scholarly journals Communities as ‘renewable energy’ for healthcare services? a multimethods study into the form, scale and role of voluntary support for community hospitals in England

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030243
Author(s):  
Angela Ellis Paine ◽  
Daiga Kamerāde ◽  
John Mohan ◽  
Deborah Davidson
Keyword(s):  
Focus Groups ◽  
Patient Experience ◽  
Community Hospital ◽  
Well Being ◽  
Healthcare Services ◽  
Multidisciplinary Teams ◽  
Community Hospitals ◽  
Community Stakeholders ◽  
Charity Commission

ObjectiveTo examine the forms, scale and role of community and voluntary support for community hospitals in England.DesignA multimethods study. Quantitative analysis of Charity Commission data on levels of volunteering and voluntary income for charities supporting community hospitals. Nine qualitative case studies of community hospitals and their surrounding communities, including interviews and focus groups.SettingCommunity hospitals in England and their surrounding communities.ParticipantsCharity Commission data for 245 community hospital Leagues of Friends. Interviews with staff (89), patients (60), carers (28), volunteers (35), community representatives (20), managers and commissioners (9). Focus groups with multidisciplinary teams (8 groups across nine sites, involving 43 respondents), volunteers (6 groups, 33 respondents) and community stakeholders (8 groups, 54 respondents).ResultsCommunities support community hospitals through: human resources (average=24 volunteers a year per hospital); financial resources (median voluntary income = £15 632); practical resources through services and activities provided by voluntary and community groups; and intellectual resources (eg, consultation and coproduction). Communities provide valuable supplementary resources to the National Health Service, enhancing community hospital services, patient experience, staff morale and volunteer well-being. Such resources, however, vary in level and form from hospital to hospital and over time: voluntary income is on the decline, as is membership of League of Friends, and it can be hard to recruit regular, active volunteers.ConclusionsCommunities can be a significant resource for healthcare services, in ways which can enhance patient experience and service quality. Harnessing that resource, however, is not straight forward and there is a perception that it might be becoming more difficult questioning the extent to which it can be considered sustainable or ‘renewable’.

The changing role of GP clinicians working in community hospitals.

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696713
Author(s):  
David Seamark ◽  
Deborah Davidson ◽  
Helen Tucker ◽  
Angela Ellis-Paine ◽  
Jon Glasby
Keyword(s):  
Medical Care ◽  
Local Community ◽  
Community Hospital ◽  
Clinical Care ◽  
Hospital Setting ◽  
Community Hospitals ◽  
Recruitment Challenges ◽  
Acute Hospitals ◽  
Changing Role

BackgroundIn 2000 20% of UK GPs had admitting rights to community hospitals. In subsequent years the number of GPs engaged in community hospital clinical care has decreased.AimWhat models of medical care exist in English community hospitals today and what factors are driving changes?MethodInterviews with community hospital clinical staff conducted as part of a multimethod study of the community value of community hospitals.ResultsSeventeen interviews were conducted and two different models of medical care observed: GP led and Trust employed doctors. Factors driving changes were GP workload and recruitment challenges; increased medical acuity of patients admitted; fewer local patients being admitted; frustration over the move from ‘step-up’ care from the local community to ‘step-down’ care from acute hospitals; increased burden of GP medical support; inadequate remuneration; and GP admission rights removed due to bed closures or GP practices withdrawing from community hospital work.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians with a consequent loss of GP generalist skills in the community hospital setting. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital care.

An Idea Worth Sustaining: Evaluation of the sustainability potential of Choosing Wisely across Ontario Community Hospitals and Family Health Teams

2020 ◽  
Author(s):  
Monika Kastner ◽  
Julie Makarski ◽  
Kate Mossman ◽  
Kegan Harris ◽  
Leigh Hayden ◽  
...  
Keyword(s):  
Primary Care ◽  
Focus Groups ◽  
Action Plan ◽  
Family Health ◽  
Healthcare Services ◽  
Choosing Wisely ◽  
Community Hospitals ◽  
Priority Areas ◽  
Care Family ◽  
Sustainability Challenges

