scholarly journals How can evidence-based interventions give the best value for users in social services? Balance between adherence and adaptations: a study protocol

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Henna Hasson ◽  
Hedvig Gröndal ◽  
Åsa Hedberg Rundgren ◽  
Gunilla Avby ◽  
Håkan Uvhagen ◽  
...  
Keyword(s):  
Decision Support ◽  
Social Services ◽  
Social Service ◽  
Evidence Based ◽  
Basic Premise ◽  
Social Service Organizations ◽  
Context Sensitive ◽  
Group Interviews ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Background Using evidence-based interventions (EBIs) is a basic premise of contemporary social services (e.g., child and family social services). However, EBIs seldom fit seamlessly into a specific setting but often need to be adapted. Although some adaptions might be necessary, they can cause interventions to be less effective or even unsafe. The challenge of balancing adherence and adaptations when using EBIs is often referred to as the adherence and adaptation dilemma. Although the current literature identifies professionals’ management of this dilemma as problematic, it offers little practical guidance for professionals. This research aims to investigate how the adherence and adaptation dilemma is handled in social services and to explore how structured decision support can impact the management of the dilemma. Methods The design is a prospective, longitudinal intervention with a focus on the feasibility and usefulness of the structured decision support. The project is a collaboration between academic researchers, embedded researchers at three research and development units, and social service organizations. A multi-method data collection will be employed. Initially, a scoping review will be performed, and the results will be used in the development of a structured decision support. The decision support will be further developed and tested during a series of workshops with social service professionals. Different forms of data—focus group interviews, questionnaires, and documentation—will be used on several occasions to evaluate the impact of the structured decision support. Qualitative and quantitative analysis will be performed and usefulness for practice prioritized throughout the study. Discussion The study will contribute with knowledge on how the adherence and adaption dilemma is handled and experienced by social service professionals. Most importantly, the study will generate rich empirical data on how a structured decision support impacts professionals’ management of adherence and adaptions. The goal is to produce more strategic and context-sensitive implementation of EBIs in social service, which will increase value for service users.

scholarly journals Exploring the impact of a decision support algorithm to improve clinicians’ chemotherapy-induced peripheral neuropathy assessment and management practices: a two-phase, longitudinal study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robert Knoerl ◽  
Emanuele Mazzola ◽  
Fangxin Hong ◽  
Elahe Salehi ◽  
Nadine McCleary ◽  
...  
Keyword(s):  
Decision Support ◽  
Peripheral Neuropathy ◽  
Management Practices ◽  
Management Strategies ◽  
Clinic Visit ◽  
Evidence Based ◽  
Two Phase ◽  
Assessment Index ◽  
Patient Reported ◽  
The Impact

Abstract Background Chemotherapy-induced peripheral neuropathy (CIPN) negatively affects physical function and chemotherapy dosing, yet, clinicians infrequently document CIPN assessment and/or adhere to evidence-based CIPN management in practice. The primary aims of this two-phase, pre-posttest study were to explore the impact of a CIPN clinician decision support algorithm on clinicians’ frequency of CIPN assessment documentation and adherence to evidence-based management. Methods One hundred sixty-two patients receiving neurotoxic chemotherapy (e.g., taxanes, platinums, or bortezomib) answered patient-reported outcome measures on CIPN severity and interference prior to three clinic visits at breast, gastrointestinal, or multiple myeloma outpatient clinics (n = 81 usual care phase [UCP], n = 81 algorithm phase [AP]). During the AP, study staff delivered a copy of the CIPN assessment and management algorithm to clinicians (N = 53) prior to each clinic visit. Changes in clinicians’ CIPN assessment documentation (i.e., index of numbness, tingling, and/or CIPN pain documentation) and adherence to evidence-based management at the third clinic visit were compared between the AP and UCP using Pearson’s chi-squared test. Results Clinicians’ frequency of adherence to evidence-based CIPN management was higher in the AP (29/52 [56%]) than the UCP (20/46 [43%]), but the change was not statistically significant (p = 0.31). There were no improvements in clinicians’ CIPN assessment frequency during the AP (assessment index = 0.5440) in comparison to during the UCP (assessment index = 0.6468). Conclusions Implementation of a clinician-decision support algorithm did not significantly improve clinicians’ CIPN assessment documentation or adherence to evidence-based management. Further research is needed to develop theory-based implementation interventions to bolster the frequency of CIPN assessment and use of evidence-based management strategies in practice. Trial registration ClinicalTrials.Gov, NCT03514680. Registered 21 April 2018.

