Team” approach was developed whereby prior silos of community nursing, therapy and frailty teams became a single, locality based and mutually supportive integrated community service. This significantly increased capacity for an urgent community response for older people with complex needs and improved clinical management and coordination of care. As a workforce review identified the need for skills development, new roles for trainee advanced frailty practitioners (AFPs) and a consultant practitioner trainee in frailty were established.FindingsStaff experience of the “One Team” model was positive. The changes were thought to encourage closer and more efficient working between primary care and a range of community health services. The improved communication between professionals enabled more personalised care at home, reducing pressure on emergency hospital services. A rapid review of the workforce model has enabled the enhanced team capacity to cover a wider geographical area and improved recruitment and retention of staff by introducing a new pathway for career progression within the expanding specialism of frailty.Originality/valueThe challenge of COVID-19 has prompted rapid service redesign to create an enhanced “One Team in the community.” The innovative workforce model looks beyond traditional roles, values the experience and capabilities of staff and develops the skills and confidence required to provide a more integrated and person-centred specialist community pathway for people living with frailty.

The GP role in improving outcomes for homeless inpatients

2018 ◽  
Vol 22 (1) ◽  
pp. 15-26 ◽  
Author(s):  
Zana Khan ◽  
Philip Haine ◽  
Samantha Dorney-Smith
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Homeless People ◽  
Routine Data ◽  
Community Services ◽  
Structured Interviews ◽  
Content Type ◽  
Complex Needs ◽  
Care Services

Purpose Homeless people experience extreme health inequalities and high rates of morbidity and mortality (Aldridge et al., 2017). Use of primary care services are low, while emergency healthcare use is high (Mathie, 2012; Homeless Link, 2014). Duration of admission has been estimated to be three times longer for homeless patients who often experience poor hospital discharge arrangements (Mathie, 2012; Homeless Link, 2014). This reflects ongoing and unaddressed care and housing needs (Blackburn et al., 2017). The paper aims to discuss these issues. Design/methodology/approach This paper reveals how GPs employed in secondary care, as part of Pathway teams, support improved health and housing outcomes and safe transfer of care into community services. It draws on published literature on role of GPs in working with excluded groups, personal experience of working as a GP in secondary care, structured interviews with Pathway GPs and routine data collected by the team to highlight key outcomes. Findings The expertise of GPs is highlighted and includes holistic assessment, management of multimorbidity or “tri-morbidity” – the combination of addictions problems, mental illness and physical health (Homeless Link, 2014; Stringfellow et al., 2015) and research and teaching. Originality/value The role of the GP in the care of patients with complex needs is more visible in primary care. This paper demonstrates some of the ways in which in-reach GPs play an important role in the care of multiply excluded groups attending and admitted to secondary care settings.

Community information portals: content and design issues for information access

2014 ◽  
Vol 32 (3) ◽  
pp. 435-449 ◽  
Author(s):  
Philip Hider ◽  
Lisa M. Given ◽  
Paul Scifleet
Keyword(s):  
Public Libraries ◽  
Geographical Area ◽  
Information Access ◽  
Community Services ◽  
Content Type ◽  
Usable Information ◽  
Lack Of Information ◽  
Wide Range ◽  
Usability Analysis ◽  
Community Information

Purpose – The purpose of this paper is to report on the findings of an audit of community information (CI) portals to provide an overview of how CI is being organised and presented on the web by aggregating services, and how CI is being shaped and shared in community networks. It also investigates the role that public libraries play in online CI provision. Design/methodology/approach – The research sampled CI portals online within the Australian web domain (.au). An audit of 88 portals was undertaken to establish the scope, role and usefulness of the portals. The audit included a comprehensive usability analysis of a sub set of 20 portals evaluated for 20 different heuristics based on Nielsen's heuristic model. Findings – The research finds that the challenge facing portals is not a lack of information, it is the need to improve the mediation between the community services and people that CI portals promise useful and usable information for. While public libraries remain integral to the provision of CI in their geographical area, they now form part of a larger online network for CI provision, involving a wide range of organisations. Originality/value – The paper discusses the ways CI portals contribute to the provision of information about community services and identifies areas where improvements are needed. In particular, it discusses how these sites function as part of larger CI networks and where more innovative, and more standardised, design could lead to greater levels of engagement and utility.

