scholarly journals Provider Diversity in the English NHS: A Study of Recent Developments in Four Local Health Economies

2012 ◽  
Vol 17 (1_suppl) ◽  
pp. 23-30 ◽  
Author(s):  
Pauline Allen ◽  
Simon Turner ◽  
Will Bartlett ◽  
Virginie Perotin ◽  
Greenwell Matchaya ◽  
...  
Keyword(s):  
Community Involvement ◽  
Economies Of Scale ◽  
Third Sector ◽  
Routine Data ◽  
Care Quality ◽  
Local Health ◽  
Barriers To Entry ◽  
Structured Interviews ◽  
Patient Pathways ◽  
The Impact

Objectives To assess the impact of provider diversity on quality and innovation in the English NHS by mapping the extent of diverse provider activity and identifying the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organizations within the NHS, and the factors that affect the entry and growth of new providers. Methods Case studies of four local health economies. Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and third sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results Involvement of diverse providers in the NHS is limited. Commissioners' local strategies influence degrees of diversity. Barriers to entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions There is scope to increase the participation of diverse providers in the NHS but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.

Impact of Public Policy on Small Third Sector Social Enterprises

2017 ◽  
pp. 84-107
Keyword(s):  
Public Policy ◽  
Chief Executive Officers ◽  
Third Sector ◽  
Chief Executive ◽  
Social Enterprises ◽  
Policy Framework ◽  
Structured Interviews ◽  
Hr Managers ◽  
Executive Officers ◽  
The Impact

This chapter provides important perspectives from key informants about their experiences of the impact of public policy on small social enterprises. Semi-structured interviews were conducted with the 10 Chief Executive Officers (CEOs), 8 HR managers, and 46 operational managers working in small third sector social enterprises in four UK regions to ascertain how government policy framework poses challenges and/or encourages small third sector social enterprises growth and success. There is clear evidence that changes in public policy have had some challenging effect on services development and in several regions, with core services, training and employment support and preventative services are showing a net deterioration.

scholarly journals Not Just How Many but Who is on Shift: The Impact of Workplace Incivility and Bullying on Care Delivery in Nursing Homes

2020 ◽  
Author(s):  
Heather A Cooke ◽  
Jennifer Baumbusch
Keyword(s):  
Power Relations ◽  
Care Delivery ◽  
Participant Observation ◽  
Care Quality ◽  
Workplace Incivility ◽  
Workplace Relationships ◽  
Structured Interviews ◽  
Term Care ◽  
Staff Members ◽  
The Impact

Abstract Background and Objectives Much of the literature examining the staffing-care quality link in long-term care (LTC) homes focuses on staffing ratios; that is, how many staff are on shift. Far less attention is devoted to exploring the impact of staff members’ workplace relationships, or who is on shift. As part of our work exploring workplace incivility and bullying among residential care aides (RCAs), we examined how RCAs’ workplace relationships are shaped by peer incivility and bullying and the impact on care delivery. Research Design and Methods Using critical ethnography, we conducted 100 hours of participant observation and 33 semi-structured interviews with RCAs, licensed practical nurses, support staff and management in two non-profit LTC homes in British Columbia, Canada. Results Three key themes illustrate the power relations underpinning RCAs’ encounters with incivility and bullying that, in turn, shaped care delivery. Requesting Help highlights how exposure to incivility and bullying made RCAs reluctant to seek help from their co-workers. Receiving Help focuses on how power relations and notions of worthiness and reciprocity impacted RCAs receipt of help from co-workers. Resisting Help/ing outlines how workplace relationships imbued with power relations led some RCAs to refuse assistance from their co-workers, led longer-tenured RCAs to resist helping newer RCAs and dictated the extent to which RCAs provided care to residents for whom another RCA was responsible. Discussion and Implications Findings highlight ‘who’ is on shift warrants as much attention as ‘how many’ are on shift, offering additional insight into the staffing-care quality link.