Abstract BackgroundEvidence shows that 30% of healthcare services are unnecessary and unlikely to benefit patients and may even be harmful. Choosing Wisely (CW) is a physician-initiated, international campaign (with campaigns in at least 20 countries) aimed at addressing unnecessary medical care through the provision of evidence-based resources and clinical guidance. Our objectives were to evaluate the sustainability potential of CW across four Ontario community hospitals and affiliated family health teams (FHT). MethodsWe recruited CW implementation teams across Ontario hospitals and their affiliated primary care family health teams (FHTs) to participate in a mixed-methods study to identify and respond to their CW implementation and sustainability challenges. The study involved the administration of a validated sustainability Survey at baseline, 6- and 12-months follow-up, and participation in two focus groups (at baseline and 6 months) to discuss identified successes and opportunities for improvement, and to respond to implementation and sustainability challenges through a team exercise involving the co-creation and implementation of an action plan to directly address them.ResultsFifteen CW implementation teams across five Ontario community hospitals and affiliated FHTs participated in the study. Three CW de-adoption priority areas were investigated by teams: de-prescribing of proton pump inhibitors (PPIs), and reducing Pre-Op testing and BUN/Urea lab testing. All 15 teams achieved a baseline sustainability team score that was well above the threshold of what is considered a potentially sustainable innovation (i.e., >55%). We observed steady improvements in sustainability scores over three time points across all primary care teams, which is a strong indication that CW is sustainable in these settings. Regardless of site or priority area, facilitators that were common across all teams were fit with existing processes and workflows, leadership support, and optimized team communication. Common challenges were: lack of awareness and buy-in, lack of leadership engagement or a champion, and lack of fit with existing workflow and culture. All teams identified at least one challenge (during the baseline focus groups) for which they co-designed and implemented a plan to address them aimed at maximizing the sustainability potential of their CW priority areas. ConclusionsEvaluating the sustainability potential of an innovation such as Choosing Wisely is critical to ensuring that they have the best potential for impact. Our work highlights that implementation teams can be empowered to influence their implementation efforts, and to realize positive outcomes for their healthcare services and patients.

scholarly journals Factors affecting the changing role of GP clinicians in community hospitals: a qualitative interview study in England

2019 ◽  
Vol 69 (682) ◽  
pp. e329-e335
Author(s):  
David Seamark ◽  
Deborah Davidson ◽  
Angela Ellis-Paine ◽  
Jon Glasby ◽  
Helen Tucker
Keyword(s):  
Personal Development ◽  
Community Hospital ◽  
Clinical Skills ◽  
Qualitative Interviews ◽  
Significant Shift ◽  
Community Hospitals ◽  
Factors Affecting ◽  
Qualitative Interview Study ◽  
Hospital Work

BackgroundGPs were a key driving force for the development of a network of community hospitals across England, and have provided medical cover for most of them. However, during the past decade there has been a significant shift, with the dominant trend appearing to be one of declining GP involvement.AimTo explore how and why the role of GPs within community hospitals in England is changing.Design and settingQualitative study in a sample of nine diverse community hospitals in England.MethodQualitative interviews with community hospital clinical staff.ResultsIn all, 20 interviews were conducted and two models of medical care observed: GPs employed by a practice and trust-employed doctors. Interviewees confirmed the trend towards declining GP involvement, with the factors driving change identified as being GP workload and recruitment challenges, a change from ‘step-up’ admissions from the community to ‘step-down’ admissions from acute hospitals, fewer local patients being admitted, increased medical acuity of patients admitted, increased burden of medical support required, and inadequate remuneration. The majority of doctors viewed community hospital work in a positive light, welcoming the opportunities for personal development and to acquire new clinical skills. GPs viewed community hospital work as an extension of primary care, adding to job satisfaction.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital work.

scholarly journals The Role of Collaborative Healthcare in Improving Social Sustainability: A Conceptual Framework

2020 ◽  
Vol 12 (8) ◽  
pp. 3195 ◽  
Author(s):  
Tahereh Maghsoudi ◽  
Rosalía Cascón-Pereira ◽  
Ana Beatriz Hernández Lara
Keyword(s):  
Conceptual Framework ◽  
Current Trend ◽  
Social Sustainability ◽  
Well Being ◽  
Healthcare Services ◽  
Collaborative Networks ◽  
Policy Makers ◽  
The Social ◽  
Service Distribution