The development and evaluation of an integrated intensive support service

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Karen Dodd ◽  
Vicky Laute ◽  
Selven Daniel
Keyword(s):  
Design Methodology ◽  
Community Support ◽  
Support Service ◽  
Community Services ◽  
Inpatient Unit ◽  
Content Type ◽  
Complex Needs ◽  
Adults With Learning Disabilities ◽  
Practical Implications ◽  
Placement Breakdown

Purpose This paper aims to describe the development and evaluation of integrated intensive support service (ISS) for adults with learning disabilities who have complex needs and are at risk of admission to an inpatient unit. Design/methodology/approach Existing services were remodelled. The service explored external service models and established an integrated ISS comprising intensive community support and intensive support beds. Findings Data indicates that the majority of people referred to the service avoid both admission to an inpatient unit and placement breakdown. Most people admitted to the inpatient unit are not known to community services. Length of stay has significantly reduced. Practical implications Other services can use the information to remodel how to provide intensive support and avoid admission to an inpatient unit. Originality/value It demonstrates how remodelling can drive improvements to reduce placement breakdown and risk of admission.

Risks of financial abuse of older people with dementia: findings from a survey of UK voluntary sector dementia community services staff

2014 ◽  
Vol 16 (3) ◽  
pp. 180-192 ◽  
Author(s):  
Kritika Samsi ◽  
Jill Manthorpe ◽  
Karishma Chandaria
Keyword(s):  
Online Survey ◽  
Local Community ◽  
Community Support ◽  
Voluntary Sector ◽  
Community Services ◽  
Warning Signs ◽  
Money Management ◽  
Content Type ◽  
Financial Abuse ◽  
People With Dementia

Purpose – Financial abuse of people with dementia is of rising concern to family carers, the voluntary sector and professionals. Little is known about preventative and early response practice among community services staff. The purpose of this paper is to investigate voluntary sector staff's views of the risks of managing money when a person has a dementia and explore ways that individuals may be protected from the risks of financial abuse. Design/methodology/approach – An online survey of staff of local Alzheimer's Society groups across England was conducted in 2011 and was completed by 86 respondents. Open-ended responses supplemented survey questions. Statistical analysis and content analysis identified emergent findings. Findings – Most respondents said their people with dementia experienced problems with money management, with almost half the respondents reporting encountering cases of financial abuse over the past year. Most were alert to warning signs and vulnerabilities and offered suggestions relevant to practice and policy about prevention and risk minimization. Research limitations/implications – Adult safeguarding practitioners are likely to encounter money management uncertainties and concerns about exploitation of people with dementia. They may be contacted by community-based support staff from the voluntary sector about individual queries but could ensure that such practitioners are engaged in local training and networking activities to promote their skills and confidence. Practical implications – As with other forms of elder abuse, professionals need to be aware of risks of financial abuse and be able to suggest effective yet acceptable preventive measures and ways to reduce risks of harm and loss. Further publicity about adult safeguarding services may be needed among local community support services. Originality/value – There have been few studies investigating the views of people working with people with dementia in the community about adult safeguarding.

Institutional context and hotel social responsibility

Kybernetes ◽  
2014 ◽  
Vol 43 (3/4) ◽  
pp. 413-426 ◽  
Author(s):  
María Dolores Sánchez-Fernández ◽  
Alfonso Vargas-Sánchez ◽  
Paula Remoaldo
Keyword(s):  
Social Responsibility ◽  
Institutional Theory ◽  
Geographical Area ◽  
Institutional Context ◽  
Theoretical Framework ◽  
Northern Region ◽  
Structural Equations ◽  
Partial Least Square ◽  
Least Square ◽  
Content Type

