Using Two-Eyed Seeing to Explore Interagency Collaboration

2018 ◽  
Vol 50 (3) ◽  
pp. 133-144 ◽  
Author(s):  
Cheryl Whiting ◽  
Stephanie Cavers ◽  
Sandra Bassendowski ◽  
Pammla Petrucka

Background Health-care environments influence service delivery; approaches need to be more wholistic and culturally competent requiring effective interagency collaboration to bridge traditional Indigenous and mainstream health services. Despite considerable research on collaboration, the concept remains misunderstood, at worst, and formative, at best. Within the nexus of these two diverse health services, there is limited information on how collaborations could be created and sustained effectively. Purpose To explore the perspectives/experiences of collaboration of select Saskatchewan health professionals practicing across these diverse services to understand the concept from their perspectives. Methods This qualitative study explored collaboration through observation and interviews to elicit perspectives (two-eyed seeing) of health professionals working within the context of a traditional–mainstream health services partnership. Results Individual- and system-level factors and accountabilities are needed for successful cross-cultural collaboration and can be enabled by embedding the virtues of Indigenous and values of mainstream health services along with building and maintaining relationships, valuing difference, creating supportive environments and wholistic approaches, having the right people at the table, and making a change for impactful outcomes. Conclusion Findings support the need for implementing contextually relevant collaborative practice models for productive, wholistic health services. Two-eyed seeing provides the ability to capture and catalyze the tremendous value and strengths of both worlds, potentiating complementary aspects to meet the needs of clients and communities.

2008 ◽  
Vol 15 (1) ◽  
pp. 7-43 ◽  
Author(s):  
Adriana Lamačková

AbstractThis article explores the issue of conscientious objection invoked by health professionals in the reproductive and sexual health care context and its impact on women's ability to access health services. The right to exercise conscientious objection has been recognized by many international and European scholars as being derived from the right to freedom of thought, conscience and religion. It is not, however, an absolute right. When the exercise of conscientious objection conflicts with other human rights and fundamental freedoms, a balance must be struck between the right to conscientious objection and other affected rights such as the right to respect for private life, the right to equality and non-discrimination, and the right to receive and impart information. Particularly in the reproductive health care context, states that allow health professionals to exercise conscientious objection must accommodate this in such a way that its exercise does not compromise women's access to health services. This article analyses the European Court of Human Rights' decision on admissibility in Pichon and Sajous v. France (2001) and argues that a balancing approach should be applied in cases of conscientious objection in the sexual and reproductive health care context.


2020 ◽  
pp. 108-114 ◽  
Author(s):  
Jennifer Chynoweth ◽  
Meaghan M. McCambridge ◽  
Helen M. Zorbas ◽  
Jacinta K. Elston ◽  
Robert J.S. Thomas ◽  
...  

PURPOSE To improve cancer outcomes for Aboriginal and Torres Strait Islander people through the development and national endorsement of the first population-specific optimal care pathway (OCP) to guide the delivery of high-quality, culturally appropriate, and evidence-based cancer care. METHODS An iterative methodology was undertaken over a 2-year period, and more than 70 organizations and individuals from diverse cultural, geographic, and sectorial backgrounds provided input. Cancer Australia reviewed experiences of care and the evidence base and undertook national public consultation with the Indigenous health sector and community, health professionals, and professional colleges. Critical to the OCP development was the leadership of Aboriginal and Torres Strait Islander health experts and consumers. RESULTS The OCP received unanimous endorsement by all federal, state, and territory health ministers. Key elements of the OCP include attention to the cultural appropriateness of the health care environment; improvement in cross-cultural communication; relationship building with local community; optimization of health literacy; recognition of men’s and women’s business; and the need to use culturally appropriate resources. The OCP can be used as a tool for health services and health professionals to identify gaps in current cancer services and to inform quality improvement initiatives across all aspects of the care pathway. CONCLUSION The development of the OCP identified a number of areas that require prioritization. Ensuring culturally safe and accessible health services is essential to support early presentation and diagnosis. Multidisciplinary treatment planning and patient-centered care are required for all Aboriginal and Torres Strait Islander people, irrespective of location. Health planners and governments acknowledge the imperative for change and have expressed strong commitment to work with Indigenous Australians to improve the accessibility, cultural appropriateness, and quality of cancer care.


Author(s):  
Meryem Türkan Işık ◽  
Gülay Yıldırım

Obesity is one of the health problems that threaten humanity considerably. In our country, considering the right to healthcare of each individual, earned by birth, they have a right to receive an equal and just healthcare. Obese individuals may suffer from negative attitudes of health professionals in providing protective health services and inpatient treatments. In this chapter, the aim was to draw attention to ethical conflicts between obese individuals and health professionals in the process of their healthcare and raise awareness of these problems.