Healthcare systems around the world face both increasing demands and inequality in service distribution. The current trend is for collaboration among healthcare actors, named as collaborative healthcare, in order to address challenges such as these to improve the social sustainability of the system. That is to provide accessible and equitable healthcare services to meet people’s health and well-being needs. Based on an integrative literature review, this study aims at crafting a conceptual framework to explore how collaborative healthcare networks contribute to social sustainability and the specific actors involved in these collaborations. It identifies relationships between different collaborative healthcare networks and social sustainability. Interprofessional networks have been the most studied in relation to social sustainability. Communication and sharing information or knowledge have been identified as used collaborative healthcare practices. This study contributes theoretically by considering a new model of the healthcare organization in which collaborative networks play a central role in improving social sustainability. In terms of practical implications, the study provides managers and policy makers with investment insights on a range of collaborative networks and practices.

scholarly journals Turned Upside Down: The Role of New York Patient Experience Leaders During COVID-19

2020 ◽  
Vol 7 (3) ◽  
pp. 287-290
Author(s):  
Sven Gierlinger ◽  
Agnes Barden ◽  
Nicole Giammarinaro
Keyword(s):  
New York ◽  
Health System ◽  
Patient Experience ◽  
Emotional Health ◽  
Well Being ◽  
Customer Experience ◽  
Frontline Staff ◽  
Corporate Office ◽  
Health And Well Being

At the epicenter of the COVID-19 crisis, New York’s largest health system, Northwell Health, leveraged leadership and innovation to ensure the health and well-being of patients, families, and employees. During this unprecedented time, the role of patient experience leader constantly morphed and transformed to meet the ever-changing needs of the community and organization. This dedicated group of leaders, supported by the Northwell Corporate Office of Patient & Customer Experience, focused primarily on remotely connecting patients and families, harnessing the power of positivity as a crisis strategy and supporting the emotional health of the frontline staff.

Does work engagement enhance general well-being and control at work? Mediating role of psychological capital

2018 ◽  
Vol 6 (3) ◽  
pp. 272-286 ◽  
Author(s):  
Manish Gupta ◽  
Musarrat Shaheen
Keyword(s):  
Work Engagement ◽  
Psychological Capital ◽  
Well Being ◽  
Healthcare Services ◽  
Equation Modeling ◽  
Content Type ◽  
Mediating Role ◽  
And Control ◽  
The Impact

Purpose The purpose of this paper is to examine the mediating role of psychological capital (PsyCap) between work engagement (WE) and general well-being (GWB) as well as between WE and control at work (CAW). Design/methodology/approach Data were collected from 200 medical employees involved in rendering healthcare services. Structural equation modeling was done to test the hypotheses. Findings Analyses of the data revealed that PsyCap mediates fully between WE and CAW and partially between WE and GWB. Research limitations/implications The results show that PsyCap plays a positive role in transferring the impact of engagement levels to GWB and CAW. The results augment the broaden-and-build theory by explaining how positivity at the workplace can help the engaged employees improve well-being and CAW. Practical implications Hospitals in India are encouraged to recruit psychologically capable (high in PsyCap) employees. Such psychologically capable and engaged employees have greater CAW and have higher general well-being. Originality/value This study is among the few preliminary studies which have focused on the mechanism through which well-being and CAW of employees involved in healthcare services in India get affected.

scholarly journals The role of pharmacy services and pharmacist comeback during COIVD-19. A narrative review

2021 ◽  
Vol 2 (1) ◽  
pp. 19-26
Author(s):  
Abdur Rashid ◽  
Ghulam Abbas Miana ◽  
Hafsa Hashmi
Keyword(s):  
Well Being ◽  
Healthcare Services ◽  
Adverse Outcomes ◽  
Pharmacy Services ◽  
Safety And Efficacy ◽  
Healthcare Settings ◽  
Policies And Procedures ◽  
The World ◽  
New Policies

SARSCoV-2, a recently discovered coronavirus, causes COVID-19, which is a respiratory infection. The disease rapidly spread across the world, prompting a pandemic declaration. During natural calamities and outbreaks, pharmacists have long been involved in public well-being management such as precautionary safeguards, immunizations, screening, authentication of medicines safety and efficacy and also involved in emergency alertness and response. Pharmacy professionals are considered an integral part in response to the ongoing COVID-19 pandemic. Pharmacists and pharmacy services are at the combat zone for patients care and safety to enhance public health. The ongoing Covid-19 pandemic had a significant impact on healthcare services around the world. New policies and procedures will be implemented to fill the void. Pharmacists expect to adopt a variety of strategies to providing pharmacy services during and after the current pandemic. Pharmacists are playing an important role in the current epidemic. It's been over a year since the Covid-19 epidemic first eventuated, and it's still unclear how long the pandemic will endure. Hence, pharmacists and pharmacy professionals are playing crucial character in the prevention, treatment and mitigation of adverse outcomes due to the covid-19 pandemic. The current publication emphasizes the potential responsibilities and actions that pharmacists might undertake in a variety of healthcare settings to assist relieve strain on an overburdened healthcare system.