An End to Incrementalism? The Impact of Expenditure Restraint on Social Services Budgets 1979–1986

1989 ◽  
Vol 18 (2) ◽  
pp. 187-210 ◽  
Author(s):  
Aidan Kelly
Keyword(s):  
Social Services ◽  
Social Service ◽  
The Elderly ◽  
Activity Data ◽  
The Public ◽  
Total Budget ◽  
Service Departments ◽  
The Impact ◽  
The Relationship ◽  
Over Time

ABSTRACTThe theory of incrementalism is a long-standing and influential perspective on policy making and resource allocation in the public sector. Previous research on social services budgeting suggests that resources are allocated incrementally, although there has been some debate as to whether this would persist in an era of prolonged expenditure restraint. Incremental budgetary outcomes are operationalised as percentage changes in budgets pro-rata with percentage changes in the total budget, and as stable shares of total expenditure for each activity. Data for 99 English social service departments supports incrementalism in that budget shares change by only 1.8 per cent, but percentage allocations depart from pro-rata incrementalism by a mean of 74 per cent. The comparison of the two summary indices over time supports those who have argued that prolonged restraint would encourage non-incremental budgeting, but change in the agency's total budget does not consistently predict budgetary outcomes. The effect of restraint on incrementalism varies with the measure used and across the component activities of the measures, but there is enough evidence to suggest a significant decline in the level of incrementalism in social service departments. In particular, non-incremental budgeting is strongly associated with the growth of day centre expenditure on the mentally ill and the elderly before 1982–3, and after that with the pursuit of the ‘community care’ strategy within state provided services for the elderly and children. Incrementalism as a general theory of agency budgeting is limited in its ability to explain variations in the degree of incrementalism between agencies, between component budgets and over time. The conclusion suggests that further research should seek explanations for these variations in the varying balance of the competing forces which shape outcomes in welfare bureaucracies and in the relationship between these forces and the organisation's environment.

scholarly journals Topical issues of medical and social assistance to elderly and senile citizens in the conditions of inpatient social service organizations

2020 ◽  
Vol 23 (3) ◽  
pp. 4-8
Author(s):  
S. S. Memetov ◽  
S. N. Pusin ◽  
N. V. Budnik ◽  
Yu. V. Kobzev ◽  
V. N. Petrova ◽  
...  
Keyword(s):  
Social Services ◽  
Russian Federation ◽  
Social Service ◽  
Social Care ◽  
The Elderly ◽  
Legal Framework ◽  
Service Organizations ◽  
Social Service Organizations ◽  
Legal Documents ◽  
The Russian Federation

The article analyzes the current regulatory and legal framework for the organization of social services for the elderly and disabled in social service institutions on the territory of the Russian Federation. The article reflects the shortcomings of legal documents regarding the organization of work of such institutions to improve the quality and accessibility of social care for patients receiving social services in social service organizations. The assessment of staffing standards is given.

Social Work and Social Entrepreneurship: Opportunities for Synergy and Social Change

2015 ◽  
Vol 20 (1) ◽  
pp. 189-198
Author(s):  
Rukshan Fernando
Keyword(s):  
Social Workers ◽  
Social Services ◽  
Social Service ◽  
Economic Recession ◽  
Service Organizations ◽  
Public And Private ◽  
Social Service Organizations ◽  
The Media ◽  
Media Reports ◽  
Private Support

Today's world faces unprecedented complexities. Governments, businesses, and nonprofits have far to go in solving these problems. The economic recession of 2007 exposed a significant decline in public and private support for social services (Pitt- Catsouphes & Berzin, 2015) and the need for social workers to facilitate new ways of addressing the complex, interwoven problems of poverty, racism, social inequity, and discrimination. Now more than ever, social workers need to understand how social services can utilize new strategies with new solutions to address these issues (Berzin, 2012). ). Shuman & Fuller (2005) coined the phrase “revolution will not be funded,” indicating that nonprofits all over the country must devise new incomegenerating strategies to empower disadvantaged groups. Although the media reports that the U.S. economy has rebounded, foundations and governments still expect social service nonprofits to leverage new forms of revenue to fulfill their missions. There is also some uncertainty about how nonprofits will be funded long term as local, state, and federal government dollars dry up. In addition, some claim that social service organizations develop complex programs that do not match the interests of funders (Foster, Kim, & Christensen, 2009).

scholarly journals The application of supply chain analysis to the evaluation of the effectiveness of social service organizations

