scholarly journals Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Kristy D. M. Wittmeier ◽  
Gayle Restall ◽  
Kathy Mulder ◽  
Brenden Dufault ◽  
Marie Paterson ◽  
...  
Keyword(s):  
Case Report ◽  
Mixed Methods ◽  
Complex Needs ◽  
Central Intake ◽  
Improve Access

scholarly journals The potential for person-centred planning to support the community participation of adults with an intellectual disability

2021 ◽  
pp. 174462952110221
Author(s):  
Darren McCausland ◽  
Esther Murphy ◽  
Mary McCarron ◽  
Philip McCallion
Keyword(s):  
Intellectual Disability ◽  
Mixed Methods ◽  
Community Participation ◽  
Social Inclusion ◽  
Mixed Methods Approach ◽  
Complex Needs ◽  
Qualitative Case Studies ◽  
Quantitative Analyses ◽  
The Right ◽  
The Impact

Person-centred planning (PCP) puts individuals with an intellectual disability at the centre of service and support planning, identifying how individuals wish to live their lives and what is needed to make that possible. PCP has been identified as having the potential to facilitate improved social inclusion and community participation. A mixed-methods approach combined quantitative analyses with qualitative case studies of individuals with severe-profound intellectual disability to assess the impact of PCP on community participation for adults with an intellectual disability at a disability service in Dublin. We conclude that PCP may provide a good basis to plan community participation and, with the right supports in place, may provide opportunities for people with complex needs to improve their community participation. Supports including familiar staff and family are critical to the success of PCP for people with complex needs, and their absence may undermine the best intentions of PCP for this population.

scholarly journals The Physical and the Emotional: Case Report, Mixed-Methods Development, and Discussion

2018 ◽  
Vol 46 (4) ◽  
pp. 549-574 ◽  
Author(s):  
Brandon C. Yarns ◽  
Kenneth B. Wells ◽  
Denise Fan ◽  
Norma Mtume ◽  
Elizabeth Bromley
Keyword(s):  
Case Report ◽  
Mixed Methods ◽  
Methods Development

Using a new patient process to improve breast care access.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 171-171
Author(s):  
Eleanor Miller ◽  
Jonathan Colon ◽  
Nancy O'Connor
Keyword(s):  
Breast Cancer ◽  
Access To Care ◽  
Nurse Practitioner ◽  
Clinical Staff ◽  
Complex Needs ◽  
Breast Center ◽  
Care Access ◽  
Nurse Navigator ◽  
New Diagnosis ◽  
Improve Access

171 Background: Access to timely care is of major focus in oncology. Clinicians and administration collaborated to improve the training and support for non medical staff involved in the new patient process at the breast center. The goal of the process was to improve upon the surgical triage of patient appointments for those with suspicious mammograms or newly diagnosed with breast cancer in less than one week, use the nurse practitioner clinics most effectively, and to triage other diagnoses and patients per updated guidelines, thereby increasing access to care. Methods: A new patient intake form was created with the assistance of IT and added to the electronic medical record as a tool for use by clinical and nonclinical staff. Clinicians and administration also met to update the new patient process forming a decision tree, which ultimately was developed into a manual. A series of in-services were held with scheduling and clinical staff for education and training. Education was also provided to refer patients with complex needs to the nurse navigator. Outcomes were measured by clinical and administrative staff. Results: Access to surgery clinics has improved for new breast patients since the process updates were implemented. Patients can be seen an average of 3.5 days sooner for both malignant and benign diagnoses. Access to the nurse practitioner clinic also improved by 9.4 days. Patients that are diagnosed within the health system can be seen within 3 days, and those that are diagnosed outside the system, within 7 days. Conclusions: It was the goal to improve access to the breast center by updating the intake and scheduling guidelines to see patients with a new diagnosis of breast cancer or other breast problems more quickly. Having guidelines that can be followed by clinical and non clinical staff promotes communication and collaboration, as well as a consistent approach among staff. In the future, the continued refinement of the new patient process and ongoing collaboration will further improve access to care.