2016 ◽  
Vol 40 (5) ◽  
pp. 562 ◽  
Author(s):  
Desley Harvey ◽  
David Plummer ◽  
Ilsa Nielsen ◽  
Robyn Adams ◽  
Tilley Pain

Objective Combining research with clinical practice has benefits for health services and practitioners. There is limited information available on strategies used by health professionals to balance research with high clinical service demands. The aims of the present study were to examine how research is initiated and to identify the factors that influence the successful integration of research into a clinical work role. Methods Semistructured recursive-style interviews were conducted with 15 research-active allied health professionals at regional health services using a combination of criterion and purposive sampling. Interviews were recorded, transcribed and analysed using constant comparative techniques to identify dominant themes, which were integrated to create a conceptual model. Results Becoming a clinician researcher involved four phases: (1) a research debut; (2) building momentum; (3) developing a track record; and (4) becoming an established clinician researcher. A research debut was enabled by pre-entry exposure to research or through quality activities, predisposing personal characteristics and research opportunities at work. Quarantined time for research, a research-friendly workplace culture and supportive research relationships enabled a clinician to thrive as a researcher despite the challenges. Conclusion The clinician researcher career trajectory contributes to a better understanding of how a research career commences and develops in clinical settings. It may assist to develop strategies to support research capacity building. What is known about the topic? There are potential benefits for clinicians and health services that flow from incorporating research into clinical roles. Factors that motivate, enable and constrain allied health research in clinical settings have been identified, but little is known about how a research career is initiated and progresses over time. What does this paper add? The present study contributes an important career path understanding to the successful development of research capacity from a clinician perspective. The clinician researcher career trajectory delineates four phases and identifies enabling and constraining factors. The study highlights the combination of factors that can initiate a research debut and lead clinicians to thrive as researchers. What are the implications for practitioners? Conducting research can provide an opportunity for a professional challenge and increased job satisfaction. A research-friendly environment, supportive research relationships and quarantined time for research contribute to research output in clinical settings.


2020 ◽  
Vol 8 ◽  
pp. 95-108
Author(s):  
Shanti Prasad Khanal

 The present study aims to examine the multi-level barriers to utilize by the youth-friendly reproductive health services (YFRHS) among the school-going youths of the Surkhet valley of Nepal. This study is based on the sequential explanatory research design under mixed-method research. The quantitative data were collected using the self- administered questionnaire from the 249 youths, aged between the 15-24 years, those selected by using random sampling. The qualitative data were collected using the Focus Group Discussions (FGDs) from the 12 participants who were selected purposively. The study confirmed that school-going youths do not have appropriate utilization of YFHS due to multi-layered barriers. However, the utilization of the service was higher among females, those the older age group, studying in the upper classes, the upper castes, and married youths. The key findings and themes are recognized as multi-layered barriers including personal-level, health system-level, community-level, and policy-level on the entire socio-ecological field. Among them, the existing health system is the foremost barrier. Multi-level interventions are, therefore, required to increase the YFRHS utilization and improve concerns for school-going-youths.  


2020 ◽  
Vol 4 (1) ◽  
pp. 41-62
Author(s):  
D. N. Parajuli

 Reproductive rights are fundamental rights and freedoms relating to reproduction and reproductive health that vary amongst countries around the world, but have a commonality about the protection, preservation and promotion of a woman‘s reproductive health rights. Reproductive rights include the right to autonomy and self-determination , the right of everyone to make free and informed decisions and have full control over their body, sexuality, health, relationships, and if, when and with whom to partner, marry and have children , without any form of discrimination, stigma, coercion or violence. The access and availability of reproductive health services are limited due to geography and other issues, non-availability and refusal of reproductive health services may lead to serious consequences. The State need to ensure accessibility, availability, safe and quality reproductive health services and address the lifecycle needs of women and girls and provide access of every young women and girls to comprehensive sexuality education based on their evolving capacity as their human rights, through its inclusion and proper implementation in school curriculum, community-based awareness program and youth led mass media. It is necessary for strengthening compliance, in a time-bound manner, with international human rights standards that Nepal has ratified that protect, promote, and fulfill the basic human rights and reproductive health rights in Nepal and also need to review standards and conventions that Nepal has had reservations about or those that have been poorly implemented in the country.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1288.1-1289
Author(s):  
I. Mcnicol ◽  
A. Bosworth ◽  
C. Jacklin ◽  
J. Galloway