Purpose – The authors want to study the connection between institutional theory and corporate social responsibility (CSR) in the set of hotels with three, four and five star situated in Galicia (Spain) and in the Northern region of Portugal. The authors aim to see whether there is a contrast of isomorphic behaviour in the institutional context of both regions. Design/methodology/approach – A quantitative study in which the authors apply the partial least square (PLS) technique, a methodology based on structural equations models using the software Visual-PLS. The authors intend to study the relationships between the pressures of institutional context and CSR practices, together with the relationship between legitimacy and these practices. The focus of the proposed model is based on the system theory. Findings – The main findings of this research clearly show that hotels are incorporated into an institutional context marked by enforced and regulatory pressures. Research limitations/implications – The proposed research model can be replicated using other units of study, sectors, geographic areas, among others, due to the explanatory capacity of the theoretical framework used. Originality/value – The originality of this work derives from the main contributions based on the theoretical framework (institutional theory and CSR), the object of study and geographical area (three, four and five star hotels located in Galicia and in the North of Portugal), the context (economic crisis), the field of study (private sphere) and the type of organizations (profit making).

Cooperative behaviour and place branding: a longitudinal case study in Italy

2016 ◽  
Vol 19 (2) ◽  
pp. 156-172 ◽  
Author(s):  
Chiara Rinaldi ◽  
Alessio Cavicchi
Keyword(s):  
Geographical Area ◽  
Place Branding ◽  
Cooperative Behaviour ◽  
Longitudinal Case Study ◽  
Case Study Methodology ◽  
Content Type ◽  
Study Methodology ◽  
As Relationship

Purpose This paper aims to understand the motivations driving cooperative behaviour between heterogeneous stakeholders in place-branding activities, focusing on contract-based and relation-based cooperation constructs. Design/methodology/approach The longitudinal case study method is used to help understanding how the investigated network has evolved over four years from an attempt to build a regional umbrella-brand to a network contract between 13 enterprises. Findings The findings suggest that the relationships of trust and shared values among stakeholders are essential to foster cooperation, but also that contract-based governance complements a relation-based governance, enhancing the performance of the alliance. Research limitations/implications The main limitation is related to the case study methodology, as results are strongly dependent on the specific characteristics of the stakeholders and the geographical area analysed. Social implications The role of stakeholders in building a place brand is increasingly important. When analysing cooperative behaviour drivers, more attention should be paid to such intangible assets as social, human, relational and organisational capital. Originality/value This longitudinal case study emphasises that for success in place-branding activities, contract-based cooperation can be particularly useful at the beginning of a network alliance, while relation-based cooperation ensures the strength and continuity of the partnership but it takes time to develop. Responsible leaders, working as relationship facilitators/enablers, are important to keep network members engaged, by creating trust and favouring mutual beneficial relationships between stakeholders.

The benefits and disadvantages of the law on the expansion of the jurisdiction of the DIFC Court

2018 ◽  
Vol 60 (2) ◽  
pp. 221-232
Author(s):  
Tareq Na’el Al-Tawil ◽  
Prabhakar Gantasala ◽  
Hassan Younies
Keyword(s):  
English Language ◽  
Geographical Area ◽  
Legal Framework ◽  
Negative Consequences ◽  
Content Type ◽  
Limited Volume ◽  
Financial Centre ◽  
The World ◽  
Long Time ◽  
The Law

Purpose This paper aims to discuss the benefits and disadvantages of the law on the expansion of the jurisdiction of the Dubai International Financial Centre (DIFC) Court. The major role of DIFC Courts in the Arab community is to handle cases related to commerce and business. For a long time, the court had been acting only in their geographical area until a new law was enacted to extend their jurisdiction all over the world. Afterward, a lot of criticism emerged as for why and how the court will benefit from such actions. The law has drawn a harsh response, although most benefits have also been experienced since the court received quite a large number of new signings. Interaction at the world business forum has benefited the economy of Dubai thanks to the law. Design/methodology/approach The following study focuses on a description of such benefits and drawbacks. The study does not evaluate a factual process of expansion but indicates the most distinct evidence of positive, as well as negative consequences of the expansion. Findings It is appropriate to make a general comment on the fact that the expansion of DIFC Court is not sufficiently effective at the current stage. Needless to say, it contains numerous positive aspects, but the gaps are evidently essential because they place the entire Court in a hard circumstance. The Court does not have a well-developed legal framework for its new area of jurisdiction as long as its limited volume of prior precedent is a distinct sign of the Court’s dependence on the UAE’s Law. In such way, DIFC Court will not be able to address issues within new fields of jurisdiction, as it simply lacks an expertise and international law in its legal framework. Moreover, the jurisdiction over new areas of international business was not verified with a plain system of mediation, which is why a current expansion of DIFC Court has to be recognized as redundant. However, its advantages are tending to produce their effects provided that the Court manages to address its current problems. Originality/value The study has described the basic benefits and drawbacks of DIFC Court expansion. To speak about the main benefits, they can be depicted as appliance of the common law, unification of English language for proceedings, presence of a preliminary arbitration and guarantees of award enforcement. In a similar way, the drawbacks of the expansion have been issued. The study has identified such drawbacks as lack of international and sophisticated expertise, untested legal framework, strong influence of forum non conveniens, and existence of a limited volume of prior precedent. The paper has not assessed a success of a factual expansion of DIFC Court jurisdiction, but it has managed to fulfill its primary purpose. Thus, the paper has identified a certain tendency concerning the expansion.

