A general practice provider federation in a mixed health economy in England: a case study investigation

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696929
Author(s):  
Jill Mitchell
Keyword(s):  
General Practice ◽  
Shared Vision ◽  
Health Economy ◽  
Structured Interviews ◽  
The North ◽  
Common Strategy ◽  
Common Purpose ◽  
Collaborative Working ◽  
The Impact

BackgroundThere is an emerging debate that general practice in its current format is out-dated and there is a requirement to move to a federated model of provision where groups of Practices come together. The emergence of federations has developed over the past 5 years but the factors that influence how federations develop and the impact of this new model is an under researched area.AimThe study explored the rationale around why a group of independent GP practices opted to pursue an alternative business venture and the benefits that this strategy offered.MethodA single organisational case study of a federation in the North of England was conducted between 2011–2016. Mixed methods data collection included individual and group semi-structured interviews and quantitative surveys.ResultsFederations promote collaborative working, relying on strategic coherence of multiple individual GP practices through a shared vision and common purpose. Findings revealed many complexities in implementing a common strategy across multiple independent businesses. The ability of the federation to gain legitimacy was two dimensional – externally and internally. The venture had mixed successes, but their approach to quality improvement proved innovative and demonstrated outcomes on a population basis. The study identified significant pressures that practices were experiencing and the need to seek alternative ways of working but there was no shared vision or inclination to relinquish individual practice autonomy.ConclusionOrganisational development support is critical to reform General Practice. Whether central funding through the GP Five Year Forward View will achieve the scale of change required is yet to be evidenced.

scholarly journals Information literacy outreach between universities and schools

2020 ◽  
Vol 14 (2) ◽  
pp. 44
Author(s):  
Sharon Wagg ◽  
Pam McKinney
Keyword(s):  
Higher Education ◽  
Information Literacy ◽  
Best Practice ◽  
Single Case ◽  
Situational Analysis ◽  
Structured Interviews ◽  
The North ◽  
Outreach Programme ◽  
The Impact

Research shows that students starting higher education (HE) often lack an essential level of information literacy (IL). To address this issue, a growing number of Higher Education Institutions (HEIs) engage with schools through Information Literacy Outreach Programmes (ILOPs). This paper explores the forces and motivations behind how and why HEIs engage with schools through ILOPs, and discusses their impact on beneficiaries. Using a UK research-led university in the North of England as a single case study (hitherto XXXX), this research project adopted a qualitative case study approach and used Situational Analysis to explore and analyse the data collected. Data collection involved semi-structured interviews with key staff that participated in the IL outreach programme, and a model was developed to illustrate diagrammatically the key outcomes and phases of the IL Outreach Programme. Key findings revealed that the IL Outreach Programme at XXXX is an effective mechanism for bridging the social worlds of schools and HE; for creating partnerships and knowledge sharing between institutions; for breaking down social barriers and inequalities; and for developing critically aware, independent learners. The significance of this paper is that it helps us understand the impact of IL outreach programmes, and how such programmes provide schools and HEIs with an opportunity to work collaboratively and share knowledge and best practice. It also provides a valuable addition to IL literature.

Ten Demi-Culverins for Aldeburgh: Whitehall, the Dunkirkers, and a Suffolk Fishing Community, 1625–1630

2019 ◽  
Vol 58 (2) ◽  
pp. 315-337 ◽  
Author(s):  
Thomas Cogswell
Keyword(s):  
North Sea ◽  
East Coast ◽  
Central Government ◽  
Fishing Community ◽  
Close Attention ◽  
The North ◽  
The North Sea ◽  
The Impact

AbstractHistorians have not paid close attention to the activities of freebooters operating out of Dunkirk in the late 1620s. This essay corrects that omission by first studying the threat from Dunkirk to England's east coast and then addressing how the central government, counties, and coastal towns responded. A surprisingly rich vein of manuscript material from Great Yarmouth and particularly from the Suffolk fishing community of Aldeburgh informs this case study of the impact of this conflict around the North Sea.

scholarly journals Evaluating the efficacy of technical measures: a case study of selection device legislation in the UK Crangon crangon (brown shrimp) fishery

2008 ◽  
Vol 65 (2) ◽  
pp. 267-275 ◽  
Author(s):  
Tom L. Catchpole ◽  
Andrew S. Revill ◽  
James Innes ◽  
Sean Pascoe
Keyword(s):  
Brown Shrimp ◽  
Crangon Crangon ◽  
Shrimp Fishery ◽  
The North ◽  
Ex Post ◽  
Wide Range ◽  
The Uk ◽  
The Impact ◽  
Technical Measures

