scholarly journals Supporting communication in semantic dementia: clinical consensus from expert practitioners

2015 ◽  
Vol 16 (3) ◽  
pp. 153-164 ◽  
Author(s):  
Jacqueline Kindell ◽  
Karen Sage ◽  
Madeline Cruice
Keyword(s):  
Nominal Group Technique ◽  
Research Literature ◽  
Dementia Care ◽  
Semantic Dementia ◽  
Nominal Group ◽  
Content Type ◽  
Modified Delphi ◽  
Client Group ◽  
Health And Social Care ◽  
The Uk

Purpose – The purpose of this paper is to gain consensus regarding the clinical priorities and tasks required in supporting communication needs in those living with semantic dementia and their families, by specialist speech and language therapists (SLTs), working in clinical practice within dementia care settings in the UK. Design/methodology/approach – A nominal group technique was used, followed by further exploration and refinement of issues using a modified Delphi technique with a group of six SLTs who specialised in dementia care and who had experience of working with individuals with semantic dementia and their families. Findings – The findings in the study demonstrate a broader scope of practice than is evident within the research literature with this client group. Therapists identified a range of psychosocial issues for both the person with semantic dementia and their family, in particular finding ways to support activity and participation in conversation and explore barriers and facilitators within the communication environment. Originality/value – This represents the first study to explore everyday practice in this rarer dementia and the information gathered here will be of use to a variety of health and social care professions interested in supporting those with semantic dementia and their families.

scholarly journals Identifying research priorities for occupational therapy in the UK: A James Lind Alliance Priority Setting Partnership

2021 ◽  
pp. 030802262110265
Author(s):  
Jo Watson ◽  
Katherine Cowan ◽  
Hannah Spring ◽  
Jenny Mac Donnell ◽  
Ruth Unstead-Joss
Keyword(s):  
Lived Experience ◽  
Nominal Group Technique ◽  
Research Priorities ◽  
Occupational Therapists ◽  
Evidence Base ◽  
Nominal Group ◽  
Future Research ◽  
Health And Social Care ◽  
James Lind Alliance ◽  
The Uk

Introduction As the scope and nature of practice evolves in an ever-changing health and social care landscape, it is imperative the profession continues to expand the evidence base underpinning interventions. The Royal College of Occupational Therapists partnered with the James Lind Alliance to bring together people with lived experience, occupational therapists and other people working in the health and care sector to identify contemporary research priorities for the profession in the United Kingdom. Method The JLA’s well-established methodology was adopted. An opening consultation survey gathered unanswered questions. Analysis of responses and evidence checking preceded an initial prioritisation survey. The final prioritisation workshop drew on nominal group technique. Findings 927 respondents submitted 2193 questions. Those within the project’s scope were captured in 66 overarching summary questions using thematic analysis. These were initially ranked by 1140 respondents. 18 questions comprising the 10 most highly ranked by people with lived experience and by those with professional experience were considered by 19 participants in the final workshop. Together, they reached consensus on the Top 10 priorities. Conclusion These research priorities provide a contemporary framework influencing and guiding future research, ensuring it addresses the issues of greatest importance to people accessing and delivering services.

scholarly journals Resource allocation decision-making in dementia care with and without budget constraints: a qualitative analysis

2020 ◽  
Vol 3 ◽  
pp. 69
Author(s):  
Fiona Keogh ◽  
Tom Pierse ◽  
Eamon O'Shea ◽  
Christine Fitzgerald ◽  
David Challis
Keyword(s):  
Decision Making ◽  
Resource Allocation ◽  
Resource Constraints ◽  
Nominal Group Technique ◽  
Budget Constraint ◽  
Dementia Care ◽  
Assessment Process ◽  
Nominal Group ◽  
People With Dementia ◽  
Health And Social Care

Introduction: Health systems in many different countries have increasingly been reorienting the delivery of dementia care to home and community care settings. This paper provides information on how health and social care professionals (HSCPs) in Ireland make decisions on resource allocation for people with dementia living at home and how resource constraints affect their decisions and choices. Methods: A balance of care approach was used to assess resource allocation across six dementia case types, from low to high needs. Workshops were held with 24 HSCPs from multiple disciplines. Participants allocated services in two scenarios: allocation with and without a budget constraint. Nominal group technique was used to structure discussions around resource allocation in both scenarios. Thematic analysis was applied to analyse the qualitative data using a general inductive approach. Results: The following themes influenced allocative deliberations: whose needs are being met; what needs are identified; decision making context; decision making process; and allocation outcomes. Participants were proficient in making decisions, using ‘decision rules’ or heuristics to help them make decisions under fixed budget rules and sticking to conventional provision when constraints were in place. Conclusions: Freedom from a budget constraint allowed HSCPs to consider a broader range of services and to take a more expansive view on what needs should be considered, with a particular emphasis on adopting a proactive, preventative approach to the allocation of resources. The effect of the budget constraint overall was to narrow all considerations, using heuristics to limit the type of needs addressed and the range of services and supports provided. The consequences were a largely reactive, less personalised system of care. The findings emphasise the need for an integrated and comprehensive assessment process that is more concerned with individualised responses rather than relying on existing models of care alone.