Local economic development and the skills gap: observations on the case of Tampa, Florida

2018 ◽  
Vol 8 (4) ◽  
pp. 451-468 ◽  
Author(s):  
Robert W. Robertson
Keyword(s):  
Economic Development ◽  
Focus Group ◽  
Workforce Development ◽  
Local Economic Development ◽  
Workforce Training ◽  
Skills Gap ◽  
Content Type ◽  
Key Stakeholders ◽  
The Usa ◽  
Public Record

Purpose The purpose of this paper is to provide an overview of the “skills gap” concerns that are increasingly prevalent in the USA and globally. In particular, the paper explores the current skills gap debate as a component of the American economy. This is an important issue as there is an increased economic uncertainty and global competition impacting many sectors. The paper specifically defines the current skills gap dilemma with respect to the USA and uses the Tampa, FL example of the practical implications of these concerns using recent survey and focus group data. Design/methodology/approach The research for this paper includes an outline of the economic development structures in place in Tampa, FL, a description of the existing mandate(s) to improve workforce training; the review of a key recent, public record report on workforce skills; and, the results of a focus group developed using key stakeholders. Initially, a public record document report titled Clarus Corporation (2013) “Hillsborough Community College: Workforce Development Scan” was reviewed to provide context and preliminary data to guide the research. In the second phase, a survey was conducted to develop a focus group of 18 key stakeholders in Hillsborough County. Nine of these stakeholders represented the education sector. These were purposefully selected from the Tampa Bay Higher Education Alliance (TBHEA) which represents approximately 30 regionally accredited academic institutions in the Tampa community (TBHEA, n.d.). In addition, another nine respondents were selected by purposeful selection representing employers who had experience with workforce training and development initiatives. Findings The group survey conducted for this paper confirms concerns by both employers and educators with respect to the existing and the future skill sets of employees. In particular, respondents note that basic skills such as communication and technical skills need more attention. Also, the focus group respondents confirm the importance of technical service certification. Fundamentally, economic development professionals, educators and employers need to develop and implement strategies and action plans to ensure that the skills gap be identified correctly and properly addressed. These initiatives must be developed with broad stakeholder input and these initiatives must be viewed as dynamic reflecting changing circumstances. Research limitations/implications This research should be viewed as exploratory in nature. The research could serve as a template to develop and track the concerns and issues of key stakeholders in the economic development process with respect to skills in the workforce on a regional or indeed a statewide basis. Practical implications Nations, states and local governments are more active in structuring workforce development support mechanisms and specific training opportunities to assist employees and businesses. All levels of government highlight the fact that they have skilled, competitive employees to assist in recruiting new companies to consider locating in their respective jurisdictions and in retaining companies. Social implications Having a clear understanding of the skills being demanded by employers as they strive to remain globally competitive is important. Local economic development officials, academicians and employers must be on the same page. Although relationships between these sectors are critical flexibility and adaptability are key to reflect changing demands. Originality/value The paper provides empirical evidence of the perceptions employers and educators have with respect to the skills gap issue in a fast growth jurisdiction. This jurisdiction promotes itself as having an abundant and skilled labor force. Data suggest that there are some concerns emerging from stakeholders.

