scholarly journals Automated conflict resolution between multiple clinical pathways: a technology report

2018 ◽  
Vol 25 (3) ◽  
pp. 142-148 ◽  
Author(s):  
Ian Litchfield ◽  
Alice Turner ◽  
Ruth Backman ◽  
João Bosco Ferreira Filho ◽  
Phil Weber ◽  
...  
Keyword(s):  
Secondary Care ◽  
Fundamental Problem ◽  
Clinical Pathways ◽  
Software Tool ◽  
Care Pathways ◽  
Long Term Conditions ◽  
Type Method ◽  
The Uk

BackgroundThe number of people in the UK with three or more long-term conditions continues to grow and the management of patients with co-morbidities is complex. In treating patients with multimorbidities, a fundamental problem is understanding and detecting points of conflict between different guidelines which to date has relied on individual clinicians collating disparate information.ObjectiveWe will develop a framework for modelling a diverse set of care pathways, and investigate how conflicts can be detected and resolved automatically. We will use this knowledge to develop a software tool for use by clinicians that can map guidelines, highlight root causes of conflict between these guidelines and suggest ways they might be resolved.MethodOur work consists of three phases. First, we will accurately model clinical pathways for six of the most common chronic diseases; second, we will automatically identify and detect sources of conflict across the pathways and how they might be resolved. Third, we will present a case study to prove the validity of our approach using a team of clinicians to detect and resolve the conflicts in the treatment of a fictional patient with multiple common morbidities and compare their findings and recommendations with those derived automatically using our novel software.DiscussionThis paper describes the development of an important software-based method for identifying a conflict between clinical guidelines. Our findings will support clinicians treating patients with multimorbidity in both primary and secondary care settings.

scholarly journals Commissioning for long-term conditions: hearing the voice of and engaging users – a qualitative multiple case study

2014 ◽  
Vol 2 (44) ◽  
pp. 1-204 ◽  
Author(s):  
Stephen Peckham ◽  
Patricia Wilson ◽  
Lorraine Williams ◽  
Jane Smiddy ◽  
Sally Kendall ◽  
...  
Keyword(s):  
Research Programme ◽  
Interactive Methods ◽  
Long Term Conditions ◽  
The Public ◽  
Patient Representatives ◽  
The Uk ◽  
The Impact ◽  
The Voice

BackgroundSome 15 million people in England have a long-term condition (LTC) but there is concern about whether or not the NHS meets their needs. To address this, consecutive governments have developed policies aimed at improving service delivery and patient and public engagement and involvement (PPEI). There has been little research that examines the impact or benefit of PPEI in commissioning. This project explored the role and impact of PPEI in commissioning for people with LTCs. The research was undertaken during a period of substantial change in the English NHS, which enabled us to observe how the NHS reforms in England impacted on approaches to PPEI.AimThe aim was to examine how commissioners enable voice and engagement of people with LTCs and identify what impact this has on the commissioning process and pattern of services. Our specific objectives were to (1) critically analyse the relationship between the public/patient voice and the impact on the commissioning process; (2) determine how changes in the commissioning process reshape local services; (3) explore whether or not any such changes in services impact on the patient experience; (4) identify if and how commissioners enable the voice and engagement of people with LTCs; and (5) identify how patient groups/patient representatives get their voice heard and what mechanisms and processes patients and the public use to make their voice heard.MethodsWe used a case study design examining the experience of PPEI in three LTC groups – diabetes, rheumatoid arthritis and neurological conditions – through three in-depth case studies. Our approach involved reviewing practice across the UK and then focusing on three geographical areas to examine practices of commissioning health care for people with LTCs, approaches to PPEI, patterns of services for people with LTCs and the activities of local patient and voluntary organisations for people with LTCs. The research had five phases and involved participatory and interactive methods of data collection and analysis.FindingsWe identified two key areas where improvements to practice in relation to PPEI can be made. The first relates to the framework or infrastructure arrangements for PPEI and how PPEI can be supported in the NHS and other organisations. To combat short-termism and the fragility of PPEI activities, sufficient resources need to be invested in developing shared understandings and sustaining relationships and infrastructures. The second area of action relates to the process for PPEI and how it should be undertaken.ConclusionAction needs to be taken by organisations at both national and local levels. PPEI is a circular process and, in itself, extremely fragile. This circular process can be ‘virtuous’– successful engagement leads to improved involvement and outcomes. However, where involvement is tokenistic or ends, patients and the public become disengaged and less involved and can be described as a ‘vicious circle’. In addition, we identified a number of key methodological issues and areas for further research that should be considered by research funders and researchers undertaking research in the area of PPEI, including a need for research on PPEI with young people.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Digital curation: the development of a discipline within information science

2018 ◽  
Vol 74 (6) ◽  
pp. 1318-1338 ◽  
Author(s):  
Sarah Higgins
Keyword(s):  
Information Science ◽  
Theoretical Models ◽  
Digital Information ◽  
Content Type ◽  
Digital Curation ◽  
The Usa ◽  
The Uk ◽  
Financial Ecology