scholarly journals Competing patient and professional agendas in service development

2014 ◽  
Vol 28 (6) ◽  
pp. 777-794 ◽  
Author(s):  
David Wainwright ◽  
Charlotte Boichat ◽  
Lance M. McCracken
Keyword(s):  
Chronic Pain ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Service Development ◽  
Management Service ◽  
Process Of Care ◽  
Content Type ◽  
Trade Offs ◽  
The Uk ◽  
Pain Patients

Purpose – The purpose of this paper is to engage stakeholders in the development of a community based chronic pain-management service and identify their different agendas for service design and delivery. Design/methodology/approach – Data were collected using the Nominal Group Technique (NGT), a ten-step process that generates qualitative and quantitative data. Seven NGT groups were conducted in the south-west region of the UK, three with General Practitioners and nurses, three with chronic pain patients, and one with Healthcare Commissioners. Findings – The patient agenda for service development focused on process of care issues particularly the need for deep- empathy and emotional support from providers, while professionals prioritised cost-effectiveness. While there was some overlap between agendas they were largely discrete and often contradictory. Research limitations/implications – The findings imply service planners will need to make trade-offs between cost-containment and patient satisfaction. The methodology did not allow trade-offs to be put to participants in a structured form. However, such techniques are available, for example, Conjoint Analysis. There may also be value in bringing together patients and professionals in joint focus groups, to see if the gap between their different agendas can be bridged through discussion. Originality/value – The findings provide a novel insight into the competing agendas of patients and professionals regarding service development and design which will be of value to service planners and managers as they strive to reconcile these differences.

What initiatives do healthcare leaders agree are needed for healthcare system improvement? Results of a modified-Delphi study

2018 ◽  
Vol 32 (8) ◽  
pp. 1002-1012
Author(s):  
Stuart Barson ◽  
Robin Gauld ◽  
Jonathon Gray ◽  
Goran Henriks ◽  
Christina Krause ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Healthcare System ◽  
Professional Training ◽  
Delphi Process ◽  
Content Type ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Health And Social Care ◽  
System Leaders ◽  
Practical Implications

Purpose The purpose of this paper is to identify five quality improvement initiatives for healthcare system leaders, produced by such leaders themselves, and to provide some guidance on how these could be implemented. Design/methodology/approach A multi-stage modified-Delphi process was used, blending the Delphi approach of iterative information collection, analysis and feedback, with the option for participants to revise their judgments. Findings The process reached consensus on five initiatives: change information privacy laws; overhaul professional training and work in the workplace; use co-design methods; contract for value and outcomes across health and social care; and use data from across the public and private sectors to improve equity for vulnerable populations and the sickest people. Research limitations/implications Information could not be gathered from all participants at each stage of the modified-Delphi process, and the participants did not include patients and families, potentially limiting the scope and nature of input. Practical implications The practical implications are a set of findings based on what leaders would bring to a decision-making table in an ideal world if given broad scope and capacity to make policy and organisational changes to improve healthcare systems. Originality/value This study adds to the literature a suite of recommendations for healthcare quality improvement, produced by a group of experienced healthcare system leaders from a range of contexts.

Achieving digital health sustainability: Breaking Free and CGL

2017 ◽  
Vol 22 (2) ◽  
pp. 72-82 ◽  
Author(s):  
Jonathan Ward ◽  
Glyn Davies ◽  
Stephanie Dugdale ◽  
Sarah Elison ◽  
Prun Bijral
Keyword(s):  
Free Group ◽  
Substance Misuse ◽  
Digital Health ◽  
Health Sector ◽  
Third Sector ◽  
Computer Assisted ◽  
Behavioural Science ◽  
Content Type ◽  
Health And Social Care ◽  
The Uk