Developing teenagers’ role consciousness as “world heritage guardians”

2017 ◽  
Vol 7 (2) ◽  
pp. 179-192 ◽  
Author(s):  
Wenhui Wang ◽  
Yin Zhang ◽  
Jing Han ◽  
Ping Liang
Keyword(s):  
Sustainable Development ◽  
Community Involvement ◽  
Age Groups ◽  
World Heritage ◽  
Three Dimensions ◽  
Structured Interviews ◽  
Content Type ◽  
World Heritage Sites ◽  
Heritage Protection ◽  
The Impact

Purpose As one of the nearest and most important groups of resource guardians, local teenagers are an important force for current and especially future world heritage protection. Nurturing their awareness of world heritage protection is an important way to achieve the sustainable development of world heritage sites (WHS). The purpose of this paper is to present a case study of local teenagers of Tai’an city in China with the aim of examining how they have developed consciousness of their role as “world heritage guardians.” Design/methodology/approach Semi-structured interviews are used to examine the awareness of 15 local teenagers on world heritage protection. The interview results are then qualitatively analyzed by using a systematic coding process. Findings The analysis shows that the formation of the guardianship role is realized through three dimensions: recognition, emotion, and action, which are subjected to role awakening, role identifying, and role strengthening stage by stage. The personal experiences of the interviewees, as well as the impact from surrounding groups both serve to influence the formation of their role as “world heritage guardians.” Research limitations/implications The framework constructed in this study on the development of teenagers’ role consciousness cannot only apply to world heritage and environmental contexts in terms of awareness of the need for conservation, but be used toward behavioral studies of other age groups. Practical implications The findings can be used as a practical guide for school teachers, government officials, and heritage managers to better carry out educational programs in terms of heritage tourism and sustainable development of WHS for teenagers. Originality/value The teenagers’ population is underrepresented in the literature in terms of community involvement with world heritage. This study is meaningful because the focus is on improving local teenagers’ awareness of the value and importance of world heritage and their preservation.

Perceptions of Students and Educators on the Impact of No Child Left Behind: Some Will and Some Won't

2005 ◽  
Vol 24 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Nancy E. Harriman
Keyword(s):  
No Child Left Behind ◽  
Students With Disabilities ◽  
Community Involvement ◽  
Special Educators ◽  
Middle Level ◽  
Structured Interviews ◽  
Negative Effects ◽  
Left Behind ◽  
K 12 ◽  
The Impact

How do students and educators perceive the No Child Left Behind law and its impact? The author reports on structured interviews with 15 staff members K-12 and 37 middle level students in a small, northeastern coastal community. The responses of students included three themes: fairness to subgroups, student effort and self-determination, and apprehensions about changing schools. Issues identified by teachers, special educators and administrators included: desirable effects of accountability; concerns about fairness to students with disabilities and diverse learning needs; conflicts between state and federal requirements; and negative effects on teaching, learning and allocation of resources. Most respondents recommended that the law be amended to achieve the original intent. Of particular relevance to special educators in small or rural schools is the overall challenge identified by educators of finding time to balance the often apparently competing demands of existing initiatives such as individualized instruction, curriculum of place, community involvement, and development of functional skills, with the additional bureaucratic and assessment related demands required by No Child Left Behind.

Does participatory ergonomics reduce musculoskeletal pain in sonographers? A mixed methods study

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110239
Author(s):  
Kristie Sweeney ◽  
Karen Ginn ◽  
Jacqueline Spurway ◽  
Jillian Clarke ◽  
Martin Mackey
Keyword(s):  
Mixed Methods ◽  
Musculoskeletal Pain ◽  
Work Conditions ◽  
Preliminary Evidence ◽  
Mixed Methods Study ◽  
Local Health ◽  
Structured Interviews ◽  
Participatory Ergonomics ◽  
Pain Prevalence ◽  
The Impact