Purpose Digital curation addresses the technical, administrative and financial ecology required to ensure that digital information remains accessible and usable over the long term. The purpose of this paper is to trace digital curation’s disciplinary emergence and examine its position within the information sciences domain in terms of theoretical principles, using a case study of developments in the UK and the USA. Design/methodology/approach Theoretical principles regarding disciplinary development and the identity of information science as a discipline are applied to a case study of the development of digital curation in the UK and the USA to identify the maturity of digital curation and its position in the information science gamut. Findings Digital curation is identified as a mature discipline which is a sub-meta-discipline of information science. As such digital curation has reach across all disciplines and sub-disciplines of information science and has the potential to become the overarching paradigm. Practical implications These findings could influence digital curation’s development from applied discipline to profession within both its educational and professional domains. Originality/value The disciplinary development of digital curation within dominant theoretical models has not hitherto been articulated.

scholarly journals ABCD position statement on risk stratification of adult patients with diabetes during COVID-19 pandemic

2021 ◽  
Author(s):  
Dinesh Nagi ◽  
Emma Wilmot ◽  
Karissa Owen ◽  
Dipesh Patel ◽  
Lesley Mills ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Clinical Care ◽  
Position Statement ◽  
Specialist Care ◽  
Long Term Conditions ◽  
Use Of Technology ◽  
Patients With Diabetes ◽  
Long Term Impact ◽  
The Uk

At the time of submission of this manuscript, the COVID-19 pandemic had cost nearly 60,000 lives in the UK. This number currently stands at over 120,000 deaths. A high proportion (one third) of these lived with diabetes. The huge acute and emergency medicine effort to support people with COVID-19 has had a major knock-on impact on the delivery of routine clinical care, especially for long-term conditions like diabetes.Challenges to the delivery of diabetes services during this period include a reduction in medical and nursing staff, limitations placed by social distancing on physical clinical space, and balancing virtual vs face-to-face care. There is a need to re-group and re-organise how we deliver routine out-patient adult diabetes services during the ongoing COVID-19 pandemic. We offer some suggestions for how patients can be stratified into red (urgent), amber (priority) and green (routine) follow up with suggestions of how often people should be seen. We also offer recommendation on how we can identify those at highest risk and try and minimise the long- term impact of COVID on diabetes careDuring the COVID pandemic we have seen things happen in days that previously took years. The restart of diabetes services has triggered a more widespread use of virtual consultations and data management systems, but also offers an opportunity for more joined-up and cohesive working between primary and specialist care. While we do our best to keep our patients and colleagues safe, this pandemic is already proving to be a catalyst for change, accelerating the appropriate use of technology in diabetes care and implementing innovative solutions. To achieve this aspiration, further work – currently led by the Association of British Clinical Diabetologists in collaboration with Diabetes UK and the Primary Care Diabetes Society – to make recommendations on future proofing diabetes care in UK is in progress.

scholarly journals Can social media reduce discrimination and ignorance towards patients with long term conditions? A chronic kidney disease example in the UK and more widely

2016 ◽  
Vol 3 (1) ◽  
pp. 35-41
Author(s):  
Shahid N Muhammad ◽  
Amy J Zahra ◽  
Howard J Leicester ◽  
Heather Davis ◽  
Stephen Davis
Keyword(s):  
Chronic Kidney Disease ◽  
Social Media ◽  
Kidney Disease ◽  
Long Term Conditions ◽  
The Uk

The Importance of Convention Status: A Case Study of the UK

2001 ◽  
Vol 6 (1) ◽  
pp. 15-24 ◽  
Author(s):  
Alice Bloch
Keyword(s):  
Asylum Seekers ◽  
Economic Rights ◽  
The United Kingdom ◽  
The Social ◽  
The Status ◽  
The Uk ◽  
Refugees And Asylum Seekers ◽  
Social And Economic Rights

Convention status accords refugees social and economic rights and security of residence in European countries of asylum. However, the trend in Europe has been to prevent asylum seekers reaching its borders, to reduce the rights of asylum seekers in countries of asylum and to use temporary protection as a means of circumventing the responsibility of long-term resettlement. This paper will provide a case study of the United Kingdom. It will examine the social and economic rights afforded to different statuses in the areas of social security, housing, employment and family reunion. It will explore the interaction of social and economic rights and security of residence on the experiences of those seeking protection. Drawing on responses to the crisis in Kosovo and on data from a survey of 180 refugees and asylum seekers in London it will show the importance of Convention status and the rights and security the status brings.