Purpose Multiple challenges remain in achieving sustainability of digital health innovations, with many failing to realise their potential due to barriers to research, development and implementation. Finding an approach that overcomes these challenges is important if society is to derive benefit from these new approaches to healthcare. Having been commissioned by local authorities, NHS Trusts, prisons, charities, and third sector providers across the UK, Breaking Free Group, who in 2010 launched Breaking Free Online (BFO), a computer-assisted therapy programme for substance misuse, have overcome many of these challenges. This has been possible through close collaborative working with partner organisations, to overcome barriers to implementation and sustainability. The paper aims to discuss these issues. Design/methodology/approach This paper synthesises findings from a series of qualitative studies conducted by Breaking Free Group in collaboration with health and social care charity, Change, Grow, Live (CGL), which explore barriers and facilitators of implementation and sustainability of BFO at CGL. Data are analysed using thematic analyses with findings conceptualised using behavioural science theory. Findings This partnership has resulted in UK wide implementation of BFO at CGL, enhanced focus on digital technologies in substance misuse recovery, and a growing body of published collaborative research. Originality/value Valuable lessons have been learnt through the partnership between Breaking Free Group and CGL, which will be of interest to the wider digital health community. This paper outlines those lessons, in the hope that they will provide guidance to other digital health developers and their partners, to contribute to the continued evolution of a sustainable digital health sector.

Improving access to adult vaccination: a tool for healthy ageing

2014 ◽  
Vol 18 (2) ◽  
pp. 58-66 ◽  
Author(s):  
Jonathan Scrutton ◽  
David Sinclair ◽  
Trinley Walker
Keyword(s):  
Older People ◽  
Group Discussion ◽  
Grey Literature ◽  
Healthy Ageing ◽  
Active Ageing ◽  
Content Type ◽  
Health And Social Care ◽  
Potential Benefits ◽  
The Government ◽  
The Uk

Purpose – The purpose of this paper is to demonstrate how access to vaccination for older people in the UK can be both improved and used as a tool for healthy ageing. Design/methodology/approach – ILC-UK released a report “Adult Immunisation in the UK”, which applied a UK perspective to a 2013 Supporting Active Ageing Through Immunisation (SAATI) report on immunisation. The ILC report combined the SAATI findings with a traditional literature review, a policy review incorporating grey literature and the outcomes of a focus group discussion. This paper highlights the key findings of the ILC-UK report. Findings – Vaccination needs to be included as part of proactive strategies to promote healthy and active ageing. Initiatives need to be explored that increase the rate of delivery of vaccinations. Barriers to the vaccination of health and social care professionals working with older people need to be removed. The government should explore using psychological insights into human behaviour to improve the take-up of vaccinations amongst adults. The range of settings where older people can receive vaccination needs to be expanded. Information on the potential benefits of immunisation should be made readily available and easily accessible to older people. Practical implications – The paper calls for a structural shift in how vaccination services in the UK are organised. Social implications – The paper calls for a cultural shift in how society views immunisation and the role it has to play in the healthy ageing process. Originality/value – The paper uses new European research on immunisation and applies it to the UK's situation.

An AHP analysis of scientometrically derived factors of entrepreneurial intentions of women and constructing a conceptual research framework

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Bhairab Chandra Patra ◽  
Usha Lenka
Keyword(s):  
Research Methods ◽  
Nominal Group Technique ◽  
Influential Factors ◽  
Entrepreneurial Intentions ◽  
Nominal Group ◽  
Scientometric Analysis ◽  
Exploratory Research ◽  
Personal Factors ◽  
Content Type ◽  
Research Framework

Purpose The purpose of this study is to analyze the entrepreneurial intentions (EI) of women to better understand the cognition process of women which will help to identify the reason for their inadequate participation in the field of entrepreneurship. Design/methodology/approach This study follows the method of a traditional literature survey followed by scientometric analysis to identify the primary factors to the EI of women. The factors obtained from the literature review were provided to the nominal group, and the process of nominal group technique (NGT) was carried out to frame a research framework. The factors were then ranked based on their significance using the analytic hierarchy process (AHP), taking into consideration the review of experts. Findings Among the primary factors, personal factors were found to be the most influential factors and weighted 54%. Self-efficacy was found to be the most prominent secondary variable and had a global weight of 22.14%. Research limitations/implications The research outcome has implications for policymaking bodies, investors, academicians and potential women entrepreneurs. Future researchers can apply exploratory research methods and confirmatory research methods to test the research framework. Originality/value Very few researchers have used the technique of scientometric analysis for the review of literature on EI of women, and to the best of the authors’ knowledge, no earlier researcher has attempted to use the technique of NGT or AHP after scientometric analysis.