scholarly journals Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

2017 ◽  
Vol 5 (19) ◽  
pp. 1-220 ◽  
Author(s):  
Emma Pitchforth ◽  
Ellen Nolte ◽  
Jennie Corbett ◽  
Céline Miani ◽  
Eleanor Winpenny ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Cost Effectiveness ◽  
Case Studies ◽  
Social Care ◽  
Community Hospital ◽  
Community Hospitals ◽  
Health And Social Care ◽  
Effectiveness And Efficiency

BackgroundThe notion of a community hospital in England is evolving from the traditional model of a local hospital staffed by general practitioners and nurses and serving mainly rural populations. Along with the diversification of models, there is a renewed policy interest in community hospitals and their potential to deliver integrated care. However, there is a need to better understand the role of different models of community hospitals within the wider health economy and an opportunity to learn from experiences of other countries to inform this potential.ObjectivesThis study sought to (1) define the nature and scope of service provision models that fit under the umbrella term ‘community hospital’ in the UK and other high-income countries, (2) analyse evidence of their effectiveness and efficiency, (3) explore the wider role and impact of community engagement in community hospitals, (4) understand how models in other countries operate and asses their role within the wider health-care system, and (5) identify the potential for community hospitals to perform an integrative role in the delivery of health and social care.MethodsA multimethod study including a scoping review of community hospital models, a linked systematic review of their effectiveness and efficiency, an analysis of experiences in Australia, Finland, Italy, Norway and Scotland, and case studies of four community hospitals in Finland, Italy and Scotland.ResultsThe evidence reviews found that community hospitals provide a diverse range of services, spanning primary, secondary and long-term care in geographical and health system contexts. They can offer an effective and efficient alternative to acute hospitals. Patient experience was frequently reported to be better at community hospitals, and the cost-effectiveness of some models was found to be similar to that of general hospitals, although evidence was limited. Evidence from other countries showed that community hospitals provide a wide spectrum of health services that lie on a continuum between serving a ‘geographic purpose’ and having a specific population focus, mainly older people. Structures continue to evolve as countries embark on major reforms to integrate health and social care. Case studies highlighted that it is important to consider local and national contexts when looking at how to transfer models across settings, how to overcome barriers to integration beyond location and how the community should be best represented.LimitationsThe use of a restricted definition may have excluded some relevant community hospital models, and the small number of countries and case studies included for comparison may limit the transferability of findings for England. Although this research provides detailed insights into community hospitals in five countries, it was not in its scope to include the perspective of patients in any depth.ConclusionsAt a time when emphasis is being placed on integrated and community-based care, community hospitals have the potential to assume a more strategic role in health-care delivery locally, providing care closer to people’s homes. There is a need for more research into the effectiveness and cost-effectiveness of community hospitals, the role of the community and optimal staff profile(s).FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Social Motives Predict Loneliness During a Developmental Transition

2017 ◽  
Vol 76 (4) ◽  
pp. 145-153 ◽  
Author(s):  
Jana Nikitin ◽  
Alexandra M. Freund
Keyword(s):  
Social Relationships ◽  
Well Being ◽  
Social Avoidance ◽  
Social Approach ◽  
Social Motives ◽  
Developmental Transitions ◽  
Avoidance Motivation ◽  
Negative Effect ◽  
Low Levels

Abstract. Establishing new social relationships is important for mastering developmental transitions in young adulthood. In a 2-year longitudinal study with four measurement occasions (T1: n = 245, T2: n = 96, T3: n = 103, T4: n = 85), we investigated the role of social motives in college students’ mastery of the transition of moving out of the parental home, using loneliness as an indicator of poor adjustment to the transition. Students with strong social approach motivation reported stable and low levels of loneliness. In contrast, students with strong social avoidance motivation reported high levels of loneliness. However, this effect dissipated relatively quickly as most of the young adults adapted to the transition over a period of several weeks. The present study also provides evidence for an interaction between social approach and social avoidance motives: Social approach motives buffered the negative effect on social well-being of social avoidance motives. These results illustrate the importance of social approach and social avoidance motives and their interplay during developmental transitions.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

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