scholarly journals Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature

2021 ◽  
Vol 14 ◽  
pp. 117863292110332
Author(s):  
Kristina M Kokorelias ◽  
Jessica E Shiers-Hanley ◽  
Jorge Rios ◽  
Amanda Knoepfli ◽  
Sander L Hitzig
Keyword(s):  
Social Services ◽  
Scoping Review ◽  
Patient Navigation ◽  
Grey Literature ◽  
Model Of Care ◽  
Complex Needs ◽  
Current State ◽  
Improve Access ◽  
Optimal Implementation ◽  
The Continuum

Patient navigation is a model of care that aims to improve access to care by reducing the complexity of navigating health, education, and social services across the continuum of care and care settings. Little is known about the processes that facilitate or impede the implementation of patient navigation programs (PNPs). We conducted a scoping review to identify and summarize the current state of knowledge regarding the implementation and outcomes of existing implemented PNPs. We employed a 6-stage scoping review framework to identify and review eligible articles. Sixty-articles met the inclusion criteria (58 peer-reviewed and 2 grey literature). The Consolidated Framework for Implementation Research served as the theoretical framework during analysis to help extract factors relevant to implementation of navigator programs. Results of the scoping review are reported thematically. Influences on implementation were identified: (a) planning to ensure alignment with organizational need (b) funding (c) multidisciplinary engagement (d) establishing workflow (e) mechanisms for communication (f) stakeholders to encourage buy-in (g) appropriate caseload (h) in kind resources. PNPs improve the experiences of patients and families. The findings of this scoping review provides implementation considerations of PNPs across global care settings. Strategies for overcoming pragmatic and logistical issues must be developed for optimal implementation.

scholarly journals InFORM: Improving care for people who Frequently call 999: co-production of guidance through an Observational study using Routine linked data and Mixed methods

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Ashrafunessa Khanom ◽  
Adrian Edwards ◽  
Bethan Edwards ◽  
Heather Hughes ◽  
Ann John ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Outcomes ◽  
Focus Groups ◽  
Linked Data ◽  
Third Sector ◽  
Care Providers ◽  
Complex Needs ◽  
Data Matching ◽  
Future Evaluation

BackgroundPeople who frequently call the 999 ambulance service present an operational challenge to providers and their needs are inadequately met by current service provision. Aim of researchTo understand patterns and health outcomes of frequent calling and to work with stakeholders to co-produce guidance for formal testing in a future evaluation. MethodsThis mixed methods study will include a scoping review of national and international literature followed by an epidemiological study of callers at the all Wales level exploring health outcomes through anonymised linked data. We will also explore the views of patients using qualitative Bio-photographic interview method with a follow up interview at six months and use focus groups with care providers from across primary and emergency care and the third sector. We will use generalised linear model to analyse quantitative data and qualitative data will be analysed thematically. ResultsFindings will include follow up of eligible patients; successful data matching and data linkage; retrieval of outcomes within 12 months. Outcomes will include: adverse events, deaths, emergency admissions; 999 attendances. Qualitative results will include Bio-photographic interviews with completed scrap books and interviews based on the books (n=34). Care provider focus groups (n= 22). Output Co-produced guidance developed with stakeholders. ConclusionHigh users of the 999-ambulance represent a significant policy challenge to emergency ambulance services and often present with complex needs. This study will inform on the characteristics of callers and how to address their care supported with a co-produced guidance for care providers.

A mixed-methods impact evaluation of the feasibility of an initiative in small rural stores to improve access to fruit and vegetables

2016 ◽  
Vol 22 (6) ◽  
pp. 545 ◽  
Author(s):  
Claire Palermo ◽  
Breeana Gardiner ◽  
Carena Gee ◽  
Stella Charaktis ◽  
Miranda Blake
Keyword(s):  
Mixed Methods ◽  
Rural Communities ◽  
Impact Evaluation ◽  
Vegetable Intake ◽  
Community Support ◽  
Fruit And Vegetables ◽  
Qualitative And Quantitative ◽  
Sustaining Change ◽  
Post Evaluation ◽  
Improve Access