Introduction Sonographers in the Western New South Wales Local Health District (WNSWLHD) reported a musculoskeletal pain prevalence rate of 95%. Participatory ergonomics, where workers are consulted about improving work conditions, was utilised to identify work-related musculoskeletal disorder (WMSD) risks and potential solutions. The aim of this study was to compare the prevalence of WMSD in a cohort of sonographers before and after implementation of ergonomic changes that were driven by recommendations from a participatory ergonomics approach. Methods This observational mixed methods study analysed the impact of participatory ergonomic-driven interventions on changes on musculoskeletal pain in a cohort of sonographers employed within the WNSWLHD. A retrospective analysis of 10 sonographer WMSD pain surveys over five sites was completed, along with semi-structured interviews regarding which interventions were perceived as useful, which interventions were not implemented and any barriers to implementation. Results Installation of patient monitors, use of ergonomic scanning techniques and job rotation were perceived as responsible for decreased musculoskeletal pain. Taking lunch breaks and microbreaks, use of antifatigue mats and having two sonographers perform mobile exams were not fully implemented. No interventions were perceived as responsible for increased pain. Conclusion This small study provides preliminary evidence that a participatory ergonomics approach facilitated identification of occupation and site-specific risks for WMSD in the WNSWLHD, allowing implementation of ergonomic changes to be tailored to the workplace, resulting in a safer work environment for sonographers.

scholarly journals Childbearing through the Lens of Women with Minor Thalassemia: A Qualitative Study

2019 ◽  
Vol 8 ◽  
pp. 1429
Author(s):  
Khadijeh Sarayloo ◽  
Zahra Behboodi Moghaddam ◽  
Khadijeh Mirzaii Najmabadi ◽  
Sharon Elizabeth Millen ◽  
Mohsen Saffari
Keyword(s):  
Sampling Technique ◽  
Educational Interventions ◽  
Health Centers ◽  
Specific Information ◽  
Local Health ◽  
Cultural Issues ◽  
Structured Interviews ◽  
Psychosocial Burden ◽  
Pregnancy And Childbirth ◽  
The Impact

Background: It is essential to provide key information and support to every woman regarding pregnancy and childbirth to enable all women to make a fully informed decision regarding their choice to reproduce.  Of particular importance; however, is that women who suffer from a specific condition that increases risks associated with reproduction, to receive specific information regarding such risks and health complications regarding pregnancy and childbirth. This study aims to explore the feelings, experiences, and needs of women with minor thalassemia in relation to childbearing. Materials and Methods: This sample comprised of 12 Iranian women with minor thalassemia who attended to local health centers in Minudasht, Golestan province, from October 2017 to January 2018. The purposeful sampling technique was employed. The data were collected through deep semi-structured interviews, analyzed using conventional content analysis and processed by using the Graneheim and Lundman method. Results: The findings were based on the participants’ experiences of pregnancy and fertility. Three major themes emerged; ‘Emotional and Physical Experience,’ ‘Satisfaction’ and ‘Social and Cultural Issues.’ The most common problem identified was the impact of emotional problems and difficulties regarding the negative implications of thalassemia on reproduction as well as the views and perceptions of family members and those within the community. Conclusion: From the findings, it is evident that thalassemia imposes a heavy psychosocial burden on those women who suffer from the condition. Local health centers in areas most affected by thalassemia would be considered the most suitable venues to introduce key health educational interventions. [GMJ.2019;8:e1429]

scholarly journals Have Bangladesh’s Polders Decreased Livelihood Vulnerability? A Comparative Case Study

2019 ◽  
Vol 11 (24) ◽  
pp. 7141 ◽  
Author(s):  
Sanchayan Nath ◽  
Frank van Laerhoven ◽  
Peter P. J. Driessen
Keyword(s):  
Community Involvement ◽  
Saline Water ◽  
Vulnerability Index ◽  
Community Response ◽  
Comparative Case Study ◽  
Infrastructure Development ◽  
Structured Interviews ◽  
Hydrological Conditions ◽  
The Impact