Community of Practice Software Management Tools

2011 ◽  
pp. 112-129 ◽  
Author(s):  
Mark Jewell ◽  
Derek H.T. Walker
Keyword(s):  
Community Of Practice ◽  
Performance Measures ◽  
Collaborative Study ◽  
Software Tool ◽  
Research Proposal ◽  
Management Approach ◽  
Anecdotal Evidence ◽  
Management Tools ◽  
The Uk

This chapter provides insights from a large UK construction organisation case study where communities of practice have been supported through use of a software tool and management approach that encourages their spread across the organisation. We provide a descriptive characterisation of what the community of practice (COP) software tool does, how it evolved, and anecdotal evidence from interviews with its users of its value to the UK case study organisation. We recognise the need to investigate COP value generation more formally, and we have developed a research proposal to undertake further work in a collaborative study with industry to provide useful COP performance measures to be undertaken. This chapter provides valuable insights from several years’ reflection upon the tool’s use and application, and we highlight both drivers and barriers to its deployment. The objective was to provide a practical example of what COP management tools could and should address.

The context of healthcare

2020 ◽  
pp. 1-34
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Northern Ireland ◽  
Healthcare Services ◽  
Health Profile ◽  
Long Term Conditions ◽  
Key Concepts ◽  
The Uk

This chapter begins by covering the UK health profile, then defines the key concepts in primary care and public health, and outlines the generic long-term conditions model. It provides a brief overview of the National Health Service, including differences in England, Northern Ireland, Scotland, and Wales. It covers current NHS entitlements for people from overseas, commissioning of services, and public health in a broader context. It also describes health needs assessment, and provides an overview of the services in primary care, the role of general practice, and other primary healthcare services. Further services, including those to prevent unplanned hospital admission, aid hospital discharge, those that support children and families, housing, social support, and care homes are all covered.

Preventing falls and falls-injuries in hospitals and long-term care facilities

2007 ◽  
Vol 17 (2) ◽  
pp. 75-91 ◽  
Author(s):  
David Oliver
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Falls Prevention ◽  
Care Homes ◽  
Term Care ◽  
Long Term Conditions ◽  
Global Challenge ◽  
The Uk ◽  
Developed Nations

Falls are predominantly a problem of older people. In the UK, people over 65 currently account for around 60% of admissions and 70% of bed days in hospitals. There are approximately half a million older people in long-term care settings – many with frailty and multiple long-term conditions. The proportion of the population over 65 years is predicted to rise 25% by 2025, and that over 80 by 50%, with a similar increase in those with dependence for two or more activities of daily living. Despite policies to drive care to the community, it is likely that the proportion of older people in hospitals and care homes will therefore increase. Accidental falls are the commonest reported patient/resident safety incidents. Similar demographic trends can be seen in all developed nations, so that the growing problem of fall prevention in institutions is a global challenge. There has been far more focus in falls-prevention research on older people in ‘community’ settings, but falls are a pressing issue for hospitals and care homes, and a threat to the safety of patients and residents, even if a relatively small percentage of the population is in those settings at any one time.

Patient satisfaction with a nurse-led, telephone-based disease management service in Birmingham

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 3-4 ◽  
Author(s):  
Pejman Azarmina ◽  
Jill Lewis
Keyword(s):  
Disease Management ◽  
Response Rate ◽  
Management Service ◽  
Educational Materials ◽  
Long Term Conditions ◽  
Qualitative Feedback ◽  
Telephone Calls ◽  
The Uk

In April 2006, a nurse-led telephone-based service was launched in Birmingham to improve the health outcomes of up to 2000 patients with high-risk, long-term conditions. Patients received regular telephone calls and educational materials selected according to their conditions. In August 2006, 506 questionnaires with 30 five-point Likert-type questions were sent to patients and 128 were returned within four weeks (25% response rate). The results showed that 96% of the respondents strongly agreed or agreed that they were satisfied with the quality of service being provided by the care managers. The educational material (care books) was found to be informative, easy to read and easy to understand. The qualitative feedback indicated that patients perceived the service to be useful, accessible and helped them to be more efficient in taking care of themselves. More than 40% of the patients agreed that the service reduced their need to go to hospital. Using a telephone-based disease management service seems to be an acceptable option for patients with long-term conditions in the UK.

scholarly journals Impact of the UK COVID-19 pandemic on HbA1c testing and its implications for diabetes diagnosis and management

2020 ◽  
Author(s):  
David Holland ◽  
Adrian Heald ◽  
Mike Stedman ◽  
Lewis Green ◽  
Jonathan Scargill ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Diagnosis ◽  
Long Term Conditions ◽  
Diagnosis And Management ◽  
Increased Risk ◽  
Poor Outcomes ◽  
The Uk ◽  
The Impact

Our findings illustrate the widespread collateral impact of implementing measures to mitigate the impact of COVID-19 in people with, or being investigated for diabetes mellitus (DM). Ironically, failure to focus of the wider implications for people with DM and other groups with long-term conditions, may place them at increased risk of poor outcomes from SARS-CoV-2 infection itself, irrespective of the implications for their longer-term health prospects.

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