Management ◽  
2012 ◽  
Vol 16 (2) ◽  
pp. 199-216
Author(s):  
Jacek Szołtysek ◽  
Aldona Frączkiewicz - Wronka
Keyword(s):  
Supply Chain ◽  
Social Services ◽  
Social Service ◽  
Service Organizations ◽  
Single Chain ◽  
Social Service Organizations ◽  
Joint Management ◽  
Chain Analysis ◽  
The Social ◽  
Supply Chain Analysis

Abstract The application of supply chain analysis to the evaluation of the effectiveness of social service organizations The identification and analysis of value chains is a way to find the sources of an organization’s in-/efficiency, and an opportunity to explore how an organization is managed. Having in mind that an “organization network” is a form similar, in its functioning, to a separate organization, one may, using the value chain concept, investigate the management of local activity programmes, as of the networks they are. The researched partnerships introduced a management innovation, in that the social service provision organizations were brought together to form one chain. The researched organizations providing social services have introduced innovations in management that are supposed to unite organizations providing social services in a single chain. This kind of approach allows to obtain additional benefits, including the joint management of subjects composing the chain. In practice, it is also connected with sharing benefits between the participants in the chain, as well as replacing the elements of competition and suspicion with cooperation and trust. Delivering value to the beneficiary, under the provision of social services, is important not only from the point of view of humanity, but also in order to maximize the use of resources, usually insufficient to meet all the needs. The presented studies of supply chains of social services in Silesia showed, that some features of these newly created areas being subject of joint management, still crave for numerous improvements. What may help is logistics, in particular business logistics, having years of experience in the area of observation and active participation in the chain management. However, unconditional adaptation of these experiences is not possible due to the fact that developed methods are based on cost and maintenance compromises, which are insensitive to human needs when the service cost for the chain is not sufficiently profitable. Therefore, it is necessary to implement different methods of managing these chains, principles of which are described in the social logistics. The authors are convinced that combination of the efforts of the organizers of social services and experienced logistics professionals can bring a double benefit. In practical terms it may help to improve the delivery of services with no deterioration of their quality, and to increase the range of services (quantitative or qualitative) based on specific resources. In the epistemological dimension it may enable to develop rules to adapt the theory of logistics for the socially significant needs. Therefore, this paper can be considered as the beginning of the discussion in this regard.

scholarly journals Advocating for Structural Change? Exploring the Advocacy Activities of Immigrant-Serving Organizations in an Unwelcoming Policy Context

2018 ◽  
Vol 18 (3) ◽  
pp. 682-703 ◽  
Author(s):  
Benjamin Roth ◽  
Seo Yeon Park ◽  
Breanne Grace
Keyword(s):  
South Carolina ◽  
Social Service ◽  
Service Providers ◽  
The United States ◽  
Service Organizations ◽  
Future Research ◽  
Policy Advocacy ◽  
Social Service Organizations ◽  
State And Local ◽  
The Impact

The growth of the immigrant population in the United States has prompted a recent increase in the number of restrictive immigration policies at the state and local levels. The literature on policy advocacy and social service organizations suggests that these local providers can engage in political activities that challenge the restrictive nature of these contexts. This qualitative study explored how immigrant-serving social service organizations engage in policy advocacy in a state with restrictive, anti-immigrant policies. In-depth interviews with directors of 50 service providers in South Carolina clearly indicate a tension between the need for policy advocacy and the risks associated with engaging in such activities. Fifty percent (50%) of the providers in our sample reported engaging in some form of policy advocacy. However, their policy advocacy activities were often indirect, non-confrontational, and episodic. Most were engaged in coalitions and other forms of indirect advocacy tactics. We discuss implications for the social work profession and recommendations for future research, including the need to further explore the impact of policy advocacy efforts on changing the policy landscape in places that are unwelcoming to immigrants.

scholarly journals Evidence-based social service in Sweden: a long and winding road from policy to local practice

2019 ◽  
Vol 15 (1) ◽  
pp. 85-102 ◽  
Author(s):  
Kerstin Johansson
Keyword(s):  
Social Work ◽  
Social Services ◽  
Social Service ◽  
New Public Management ◽  
Work Practice ◽  
Social Work Practice ◽  
Political Support ◽  
Knowledge Development ◽  
Evidence Based ◽  
Complete Replacement

