Developing new models of care at speed: learning from healthcare redesign for children with COVID-related multisystem inflammation

This article describes the rapid, system-wide reconfiguration of local and network services in response to the newly described paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) (also known as multisystem inflammatory syndrome in children). Developing the model of care for this novel disease, whose natural history, characteristics and treatment options were still unclear, presented distinct challenges.We analyse this redesign through the lens of healthcare management science, and outline transferable principles which may be of specific and urgent relevance for paediatricians yet to experience the full impact of the COVID-19 pandemic; and more generally, for those developing a new clinical service or healthcare operating model to manage the sudden emergence of any unanticipated clinical entity. Health service leaders in areas where COVID-19 is, or will soon be, in the ascendancy, and who are anticipating the imminent influx of PIMS-TS, should use these principles and recommendations to plan an agile, responsive and system-wide model of care for these children.

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Using the PEPPA framework to develop the nurse practitioner role in emergency care: Critical reflections

Nordic Journal of Nursing Research ◽

10.1177/2057158520988478 ◽

2021 ◽

pp. 205715852098847

Author(s):

Erika Boman ◽

Kim Gaarde ◽

Rika Levy-Malmberg ◽

Frances Kam Yuet Wong ◽

Lisbeth Fagerström

Keyword(s):

Emergency Department ◽

Nurse Practitioner ◽

Current Model ◽

Models Of Care ◽

Advanced Practice Nursing ◽

Model Of Care ◽

New Model ◽

New Models ◽

Nursing Roles ◽

Practitioner Role

In this article, we describe and critically reflect on how the PEPPA framework, a Participatory Evidence-based Patient-focused Process for Advanced Practice Nursing, was used to develop a new model of care including the nurse practitioner (NP) role in an emergency department in Norway, where the role is in its infancy. While there is limited earlier research on the applicability of the PEPPA framework, it was here found to be useful. Supported by the framework, we mapped the current model of care, identified stakeholders and participants, determined the need for a new model of care, identified priority problems and goals, and defined the new model of care and the NP role. The PEPPA framework is recommended to develop new models of care including the NP role. Nonetheless, the process has not been straightforward. It is noted that to communicate and establish the new role in a setting as demanding as an emergency department takes time. Support from the management team is essential to succeed in developing and establishing new models of care and new nursing roles, such as the nurse practitioner role.

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If ever we needed clinical leadership, it is now

Faculty Dental Journal ◽

10.1308/204268512x13466824724472 ◽

2012 ◽

Vol 3 (4) ◽

pp. 182-183

Author(s):

Peter Lees ◽

Laura Mitchell

Keyword(s):

National Health Service ◽

Health Service ◽

National Health ◽

Models Of Care ◽

Concerted Effort ◽

Local Management ◽

Clinical Leadership ◽

New Models ◽

Dangerous Place ◽

Reducing Costs

Thanks to the recession, the National Health Service (NHS) is in a dangerous place. If we are to still have an NHS with the founding principles we hold dear, there needs to be a concerted effort to deliver new models of care that protect and enhance quality while reducing costs. The scale of the challenge (£20 billion and rising) is such that this will not be resolved by central dictate or by local management. Instead, it needs full engagement of clinicians who truly understand how to deliver care and how to deliver it better, now.

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Models of care in forensic psychiatry

BJPsych Advances ◽

10.1192/bja.2021.34 ◽

2021 ◽

pp. 1-14

Author(s):

Harry G. Kennedy

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Service ◽

Forensic Psychiatry ◽

Best Practice ◽

Models Of Care ◽

Systematic Evaluation ◽

Formal Models ◽

Model Of Care ◽

Welfare Agencies

SUMMARY Forensic psychiatry services have grown and become more complex in structures, processes and pathways. Legacy customs, practices and changing policy are now organised into formal models of care. These are written accounts of how a health service is delivered, outlining best practice and services for patients progressing through the stages of their condition and the care and treatment available. This article explores the four key elements of a model of care: goals; pathways and processes; treatment programmes; and systematic evaluation. It describes the most common model of care in forensic services, which builds on structures of stratified therapeutic security. It also considers variations on this basic or standard model matched to needs arising from the complex interrelationship with other parts of the mental health service for the population served and with criminal justice, primary care and physical health, housing and welfare agencies.