Communities living in coastal regions are vulnerable to flooding, salinity intrusion, and natural hazards. This is aggravated by climate change. In order to reduce this vulnerability, governments have invested heavily in developing coastal infrastructures. One type of infrastructure development regards polders (i.e., pieces of land previously subject to permanent or temporal overflow that are now surrounded by embankments that prevent inundation). The impact of polderization on livelihood vulnerability is not straightforward and is therefore still poorly understood. In order to analyze such impacts, we present a comparative case study of four polders in Bangladesh that are characterized by varying societal circumstances, hydrological conditions, hydrological interventions, and different levels of community response to polderization. How does livelihood vulnerability vary temporally and spatially in polders, and what explains such variation? We use data collected via 162 surveys, 40 semi-structured interviews, and secondary research to analyze trends in the scores of the livelihood vulnerability index. Based on our analysis, we argue that after accounting for interactions amongst variables like hydrological conditions, hydrological interventions, community response, and other societal factors, livelihood vulnerability is lower in polders characterized by higher community involvement in using hydrological interventions to control the flow of saline water.

Traversing the women entrepreneurship in South Asia

2018 ◽  
Vol 12 (1) ◽  
pp. 50-66 ◽  
Author(s):  
Tanu Shukla ◽  
Gajendra Singh Chauhan ◽  
Saumya Saumya
Keyword(s):  
Quantitative Research ◽  
First Generation ◽  
Barriers To Entry ◽  
Structured Interviews ◽  
Extrinsic Factors ◽  
Female Entrepreneurs ◽  
Content Type ◽  
Intrinsic Factors ◽  
Complex Picture ◽  
The Impact

PurposeMarginalization of women in STEM sectors is a widely discussed trend that has percolated into the corporate sector. The purpose of this study is to identify factors that act as barriers to entry to female entrepreneurs and to understand the impact of these factors in the context of startup landscape. The scope of this paper covers chiefly first-generation entrepreneurs while elaborating the presence of the Lucite ceiling effect. It aims to categorize and elucidate the responsible variables while developing a model for the same.Design/methodology/approachThe research is an exploratory study that provides a complex picture of how female entrepreneurs understand and experience the work culture at their workplace. The population under consideration is “urban startups”; these have been characterized as technology/non-technology-based and non-agricultural in nature. The sample in the study consists of male and female entrepreneurs of first-generation entrepreneurs belonging to the urban middle class and either founders or co-founders. The exploration presents a groundbreaking examination based on narrative inquiry and semi-structured interviews.FindingsThe research led to distinct findings that can be utilized to improve the condition of female entrepreneurs and encourage their involvement in the ecosystem. The model is proposed on the basis of extrinsic and intrinsic factors, which lead to the Lucite ceiling phenomenon. The causes ranging from family pressure to fulfilling relevant requirements such as financing the venture were classified under these. Ultimately, inferences were drawn as to how these may be affecting the growth of women in the sectors.Research limitations/implicationsThe identified intrinsic and extrinsic factors have been detailed, presenting further opportunities to focus on specific metrics by the stakeholders, namely, the policy-makers and the entrepreneur community. The study has been limited to urban startups to allow for convenience sampling, which is justified considering the issues highlighted in the existing knowledge. While this study has been carried out in the context of urban startups, it leaves scope for extension and extrapolation of the presented model in the rural context.Practical implicationsThe study presents a formally structured representation of the issues faced by female entrepreneurs in a manner which is mutually exclusive and collectively exhaustive. Such a categorization can, in the contemporary times, enable targeted mitigation of the same through well-planned policy initiatives and legislation. In addition, it provides a strong baseline for extensive quantitative research in this field, especially in the context of emerging economies in fast-developing nations.Originality/valueThe framework helps lay a groundwork for thoughtful research on women’s entrepreneurship. The Lucite ceiling phenomenon is a more aggravated version of the “glass ceiling”. The reasons for the prevalence of this effect in this context have not been explored before, thus providing a great scope to be further investigated.