Background:NRAS follows best practice, evidence-based standards in all we do. Whilst huge strides have been made in the diagnosis and treatment of RA, the impact on quality of life can be significant and for many this disease remains hard to come to terms with. NRAS services and resources can improve the outcomes of people with RA/Adult JIA through a framework of supported self-management resources tailored to individual need. It is particularly important to provide the right support at the beginning of a person’s journey with RA, when unhelpful health beliefs, anxiety and incorrect information can influence how someone responds to prescribed medication and treatment thus impeding their ability to achieve the best outcomes. We know, for example, that many people do not take their medication as prescribed which reduces their chances of achieving remission or low disease activity state.Objectives:To demonstrate that by referring patients online as part of a quality improvement programme to NRAS Right Start Service, we can show improved outcomes for patients with early RA when measured by the MSKHQ. Referred patients will benefit by: a) Better understanding what RA is; b) knowing how it can affect them; c) getting the right support; d) feeling more in control; receiving a tailored pack of information that meets their personal needs; e) be able to talk to a like-minded person who has lived with RA. It’s a 4 step process which starts with the health professional referring their patient to NRAS on line. NICE Quality Standard 3 states that “Adults with rheumatoid arthritis are given opportunities throughout the course of their disease to take part in educational activities that support self-management.” Our service enables health professionals to meet their responsibilities against this national quality standard.Methods:In preparation for the introduction of this service at BSR congress 2019, an audit of the NRAS helpline service was undertaken at the end of 2018 and remains on going. Currently we have 224 responses which have been analysed against specific criteria. An Advisory Board comprising 7 clincians, from different hospitals was appointed to work with NRAS on this important research.Results:In the helpline audit, when asked ‘how concerned are you about your disease’?, alarmingly, 78% of those surveyed scored their level of concern about their disease at 7 or higher out of 10, while only 8% scored it at 5 or below. When asked about the emotional effects of their RA, 62% scored it as 7 or more where 10 was the worst possible impact. 94% of survey respondents said that they would definitely or very likely recommend NRAS and its services to another person. These results led to the development of New2RA Right Start launched in 2019, whereby health professionals across the UK can refer their patients directly to NRAS via a consented online referral which is fully GDPR compliant. To date (31stJan, 2020), we have made calls to 101 patients, from 24 referring hospitals of which 55 have been successfully completed, 34 have had information sent through the post although our helpline team were unable to speak to them, and 12 remain open. Data analysis on the service is being carried out by King’s College Hospital London, comparing the results of patients who have been referred to Right Start within the national audit who have completed a baseline and 3 month follow up MSKHQ and patients in the audit who have not participated in Right Start.Conclusion:Anecdotally, we have had a tremendous response to this service from both patients and referring health professionals. We await data from King’s on the above figures, which we will have within the next 2 months and further data, should this abstract be accepted, will be available prior to June 2020. Right Start enables health professionals to comply with QS3 above, of the NICE Quality Standards in RA, one of the key standards against which they are being audited in the NEIAA national audit. Once data and write up in a peer review journal has been published we plan to roll this service out to people with more established disease.References:[1]To be done, not included in word count.Acknowledgments:I would like to thank Ailsa Bosworth MBE, Clare Jacklin, and James GallowayDisclosure of Interests:Iain McNicol Shareholder of: GSK, Ailsa Bosworth Speakers bureau: a number of pharmaceutical companies for reasons of inhouse training, advisory boards etc., Clare Jacklin Grant/research support from: NRAS has received grants from pharmaceutical companies to carry out a number of projects, Consultant of: I have been paid a speakers fee to participate in advisory boards, in house training of staff and health professional training opportunities, Speakers bureau: Various pharma companies, James Galloway: None declared


2016 ◽  
Vol 113 (31) ◽  
pp. E4531-E4540 ◽  
Author(s):  
Braden A. Purcell ◽  
Roozbeh Kiani

Decision-making in a natural environment depends on a hierarchy of interacting decision processes. A high-level strategy guides ongoing choices, and the outcomes of those choices determine whether or not the strategy should change. When the right decision strategy is uncertain, as in most natural settings, feedback becomes ambiguous because negative outcomes may be due to limited information or bad strategy. Disambiguating the cause of feedback requires active inference and is key to updating the strategy. We hypothesize that the expected accuracy of a choice plays a crucial rule in this inference, and setting the strategy depends on integration of outcome and expectations across choices. We test this hypothesis with a task in which subjects report the net direction of random dot kinematograms with varying difficulty while the correct stimulus−response association undergoes invisible and unpredictable switches every few trials. We show that subjects treat negative feedback as evidence for a switch but weigh it with their expected accuracy. Subjects accumulate switch evidence (in units of log-likelihood ratio) across trials and update their response strategy when accumulated evidence reaches a bound. A computational framework based on these principles quantitatively explains all aspects of the behavior, providing a plausible neural mechanism for the implementation of hierarchical multiscale decision processes. We suggest that a similar neural computation—bounded accumulation of evidence—underlies both the choice and switches in the strategy that govern the choice, and that expected accuracy of a choice represents a key link between the levels of the decision-making hierarchy.


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