It is possible to discern a new trend replacing New Public Management (NPM) in human service organisations. This trend comprises a discussion about evidence and governance with the goal of establishing a knowledge-based practice within Swedish social service. Efforts aimed at promoting an evidence-based practice have been an explicit part of Swedish social policy for more than 15 years. As a public venture aimed at changing local municipality social work practice, the initiative described in this article has few predecessors in terms of personnel, finance, or political support. The purpose of this article is twofold: first, to describe the intervention and its implementation, and second, to analyse the intervention and its implementation and some implications of them. The article uses translation and institutional theory. The overall aim is to analyse the intervention and its implementation from the perspectives of power and governance. The empirical data include documents, interviews, and a survey of professionals. Data were collected between 2009 and 2016. This article shows that the intervention has been interpreted and reinterpreted during its implementation, and that the intervention has not yet created any radical change or knowledge development in social work practice. The article argues that evidence-based governance and other forms of governance constitute a successor of NPM, though far from a complete replacement. It is also obvious that actors such as researchers, professionals, and clients seem to have limited influence over future knowledge development within social services.

Moving away from opportunity? Social networks and access to social services

Urban Studies ◽  
2019 ◽  
Vol 57 (8) ◽  
pp. 1696-1713
Author(s):  
Jae Sik Jeon
Keyword(s):  
Social Networks ◽  
Social Services ◽  
Residential Mobility ◽  
Low Income ◽  
Social Service ◽  
Service Providers ◽  
The Body ◽  
Social Service Agencies ◽  
Moving To Opportunity ◽  
The Impact

Strong social connections often deter residential mobility beyond reach of the social network. A missing link in the body of research on this subject is the significance of the role of social networks in pooling resources for costly services and neighbourhood-level access to social services. Few have explored whether assistance from local social service agencies may substitute for practical help from social networks, thereby enabling low-income assisted renters to locate housing in more desirable neighbourhoods. Relying on data from the Moving to Opportunity experiment, this article examines the impact of social networks and social services on the dynamics of residential mobility. I find that the existence of social networks in the place movers left behind tends to increase the likelihood of moving back, but this likelihood varies with current access to social service providers and distance moved. These findings suggest that policy efforts in spatial dispersion of poverty should pay close attention to the geography of social services.

scholarly journals 978. Assessing the Impact of a Mobile Device-Based Clinical Decision Support Tool on Guideline Adherence and Mental Workload

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S40-S40
Author(s):  
Katherine Richardson ◽  
Sarah Fouquet ◽  
Ellen Kerns ◽  
Russell Mcculloh
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Mental Workload ◽  
Clinical Decision ◽  
Medical Decision ◽  
Evidence Based ◽  
System Usability Scale ◽  
Nasa Tlx ◽  
Evidence Based Guidelines ◽  
The Impact

Abstract Background Fever in infants <90 days old can indicate a serious bacterial infection (SBI) such as urinary tract infection, bacteremia, or meningitis. Clinical management of febrile infants varies widely. Implementing clinical practice guidelines (CPGs) can help standardize care, and electronic clinical decision support (eCDS) tools are a potential means of distributing CPGs. Little is known regarding the individual-level impact of eCDS tool use on medical decision-making. Children’s Mercy Kansas City developed a mobile eCDS tool (CMPeDS: Pediatric Decision Support) that was used internationally in a practice standardization project focused on the management of febrile infants. Methods We conducted a prospective cross-over simulation study amongst pediatric healthcare providers. Attending and resident physicians performed simulated patient scenarios using either CMPeDS or a standard text reference (the Harriet Lane Handbook). Participants’ responses in the simulation were evaluated based on adherence to evidence-based guidelines. Participants’ mental workload was assessed using the NASA Task Load Index survey (NASA-TLX, in which lower scores are optimal) to assesses mental, physical, and temporal demand, as well as performance, effort, and frustration when completing a series of tasks. Paired t-test and ANOVA were used to determine significance for case performance scores and NASA-TLX scores, respectively. A System Usability Scale (SUS) was used to determine usability of the CMPeDS app. Results A total 28 of 32 planned participants have completed trial procedures to date. Mean performance scores on the cases were significantly higher with CMPeDS vs. standard reference, (87.7% vs. 72.4% [t(27) 3.22, P = 0.003]). Participants reported lower scores on the NASA-TLX when using CMPeDS compared with standard reference tool (Figure 1). Mean score on SUS was 88.2 (scale 0–100) indicating excellent tool usability (Figure 2). Conclusion Using the eCDS tool CMPeDS was associated with significantly increased adherence to evidence-based guidelines for febrile infant management and decreased mental workload in simulation. Our findings highlight the potential value of eCDS deployment as part of CPG implementation projects. Disclosures All authors: No reported disclosures.

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