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Implementing new models of care: Lessons from the new care models programme in England

International Journal of Care Coordination ◽

10.1177/2053434518770613 ◽

2018 ◽

Vol 21 (1-2) ◽

pp. 50-54 ◽

Cited By ~ 4

Author(s):

Anna Starling ◽

Keyword(s):

National Health Service ◽

Health Service ◽

National Health ◽

Models Of Care ◽

Community Services ◽

The Body ◽

Care Community ◽

National Team ◽

New Models ◽

Care Models

In 2014, the body that leads the National Health Service in England published a new strategic vision for the National Health Service. A major part of this strategy was a three-year-long national programme to develop new care models to coordinate care across primary care, community services and hospitals that could be replicated across the country. Local ‘vanguard sites’ were selected to develop five types of new care model with support from a national team. The new care models programme provided support for local leaders to enable them to collaborate to improve care for their local populations. We interviewed leaders in the vanguard sites to better understand how they made changes to care locally. Drawing on the insights from these interviews and the literature on cross-organisational change and improvement we devised a framework of 10 lessons for health and care leaders seeking to develop and implement new models of care. The framework emphasises the importance of developing relationships and building capability locally to enable areas to continuously develop and test new ideas.

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Moving Towards Family Solutions: An Introduction to an Immersive Simulation Workshop

Institutionalised Children Explorations and Beyond ◽

10.1177/2349300319894499 ◽

2020 ◽

Vol 7 (1) ◽

pp. 21-28 ◽

Cited By ~ 1

Author(s):

Nicole Wilkea ◽

Delia Pop ◽

Elli Oswald ◽

Amanda Howard ◽

Meredith Morgan1

Keyword(s):

Residential Care ◽

Family Care ◽

Models Of Care ◽

Model Of Care ◽

New Models ◽

Current Article ◽

Children’S Homes ◽

Family Based ◽

Experiential Workshop ◽

Support Family

Residential care organisations, such as children’s homes, are well-positioned to reshape their programmes to support family-based models of care. However, new models bring unknown factors, making organisations hesitant to transition programmes. To alleviate concerns and support transition, researchers developed an experiential workshop mirroring the conditions of an organisation transitioning to family care. Workshop participants are guided through a series of activities and discussions detailing the transition of a fictional programme to a family-based model of care. The workshop focuses on six key components: engagement, case management, families, asset transitions, measurement and fundraising. The workshop also gives participants the opportunity to create a personalised plan for their programme. The goal of the current article is to present this workshop framework and share the free Facilitator’s Toolkit ( https://cafo.org/ovc/sim-lab/ ).

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Helmets or physiotherapy? Natural history and treatment options for non-synostotic skull deformity in children – results of a literature search

Neuropediatrics ◽

10.1055/s-0030-1265575 ◽

2010 ◽

Vol 41 (02) ◽

Author(s):

C Reihle ◽

K Marquard ◽

R Keimer

Keyword(s):

Natural History ◽

Literature Search ◽

Treatment Options ◽

Skull Deformity

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Taking advantage of Covid-19 to improve hospital models of care: are we moving in the right direction?

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.210 ◽

2021 ◽

pp. 1-7

Author(s):

Raffaella Gualandi ◽

Anna De Benedictis

Keyword(s):

Hospital Management ◽

Models Of Care ◽

Patient Needs ◽

Model Of Care ◽

Letter To The Editor ◽

Rapid Changes ◽

Improve Hospital ◽

The Right ◽

Shed Light

Abstract In this letter to the Editor, we shed light on the rapid changes the Covid-19 virus has generated in hospital management. Recent experiences in the field aim to reorganizing hospital processes and policies. In this new scenario, new patient needs emerge, and a change in the hospital model of care should include them.

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Quality management systems in Aboriginal Community Controlled Health Services: a review of the literature

BMJ Open Quality ◽

10.1136/bmjoq-2020-001091 ◽

2021 ◽

Vol 10 (3) ◽

pp. e001091

Author(s):

Jenifer Olive Darr ◽

Richard C Franklin ◽

Kristin Emma McBain-Rigg ◽

Sarah Larkins ◽

Yvette Roe ◽

...

Keyword(s):

Quality Improvement ◽

Quality Management ◽

Health Service ◽

First Nations ◽

Quality Management System ◽

Grey Literature ◽

Models Of Care ◽

Clinical Governance ◽

Aboriginal Community ◽

Continuous Quality

BackgroundA national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector.AimThe literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector?MethodsThematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability.ResultsSixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care.ConclusionThe ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC.

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