Abstract Catchpole, T. L., Revill, A. S., Innes, J., and Pascoe, S. 2008. Evaluating the efficacy of technical measures: a case study of selection device legislation in the UK Crangon crangon (brown shrimp) fishery. – ICES Journal of Marine Science, 65: 267–275. Bycatch reduction devices are being introduced into a wide range of fisheries, with shrimp and prawn fisheries particularly targeted owing to the heavy discarding common in these fisheries. Although studies are often undertaken to estimate the impact of a technical measure on the fishery before implementation, rarely have the impacts been assessed ex post. Here, the efficacy of the UK legislation pertaining to the use of sievenets in the North Sea Crangon crangon fishery is assessed. Three impacts were evaluated: on fisher behaviour (social), on the level of bycatch (biological), and on vessel profitability (economic). An apparent high level of compliance by skippers was identified despite a low level of enforcement. The estimated reduction in fleet productivity following the introduction of the legislation was 14%, equalling the mean loss of Crangon landings when using sievenets calculated from catch comparison trawls. Sievenets did reduce the unnecessary capture of unwanted marine organisms, but were least effective at reducing 0-group plaice, which make up the largest component of the bycatch. Clearly the legislation has had an effect in the desired direction, but it does not address sufficiently the bycatch issue in the Crangon fishery.

Three stages of entrepreneurial orientation: the founder’s role

2019 ◽  
Vol 26 (2) ◽  
pp. 285-306 ◽  
Author(s):  
Torbjörn Ljungkvist ◽  
Börje Boers ◽  
Joachim Samuelsson
Keyword(s):  
Entrepreneurial Orientation ◽  
Single Case ◽  
Annual Reports ◽  
Structured Interviews ◽  
Theoretical Understanding ◽  
Content Type ◽  
Five Dimensions ◽  
The Impact ◽  
Over Time

Purpose The purpose of this paper is to understand the development of the five dimensions of entrepreneurial orientation (EO) over time by taking a founder’s perspective. Design/methodology/approach The paper draws on an in-depth single-case study. It combines semi-structured interviews in the company with archival data, such as annual reports, press clips and interviews in business magazines. Findings The results indicate that the EO dimensions change from being personalized and directly solution-oriented to being intangible value-creation-oriented. Originality/value By suggesting ownership-based EO configurations, this study contributes insights into how different ownership forms propel EO. These configurations – that is, personal, administrative based and intangible focused – show the impact of the EO dimensions and provide a systematic and theoretical understanding of EO change over time.

scholarly journals Patient Centred Medical Home (PCMH) transitions in western Sydney, Australia: A qualitative study

2019 ◽  
Author(s):  
Christine Metusela ◽  
Tim Usherwood ◽  
Kenny Lawson ◽  
Lisa Angus ◽  
Walter Kmet ◽  
...  
Keyword(s):  
General Practice ◽  
Hospital Admissions ◽  
Healthcare Providers ◽  
Models Of Care ◽  
Shared Vision ◽  
Fee For Service ◽  
Structured Interviews ◽  
Practice Nurses ◽  
Funding Model ◽  
Sydney Australia

Abstract Objectives Patient Centred Medical Homes (PCMHs), increasingly evidenced to provide high quality primary care, are new to Australia. To learn how this promising new healthcare model works in an Australian setting we explored experiences of healthcare providers in outer urban Sydney, where a number of practices are transitioning from traditional Australian general practice models to incorporate elements of PCMH approaches. Design We collected qualitative data from semi-structured interviews with healthcare providers working in a range of transitioning practices and thematically analysed the data. Setting and participants We interviewed 35 participants including general practitioners, practice managers and practice nurses from 25 purposively sampled general practices in western Sydney, Australia, seeking maximal variation in practice size, patient demographics and type of engagement in practice transformation. Results Interviewees described PCMH transformation highlighting the importance of whole of practice engagement with a shared vision; key strategies for transformation to PCMH models of care including leadership, training and supportive information technology; structures and processes required to provide team-based, data-driven care; and constraints such as lack of space and the current Australian fee-for-service general practice funding model. They also reported their perceptions of early outcomes of the PCMH model of care, describing enhanced patient and staff satisfaction and also noting fewer hospital admissions, as likely to reduce costs of care. Conclusions Our study exploring the experience of early adopters of PCMH models of care in Australia, informs the international movement towards PCMH models of care. Our findings provide guidance for practices considering similar transitions and describe the challenges of such transitions within a fee-for-service payment system.