scholarly journals Exploring health work: a critical-action perspective

2017 ◽  
Vol 31 (5) ◽  
pp. 567-580 ◽  
Author(s):  
John Hassard ◽  
Paula Hyde ◽  
Julie Wolfram Cox ◽  
Edward Granter ◽  
Leo McCann
Keyword(s):  
Health Service ◽  
New Public Management ◽  
Hybrid Approach ◽  
Community Services ◽  
Ethnographic Study ◽  
Research Issues ◽  
Content Type ◽  
Main Research ◽  
Service Organisation ◽  
Critical Action

Purpose The purpose of this paper is to describe a hybrid approach to the research developed during a multi-researcher, ethnographic study of NHS management in the UK. Design/methodology/approach This methodological paper elaborates a hybrid approach to the sociological analysis – the critical-action theory – and indicates how it can contribute to the critical health management studies. Findings After exploring the various theoretical, methodological and philosophical options available, the paper discusses the main research issues that influenced the development of this perspective and the process by which the critical-action perspective was applied to the studies of managerial work in four health service sectors – acute hospitals, ambulance services, community services and mental healthcare. Research limitations/implications This methodological perspective enabled a critical analysis of health service organisation that considered macro, meso and micro effects, in particular and in this case, how new public management drained power from clinicians through managerialist discourses and practices. Practical implications Healthcare organisations are often responding to the decisions that lie outside of their control and may have to enact changes that make little sense locally. In order to make sense of these effects, micro-, meso- and macro-level analyses are necessary. Originality/value The critical-action perspective is presented as an adjunct to traditional approaches that have been taken to the study of health service organisation and delivery.

scholarly journals Homelessness and integrated care: an application of integrated care knowledge to understanding services for wicked issues

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Michael Clark ◽  
Michelle Cornes ◽  
Martin Whiteford ◽  
Robert Aldridge ◽  
Elizabeth Biswell ◽  
...  
Keyword(s):  
Integrated Care ◽  
Hospital Discharge ◽  
Secondary Analysis ◽  
Policy Issue ◽  
Content Type ◽  
Complex Needs ◽  
Integration Of Services ◽  
Key Issues ◽  
Discharge From Hospital ◽  
High Degree

PurposePeople experiencing homelessness often have complex needs requiring a range of support. These may include health problems (physical illness, mental health and/or substance misuse) as well as social, financial and housing needs. Addressing these issues requires a high degree of coordination amongst services. It is, thus, an example of a wicked policy issue. The purpose of this paper is to examine the challenge of integrating care in this context using evidence from an evaluation of English hospital discharge services for people experiencing homelessness.Design/methodology/approachThe paper undertakes secondary analysis of qualitative data from a mixed methods evaluation of hospital discharge schemes and uses an established framework for understanding integrated care, the Rainbow Model of Integrated Care (RMIC), to help examine the complexities of integration in this area.FindingsSupporting people experiencing homelessness to have a good discharge from hospital was confirmed as a wicked policy issue. The RMIC provided a strong framework for exploring the concept of integration, demonstrating how intertwined the elements of the framework are and, hence, that solutions need to be holistically organised across the RMIC. Limitations to integration were also highlighted, such as shortages of suitable accommodation and the impacts of policies in aligned areas of the welfare state.Research limitations/implicationsThe data for this secondary analysis were not specifically focussed on integration which meant the themes in the RMIC could not be explored directly nor in as much depth. However, important issues raised in the data directly related to integration of support, and the RMIC emerged as a helpful organising framework for understanding integration in this wicked policy context.Practical implicationsIntegration is happening in services directly concerned with the discharge from hospital of people experiencing homelessness. Key challenges to this integration are reported in terms of the RMIC, which would be a helpful framework for planning better integrated care for this area of practice.Social implicationsAddressing homelessness not only requires careful planning of integration of services at specific pathway points, such as hospital discharge, but also integration across wider systems. A complex set of challenges are discussed to help with planning the better integration desired, and the RMIC was seen as a helpful framework for thinking about key issues and their interactions.Originality/valueThis paper examines an application of integrated care knowledge to a key complex, or wicked policy issue.

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