Beyond healthcare leadership? The imperative for health and social care systems

2020 ◽  
Vol 33 (4) ◽  
pp. 351-363
Author(s):  
John Duncan Edmonstone
Keyword(s):  
Health Care ◽  
Leadership Development ◽  
Social Care ◽  
Current Model ◽  
Healthcare Leadership ◽  
Content Type ◽  
Health And Social Care ◽  
The Future ◽  
Care Systems ◽  
The Uk

Purpose This paper aims to make the case that there is a need to move beyond a focus on an approach to leadership development which is confined to health care only. It argues that, given the economic, financial, social and organisational context within which health and social care organisations in the UK operate, there is a need to develop leadership within health and social care systems, rather than within the existing “siloed” sectors. Design/methodology/approach The paper considers the context within which health and social care organisations in the UK operate; examines the nature of those organisations; makes the case for focusing on the health and social car system through systems leadership; and identifies the need for leadership, rather than leader development. Findings There is a danger of health and social care organisations “walking backwards into the future” with eyes fixed on the past. The future lies with treating health and social care as a system, rather than focusing on organisations. The current model is individual leader focused, but the emerging model is one of collective multi-agency teams. Originality/value The paper seeks to go beyond a health-care-only focus, by asserting that there is a need to regard health and social care as a single system, delivered by a multiplicity of different organisations. This has implications for the kind of leadership involved and for how this might be developed.

scholarly journals Connections with nature for people living with dementia

2019 ◽  
Vol 23 (3) ◽  
pp. 142-151 ◽  
Author(s):  
Simon Chester Evans ◽  
Julie Barrett ◽  
Neil Mapes ◽  
June Hennell ◽  
Teresa Atkinson ◽  
...  
Keyword(s):  
Social Interaction ◽  
Online Survey ◽  
Good Practice ◽  
Dementia Care ◽  
Care Homes ◽  
Content Type ◽  
Outdoor Spaces ◽  
The Uk ◽  
Extra Care Housing

Purpose The benefits of “green dementia care”, whereby people living with dementia are supported to connect with nature, are increasingly being recognised. Evidence suggests that these benefits span physical, emotional and social spheres and can make a significant contribution towards quality of life. However, care settings often present specific challenges to promoting such connections due to a range of factors including risk-averse cultures and environmental limitations. The purpose of this paper is to report on a project that aims to explore the opportunities, benefits, barriers and enablers to interaction with nature for people living with dementia in residential care and extra care housing schemes in the UK. Design/methodology/approach Data were gathered from 144 responses to an online survey by managers/staff of extra care housing schemes and care homes in the UK. In depth-case studies were carried out at three care homes and three extra care housing schemes, involving interviews with residents, staff and family carers. Findings A wide variety of nature-based activities were reported, both outdoor and indoor. Positive benefits reported included improved mood, higher levels of social interaction and increased motivation for residents, and greater job satisfaction for staff. The design and layout of indoor and outdoor spaces is key, in addition to staff who feel enabled to promote connections with nature. Research limitations/implications This paper is based on a relatively small research project in which the participants were self-selecting and therefore not necessarily representative. Practical implications The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes. Social implications Outdoor activities can promote social interaction for people living with dementia in care settings. The authors’ findings are relevant to the recent policy focus on social prescribing. Originality/value The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

Utility relocation management in highway projects

2018 ◽  
Vol 8 (2) ◽  
pp. 171-182 ◽  
Author(s):  
Aneetha Vilventhan ◽  
Satyanarayana N. Kalidindi
Keyword(s):  
Case Studies ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Policy Changes ◽  
Highway Projects ◽  
Content Type ◽  
Coordination Strategies ◽  
Underground Utilities ◽  
Multiple Case ◽  
Practical Implications

Purpose Utility relocation issues are unfortunately frequent and recurring problems in several countries’ highway projects. Very few studies have addressed the utility relocation issues in highway projects. The purpose of this paper is two-fold. First, this paper explores how the utility relocation issues are managed in highway projects. Second, this paper systematically identifies the prioritized technical and coordination strategies to be adopted to avoid delays in utility relocation. Design/methodology/approach Multiple case-based research methodology was used to explore how the utility relocation issues are managed in highway projects. Empirical evidences from 11 road and bridge projects in India were used to develop the descriptive storyline for each of the project. The strategies used to manage the utility relocation issues were identified from three sources namely literature review, case studies and nominal group technique (NGT). The strategies were then evaluated quantitatively using NGT. Findings The analysis of the case studies showed that the delays in utility relocation were in the range of 5-52 months. It was found that the duration of relocation of utilities is impacted more significantly by the complexity of underground utilities rather than the size of the projects. Strategies that are used to manage utility relocation were identified across two groups namely; technical and coordination strategies. Practical implications Recommendations are provided for the practical use and policy changes. Originality/value The prioritized technical and coordination strategies can be used systematically to avoid delays in utility relocation.

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