Retail stores are a promising setting for improving access to nutritious food. This study opportunistically evaluated an initiative that supported stores in small rural Victorian towns to sell fresh fruit and vegetables. It aimed to measure whether the initiative showed a trend towards improved access to fruit and vegetables in these rural communities. A mixed-methods, pre-post evaluation was employed to measure the range and price of 39 fruits and 45 vegetables, together with 15 interviews with stakeholders 2.5 years after the commencement of the initiative. Twenty-one of 35 eligible stores took up the initiative. Analysis of qualitative and quantitative data showed that the initiative improved the availability of and access to fruit and vegetables, and that stores have a role in improving access to fruit and vegetables. The overall range of fruit and vegetables increased over 18 months from a median of 10 varieties (n=10) to 17 varieties (n=15) (P=0.028) and the prices decreased over 12 months in five out of seven stores where data was available. The capacity to influence availability of fruit and vegetables was affected by time, human resources and community support. Sustaining change to fruit and vegetables access is challenging. Using stores for health promotion may be an effective strategy for improving rural populations’ fruit and vegetable intake.

Pushing the Integration Envelope: A Network Analysis of Study Abroad Website Content

2021 ◽  
pp. 155868982110154
Author(s):  
Melissa Whatley ◽  
Amy E. Stich
Keyword(s):  
Mixed Methods ◽  
Network Analysis ◽  
Study Abroad ◽  
Mixed Methods Research ◽  
Explanatory Power ◽  
Quadratic Assignment ◽  
Future Research ◽  
Traditional Research ◽  
Website Content ◽  
Improve Access

This article demonstrates how network analysis of qualitative content can be used to build on traditional research approaches to confirm and expand prior findings and to point to fruitful directions for future research. Drawing on mixed methods research on policies and practices that improve access to study abroad at U.S. higher education institutions, we demonstrate how network analysis, namely, quadratic assignment procedure and community detection, of qualitative content codes can enhance the explanatory power and generalizability of previous research. Our use of network analysis contributes an empirical example that validates, challenges, and deepens conversations surrounding network analysis in mixed methods research, all while pushing the envelope on how and when qualitative and quantitative data can and should be integrated.

scholarly journals Patient experiences of rehabilitation following traumatic complex musculoskeletal injury – A mixed methods pilot study

Trauma ◽  
2021 ◽  
pp. 146040862098812
Author(s):  
LA Silvester ◽  
AJ Trompeter ◽  
CB Hing
Keyword(s):  
Mixed Methods ◽  
Pilot Study ◽  
Patient Reported Outcomes ◽  
Open Fractures ◽  
Current Therapy ◽  
Full Time ◽  
Post Injury ◽  
Multiple Fractures ◽  
Complex Needs ◽  
Patient Reported

Introduction The aim of this pilot study was to measure patient reported outcomes and evaluate their rehabilitation experience following traumatic complex musculoskeletal (CMSK) injury. Methods A mixed methods prospective observational study was undertaken between December 2015 and March 2018 to explore patient reported outcomes following CMSK injury sustained as a result of major trauma and perception of their rehabilitation and its impact on their recovery. The participants were asked to complete a series of outcome measures at 18-months post-injury. The data was anonymised and analysed by the lead researcher. Results Thirty patients were recruited into the study (19 males, 11 females) between 23 and 76 years of age (median 52 years). Their injury profile was split between open fractures 30%, pelvic fractures 23%, multiple fractures 27% and polytrauma 20%. The majority (60%) reported moderate disability at 18-months post injury with 50% returning to full time employment. Patients with multiple or open fractures reported the worst outcomes. There was no relationship between frequency, quantity or duration of physiotherapy and outcome. However, 77% reported supplementing their NHS rehabilitation with other interventions such as gym membership, hydrotherapy and psychological therapies. The thematic analysis showed that patients considered intensity, quality and coordinated timely access to rehabilitation as the most important factors. Conclusion From a patient perspective, the current NHS rehabilitation provision does not appear to meet their complex needs. In addition to physical and vocational rehabilitation, patients wanted effective pain management and psychological support. Strengthening current therapy services and involving other sectors (e.g. Citizen’s Advice) could help achieve this. Early access to an intensive multidisciplinary rehabilitation programme was perceived to have positive benefits and improve outcomes.

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