scholarly journals Patient Centred Medical Home (PCMH) transitions in western Sydney, Australia: A qualitative study

2019 ◽  
Author(s):  
Christine Metusela ◽  
Tim Usherwood ◽  
Kenny Lawson ◽  
Lisa Angus ◽  
Walter Kmet ◽  
...  
Keyword(s):  
General Practice ◽  
Hospital Admissions ◽  
Healthcare Providers ◽  
Models Of Care ◽  
Shared Vision ◽  
Fee For Service ◽  
Structured Interviews ◽  
Practice Nurses ◽  
Funding Model ◽  
Sydney Australia

Abstract Objectives Patient Centred Medical Homes (PCMHs), increasingly evidenced to provide high quality primary care, are new to Australia. To learn how this promising new healthcare model works in an Australian setting we explored experiences of healthcare providers in outer urban Sydney, where a number of practices are transitioning from traditional Australian general practice models to incorporate elements of PCMH approaches. Design We collected qualitative data from semi-structured interviews with healthcare providers working in a range of transitioning practices and thematically analysed the data. Setting and participants We interviewed 35 participants including general practitioners, practice managers and practice nurses from 25 purposively sampled general practices in western Sydney, Australia, seeking maximal variation in practice size, patient demographics and approaches to PCMH transitions. Results Interviewees described PCMH transformation highlighting the importance of whole of practice engagement with a shared vision; key strategies for transformation to PCMH models of care including leadership, training and supportive information technology; structures and processes required to provide team-based, data-driven care and constraints such as lack of space and the current Australian fee-for-service general practice funding model. They also reported early outcomes of the PCMH model of care, in particular enhanced patient and staff satisfaction and fewer hospital admissions which were described as likely to reduce the costs of care. Conclusions Our study exploring the experience of early adopters of PCMH models of care in Australia, informs the international movement towards PCMH Primary Health Care approaches. Our findings provide guidance for practices considering similar transitions and describe the challenges of such transitions within a fee-for-service payment system.

scholarly journals Forestación peridoméstica en Patagonia y conocimiento ecológico tradicional: un estudio de caso

2012 ◽  
Vol 11 (2) ◽  
pp. 321 ◽  
Author(s):  
M. Betina Cardoso ◽  
Ana Haydeé Ladio
Keyword(s):  
General Practice ◽  
Cultural Landscape ◽  
Ecological Knowledge ◽  
Multivariate Methods ◽  
Small Community ◽  
Structured Interviews ◽  
Living Space ◽  
Rio Negro ◽  
Forested Areas

The Patagoniansteppe is a cultural landscape which is constantly being recreated by man. In this case study, peridomestic forestation oftree species was analysed in a small community, including the richness of plants used and the reasons behind their choice.In the Mapuche population of Pilkiniyeu del Limay (Río Negro) free and semi-structured interviews were carried out with28 interviewees. The data was analysed using both uni- and multivariate methods. Results indicate that nine exotic speciesare used. These forested areas, used for meetings and recreation, provide useful living space and are of great socialimportance. The principal motivation behind this forestation is the need for materials for building fences (96%), toprovide shelter from the elements (86%), firewood (43%), and cattle fodder (11%). The MSD revealed a shared valuesystem with respect to the forestation. The traditional ecological knowledge that people use in the selection and use offirewood species does not seem to have an influence on choices made when planting trees around their homes. This couldindicate that forestation is a general practice deeply rooted and influenced by the oblique transmission carried out byexternal agriculture agents who visit and offer help to this community.

scholarly journals Evacuation Data from a Hospital Outpatient Drill The Case Study of North Shore Hospital

2020 ◽  
Vol 5 ◽  
Author(s):  
Anass Rahouti ◽  
Ruggiero Lovreglio ◽  
Phil Jackson ◽  
Sélim Datoussaïd
Keyword(s):  
Built Environment ◽  
Fire Safety ◽  
Movement Time ◽  
Data Set ◽  
Healthcare Facilities ◽  
Staff Members ◽  
North Shore ◽  
The North ◽  
The Impact