scholarly journals Sex-specific differences in management and treatment in ST-elevation myocardial infarction – a German nationwide real-life analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L Kuehnemund ◽  
J Koeppe ◽  
A J Fischer ◽  
J Feld ◽  
J Illner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sex Differences ◽  
Real Life ◽  
Routine Data ◽  
St Elevation Myocardial Infarction ◽  
Current Debate ◽  
Local Health ◽  
Female Sex ◽  
St Elevation ◽  
The Impact

Abstract Background/Introduction Acute myocardial infarction (AMI) continues to be the leading cause of death in men and women worldwide. The outcome of patients with AMI improved during the last years but the impact of sex is under current debate since female sex has repeatedly to be associated with an unfavourable outcome in AMI. Purpose This retrospective routine-data-based analysis sought to examine sex differences of recent trends in in-patient healthcare and outcome of ST-elevation myocardial infarction (STEMI). Methods The dataset of the Federal Association of the Local Health Insurance Funds was used to identify patients who were hospitalized for STEMI in Germany between January 2010 and December 2017. Further, data on concomitant diseases, risk constellations, selected cardiovascular procedures, as well as in-hospital and 30-days mortality were assessed and further analyzed with regard to sex differences. Results In total, we identified 175,187 STEMI patients over the 8-year period, thereof about 35% female patients. Women with STEMI were older (median (interquartile range (IQR)): 76 (19) vs. 64 (20) years in men) and had more comorbidities including diabetes (44.9% vs. 35.5%), hypertension (90.9% vs. 82.8%), congestive heart failure (54.7% vs. 43.8%) and chronic kidney disease (33.5% vs. 22.3%); all p<0.001). Further, female STEMI patients underwent less often percutaneous coronary intervention during hospitalization (PCI; 75.5% vs. 85.2%; p<0.001). Complications such as shock (14.8% vs. 13.0%) and bleeding (9.3% vs. 6.6%; both p<0.001) could be observed more frequently in women. Female sex was independently associated with a higher adjusted 30-day mortality (Odds Ratio 1.08; CI 1.05–1.12; p<0.001). Conclusion In a contemporary unselected cohort, one-third of STEMI patients are female. Women with STEMI are older with higher cardiovascular risk, and continue to receive less likely interventional revascularization therapy compared to male STEMI patients. Moreover, female STEMI patients were observed higher complications and death during index hospitalization and 30 days thereafter. Further analyses are urgently needed to identify causes of under-treatment and impaired outcome in women with STEMI. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): joint federal committee, Germany.

scholarly journals Kidney Care during COVID-19 in the UK: Perspectives of Healthcare Professionals on Impacts on Care Quality and Staff Well-Being

2021 ◽  
Vol 19 (1) ◽  
pp. 188
Author(s):  
Archontissa Maria Kanavaki ◽  
Courtney Jane Lightfoot ◽  
Jared Palmer ◽  
Thomas James Wilkinson ◽  
Alice Caroline Smith ◽  
...  
Keyword(s):  
Online Survey ◽  
Healthcare Professionals ◽  
Healthcare Access ◽  
Healthcare Delivery ◽  
Well Being ◽  
Care Quality ◽  
Free Text ◽  
Structured Interviews ◽  
The Uk ◽  
The Impact

In light of the rapid changes in healthcare delivery due to COVID-19, this study explored kidney healthcare professionals’ (HCPs) perspectives on the impact of these changes on care quality and staff well-being. Fifty-nine HCPs from eight NHS Trusts across England completed an online survey and eight took part in complementary semi-structured interviews between August 2020 and January 2021. Free-text survey responses and interviews were analysed using inductive thematic analysis. Themes described the rapid adaptations, concerns about care quality, benefits from innovations, high work pressure, anxiety and mental exhaustion in staff and the team as a well-being resource. Long-term retention and integration of changes and innovations can improve healthcare access and efficiency, but specification of conditions for its use is warranted. The impact of prolonged stress on renal HCPs also needs to be accounted for in quality planning. Results are further interpreted into a theoretical socio-technical framework.

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