Assessing the fire safety of buildings is fundamental to reduce the impact of this threat on their occupants. Such an assessment can be done by combining existing models and existing knowledge on how occupants behave during fires. Although many studies have been carried out for several types of built environment, only few of those investigate healthcare facilities and hospitals. In this study, we present a new behavioural data-set for hospital evacuations. The data was collected from the North Shore Hospital in Auckland (NZ) during an unannounced drill carried out in May 2017. This drill was recorded using CCTV and those videos are analysed to generate new evacuation model inputs for hospital scenarios. We collected pre-movement times, exit choices and total evacuation times for each evacuee. Moreover, we estimated pre-movement time distributions for both staff members and patients. Finally, we qualitatively investigated the evacuee actions of patients and staff members to study their interaction during the drill. The results show that participants were often independent from staff actions with a majority able to make their own decision.

scholarly journals Exploring the Impact of Resettlement on Women: A Case Study of the Nam Mang 3 Hydropower Dam in Central Laos

2021 ◽  
Author(s):  
◽  
Singkham Lueyeevang
Keyword(s):  
Energy Production ◽  
Strategy Development ◽  
Structured Interviews ◽  
Time Saving ◽  
Grazing Land ◽  
Hydropower Dam ◽  
Hydropower Dams ◽  
Dam Site ◽  
The Impact

<p>Over the last decade, construction of hydropower dams has increased rapidly around the world, including in developing countries. For many countries including Laos, energy production and export play a significant role in promoting and boosting economic growth and development. Energy production generates substantial revenue and foreign exchange from exporting electricity and expands economic activity domestically. However, construction of hydropower dams also causes negative effects on the people who live at and around the dam site. Some local communities have been affected indirectly, while others require relocation to other areas bringing significant change, including for women. This research explores the impact of resettlement from hydropower dam creation on women by using the Nam Mang 3 hydropower dam in central Laos as a case study. This dam, completed in 2005, required the relocation of approximately 150 households from two villages at the dam site. The research draws on a social constructivist epistemology, qualitative methods including semi-structured interviews, and analysis of relevant policy documents. Interviews involved 18 participants including both male and female from the three affected villages. Results indicate that the resettlement of villagers by the Nam Mang 3 hydropower dam has generally improved living conditions of the resettled communities. Women were found to have greater opportunities to benefit from home-based business, employment and wage labouring. In addition, with better access to modern facilities and services, women have been able to save greater time from agricultural activities and divert this time saving to other economic activities. Overall, access to water supplies, roads, and transport have reduced women’s workload significantly. Access to improved health services and facilities have also improved women’s wellbeing. Girls have greater opportunities to attend school and seek employment in towns. However, this research identified some challenges experienced by the resettled such as the reduction of agricultural and grazing land area, and that new livelihood options were not accessible to all women. Instead of these challenges, the experience with the Nam Mang 3 hydropower project has highlighted one of the key lessons learnt that is worth highlighting for future resettlement programs, which is to have the resettlers fully engaged in the entire process of resettlement and livelihood strategy development.</p>

scholarly journals SPECIALIST SERVICE IN LIVER TRANSPLANT IN A UNIVERSITY HOSPITAL: A CASE STUDY

2017 ◽  
Vol 26 (2) ◽  
Author(s):  
Sílvia Ferrazzo ◽  
Mara Ambrosina de Oliveira Vargas ◽  
Diana Coelho Gomes ◽  
Francine Lima Gelbcke ◽  
Karina Silveira de Almeida Hammerschimidt ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Care Service ◽  
University Hospital ◽  
Structured Interviews ◽  
Specialist Service ◽  
Immunosuppressed Patients ◽  
Structures Of Care ◽  
The Impact

ABSTRACT Objective: was to describe the flow of a specialist service in the care of liver transplant in a university hospital. Method: a qualitative research in the form of a case study, performed in a transplant service in southern Brazil. Data collection occurred from November 2013 to February 2014 through the triangulation of data, document analysis, structured interviews with 11 professional and semi direct observations interviews. Data analysis was performed by analysis of thematic content. Results: describes the flow of service and revealed the involvement of a multidisciplinary team in a cohesive manner, with competence recognized by patients and other sectors of the institution and structural deficiencies in care service for immunosuppressed patients. Conclusion: it was found that there is a need for studies that address the structures of care in liver transplantation services and to evaluate the impact of the quality of the life expectancy and proper recovery of persons undergoing liver transplantation.

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